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Thursday, 17 November 1983
Page: 2927


Mr SINCLAIR(9.58) —I commend the honourable member for Lyne (Mr Cowan) for his very thoughtful and positive contribution to this measure. I do not intend to delay the House, but I want to raise a couple of matters. The Health Legislation Amendment Bill (No. 2) 1983 is basically concerned with two matters that are of prime importance in the country, nursing homes and the isolated patients travel and accommodation allowances scheme. The remarks that have been made during this debate about the quality of medical and nursing home advice in the bush concern something that is of tremendous importance in my own electorate. I know how worried the proprietors of private nursing homes are at the changes that the Minister for Health (Dr Blewett) is introducing and the implications of these changes in regard to their ability to sustain their operations. Numbers of proprietors are talking of either closing down or being forced to do so because of their inability to provide the same level of services which they have traditionally provided. If that were to happen I believe that it would be a great disservice to the community. It is something that I trust will not happen and should certainly not be induced by any legislative change introduced by the Government.

I want to address in particular three areas which relate to the overall health policy of the Government. The first is that, of course, as far as nursing homes and hospitals are concerned, they will succeed only if there is an adequate level of qualified medical advice and medical services available. I am told that the Minister has had no discussions with visiting medical officers of the major public hospitals, whether in the country or in the city. Numbers of those medical officers have come to see me expressing concern at the changes that the Medicare proposals will impose on them. If these highly qualified specialists will not be able to receive something like fair compensation for the service they provide they too, like the nursing homes, will be forced to move on. Some will go overseas. Certainly, the level of service and attention that they provided, I feel, may well be prejudiced. I urge the Minister, given the very real degree of change that he is imposing on the visiting medical officers' way of life, to enter into consultation with them to try to remove some of the concern they now hold.

In introducing this scheme, the Minister has very much changed a practice which for so long has seen most of these medical officers providing a contribution to the hospital on the basis that their own practices sustain their ability to provide those contributions to public hospitals for virtually no sessional payment. There are many variations between individuals. I believe that those problems need to be addressed.

The second problem is that there are certainly very real difficulties in the maintenance of the way in which bills are to be issued by individual doctors. As I understand it, at the moment there is a necessity under the law to provide a number on a doctor's bill. It is different for each hospital and for each surgery. Wherever the doctor practises he is forced, even for the same patient, to provide a number. The consequences of that again will be an administrative nighmare and, I suspect, will not improve the medical care available to individual patients around Australia. I do not believe that is in any way in the interests of efficient administration of medical care in Australia.

Debate interrupted.