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Wednesday, 11 November 1959

Mr ANDERSON (Hume) .- Mr. Deputy Speaker,Government supporters never expect the Government to receive any bouquets from Labour for the introduction of new measures. I feel that the whole of the opposition to this bill is based on Labour's nostalgic love for socialized medicine and its despair at having been unable to introduce a national health scheme similar to the schemes in the United Kingdom and New Zealand.

Nobody questions the sincerity of the honorable member for Batman (Mr. Bird), but much of his case against this Government's national health scheme was based on isolated examples. He talked of the great disparity between the medical benefit that he received for recent medical treatment and the doctor's fee. If a person goes to a fashionable surgeon, he must be prepared to pay more than the average fee. A government cannot base a health scheme on the charges made by fashionable surgeons and doctors.

Mr Bird - They all charge similar fees.

Mr ANDERSON - Fashionable doctors do not charge the same as do those who are not so fashionable. One pays a great deal more for ari operation by a fashionable surgeon than ' for an operation by an ordinary highly trained and competent surgeon.

The question which is exercising the minds of members of democratic governments everywhere is: What is the cost of national health? The honorable member for Batman glibly talked about having been to a doctor for treatment and then to a physiotherapist, and said that he had to pay too much. I suppose that if everything were free half of us would spend much of our time imagining that we had a pain in the neck or the back and going to physiotherapists for treatment. If we did, the unfortunate taxpayer would have to pay the cost. To me, it seems that some one must introduce reason into any national health scheme. The right honorable member for Cowper (Sir Earle Page), fresh back from England and New Zealand, has told us that the critical problem is the prohibitive cost, because, in national health schemes, we deal with human frailties. When treatment is charged for, a person who feels a little ill will tend to wait for a time in order to see whether his condition becomes worse. If treatment is free, people who are not really ill will clutter up the doctors' surgeries and those who are really ill will be unable to get treatment.

Our psychological outlook on these things is different from that of Labour. Labour believes in the direct use of personal force. It believes in forcing doctors and patients. If such ideas were given effect, the doctors would become social bureaucrats and the chemists would be nationalized. Labour believes in personal forces and in socialization. We, on the other hand, believe in impersonal forces. Let the individual insure himself and receive individual benefit. Labour would like everybody to become a cipher or a number. This attitude has probably been brought about by belief in browbeating. I do not know whether that is so, but the Labour attitude towards free medicine has no appeal to me. I would rather pay a little bit towards the cost of medical treatment.

On the question of criticism, I would support the last speaker, the honorable member for Batman, who said that there is too big a disparity between what the average patient gets and what he has to pay. The figure originally intended was 90 per cent. The honorable member for Fawkner (Mr. Howson) was wrong last night when he said that it was 80 per cent. On this ground, I have some sympathy with the honorable member for Batman but, with regard to a lot of his other points, I have no sympathy at all. Our national health scheme was introduced after the pitfalls of the schemes in New Zealand and the United Kingdom had been recognized. To my mind, those two schemes have been of great detriment to the nations concerned.

If you examine the casualty lists for prisoners of war of the various nationalities - American, Australian, Dutch and British - you will find that the Britishers with their cradle to the grave welfare state had the heaviest casualties. We are a young country living in an Asian world and if we bring up our young people with a character which refuses to accept responsibility, how long will we remain a nation? This is where it starts - in national health and in a man's personal and family responsibilities.

I do not usually interject, but yesterday, when the honorable member for Port Adelaide (Mr. Thompson) was saying that 50 per cent, of British revenue was spent on the welfare state I interjected and said that it was dreadful. It is dreadful that 50 per cent, of the tremendous taxation of the people of the United Kingdom should be spent on the welfare state. To my mind, it will not do us any good if we adopt that principle.

The honorable member for Eden-Monaro (Mr. Allan Fraser) was very critical of doctors who over-prescribe. That is a weakness in the present scheme. It is a natural and human reaction of doctors to do the best they can for their patients. After all, when we go to a doctor or a lawyer, we expect him to do his best for us. The honorable member was quite critical of doctors but I am sure that he acts similarly every day of his life. Presumably some of his constituents who have been denied benefits to which they consider themvlsees entitled come to him and ask him to make representations for them. Likewise, many people who have been rejected by repatriation tribunals no doubt ask him to make representations on their behalf. What does he do? Does he not examine the facts and put up a strong case for them? Of course he does. It is probably quite true that some doctors over-prescribe, but that is the human reaction of a person who is working for his client. This bill is designed to prevent over-prescribing or to bring it within reasonable bounds. At the same time, it is designed to benefit the patients because, in many cases, these new drugs are not necessarily the best to prescribe. I am not a doctor but I understand that the necessity for the patient to pay 5s. will relieve doctors and, in time, improve prescribing.

