Minister for Health and Aged Care – Press Conference in Canberra – 10 August 2023

Read the transcript of Minister Butler's press conference at Parliament House about 60-day prescriptions coming into effect on September 1.

The Hon Mark Butler MP
Minister for Health and Aged Care

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MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Five years ago now the medicines experts who manage our PBS - the medicines experts on the Pharmaceutical Benefits Advisory Committee - provided advice to the former government that doctors should be able to issue 60-day prescriptions for common medicines used for ongoing health conditions. These are patients who might be on the same medicine for hypertension or high cholesterol or a range of other conditions, not just for years or even decades, but sometimes for the remainder of their life. The former government chose not to accept that advice. I announced in May that we would accept that advice and we would allow doctors to issue those 60-day prescriptions for stable patients with ongoing health conditions with that first tranche of medicines due to take effect on the 1st of September - so before Parliament comes back in three weeks’ time.


I'm very pleased that the Senate today has confirmed the Government's position, confirmed that doctors will be able to provide 60-day scripts for those conditions in the first tranche of medicines on 1st of September. Now I can't overstate the importance of this for patients. We were elected on our promise to deliver cheaper medicines for Australian patients and already, in the first 12 months, we've delivered three waves of cheaper medicines reform. But this is a critically important fourth wave, one that will deliver half price medicines for 6 million patients who live with these medicines year in, year out, decade in, decade out. It's a policy that simply makes sense.


I've said a lot about our commitment to strengthening Medicare and modernising Medicare to make sure that our Medicare system so cherished by the Australian people reflects the patient profile of the 2020s, rather than the patient profile of the 1980s when the scheme was first introduced, and that means modernising and strengthening the PBS, as well. 30-day scripts make a lot of sense if you're going to a doctor for a one-off episode of illness, an infectious disease or because you fall off the ladder and sprained something. A single course of medicine should and will continue to be the subject of a 30-day script. It doesn't make as much sense if you’re on the same medicine for the rest of your life. That is much more likely to be the patient profile of the 2020s. This is why pretty much every country we usually compare ourselves to has 60- or even 90-day scripts for these ongoing health conditions.


This measure will halve the cost of these medicines for 6 million patients - obviously incredibly good for hip pocket at a time of a global cost of living crisis. We also know, from evidence overseas, that it improves medication compliance by as much as 20%. So, it will be good for their health as well. But critically, importantly as well, it will free up millions of GP consults every single year -consults that are currently taken up issuing routine repeat scripts instead of dealing with the serious health conditions that we know are going uncared for because of the waiting lists to see a GP that we know across the country, right now.


Now the Coalition had a chance to back patients today. But they instead chose to back the powerful pharmacy lobby. This is what they did five years ago. It's what they did yesterday when they launched this motion disallowance to block access to cheaper medicines and that's what they did in the vote that took place in the past hour in the Senate today. We can at least say they are consistent.


But I'm so grateful for the constructive engagement from other Senators and also crossbenchers in the House of Representatives. I particularly want to thank Senator Steele John and The Greens party for their support in the Senate motion today. I want to thank Senator Thorpe and Senator David Pocock for their constructive engagement over the past few months now, playing a very constructive role, particularly in the opioid dependence treatment program reforms that are delivering great relief to do the 50 thousand or so Australians who deal with opioid dependence. So, I want to thank them both for that engagement and also the support in defeating the Coalition's attempt to block cheaper medicines. I also want to thank the Jacqui Lambie Network, Senator Tyrrell, and obviously Senator Lambie, as well, for their engagement over the past couple of months and particularly raising the need for targeted support for smaller rural pharmacies, which I announced a week or two ago when the last $148 million of our committed reinvestment into supporting community pharmacy.


