EXPLANATORY STATEMENT
NATIONAL HEALTH ACT 1953
AMENDMENT DETERMINATION UNDER PARAGRAPH 98B (1) (a) No. 5
The Pharmaceutical Benefits Remuneration Tribunal (“the PBRT”) is established under section 98A of the National Health Act 1953 (“the Act”). Paragraph 98B(1)(a) of the Act provides that a function of the PBRT is to determine the manner in which the Commonwealth price (as defined in section 84 of the Act) for all or any pharmaceutical benefits is to be worked out for the purpose of payments to approved pharmacists for the supply of pharmaceutical benefits.
Subsection 98BAA(1) of the Act requires that, where the Commonwealth and the Pharmacy Guild of Australia (or another pharmacists’ organisation representing a majority of approved pharmacists) enter into an agreement relating to the manner in which the Commonwealth price for pharmaceutical benefits is to be calculated, the PBRT, when making a determination pursuant to paragraph 98B(1)(a) of the Act, is to give effect to the terms of that agreement. The current agreement is the Fourth Community Pharmacy Agreement (“the Fourth Agreement”) between the Commonwealth and the Pharmacy Guild of Australia, which was signed on 16 November 2005 and commenced on 1 December 2005. On 23 June 2006 the PBRT made the National Health Act 1953 Pharmaceutical Benefits Determination under paragraph 98B(1)(a) which commenced on 1 July 2006 (“the Principal Determination”). The Principal Determination gives effect the terms of the Fourth Agreement that set out the fees that are to be paid to pharmacists for the supply of pharmaceutical benefits. The Principal Determination has been previously amended on 26 July 2006 (with effect from 1 August 2006), 4 October 2006 (with effect from 1 October 2006), 24 November 2006 (with effect from 1 December 2006) and 28 February 2007 (with effect from 1 March 2007).
Effective from 1 April 2007, various legislative instruments which are incorporated by reference into the Principal Determination are revoked and remade. The purpose of this determination is to amend the Principal Determination to reflect necessary changes to the references to the legislative instruments which are incorporated by reference into the Principal Determination. The amendments to the Principal Determination are necessary to ensure that the remade legislative instruments are incorporated by reference under section 14 of the Legislative Instruments Act 2003.
Consultation
The Principal Determination is a legislative instrument for the purposes of the Legislative Instruments Act 2003. Amendments to the Principal Determination have been made in consultation with the Pharmacy Guild of Australia, an organisation representing a majority of approved pharmacists. The Pharmacy Guild of Australia is a party to the Fourth Agreement and supports this Determination.
Further details of the Determination are set out in the Attachment.
ATTACHMENT
NOTES ON CLAUSES TO THE DETERMINATION
Clause 1 – Name of Determination
Clause 1 provides that the name of the Determination is the National Health Act 1953 Pharmaceutical Benefits Amendment Determination under paragraph 98B(1)(a) No. 5
Clause 2 – Commencement
Clause 2 provides that the Determination commences on 1 April 2007.
Clause 3 – Amendment of the Determination under paragraph 98B(1)(a)
Clause 3 provides that the National Health Act 1953 Pharmaceutical Benefits Determination under paragraph 98B(1)(a) made on 23 June 2006 (“the Principal Determination”) is amended as set out in the Schedule.
Schedule – Amendments
Item 1 – provides that all references in the Principal Determination to ‘the determination under paragraph 98C(1)(b) of the Act as set out in PB 14 of 2007’ are amended to ‘the determination under paragraph 98C(1)(b) of the Act as set out in PB 24 of 2007.
Item 1 – provides that all references in the Principal Determination to ‘the determination under paragraph 85A(2)(a) of the Act as set out in PB 12 of 2007’ are amended to ‘the determination under paragraph 85A(2)(a) of the Act as set out in PB 20 of 2007.
Item 2 – provides that all references in the Principal Determination to ‘the determination under subsection 85(6) of the Act as set out in PB 12 of 2007’ are amended to ‘the determination under subsection 85(6) of the Act as set out in PB 20 of 2007’.
Item 3 – Paragraph 37 – provides that the reference in paragraph 37 to ‘the determinations under sections 85, 85A and 88 of the Act as set out in PB 12 of 2007’ is amended to ‘the determinations under sections 85, 85A and 88 of the Act as set out in PB 20 of 2007.
