Dr Kerryn Phelps, Health Editor, with Tracey Grimshaw, Channel Nine 'Today'

PHELPS: Good morning, Tracey.

GRIMSHAW: Kerryn, the Treasurer says that the Pharmaceutical Benefits Scheme had to be reined in, to ensure its own viability. Is there no merit in that argument at all?

PHELPS: I think that everybody knew that there had to be some prudent management of the Pharmaceutical Benefits Scheme (PBS), but I think everyone was really a bit in shock to see it in black and white that there is going to be a two billion dollar cut to that scheme, and there is no evidence that's good public health policy in the long-term.

GRIMSHAW: The PBS blew out by $700 million last year, we're told. I don't suppose that could be allowed to continue, could it?

PHELPS: That was a spike, and it was related to two particular drugs that were very aggressively marketed, Celebrex and Zyban. And, I think what we need to do is to look at the reasons as to why there was such a consumer demand for those medications, by brand name, and where they have gone now, which is much less popular. And to say 'well, should we allow such aggressive marketing by the pharmaceutical companies to the consumers, before the doctors have had a chance to really asses these new medications, and see where they fit in the whole prescribing ……

GRIMSHAW: Tell me about this measure. Is there anything wrong with making doctors account to the Health Insurance Commission for the drugs they prescribe? What is that going to mean?

PHELPS: When you increase the amount of information that a doctor is forced to provide to the Health Insurance Commission (HIC), it means… say, for example, a patient comes in to see me as a GP, and they want a medication, let's just say for example, well there is a whole range of medications that need to go onto authority prescription, but let's say for schizophrenia, when that patient has to have the authority, I have to ring up the clerk in the HIC, and I have to say the patient's Medicare number, their name, my prescriber number, the number of the prescription, then I have to give the medication, and then I have to give the diagnosis. Now, what the authority prescriptions are now going to require is more information than that, which might include dates of pathology tests, what hospital that they were seen in, a whole range of investigations that they have had, to satisfy a certain protocol set down by the HIC. Now, this is going to add such a lot of administration to what GPs and specialists already have to do. Specialists, for example, dealing with people with cancer treatment, they're dealing with these sorts of authority prescriptions almost with every patient.

GRIMSHAW: So, what is this going to mean out there in the community? What effect is it going to have on health care?

PHELPS: There are a few things. One is that it is going to mean that doctors are going to have to spend more time on red tape. The second thing is it is going to mean that people who are on low and fixed incomes, who don't qualify for the concession status, for the PBS, are going to be paying a lot more for their medications. So, let's say they are paying at the moment $22.40, that will go up to $28.60, which is more than the Medicare rebate for a doctor's visit. People who are on pensions will have to pay a dollar more per prescription. Now, if you're only on one medication that may not sound like a lot of money, but if you are on a whole lot of medications it means a lot of extra money people are going to have to come up with early in the year, before they reach their safety net.

GRIMSHAW: Can we look at some of the positive aspects of the Budget? Extra aged care subsidies, cancer treatment for outer metropolitan rural areas, that sort of thing?

PHELPS: It's been a case of robbing Peter to pay Paul, and if you have a look at the overall Budget, over the next four years, they have taken a billion dollars out of health. Now, in a debate that we have been having about whether what we are currently spending on health is enough to meet the need, and whether it should be increased to a greater percentage than we are already paying, it just seems remarkable that they would have reduced that spending money by a billion dollars. But there are some good measures. They have delivered on the election promises for aged care, particularly the Community Aged Care Packages, and that's important. There have been some radiology therapy units that have provided for six regional centres, that's a good thing as well. Some treatment for people with macular degeneration, which we have discussed on this program not so long ago, that's also an important step.

GRIMSHAW: You are, on another matter, a non-budgetary matter, about to be challenged for the leadership of the AMA. Are you worried it?

PHELPS: Well, I don't think you can ever be complacent about a leadership challenge, and I think it gives people who might have a gripe about the way things are being done, a chance to be heard, and be taken notice of, if we don't already. But I think that the important thing is that the AMA and I think indeed the public also want to see some stability and continuity in important issues that we are dealing with at the moment.

GRIMSHAW: Thanks for your time.

PHELPS: Thank you.

Ends