The land on which we gather is Ngunnawal land.

As we celebrate Indigenous culture and acknowledge elders past, present and emerging, its important that we honestly and forthrightly acknowledge the scourge of disadvantage in our country.

And in no field is the disadvantage more acute than health. As the Guild itself has said, Aboriginal and Torres Strait Islander people have by far the worst health outcomes and the clearest inequity in health care provision of any identifiable group in the Australian population.

That must change and Im totally committed to working with pharmacists, clinicians and health care professionals to ensure that it does.

There are many members of Parliament present tonight and I acknowledge them all collectively. I acknowledge specifically my counterpart the Minister for Health, Greg Hunt.

Of course, I acknowledge your President, George Tambassis and Guild members from around Australia.

Friends

Its almost four months since Australia lost Bob Hawke.

On the night Bob died, George Tambassis sent around a speech that Bob had given to the South Australian Guild in September 1990.

The Hawke Government and the Guild had spent the previous year locked in the so-called Chemists Dispute. Bob called it something of a blue a beauty.

But the dispute had been settled, and Bob went to Adelaide to make the peace.

He said this:

A hundred years ago it was the physician who was the main provider of care for the ill.
But with the invention of a never-ending range of new pharmaceuticals, the primary health care role of the physician has increasingly been shared by the pharmacist
Families have increasingly looked to pharmacists as a source of convenient, efficient and reliable advice
And pharmacists have increasingly brought new skills and professionalism to the task of meeting those needs.
Of course [this] has been accompanied by many questions ethical, medical, economic that demand attention.

Of course these words are still true. Arguably they are even more pertinent today.

In the 29 years since the speech, our reliance on community pharmacy has only grown.

But as weve seen in recent weeks, some still question your role in primary care.

And as Minister Hunt might admit, the Guild and the Government of the day still have the odd blue.

But the legacy of the Chemists Dispute was a new way of working together.

Bob said in 1990 that he wanted to open a new chapter in the relationship between the Pharmacy Guild and the federal Government.

And he did just that. The following year, Labor and the Guild signed the first Community Pharmacy Agreement.

Almost three decades later, you are now negotiating the 7th CPA.

In that regard, the Labor model to resolve issues and improve the government-pharmacist interface has stood the test of time.

Ill say a little more about the approach of the Alternative Government to some of the issues in the CPA and pharmacy more broadly in a moment, but before I do I want to acknowledge one other Member of Parliament who is present tonight.

Emma McBride served her community as a pharmacist for almost two decades before she was elected as the Member for Dobell in 2016 making her just the eighth pharmacist to sit in the Parliament. Lets reflect on that for a second. There have been about 2000 people serve in Parliament since Federation. And Emma is just the eighth pharmacist to do so.

After her re-election this year, she was appointed as to assist me as the Shadow Assistant Minister for Mental Health.

But while Emma is technically my Assistant Shadow Minister on Mental Health, I rely on her as sounding board more generally on health policy. Its very valuable to me to have a health care professional of Emmas standing as part of the Shadow Health team.

Of course, as well as Emma, I have plenty of community pharmacists in my own community in Western Sydney whom I use as sounding boards.

Ill tell you about two of them tonight, because they have very different but very compelling stories which underline the value of pharmacy to communities.

First, Mario Barone. The Barones have a long track record of service to the community. Marios dad Charlie opened Barone Pharmacy on Spencer Street in Fairfield in 1967. Emma and I both attended the 50th anniversary celebrations of the pharmacy a couple of years ago.

52 years later, Mario continues the family tradition across three suburbs. What a fine family tradition that is.

The other is Chris Kahawati. Chris has a very different story.

Chriss family moved to Australia from Syria when he was a kid. When he arrived, he didnt speak a word of English.

But he worked hard, graduated with first class honours in pharmacy, and now owns pharmacies in Fairfield and Gregory Hills. I was honoured to cut the ribbon to open his Fairfield pharmacy.

Mario and Chris may have different back-stories, but they share a bond of great patient and community service.

And theyll both be watching the 7CPA negotiations closely. Because the negotiations will impact more than their businesses. Theyll shape the health of their thousands of patients of our community.

I know thats true for all of you. And its the principle that will guide Labor as we consider policy questions around pharmacy.

Frankly, not whats good for pharmacists or whats good for doctors. But whats good for patients and the community.

