Health minister Greg Hunt, his office and the Department of Health spent almost three days constructing a long response to a very simple question about the policy rationale for the arrangements governing the Opiate Dependence Treatment Program (ODTP).
It could be politely described as a 'carefully constructed legal response'.
It is wrong, ridiculous and sad.
Worst of all, nowhere in the response has the minister directly addressed the plight of patients accessing PBS-listed treatment for opiate dependence.
Some of these patients are forced to pay private dispensing fees in excess of $200 every month - none of which counts towards their safety-net.
Surely this minister is better than that?
Yet it seems the priority was to construct any argument to legally defend the indefensible, regardless of how wrong or embarrassing, even if it means the health minister claims he essentially has the powers of a medieval king when it comes to the PBS.
This response is very hard to understand unless the intent is to do nothing to help this group of patients.
According to Minister Hunt, Section 100 of the National Health Act 1953 grants him the power to do pretty much anything he likes.
Has he considered the implications of his response?
PBAC advice required to extend the listing of a medicine? Not according to Minister Hunt. Changed prescribing restriction? No problem. Double the ex-manufacturer price of a listed medicine? Done!
Minister Hunt effectively says he can do all this under 'existing legal authority' and without actually exercising any power that would be subject to parliamentary scrutiny.
This publication will hold Minister Hunt accountable to this claim - no more hiding behind expert committees when it comes to PBS decision-making. He can always just make a 'special arrangement'.
Unfortunately, so far, this claimed power has only been invoked to deny a group of stigmatised and vulnerable patients the protection of PBS co-payments and the safety net.
To make matters worse, as in the case of the ODTP, the documents relating to these decisions are not even required to be made public. The Department of Health obfuscated on a Freedom of Information request and took three months to release the relevant document.
The nonsense with all this is that it seems the ODTP is the only special arrangement under Section 100 where the government has not bothered to exercise its power through a legislative instrument consistent with the requirements of the Legislation Act 2003.
There are over one dozen other programs where the government has implemented a 'special arrangement' through legislative instruments.
These other arrangements provide for access to medicines in remote indigenous communities, growth hormone for children, treatment for spasticity, fertility treatment, ensuring access to cancer therapy and special arrangements during the pandemic.
The only one missing is that which denies one patient group PBS protections most Australians believe they can take for granted.
