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Wednesday, 11 November 1959

Mr REYNOLDS (Barton) .- Mr. Speaker,last evening, I endeavoured to make four main points in dealing with this bill. The first of these was that Labour is opposed in principle to this so-called voluntary health scheme which compels the payment of taxes, on the one hand, and membership of a private benefit organization, on the other, in order that benefits may be gained from what is compulsory taxation. So, first, Labour is opposed in principle to this kind of system.

Secondly, although we agree that the scheme should be conducted efficiently and economically, we say, in our concern over the substantially increased costs, that we should have regard also for the considerable benefits and savings effected by the scheme. For instance, it is estimated that the wider availability of costly drugs has meant a saving of about £30,000,000 in the last six years. I do not say that this scheme is the sole reason for that saving, but it plays a prominent part in it. It is asserted that a saving of about £30,000,000 in the last six years has been made possible by the reduced demand for hospital accommodation, not only because it has not been necessary to build hospitals that would otherwise have had to be built, but also because the average time spent in hospital has been very substantially reduced. I think I mentioned last night that, not many years ago, the average time spent in hospital by a patient was nine days. This has now been reduced to three and one-half days.

Another aspect of this saving, of course, is that absenteeism from work owing to sickness has been substantially reduced. One could expect, as a consequence, a substantial contribution to national productivity owing to the better health of the community. Apart from these main aspects, Mr. Speaker, there is the humanitarian aspect, which should occupy first place. I refer to the reduction in the pain and suffering experienced by people who are un fortunate enough to become ill. I make the further point that the Government has been preoccupied with the increasing costs of pharmaceutical services under the other aspects of the national health scheme and has not been interested enough to look at, or to attempt to make any assessment of, the benefits and savings deriving from the scheme.

Last evening, I made the third point that the proposed 5s. charge in respect of the making up of prescriptions, a good many of which were hitherto free, will be a very harsh burden on some people, and especially, I submit, on the family man and on those aged sick people in our community who are not covered by the pensioner medical service. At question time this afternoon, I raised the whole matter of the means test in respect of pensions. Although the number of people eligible for pensions has been increasing, the fact is that about 51 per cent, of those who are eligible for the pension by age are denied it.

Linked with this denial of the pension is the denial of benefits under the pensioner medical service. About 70,000 of those who receive the pension are disqualified from receiving benefits under the pensioner medical service because the 1955 amendment of the National Health Act introduced by this Government imposed a means test by providing that any person entitled to a pension who received additional income of £2 a week was to be denied benefits under the pensioner medical service.

Many of these people are recipients of superannuation as a result of their thrift. The penalty for their thrift is to be denied a full pension and, in addition, to be denied the pensioner medical service at a time of their life when they are prone to sickness, and therefore may need hospital care and drugs. Worse than that, under this legislation they will have to pay, along with the rest of the community, for pharmaceutical benefits that hitherto were free.

The fourth point that I intended to make was to urge that, as a consequence of what I have said, at least we should make a start on abolishing the means test which was imposed in 1955 in respect of the pensioner medical service. I consider that that means test should be abolished immediately. This would not cost over much to the community. In view of the persons who would benefit - the aged citizens - I think that the community would be only too pleased to bear that cost.

I want to say a little more on the hospital aspect of the national health scheme. The bill before us does propose to abolish the requirement that all persons over 65 years of age shall automatically transfer to the special fund part of the medical benefits scheme. Those persons are now to be allowed to remain in the ordinary fund in respect of medical benefits, but not in respect of hospital benefits. This is a serious imposition upon them. At best, people who are in the special fund can get only £12 12s. per week towards the cost of their hospital treatment. The Minister for Health (Dr. Donald Cameron) nods his head.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - The Minister shakes his head.

Mr REYNOLDS - I will be interested to hear the Minister's explanation of this matter. So far as I can see, the maximum amount that chronically ill people, people with pre-existing illnesses, and people transferred to the special fund, can get is £12 12s. per week. That has been the experience of friends of mine who have gone into hospital and made bitter complaints about this situation because they had been paying into funds for many years. It has been reported frequently in the daily newspapers recently that people who have been paying into a hospital fund at a high rate for many years suddenly find that, because they are over 65 years of age, they have been transferred to the special fund, and that, therefore, they are eligible only for the restricted amount provided by the special fund and not for the amount provided for in the table under which they had contributed for many years. If that is not true, I will be very glad to hear the Minister say so. My statements are based on information from a hospital benefits fund and from the Department of Health.

