Minister for Health and Aged Care – speech – Pharmaceutical Society of Australia Conference – 28 July 2023

Read the transcript of Minister Butler's speech at the Pharmaceutical Society of Australia Conference 2023 in Sydney.

The Hon Mark Butler MP
Minister for Health and Aged Care

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I’m really delighted to be here today and value the invitation from PSA very highly.

Can I add my acknowledgment of country and pay my respect to elders past, present and emerging of the Gadigal people of the Eora Nation.

We do this in such an important time in the nation’s long road to reconciliation with First Nations people.

We’re only some months away from a vote, to respond to the really generous call from First Nations leaders at Uluru, almost six years ago.

They asked the Australian people, 30 years on from the High Court finally, sweeping aside that legal fiction that this was vacant land when Europeans arrived back in 1788, to do the same, to recognise First Nations people were here back then -hundreds of thousands of them.

The longest, oldest continuously surviving culture on the planet here for 65,000 years.

A fact that should be enshrined in our nation's founding document the Constitution but giving shape to that recognition through a Voice to the Parliament and to the Government.

I can't think of an area of policy where that Voice is more important than in health.

You all know that better than me.

The yawning gap in life expectancy reported to Parliament and to the community every single year.

The fact that over the last decade, cancer deaths in Australia have reduced by 10 per cent, while at the same time, they increased by 12 per cent for First Nations Australia.

The fact that they're seven times as likely to die of kidney disease.

That young Indigenous Australians are twice as likely to take their own life.

They suffer from diseases that were eradicated from developed economies 50 to 60 years ago, like rheumatic heart disease, a disease that doctors in the major cities in Australia are likely never to come across but are experienced in remote Aboriginal communities at rates not seen anywhere else in the world, including Sub Saharan Africa.

We have to be honest that with the best of intentions and very significant investments, year after year after year, we are not making change.

And in those few areas where we are making change, we're not making it quickly enough.

The current approach simply isn't working in health policy, as in so many other areas of policy.

Listening to people impacted by those decisions, has to make better practical outcomes for First Nations Australians and give them the opportunity in a country like this to live healthier, happier, longer lives, as so many other Australians do.

Thank you for the acknowledgment of that important vote that is taking place later this year.

I offer my respect to Elders, both past and present, and extend that respect to any First Nations people joining us today.

I want to thank and acknowledge all of the pharmacy groups that are here today.

I know you come here with the spirit of unity at this very important event for pharmacy.

I particularly want to acknowledge Dr Fei Sim, in her second conference as the President and Steve Morris the new CEO for the PSA.

I want to thank Fei not just for the leadership role she plays in her own industry, but also for playing a really important role for the Government as a member of the Women's Health Advisory Board working with Ged Kearney, the Assistant Minister for Health, on pulling together a women's health strategy right across the system and right across the country.

As I said, it’s a pleasure to be with you today.

It is clear to me, as I’m sure it is to you, that these are difficult times in healthcare in Australia.

Against the backdrop of those demographic changes that Fei talked about – an ageing population and inexorably increasing incidence of chronic diseases.

We've also experienced real financial pressure, particularly in the Medicare system, combined with a once in a century pandemic.

It has left a legacy that still looms large right across the system as it does frankly across every health system in the world.

It has never been harder to see a GP and specialist wait lists are getting longer than ever.

Our hospitals are struggling through a mountain of deferred care.

Health concerns that would once have been caught during screening or consultation are instead showing up when they are much more acute.

Workforce shortages are felt keenly around Australia, but particularly in rural and regional communities.

Our workforce is fatigued, even as global demand for health workers soars.

This is true for pharmacy, just as it is for other health settings that kept their doors open during the pandemic.

None of this will be news to you.

From your position on the frontline in communities and hospitals around Australia, you see this every day.

And as Health Minister, so do I.

The pressures mean that difficult decisions have to be made about how healthcare is delivered in Australia.

Digital systems need to be upgraded. The walls between silos need to come down. Outdated red tape needs to be cut.

Every health worker needs to be supported to work to the full extent of their skills and training.

And as a sector, we all need to have a laser like focus on patient access and patient benefit.

Certainly, that is my focus as Health Minister and the focus of this Government.

