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Wednesday, 11 November 1959

Mr WILSON (Sturt) .- The purpose of the National Health Act 1953 was to carry out the policy of the Government parties contained in the policy speech of 1949, which was -

To make social provision in relation to sickness on a contributory basis, free from a means test, and in which adequate medical services are within the reach of all.

The national health scheme then introduced was a voluntary contributory scheme, free of means test, which provided that those persons who make contributions to approved medical or hospital associations, when sick or in hospital, will receive in association or fund benefits plus Commonwealth benefits a substantial proportion of the hospital or medical fees incurred. The scheme has been an outstanding success and is to-day recognized as probably the finest medical and hospital scheme in the world.

As with all new acts, certain difficulties arose shortly after this act was passed. It was found that the aged and the chronically sick had difficulty in securing insurance. The hospital and medical associations regarded them as bad risks and, in many instances, were not prepared to insure them. These people, therefore, were unable to receive either the association benefit or the Commonwealth benefit. To meet this situation the Government passed an amendment to the act in 1958 which provided that medical and hospital associations should be permitted to transfer aged and chronically ill persons to what was known as a special fund which meant that those people were then able to insure with a fund and, being insured, were able to receive not only the Commonwealth benefit but also the fund or association benefit

The Government guaranteed these associations against any loss. In other words, the Government very properly threw upon the whole community the burden of any loss that the associations might incur in insuring aged and chonically ill people who, unfortunately, are more susceptible to sickness and more in need of hospital treatment than are younger and healthier people. The Government found it necessary to provide some line of demarcation between those who were in hospital because they were really ill, and those who were in hospital merely because of old age or infirmity and had nowhere else to go. The Government decided to draw that line of demarcation according to the kind of hospital in which the people had secured a bed- It, therefore, made two classes of approved hospitals - those which were recognized for fund benefit and those which were not. This again produced anomalies and hardship because some aged and chronically ill people were unable to get into public or recognized hospitals and were compelled to go into hospitals which were approved but not recognized and. although they received the Commonwealth benefit, they were ineligible for the fund or association benefit.

Some of us felt that this attempted solution of the problem was not satisfactory. We made representations to the Government, and I am delighted to see that the anomaly to which I have referred will be eliminated when this bill becomes law. We suggested to the Government that the nature of the illness, and not the hospital should be the deciding factor as to whether a person should receive the fund benefit. If a person were in need of hospital treatment because of illness, he should receive the fund as well as the government benefit provided that he was receiving treatment equivalent to the treatment that he would have received in a public hospital. This bill will remove the injustices and anomalies which have arisen since the passing of the amending act in 1958.

Section 10 of the existing act provides that fund benefit will now be payable to special account contributors, that is, the aged and chronically ill, in both recognized and non-recognized hospitals where the Director-General of Health authorizes the payment. The bill further provides that the Director-General shall authorize the payment - it is completely mandatory - where the special account contributor is suffering from illness or injury which requires hospital treatment of a kind provided in public hospitals, and where the treatment is of a standard substantially equal to that which the patient would receive in a recognized hospital. This amendment will be of immeasurable benefit to the aged and chronically ill. It has received the approval of people throughout Australia who have been extremely worried by the difference between the benefits payable to those in recognized hospitals and the benefits payable to those in hospitals not so recognized.

I congratulate the Government upon introducing this reform, and I thank the Minister and his colleagues for having acceded to the requests of those of us who have been particularly troubled by the relevant section of the act. We can say now without any reservation whatsoever that we have the finest national health act in the world. It is a truly national act; it provides for a contribution; it contains no means test; and it gives substantial help to insured persons to meet both hospital and medical expenses.

I support the action of the Government in prescribing a contribution towards pharmaceutical benefits. When people have to pay something out of their own pockets they will think twice before purchasing medicines unnecessarily. When medicines are free, there is always the danger that you will obtain pills or medicine without any thought of the cost. The proposed charge of 5s. is only small, but most people will think twice before they purchase medicines unnecessarily. I support the Government's proposal because I believe it to be in line with the contributory policy of national insurance that the Government has laid down. I should like to see a scheme on the basis of the scheme that was proposed by the right honorable member for Cowper (Sir Earle Page) and several honorable members on this side of the House. If pharmaceutical benefits were supplied on substantially the same basis as are medical and hospital benefits, namely, that the people themselves make a contribution towards the cost, this legislation would be further improved. But while the Government is considering the views that have been advanced by the right honorable member for Cowper, the present proposal to make a charge of 5s. for each prescription will give stability to the scheme. It is in accord with the general policy of the Liberal Party and the Australian Country Party, both of which I support.

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