And so tonight, I want to touch on the two broad challenges that I think the 7CPA should address in the interests of all Australians.

Affordability

The first is the affordability of PBS medicines for patients.

Because for many Australians, even the concessional co-payment of $6.50 is often beyond reach.

The Governments own data proves it. The Bureau of Statistics says that 961,000 Australians a year delay or avoid filling prescriptions due to cost.

Thats worth repeating. In a country that boasts about universal access to medicines, almost a million people a year cant afford them.

That undermines their health. It undermines your small businesses. And it contributes to the inequalities that undermine our society.

Women are 70 per cent more likely than men to delay or avoid prescriptions.

And people who live in disadvantaged areas or have long-term health conditions are forced to skip medicines at around twice the rate of other Australians.

Put simply, if youre poorer or sicker, you are less likely to get the essential medicines you deserve.

Dollar discount

Of course, the Governments response to this challenge in the 6CPA was the dollar discount.

In 2016 we were told it was a landmark reform that would make medicines more affordable for all Australians.

But by 2017, with take up rates of less than a third, the dollar discount was under review.

Even by Canberra standards its been a long review.

So the current negotiations are a chance to consider whether the dollar discount is the best mechanism to improve affordability.

The evidence of the last four years would say not.

I know that the dollar discount has placed more pressure on the viability of some smaller pharmacies as other costs such as rent have certainly not been falling.

But of course, the dollar discount should only be changed in a way that makes medicines more affordable, not more expensive.

This should be a focus of the current negotiations.

Dispensing quantities

I suspect that the Pharmaceutical Benefits Advisory Committees recommendation to double dispensing quantities for some medicines will also feature in the negotiations.

Implementing the recommendation in the 2019 Budget would have been against the letter and spirit of the 6CPA.

But, frankly no Government can simply ignore the recommendations of the independent PBAC.

Equally, the Government should not ignore the Guilds advice that the recommendation would undermine both patient care and the viability of your small businesses.

If the unintended consequence of the recommendation is the closure of some pharmacies particularly in regional areas then it will be harder, not easier, for patients to take prescribed medicines.

I dont pretend to have easy answers on either the dollar discount or the PBACs recommendation.

Reaching compromise on both issues will require good will, creativity and I suspect some investment.

The Government will have Labors strong support on anything it does to improve the affordability of medicines while strengthening community pharmacy.

Access to primary care

The second broad challenge that the 7CPA needs to address is access to primary care.

One in five Australians say they wait too long for a GP appointment. Women and people who live in disadvantaged areas or the bush fare even worse.

That contributes to the pressure on our emergency departments, where presentations are at record highs.

The good news is that all Australian governments now agree that you can play a part in improving access to primary care.

As we endure flu season, Im reminded that every state and territory now allows pharmacists to administer the flu vaccine. You provided over a million last year, and Im told that could double this year.

But the bad news is that the role of pharmacists remains contested.

Labor agrees that pharmacists can work to their full scope of practice without fragmenting or duplicating care.

But should that include provision of a wider range of vaccinations? Access to the National Immunisation Program? Repeat prescriptions for some medicines?

Ultimately those are clinical questions. Again, we must be guided by one principle only: how is the best interest of the patient served?

That question would best be answered in collaboration between pharmacists and other health professions, and with experts in government, guided by clinical best practice.

To conclude.

The dollar discount. Double scripts. Scope of practice.

Some have called these cash grabs or turf wars. I couldnt disagree more.

Because a CPA isnt just a commercial transaction. Its an investment in the network of community pharmacies, and in their work to improve the health of all Australians.

Or as the National Medicines Policy puts it, timely access to the medicines that Australians need, at a cost individuals and the community can afford.

That is whats up for grabs every time the Commonwealth and the Guild sit down to negotiate a CPA.

In that speech 29 years ago, reflecting on the dispute, Bob Hawke finished in this way:

The debate between us was too often cast as a battle of short-term considerations for pharmacists maintaining income and employment levels, and for the Government cost containment.

What was really at stake, and what has been genuinely safeguarded by the package of measures on which we have agreed, was the viability of pharmaceutical health care itself and, by extension, the good health and well being of our fellow Australians.

My hope is that well be able to say the same of the 7th Community Pharmacy Agreement.

Through that agreement and beyond, I look forward to positive, frank and constructive engagement with the Guild as we strive to improve health outcomes for all Australians.

Thank you.