Mr ANDREW (5:06 PM) —I rose somewhat provoked by the allegation of the member for Hunter (Mr Fitzgibbon) that the government had in some way sought to so compress this debate that he was denied his democratic rights to represent the people of the Hunter. As the Chief Government Whip, I am painfully aware and I suspect that he is reasonably well aware of the fact that the very issue we are debating in the half an hour devoted now is well above what was originally negotiated and was designed to accommodate the opposition. I would have thought he may have been a little more gracious about that.

In dealing with these health amendments, everyone in this House, regardless of which side they sit on, recognises the real problem. The real problem is the escalating cost of health care. No-one in this House at least over 30 years of age is not well aware that health care is inevitably going to cost whoever is in power more and more of its share of the taxpayers' revenue.

Let me illustrate the point. Perhaps before the member for Hunter (Mr Fitzgibbon) was thought of, 30 years ago I had an appendicectomy with little more than a kitchen knife on a table, if you know what I mean. Today, if I fronted up to my local GP and he said, `You need your appendix removed,' I would say, as I suspect every other male and female around here would, `With a body like mine, you really cannot afford to scar it. So I would like keyhole surgery. I would like laser treatment—I want to be back at work tomorrow—and as little bloodshed as possible.' That is fine. He will do it for me. But, effectively, it will cost a great deal more than the treatment using a kitchen knife on the kitchen table.

Precisely the same analogy applies to any one of the medical practices that we now take for granted. Thirty years ago a heart condition diagnosed in someone my age may well have been fatal. Today the doctor says, `We will replumb.' The question of the cost scarcely even enters into it. Even more remarkably—and thankfully—diseases of 30 years ago that effectively would have killed us, terminal illnesses, can now be kept at bay because of modern surgery. All of these practices cost money, and they cost an increasing proportion of the health budget. That is the bind that the government faces, it is a bind that the opposition faced when they were in government for 30 years, and it is a bind to which there is no easy solution.

It is compounded by the fact that, for people in our salary bracket, going to the doctor is a ridiculously cheap exercise. Let us say it costs $25 for a consultation: the government picks up $18 or something like that. For those on the other end of the salary scale, going to the doctor remains an expensive exercise, much of which rightly is picked up by the general taxpayer. It is exacerbated by the fact that in 1989 many people on well below average weekly earnings, who therefore were unable to afford private health insurance, probably were forced to spend more money on maintaining their car than maintaining their health. This is the bind the government faces: how do you bridge this gap between the escalating cost of health and the willingness of people in our salary bracket to pay and the ability of people in a lower salary bracket to pay?

That is why health is becoming an increasing problem for state governments. The federal government has not walked away from it, as the member for Fremantle (Dr Lawrence) had suggested. State governments increasingly have tended to depend on the federal government. As the minister made it quite obvious, the federal government is picking up more and more of the share of the health cost but, in doing so, the state governments—whether conservative or not—have tended to walk away from some of their responsibility.

In the time remaining, I must add that, while this is a complex and difficult problem, it is not a problem which we should shirk. On the world scale, Australia still delivers a first-class health service at a very competitive price. We have a problem we have to resolve, but relative to our surrounding countries and relative to the rest of the world—with the possible exception of the Swedes and the Japanese—we have a health system that is the envy of much of the rest of the world, and the government is committed through this legislation to maintaining that system.