Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
 Download Full Day's HansardDownload Full Day's Hansard    View Or Save XMLView/Save XML

Previous Fragment    Next Fragment
Wednesday, 13 May 1970

Mr Les Johnson (HUGHES, NEW SOUTH WALES) - Mr Chairman,I move:

That the following new clause be instered in the Bill: " 19a. Section 32 of the Principal Act is amended by adding at the end of sub-section (1.) the words and the conditions of the agreement shall be reviewed at least once every two years.'.".

Section 32 of the principal Act, with which the Committee is dealing now, as 1 understand it is headed 'Pensioner Medical Service'. lt makes reference to the fact that the Minister for Health on behalf of the Commonwealth may enter into an agreement with the Australian Medical Association for and in respect of the provision by medical practitioners of medical services for pensioners and their dependants. In relation to this general provision I have moved an amendment the effect of which is that this agreement be reviewed at least every 2 years.

The Opposition feels that it is an open ended arrangement to leave this provision as it is at the present time. If the Bill is perused one will start to identify the importance of this matter. Among other things, the agreement defines the scope of medical services to be rendered by medical practitioners. It sets out the terms and conditions of the agreement that the DirectorGeneral may enter into with a medical practitioner for and in respect of his rendering of these services at such fees and allowances as are prescribed. So it is fair to say that this provision covers all the most important matters that pertain to the pensioner medical service. The Opposition would not be content to have the agreement go on ad infinitum without any opportunity presenting itself to bring the matter under review.

One of the reasons why I refer to this matter is that at the present time the pensioner medical service in our view is totally inadequate in that it provides for services of a general practitioner nature but not those of a specialist nature. We would hope that, well within 2 years, but in certainly no longer than 2 years, we would be taking the opportunity to extend specialist services to pensioners. In fact, one gains the impression - the Minister may care to correct me if I am wrong - that pensioners are being relatively disadvantaged under this legislation. Specialist services are readily available under the new arrangement. But the pensioner medical service remains limited to services of a general practitioner nature and is not to be updated or upgraded in any way at all.

Five weeks ago the Minister for Health in a letter to the Australian Medical Association dealt with this matter. He was referring to the updating of common fees. This is a relevant matter. In his letter to the Australian Medical Association the Minister said:

The Government acknowledges that an equitable method of updating most common fees has to be worked out. The AMA has already proposed a method of updating and the Government is currently considering the proposals. I am confident that, in the near future, a form of updating can be agreed which will protect the interest of doctors, patients and the Government.

Then, indeed, the matter was referred to in a letter from the Secretary-General of the Australian Medical Association dated 1st May 1970. The profession, through the AMA, has made it quite clear that it regards this matter importantly.

From my own standpoint, I can say that every doctor to whom I have talked about this scheme feels that it is imperative that we make an agreement to review periodically the arrangement under which they participate in the scheme. These doctors are well aware of the fact that an enormous deterioration has occurred since the scheme was introduced. In the letter of 1st May to which I have referred we read:

The AMA has asked for an assurance f-o-i the Government that an agreed mechanism t'.ir updating medical benefits in relation to justifiable periodic variations in medical fees will be introduced.

It has also asked that anomalies in the new schedule of benefits should be dealt with expeditiously by a reconstituted Anomalies Committee, which will start work as soon as possible.

I will not quote all of the remaining paragraphs of the letter, but it concludes:

Without an updating mechanism and rapid correction of faults in the benefit schedule, contributor satisfaction will not be achieved.

I am quite prepared to speak for the needs of the medical profession in this "Utter. I certainly speak for the require ments of contributors. 1 agree with the views of the Australian Medical Association: Contributor satisfaction will not be achieved until there is written into this Bill specific provision for periodic reviews. After all, the rate at which inflation is taking place in this country probably is unprecedented. We know what happened when the national health scheme of this Government was first introduced after the decent legislation that operated under the Chifley Government was disposed of by this Government. Sir Earle Page proposed that contributors would receive by way of refund up to 90% of the cost of all health services. The net effect of all that has happened in the interim is that the patient today must find, on the average, I think approximately onethird of the amount that he expends in respect of medical services.

As the provision stands at present it is highly unsatisfactory. It is completely open ended. It will not be to the satisfaction of the contributor or of the medical profession unless a specific provision is written into this legislation which will guarantee that the Government periodically will look at the terms and conditions under which the medical practitioner works. I commend this amendment to the Committee. I regard this matter as one of the most important facets of this legislation. I am satisfied that those members opposite who have had any contact with the profession, either on an individual or group basis, will substantiate my claim that doctors feel that they are going to become the captive of a fairly neglectful government, as history has it - a government that has not given satisfaction to either contributors on the one hand or to doctors on the other. Doctors are reluctant and pessimistic about coming into this scheme unless the Government is prepared to show its good faith by writing into the scheme a specific proposal that the conditions under which doctors are going to work are to be reviewed from time to time. For that reason I commend the amendment to the Committee.

Suggest corrections