Labor, very proudly, is the Party that started Medicare and the Pharmaceutical Benefits Scheme before it, and we will always work to strengthen them. 

We look forward to working closely with the PSA as the peak body representing pharmacists in Australia, regardless of where they practice, to enhance and evolve this role for the mutual benefit of your profession and the Australian community.

This includes ensuring pharmacists can work to the top of their scope to build the strength of the sector.

We want more Australians to benefit from your experience and your care, in more ways than they already do.

Because Australians need that support, now more than ever.

Australians are doing it tough right now.

Cost of living pressures bear heavily.

Every year, nearly a million Australians delay buying medicine that their doctor has said is necessary for their health, because they can’t afford it.

In a country as wealthy as ours, Australians shouldn’t have to make a choice between buying food or paying rent on the one hand or buying medicine.

Which is why making medicines cheaper was a key election commitment of this Government. 

Cheaper medicines

It is one that we have moved on several fronts to implement.

In January, we lowered the general patient co-payment to $30 per script.

Already, in less than seven months, Australians have saved $118 million on nearly 11 million cheaper prescriptions.

The new nationally consistent opioid dependence treatment program means tens of thousands of Australians will finally get the same benefits that every other Australian gets for PBS medicines.

From July 1, they pay the PBS co-payment on these vital medicines and save up to $200 a month.

Think about how much an extra $200 a month means to someone on income support.

Because four out of five Australians receiving treatment for opioid dependency are on income support.

Of course, it’s good for their hip pocket, but it’s also good for their health.

In just the last few weeks, we’ve already heard of some Australians who were still injecting drugs, now making the safer choice to begin opioid dependency treatment, because that $200 a month cost barrier has finally been removed.

These early reports are incredibly positive and I look forward to seeing more hard data in coming months.

And, of course, we are introducing 60-day prescriptions for more than 300 medicines and 6 million Australians with ongoing health conditions, giving them twice the medication for the cost of a single prescription.

This policy was recommended by independent clinical experts at PBAC back in 2018 and has been the subject of much discussion and debate since then – particularly this year.

Now, I know that change is difficult.

But the international experience has shown that by working in partnership with Government and the pharmacy sector – 60-day prescriptions can be implemented without significant impact on the sector.

That’s why it is the norm in so many countries around the world, countries that we world normally compare ourselves to, like New Zealand, Canada, the UK and others.

The move to 60-day prescriptions is undeniably good health policy.

It will help alleviate the cost-of-living pressures that many Australians are facing.

It will help reduce pressure on our doctors, our emergency departments, and the wider health system.

Importantly, it will mean fewer Australians have to make the choice between buying food, paying rent or buying medicine.

60-day prescriptions transition

Of course, we want to support pharmacists through the implementation of this policy.

Which is why every single dollar that the Government saves with 60-day prescriptions will be reinvested straight back into community pharmacy sector, so pharmacists play an even more central role in the health care of Australians. 

Some of the reinvestment measures have already taken effect, like the doubling of the budget for the Regional Pharmacy Maintenance Allowance, and the changes to opioid dependency treatment for tens of thousands of Australians who will now buy their medicine from PBS-approved pharmacies at PBS prices.

Others are on the way, like expanding the scope of pharmacists into residential aged care to work on-site in a clinical role, improving medication management and safety.

And on January 1, we will further expand the National Immunisation Program to pharmacists, and have pharmacists finally paid the same rate that a doctor gets to administer a vaccine.

The NIP is an uncapped program that will grow over time, as more vaccines are added and Australia’s population grows.

And we shouldn’t forget that on July 1, we also delivered a major increase in government payments to every single pharmacy around the country.

All community pharmacies are now paid 7 per cent more for services like dispensing, handling, administration and infrastructure.

Indeed, the boost to pharmacy payments is nearly double the increase to Medicare rebates that took effect at the same time, even though that was the largest increase to Medicare rebates since Paul Keating was Prime Minister.

Scope of Practice Review

Another key Government commitment is to enable pharmacists to work to their full scope of practice.

Starting this year, the National Scope of Practice Review will identify barriers and incentives for all health professionals, including pharmacists, to be better recognised, better supported, and better utilised.