Even worse, in my opinion, is the position of persons who cannot get into what is called an " approved hospital ", under the act All that they get is 8s. a day from the Commonwealth, but if they happen to be in a fund, they can get £7 per week, the whole of the £7 coming from the Com monwealth. In order to get the Commonwealth benefit they are obliged to belong to a fund, but the fund gives them nothing. Not a penny! I cannot see the reason for this.

The reason given for the elimination of the provision that persons over 65 years of age shall automatically be transferred to the special medical benefits fund is that the cost to the funds has not been nearly as much as was anticipated. In other words, the calls by persons over 65 on medical services has not been as great as was anticipated. I am wondering why similar action was not taken in respect of hospitals. Why should people of 65 years of age and over, if they so desire, not remain in an ordinary fund and pay for the ordinary hospital benefits? At present, even people who have been contributing to a hospital fund for many years in respect of themselves and their dependants are transferred to a special fund when they become 65 years of age. A payment of £12 12s. a week is totally inadequate to meet hospital bills. Many of these old people cannot get into public hospitals. They are the ones whom the public hospitals will not have because so many of them are long-term patients. Therefore, they have to go into private hospitals and there they have to pay at least £16s 16s. or £17 17s. a week for even the cheapest accommodation. So, the reimbursement of £12 12s. is quite inadequate for their purposes.

The position of elderly people as far as hospital accommodation is concerned is acute. Often, in desperation, they have had to be put into mental hospitals. They should never have to be in those places. That point is made in the report of the Inspector-General of Mental Hospitals in New South Wales for the year ended 30th Tune, 1958. This kind of remark that has appeared in each report of the InspectorGeneral in recent years in respect of elderly people is as follows: -

For some years now I have expressed my concern at the very high percentage of elderly people who are committed to the mental hospitals for treatment. I have stated that many of these people are only slightly deranged and suffering only from the consequences of growing old. Certification and admission to a mental hospital seemed to be an unnecessarily harsh step to take with far too many of them. Unfortunately the position was no better last year.

He goes on to say that 31 per cent, of the people admitted to mental hospitals were over 60 years of age.

The reason that they are put in these hospitals is, first that they cannot gain admission to a public hospital. Secondly, in many cases, they cannot possibly afford to pay for a long period in a private hospital. The only other alternative is to put them into a mental hospital. Bad as that is, those of them who receive age pensions are denied those pensions when they enter the mental hospitals, the upkeep of which is paid for by the State, although some capital expenditure is contributed by the Commonwealth.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - That was a Labour Government arrangement.

Mr REYNOLDS - I do not care whose arrangement it was. It is a pretty bad one to sustain. I hope that we are not going to go back ten or fifteen years for a criterion of what we should do in this age. We are long past the time of rehabilitation for most of the ex-servicemen and, therefore, could do something for these people who are denied the pension. The State is also denied a proportion of their pension for their upkeep, which costs more in a mental hospital than it would in an ordinary hospital. As far as I know, these people are also denied coverage under the special fund provisions of the national health scheme. I very much agree with the statements of the Reverend H. Hawkins, Superintendent of the Leichhardt Methodist Mission, He said that geriatric hospitals - hospitals dealing with the problems of aged persons - are perhaps our greatest need for the aged in Australia to-day. Anybody who has any sense of responsibility for the welfare of our aged people must agree with that statement. I suggest that the Government should co-operate with the States, as it has done in respect of mental hospitals, to create special hospitals in the larger communities solely for the treatment of aged people. Those hospitals should be reserved for and available to aged persons in order to bring some reality to the pensioner medical service in giving free public ward treatment to our aged people. Where it is not possible to create a special hospital for the purpose, special wards should be reserved in public hospitals so that our aged people may receive the specialist care that they need. Where people must enter private hospitals the Government should pay them a subsidy by way of a contribution equal to the cost of public ward treatment, which the Government would pay if they were treated in an ordinary public hospital.

I do not know what will happen to the aged and senile under the bill now before us.

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