The honorable member for Batman said that the Government was treating the chemists cavalierly. That is not so. The chemists are not collecting taxes for the Government; they are collecting their own fees. In many years, this must be to their advantage because they have bad debts. At least they will receive the Government's contribution, even if they fail to collect the 5s. So they will not be out of pocket too much. The Labour method of solving this problem would be to nationalize chemists, who would then become Government employees. That method would destroy a most important factor in the health service - the family chemist. The chemist-patient relationship is preserved by this health scheme just as the doctor-patient relationship is preserved.

One point of negotiation which I feel the Minister understands is that, because the scheme is extending into wider fields of drugs, the chemist will have to be allowed a higher dispensing fee. It is in that respect that I think chemists have expressed concern at the proposed alteration of present methods. I agree that chemists should be given a better fee because they will not be able to make the same extra charges as they used to make in order to cover losses and bad debts. I believe that, in negotiating with the chemists' guild the Government will be fair and reasonable. The danger of the chemists making too large a profit at the expense of the taxpayer is normally governed by the impersonal forces of the capitalist system. If a chemist is making a very large profit, what happens? More chemists come along and, in time, the position rights itself. The Government parties prefer impersonal forces to the personal force of the socialist.

One part of this new scheme exercises my mind to some degree. This concerns repeat prescriptions. There are people, rich and poor, who suffer, say, from diabetes. I understand that, under the new proposals, the doctor will give a prescription for one month and for two repeats. Each of those repeats and the original prescription will cost 5s. But in the whole period the patient may go only once to the doctor for the prescription. In respect of people in the lower income brackets there could be hardship. I think that only the passage of time will reveal whether this system will impose a burden on those who are least able to bear it.

I have been surprised to learn in this debate, of the number of mistakes that Labour Party speakers have made in understanding the bill. The honorable member for Barton (Mr. Reynolds) said most emphatically that when a person became 65 years of age he was transferred to a special fund and that when his benefits expired, he got nothing at all. That is not a fact. Such a person, when he is transferred to the special fund is entitled to exactly the same amount as he was entitled to before transfer. There is a further condition that £12 12s. a week shall be paid to those who are transferred to the special fund after their ordinary benefits expire.

Yesterday, the honorable member for Eden-Monaro, leading for the Opposition, made an error in the interpretation of this bill. Several times, in this debate, as in all debates dealing with social welfare, the Labour Party has dragged out tales of misery and woe. Apparently, every Labour constituency is peopled only by those who are poverty stricken and suffering the torments of the damned - a veritable Dante's Inferno. I do not find that that is so in my constituency. I do find some cases of tragedy which must exist throughout our society. The other day, the case of a married couple was brought to my attention. The husband had been working for an employer who had not taken out worker's compensation insurance. The man was seriously injured and could not be paid compensation. That is the kind of case for which there is no special provision. But if as Labour would have it, maximum benefits are paid the whole time, irrespective of a person's situation, the impost on the national economy becomes so great that there is never sufficient money to provide for special cases.

In every society and every constituency there are these things. They are not as numerous as contended by the Opposition, but we all know of them. If you spend all your money on those who are not really in need, how can you possibly provide for the exceptional cases? I suggest to the Opposition that sometimes it is not a bad idea to think of everybody. We should not try to use all the available money but should keep some for a few special cases. We should try to be more reasonable and put the scheme on the basis of what it is possible for a government to contribute and then try to make provision for the special cases.

This is a continuing scheme. No scheme is perfect. The present legislation does great credit to the Minister for Health (Dr. Donald Cameron). He is rectifying several weaknesses in the scheme. Provision has been made for new hospitals and a wider range of drugs. These are improvements to the scheme. But in operating the scheme let us retain some personal responsibility and get away from the awful thought of nationalized medicine and the welfare state, which would ultimately destroy a nation. In our geographical situation we cannot afford to be destroyed in this way. I believe that with the gradual improvements that are being made to the scheme, we will find that our scheme is one of the world's best.

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