The review will be underpinned by extensive stakeholder engagement and collaboration, in consultation with states and territories.

One of the factors that will likely be considered is pharmacist prescribing – an issue of some interest to you and – may I say – to other sectors.

The review will look at service gaps and the professionals who are skilled and experienced to fill those gaps.

It will look at opportunities for further upskilling to enable professionals to expand their scope of practice to meet the needs of the community.

It will unlock a wealth and breadth of untapped expertise.

I expect the final report of the Review to be delivered to the Government in the middle of next year.

Seizing the growth areas

Change is coming. Because it must.

Australians know that our pharmacies and pharmacists are strong and resilient.

I know that, with support, you will be able to seize the opportunities that these growth areas open up.

Earlier this week, I visited the Lyell McEwin Hospital in Adelaide where I met a young hospital pharmacist named Sam. 

She had been recently credentialed in an expanded scope of practice that allows hospital pharmacists like her to independently prescribe medicines for patients, working in alignment and partnership with the treating doctor – part of the Partnered Charting Model being rolled out in a number of hospitals around Australia, the PPMC model.

This sort of expanded scope gets great results for patients.

The evidence shows that it leads to shorter hospital stays and much lower error rates.

And for pharmacists like Sam, it is incredibly fulfilling.

She told me just how rewarding it is to be involved as a central part of the clinical team, working with newly admitted patients.

Just the other week, I visited a pharmacy in my own electorate that is already innovating with a new business model and model of care.

Andrew Sluggett and the team at CPIE specialise in the preparation and supply of compounded injectable medicines for cancer, palliative care and infections.

Andrew’s pharmacy is supporting local hospitals to deliver infusions, as well as to patients through the hospital in the home program.

Andrew is well known to many of you – he’s a former Pharmacist of the Year and until last month, a board member of the PSA.

Andrew explained to me that, internationally, there are examples of this type of service being delivered in community pharmacy, as well as in the home, this is a real growth opportunity for the sector and a real opportunity to take pressure off hospitals.

Pharmacies in our major capital cities will no doubt find it easier to embrace these growth opportunities.

But I know that regional and rural pharmacies are up to the task, and we’ll make sure they won’t do it alone.

Pharmacies hold a special place in rural and regional Australia – they’re a critical part of the fabric of their community and are often the most accessible health setting.

Increasingly in some towns they are the only health setting.

But they also face particular challenges not seen so much in the cities.

A smaller rural pharmacy usually has a smaller customer base, which usually means a smaller retail footprint.

So dispensing medicines often makes a larger proportion of their total activity of revenue.

That’s why rural and regional pharmacies are rightly the focus for the government’s reinvestments.

Which is why, in addition to doubling the Regional Pharmacy Maintenance Allowance from the 1st of this month, today I can announce the final reinvestment measure to support pharmacies in the transition to 60-day prescriptions: a new Regional Pharmacy Transition Allowance.

On September 1, the same day the first tranche of the 60-day prescriptions comes into effect, this $148.2 million measure will provide a new allowance for eligible pharmacies in regional, rural and remote Australia.

Along with the doubling of the Regional Pharmacy Maintenance Allowance, this new transition payment will mean that any reduction in dispensing revenue will be offset for eligible pharmacies this financial year.

This will provide significant additional support for more than a thousand pharmacies, the vast majorty in regional, rural and remote Australia.

The support will continue over four years, gradually reducing as community pharmacies seize new growth opportunities and a more prominent role in primary care.

Smaller pharmacies in our outer suburbs and other MM2 locations will also be eligible for support, with a flat fee each year, for four years, to support them to transition to new business models that deliver additional pharmacy services to Australians.

Dispensing medicines is complex and critical, but it is not the only reason that pharmacies and pharmacists are so highly valued.

This Government is committed to providing opportunities for pharmacists to play an even more central role in the healthcare of Australians.

Reforms for a stronger health system

Because let’s be clear: the reforms to enable 60-day prescriptions are not just about a cost saving for patients.

They are reforms that help to modernise and strengthen the PBS, just as we are modernising and strengthening Medicare.

Those two institutions were designed at times when the health burden that  Australians faced were typically short, single issues – like an infection – that needed short, single episodes of care – like antibiotics.