I'm delighted we've been able to deliver this reform. It is an important health reform, as well as a cost of living relief measure for 6 million patients. That's why it had such strong support from the Consumers Health Forum and more patient groups than I can list. Every serious patient group in the country supported this reform. And I thank them for their advocacy – very, very resolutely supporting the interests of those that they represent with chronic conditions. And I also want to thank the doctors’ groups for their advocacy. There will, as I said, be millions of GP consults that don't happen because of this reform. And you could imagine that a doctors’ group might have opposed this reform for that reason. But they recognise the importance of freeing up those consults, to allow them to use those consults for serious health conditions rather than routine and repeat scripts. And they also recognise the health benefit that will accrue to millions of people who are living in Australia with chronic health conditions. So, I thank the AMA, the College of General Practice, the Rural Doctors Association, the College of Rural and Remote Medicine, the Rural Health Alliance, and so many others who gave our measures such strong support, as well.


Happy to take questions.


JOURNALIST: Can I just ask how much it would cost pharmacies in terms of lost revenue? Have you ever done modelling on that and then compared to how much pharmacies would make back from the benefits that you announced for rural and regional pharmacies?


BUTLER: I committed, when I announced this, we'll reinvest every single dollar the Commonwealth saves from this measure, which is about $1.2 billion over four years and I've announced the way in which we will commit we will deploy that $1.2 billion. Let's just take a step back and use the pharmacy industry's own figures. Over the course of the last four years, the pharmacy industry revenue is about $100 billion. It grew by 30% over that four years. If it’s $100 billion dollars over the next four years, assuming no continued growth of the type we've seen in the past four years, the hit to revenue will amount to somewhere between 1% and 2%, on the modelling that we did for the Budget measure that was released in May. So, it's not nothing, but in the context of 30% growth over the last four years, the sort of catastrophic claims that are being made by the Coalition and the pharmacy lobby itself, simply don't stand up to scrutiny.


Now, can I say this - because there's been a lot of talk about this over the last 48 hours - the Coalition had been using figures around pharmacy closures that they plan to take from a report that Henry Ergas did for the Pharmacy Guild a month or so ago. And the figures they use were described by Henry Ergas himself, the writer of the report as “grossly incorrect” in a letter that he provided to the Australian Financial Review. I also make the point that Henry Ergas did a report for the Pharmacy Guild back in 2015, when Sussan Ley was the Health Minister, for a relatively modest medicines price of medicines measure that was introduced by the former government. Which – surprise, surprise - also predicted that there will be hundreds of pharmacy closures and widespread job losses. Well, what happened in the wake of that measure - which actually did pass? Pharmacy grew: there were hundreds more pharmacies opened. There weren't the widespread job losses that Henry Ergas and the Guild said were going to happen after the measure that took effect under Sussan Ley.


Can I also make the point here, that in the three months since I've announced this measure, there have been twice as many applications for new pharmacies to be opened – which require government approval – twice as many applications for new pharmacies, since I announced this measure, as there were in the same period last year. So clearly, this sort of massive hit to business confidence that the pharmacy lobby and Coalition have claimed would happen is not being reflected in investment in the pharmacy sector.


JOURNALIST: So, can you make a promise that after this policy comes in, in September, we won’t see pharmacy closures - is that something you can 100% commit to?


BUTLER: We don't run pharmacy businesses; in the same way we don't run general practices or any other part of the health sector. Pharmacy owners will make decisions about their operations, for a whole range of reasons. Now, we had a Member ask us a question about the pharmacy in Montville that has decided to close and merge with a pharmacy about 15 minutes away. Now the Member didn't mention the fact that this pharmacy was co-located with a general practice - which is quite common - and that the general practice had closed months before I announced this cheaper medicine measure. So, often what happens if in general practice does close, the pharmacy closes with it. Now it's got nothing to do with 60-day prescriptions - in spite of the nature of the question that was asked to the Prime Minister in Question Time. So, businesses will make their own decisions because of a range of different factors. We have made a commitment, though, to reinvest every dollar that we save, particularly focused on smaller rural pharmacies, and we're very confident that pharmacy has a very strong, vibrant future in Australia.


