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Wednesday, 14 September 1983
Page: 820


Mr MacKELLAR(10.50) —In relation to the clauses which we are debating at present, I would like to reinforce the remarks of the previous speakers who have outlined particularly clearly the fact that a very disreputable campaign was waged last year, spearheaded by the Australian Labor Party in particular and its mouthpieces in the medical profession, the Doctors Reform Society, which has shown its true colours at last by the selection of Dr Andrew Refshauge as a left wing Labor Party candidate in New South Wales. The fact of the matter remains, as other honourable members have pointed out, that the great majority of the members in the medical profession are honourable people.

There is the problem of fraud and overservicing and nobody runs away from this problem, but they are very different problems. Fraud is something which can be proved in a court of law and should be proved in a court of law. If doctors are guilty of fraud, the full weight of the law should be visited upon them. But overservicing is a very different kettle of fish indeed. What is overservicing for one person may not be overservicing for another person. One of the tremendous difficulties that bureaucrats and politicians have in relation to medical services not being the provider and the professionals supplying those services is to make decisions as to what is appropriate treatment and what is not appropriate treatment. The only arbiters as to what is appropriate treatment , the frequency of treatment, and the extent of treatment, must be the profession itself. When we have intervention of bureaucrats and politicians into this professional relationship between a doctor and his patient, then we are heading for very serious trouble indeed.

We are seeing in these clauses the move towards the cruel deception that somehow we have a free health service because we are removing from the minds of the populace in general the fact that they have to pay something for health services. They go along to the doctor and he agrees to bulk bill, so no moiety is involved. There is no financial or fiduciary arrangement between the doctor and his patient. This removes restraint on both sides of that arrangement. It removes restraint on the doctor and it removes restraint on the patient. What we have is the building up in the population of a view that here we have somehow a so-called free system. It does not cost them anything. With the removal of these restraints, which are very real restraints, we have a very great incentive for overservicing. Then we have the difficulty of defining what is overservicing. In that difficulty of definition we will find a bigger and bigger bureaucracy being built up and more and more intrusion into the affairs and the relationships between doctors and their patients and an inevitable breakdown in that special relationship which I believe is so important between a doctor and his patient.

I believe, as the honourable member for Bradfield (Mr Connolly) has described, that this doctrinal obsession by the Labor Party with this particular arrangement can, in the long term, only serve to weaken that very special relationship between a doctor and his patient and remove very proper restraints on both the doctor and the patient in terms of the number of services, the variety of services and the amount of servicing which should be carried out in relation to any particular patient.