Australia today is a very different place, with a very different burden of disease – chronic conditions are now the norm.

As many as nine million Australians take a medicine for a chronic condition on the 60-day prescription list. That’s nearly half the adult population of this country.

30-day prescriptions made a lot of sense when people would go into their doctor or pharmacy for a one-off script or a short course of antibiotics for a short illness.

But 30-day scripts make less sense for Australians who are on the same medicine, year in and year out, often for decades or even the rest of their lives.

Modernising and strengthening Medicare to better enable team-based care and modernising and strengthening the PBS to better treat chronic disease are two sides of the same coin.


We want the pressures in our health system, the new growth opportunities for pharmacy and the Scope of Practice Review to inform the Eighth Community Pharmacy Agreement.

The next CPA should be about more than dispensing revenue for pharmacy owners and must be about the professional standards, the professional development, the integration of pharmacy as a sector in primary care and ultimately the role of pharmacists in supporting patients.

Which means that, as a Government we need to be listening to all to pharmacists across all settings, as well as pharmacy owners.

The PSA represents all pharmacists, no matter where they work.

The PSA will be absolutely essential to the task of working through the issues like the scope of practice review.

As you probably know, there have been strong arguments put to the Government around bringing forward the negotiations for the 8CPA.

We’re exploring that very closely and will have more to say on that soon.

Whenever it starts, I look forward to the PSA’s involvement in the development of the 8CPA, as the steward of professional standards.

New Professional Practice Standards

I’m also pleased to announce today that work on the updated Professional Practice Standards – the PPS – is now complete, and the latest version published.

The standards are a fundamental resource that articulate the professional behaviour expected of all pharmacists in Australia.

In April last year, my department engaged the PSA to review, update and implement the standards and to develop additional tools and resources to support the delivery of consistent, high-quality pharmacy programs and services.

I commend the PSA’s significant contribution to the ongoing professional development of pharmacists to deliver a high standard of practice, and to ensuring quality and integrity in the sector.

The updated standards mark delivery of a commitment made under the last CPA to fund the PSA to further promote the standards of professionalism in pharmacy.

But more importantly, the refreshed standards maintain their relevance in a contemporary pharmacy practice environment.

They will enable pharmacists to reflect on, and measure, their commitment to delivering safe, high quality, and effective pharmacy services.

Medicine safety

I also want to acknowledge the PSA’s leadership in the area of medicine safety.

The PSA has taken an active lead revising the guidelines for pharmacists delivering Medication Management Review and Quality Use of Medicines services.

The PSA has also created a medicine safety report series highlighting opportunities to make meaningful improvements to the safe use of medicines – protecting consumers from harm and improving quality of life.

In addition, the Government is redesigning the Quality Use of Diagnostics, Therapeutics and Pathology Program to improve the way medicines and medical tests are prescribed and used.

The redesign will be supported with two new competitive grant opportunities that will run every two years – Health Professional Education, and Consumer Health Literacy.

The aim is to improve the quality use of therapeutics, diagnostics and pathology for consumers and health professionals, improve the health literacy of Australians through the education of health professionals and consumer groups, and reduce the misuse of medicines and other technologies.

This program contributes to the National Medicines Policy, now updated, which recognises the substantial changes across the health, medicines and medical technology landscape, including digital health, genomics and precision medicine.

The policy underlines the importance of medicines being used safely, optimally and judiciously, with a focus on informed choice and well-coordinated person-centred care.

There is an important role for pharmacists in each of these elements.


I hope my remarks today make it clear that this Government is committed to the interests of both you – the nation’s pharmacists – and the Australian people.

Putting patients first, while helping pharmacists grow to be even more important players in the health and wellbeing of Australians, are not mutually exclusive.

Indeed, while our perspectives may differ from time to time, the objective remains the same – we want all Australians to be able to access quality care no matter where they live.

And to achieve that, we need pharmacists to play an even more central role in the health of Australians.

Our vision is for a health system that empowers coordinated and multidisciplinary teams of healthcare professionals.

We see you as an integral part of these teams.

You – through the PSA – are really important partners on the Government’s health and aged care reform journey.

Thank you.


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