JOURNALIST: The Coalition has said that they wanted to delay their Disallowance Motion and instead Labor force it on for a vote. Is there any chance that we're going to be back here in September with another Disallowance Motion from the opposition?


BUTLER: You'd have to ask Anne Ruston and Pauline Hanson that question, who co-sponsored the disallowance. Now the reason why we thought it was critically important to deal with this matter, today, is that the measure - the first tranche of medicines that will be subject to 60-day prescriptions - take effect on the 1st of September, which is before the Parliament comes back. So, thousands and thousands of GPs, millions of patients, pharmacies, would be unsure about their ability to put into practice the Government policy while there is this sword of Damocles hanging over them - being a Motion of Disallowance - launched in the last 24 hours of this parliamentary sitting period, and not dealt with, until after the measure was supposed to take effect. The legal uncertainty, the practical chaos out in the general practice and pharmacy sector would have been completely unbearable. So that's why we took such effort to bring it on. And Senators have a view about the substance of this measure. The procedural games that were played by the Coalition and One Nation over the course of the last several hours were just going to create chaos in the general practice and pharmacy sector.


Enough is enough. There has been debate about this. There have been scare campaigns that have been utterly base, unfounded suggestions about the impact of this. Everyone knows the issues. Everyone's been subjected to relentless lobbying in the Senate. It is time to provide certainty for the general practice sector, for the pharmacy sector and, most importantly, for millions of patients who deal with ongoing disease. That's why we insisted on the vote taking place today. It would have been unsustainable for it to hangover past the 1st of September.


JOURNALIST: But what the Government did today though, does it actually achieve certainty, given the Coalition can do a disallowance motion again later?


BUTLER: The Coalition can always try another device to block access to cheaper medicines. I don't have control over that. But what we have now is an expression of will by the Senate about this policy. Now Senator Ruston and Senator Hanson want to roll this up again, when we come back, be that on their head. Be that on their head. The Senate has expressed its will. I thank them for that. I thank them for doing it today. And I thank them for backing patients rather than the powerful pharmacy lobby that's been doing so much work in this building over the last couple of months.


JOURNALIST: Minister, you talk about the powerful pharmacy lobby. In the past, the Community Pharmacy Agreements have been negotiated in secret. Are you guaranteeing that we can have more transparency as you negotiate the next one. Will you look at opening the sector up to competition? Is a time to allow supermarkets to employ pharmacists to dispense drugs? Can we get rid of these crazy location rules that stop new pharmacies opening? And can we have a proper examination of does it actually cost a pharmacist $13 to dispense a script, when some of them have a robot that means you can get the medicine with the latest smartphone in 30 seconds?


BUTLER: There’s quite a lot in that. As you know, we indicated a willingness to bring forward the negotiation of the next Agreement. But we're still working on, I guess, preliminary arrangements with different players in the pharmacy sector, including the Guild about this. I've certainly indicated my intent to make sure that all voices in the pharmacy sector are heard very directly, very clearly, in those negotiations. Voices like the Pharmaceutical Society of Australia which is the peak professional body – it doesn't represent business owners - it is the peak professional body in the sector. And given that this next period for pharmacy will, I hope, certainly involve substantial debate about what additional work or additional health services pharmacists can deliver, it's important that the peak professional body be directly heard. There are obviously other voices that haven't been directly represented or very well represented, at all, in previous negotiations and we're giving consideration to ways in which that can be guaranteed in the future. As to the subject of negotiations in the Agreement some of the measures or points that you've made, that will be the subject of negotiations and we haven't even started them yet.


JOURNALIST: On another topic, this new product from Solo, alcohol Solo, that the crossbench have raised concerns about. Do you share that?