Overview
The National Health Act 1953 was enacted to provide a framework for the administration of national health services in Australia, including the regulation of the supply of pharmaceutical benefits. The Act was introduced to address the need for a comprehensive and coordinated approach to the provision of health services across the country. The Pharmaceutical Benefits Remuneration Tribunal (PBRT), established under the Act, was tasked with determining the manner in which the Commonwealth price for pharmaceutical benefits is to be calculated for payments to approved pharmacists. The Parliament of Australia made the National Health Act 1953 Pharmaceutical Benefits Amendment Determination under paragraph 98B(1)(a) No. 5 on 28 February 2007, with the primary policy objective being to ensure the continued smooth operation of the pharmaceutical benefits scheme by updating the references to legislative instruments incorporated by reference into the Principal Determination. This amendment was made in consultation with the Pharmacy Guild of Australia, an organisation representing a majority of approved pharmacists, and is intended to reflect necessary changes to the references to the legislative instruments which are incorporated by reference into the Principal Determination.
Scope and Application
The National Health Act 1953 Amendment Determination under paragraph 98B(1)(a) No. 5, issued pursuant to the National Health Act 1953, pertains to the operations of the Pharmaceutical Benefits Remuneration Tribunal (PBRT). This legislation applies to the PBRT, which is tasked with determining the Commonwealth price for pharmaceutical benefits, in line with agreements such as the Fourth Community Pharmacy Agreement between the Commonwealth and the Pharmacy Guild of Australia. The amendment determination, which came into effect on 1 April 2007, focuses on updating references to legislative instruments incorporated by the Principal Determination, ensuring compliance with the Legislative Instruments Act 2003. The changes reflect updates in the legislative instruments to maintain accuracy and relevance in the remuneration calculations for pharmacists supplying pharmaceutical benefits. The amendments were made in consultation with the Pharmacy Guild of Australia and aim to ensure that the PBRT's determinations align with the current legislative framework.
Key Provisions
The National Health Act 1953 Amendment Determination under paragraph 98B(1)(a) No. 5, which commences on 1 April 2007, serves to amend the National Health Act 1953 Pharmaceutical Benefits Determination under paragraph 98B(1)(a) made on 23 June 2006, known as the Principal Determination (sections 2 and 3). This amendment reflects necessary changes to the references to legislative instruments incorporated by reference into the Principal Determination. Specifically, it updates references from PB 12 of 2007 to PB 20 of 2007 and from PB 14 of 2007 to PB 24 of 2007, ensuring compliance with the Legislative Instruments Act 2003 (Schedule, Items 1-3). The Pharmaceutical Benefits Remuneration Tribunal (PBRT), established under section 98A of the Act, has the function of determining the Commonwealth price for pharmaceutical benefits, as stipulated in section 98B(1)(a) of the Act. When the Commonwealth and the Pharmacy Guild of Australia enter into an agreement on the calculation of the Commonwealth price, the PBRT must give effect to the terms of that agreement, as required by subsection 98BAA(1) of the Act. The Fourth Community Pharmacy Agreement (Fourth Agreement) signed on 16 November 2005 and commencing on 1 December 2005, currently governs these terms. The Principal Determination, which commenced on 1 July 2006, gives effect to the Fourth Agreement by setting out the fees payable to pharmacists for the supply of pharmaceutical benefits.
The Amendment Determination imposes obligations on the parties governed by the Principal Determination, ensuring that references to legislative instruments are updated to reflect the remade instruments under section 14 of the Legislative Instruments Act 2003. This includes ensuring that references to PB 12 of 2007 and PB 14 of 2007 are updated to PB 20 of 2007 and PB 24 of 2007, respectively (Schedule, Items 1-3). The determination also mandates that the PBRT continues to give effect to the terms of the Fourth Agreement in its determinations. Additionally, the requirement for consultation with the Pharmacy Guild of Australia, an organisation representing a majority of approved pharmacists, underscores the collaborative approach in amendments to the Principal Determination.
The Act does not explicitly state offences, penalties, or civil/criminal consequences for breach within the Amendment Determination. However, any failure to comply with the requirements of the Principal Determination and its amendments could potentially lead to disputes or legal actions, particularly if such non-compliance affects the payment of pharmaceutical benefits to pharmacists. The specific consequences would depend on the nature of the breach and the subsequent actions taken by the affected parties or regulatory bodies.