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Wednesday, 14 September 1983
Page: 816


Dr BLEWETT (Minister for Health)(10.22) —I will reply to the points that were raised. First of all, I take the so-called constitutional or parliamentary point. As both the honourable member for Warringah (Mr MacKellar) and the honourable member for Mackellar (Mr Carlton) know, in relation to hospitals a whole lot of arrangements and guidelines are reached between the States and the Commonwealth, which are not subjected to this Parliament because they are of the nature of arrangements between the State governments and the Commonwealth Government. In fact every time the former Government changed the hospital cost sharing agreements, there was a whole lot of arrangements which were never subject to this Parliament's approval. This is just another one of those arrangements in which the honourable member for Warringah and the honourable member for Mackellar were involved inevitably in the relationship between the Commonwealth Government and the State governments in hospital matters.

Secondly, there has been widespread concern, about which both the honourable member for Mackellar and the honourable member for Warringah know, amongst all State health Ministers, and I believe it has also been shared by Commonwealth health Ministers, in regard to some problems relating to rights of private practice in public hospitals. In fact, the Jamison Commission of Inquiry into the Efficiency and Administration of Hospitals, when it reported on this issue, recommended that the rights of private practice for salaried specialists in hospitals be gradually wound down. The previous Government did not accept that recommendation, nor do we accept it. What we are trying to do here is primarily not to cut back specifically the income of doctors.

If honourable members look at the details of our proposals, which are very closely in accord with many of the practices that already occur in the States, I do not think that they will find them particularly draconian in income terms. First, our proposals will ensure that at last we know the details of such private practice rights, for which we have no national figures at all. Secondly they will prevent those kinds of rights from becoming open-ended. That is the purpose of this arrangement with the States. I say on this matter that there is a considerable degree of co-operation between the States and the Commonwealth, all concerned with this problem. The reason why we have approached the diagnostic services first of all is partly because they can be relatively easily identified in relation to the schedule and because they have raised the greatest concern amongst Ministers and others who have been looking at this matter.

Question put:

That clause 18 be agreed to.