BUTLER: I haven't been able to familiarise myself yet with this new product: Hard Solo, I think it's called. What I have done over the course of the day is reaffirm as a general principle our Government's commitment to making sure that young people are protected from marketing, particularly deeply cynical, targeted marketing of unhealthy products to young people, particularly to minors. I've said a lot over the last several months about my determination to deal with that marketing of vapes or e-cigarettes, which is so clearly targeted at young people, in some cases very, very young people. This is not a new area for consideration in this building - that is the marketing of alcohol to young people. When we were last in Government - we had Kevin Rudd in the Chamber today - when we were last in Government we dealt with what was known as alcopops and the marketing of those products to younger people. So, I've asked the Department for advice. I still haven't actually seen the product itself or even a picture of it. I've been quite busy today. I know the deep interest of some of the crossbench Teal Members – for want of a better description – and many of them – including particularly Kylea Tink, who been particularly vocal about this – have a deep, long history in public health which I respect. So, I'll get some advice. They obviously have the ability as Members of Parliament to lodge complaints around the Advertising Standards if they feel those have been breached. But I'll take some advice and reserve my judgment right now, given I haven't really seen this.


JOURNALIST: If the Coalition moves another Disallowance Motion when Parliament comes back and you've already got a 60-day script, and that Motion is successful, would you then have to go back to your doctor a second time, costing Medicare and you more money and get a 30-day script?


BUTLER: This is a very, very live debate. And I would have to take legal advice about that and I'm sure the doctors’ groups would, and pharmacy groups - for that matter - would be very nervous about the question of whether what they were doing was legal. So would patients have to flock back to their GP to get a new script. This was something we were we were thinking through, over the course of today, about whether there was really any merit in letting this hangover to the next sitting period. And I don't have final legal advice about that. But given the fact that we've, I think, expressed the clear will of the Senate in relation to this. I hope that the Coalition hears that will and wouldn't do something so destructive and irresponsible as to introduce another Disallowance Motion after this measure has actually started taking effect.


JOURNALIST: It looks like they have. Our office is saying McKenzie and Ruston also lodged another Disallowance Motion.


BUTLER: Right.


JOURNALIST: So, what does that - it just goes back to the previous question?


BUTLER: Again, I haven't seen that Motion, but the circus continues. I mean, I just wonder when the Coalition is going to learn to back the interest of patients, rather than the pharmacy lobby. The Senate has expressed its will. It’s not about the procedure, but about the substance of the Motion. And a majority of the Senate – clear majority of the Senate – supported the Government's measure. Frankly, the Coalition should just listen to that and move on.


JOURNALIST: I just wanted to - given what's happened this afternoon - are you confident about the future of this scheme now?


BUTLER: I'm confident about the will of the Parliament. I'm confident about the will of the Senate. I haven't seen this Motion, but I'm sure it's right that they've launched another Disallowance Motion, if you say that. That, for me, is just an extraordinary act of irresponsibility and shows what a tin ear this Coalition has around cost of living measures.


JOURNALIST: On the crossbench, sorry, you mentioned having fruitful discussions with them ahead of this vote, we saw some of them come to the Government side. Did you promise them anything in return, were there active negotiation about what you would give, or whether something will be brought on, in return, for these - which is why they stick, essentially, with you guys should the Disallowance Motion come up or was it just out of the goodness of their hearts and the desire to side with the Government?


BUTLER: We have constant negotiations. I have constant negotiations with the crossbench. They were particularly focused ones around this measure. But crossbench Senators and Members of the House have a deep interest in health policy. And I learn a lot from them, both in terms of their experience, their history, but also their connection to particular communities around the country. I've talked particularly about the focused advocacy of a number of crossbench Senators around the rollout of the opioid dependence treatment program. Senator Pocock had a particular interest in that, as did the Greens Senators. Senator Thorpe has made a number of strong representations about medicines measures as they apply to First Nations Australians, particularly First Nations Australians in prisons. Those are really valuable and important discussions as well. Thanks everyone.




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