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Thursday, 19 March 1987
Page: 1109


Dr BLEWETT (Minister for Health)(11.46) —in reply-I think the abysmal contribution of the Opposition to the health debate has been typified by this debate on the Australian Institute of Health Bill. In saying that, I would like to exclude the honourable member for Corangamite (Mr McArthur) because, while I might disagree with some of his arguments, at least they are capable of respect. They were very relevant to the issues at hand. I am afraid that I cannot say the same about his seniors, the shadow Minister for Health, the honourable member for Barker (Mr Porter), and the ex-Health Minister, the honourable member for Warringah (Mr MacKellar). I hope that health professionals throughout this country will read their contributions to this debate on the Australian Institute of Health.

There is an agreement on all sides that the level of health statistics and basic health data in this country are very poor and that we compare very badly with most other advanced industrial societies. Indeed, as I said in my second reading speech, that is not something that we can cure overnight. These are long term problems. These problems are the result of long term neglect by previous governments and, specifically, by a party which has been in power for most of the last 30 years. We are not going to be able to overcome these long term problems overnight.

My colleagues the honourable member for Scullin (Mr Jenkins) and the honourable member for Perth (Dr Charlesworth) pointed out quite clearly the whole range of reports over the last decade recommending an independent body to carry out the collection of this data. Indeed, some of those reports-for instance, the Independent Review of Research and Educational Requirements for Public Health and Tropical Health in Australia undertaken by Professor Kerr White-made it quite explicit that the statistical collection should be in a statutory authority. The honourable member for Warringah, who was for two years the Minister for Health, scarcely mentioned his neglect. When faced with some of these reports he did nothing in that two-year period to address this very difficult problem. The issue between us is simply whether this body should be a statutory authority. We have had again a very negative approach from the Opposition which says: `No, it should not be a statutory authority'.

I hope that the people in the other place will read the arguments advanced for rejecting the motion of a statutory authority. The honourable member for Warringah said nothing about the issue. He gave his standard speech on waiting lists which he has given in every health debate in this Parliament for the last two years. The ex-Minister for Health made no contribution and produced no argument whatsoever for not making this body a statutory authority. The only argument produced by the shadow Minister for Health was a paranoiac argument about the activities of another statutory authority in the health area-the Health Insurance Commission. His obsessive speech on the HIC would have been laughable except for the tragic fact that this argument is simply warping his judgment over a whole range of health issues. He has a complete obsession with the so-called wickedness of the Health Insurance Commission. We have really had very little in the way of an argument opposed to making the Australian Institute of Health a statutory authority.

I agree with the honourable member for Barker that we should not proliferate statutory authorities in this country. During my four years as Minister for Health we have created no statutory authorities-this is the first one. The reason for doing so is simply the compulsion of experience. We have endeavoured to carry out the task of a national collection of health data in this country through the Department of Health. I am convinced, and I think most health professionals in this country are convinced, that it is not possible to do this through that method. It will not be effective. If in fact this Bill does not go through, in another 10 years time we will be in the same position with the quality of health statistics in this country.

There are three major reasons. First of all, we are very dependent on State governments for the basic health statistics because they are the deliverers of health services. They have made it perfectly clear that unless we have a body divorced from the Commonwealth Department of Health-separate, independent and not under that Commonwealth department-we will not gain State confidence to provide statistics. I think that is understandable because a lot of this information is very sensitive and under this Government and previous governments there have often been adverse relations between the Commonwealth Department of Health and the State departments. States are willing, under the proper guarantees and the arrangements that we have reached with them, to pass that information on through a separate statutory authority. So I have to say that, as a result of our experience, we will only be able to get that data from the State health departments if we have an independent statutory authority in the way proposed. That is the first reason for going in this direction.

The second reason is that I believe that the only way to ensure the long term viability of the Australian Institute of Health is through a statutory authority. I was convinced of the rightness of that judgment by a passing reference just made by the ex-Minister for Health, the honourable member for Warringah. He said: `We should spend less time with academic pursuits of this sort of group'. As Health Minister I have to say that, inevitably, within the Health Department the concern is with the immediate, particular and short term problems. If we have the Institute within that framework, under the Department, when there have to be cuts and when there has to be restraint the body that will be affected will be that which relates to the long term aspects. We could say: `Yes, we can put that off this year. We can cut back those activities'. If we want to have a long term, viable body as a collector of data in the health area we have to exclude it from that overall control of the Commonwealth Health Department or any health department. Of course, this is the way that most countries have gone. In order to ensure that these kinds of activities will not be subject to that day to day interference and to the immediate constraints imposed on departments, most countries have created independent bodies to secure these basic health statistics to provide their independent data on the health status of their nations. That is the second reason.

The third reason is that it is important that we attract to this body researchers of very top quality. The collection of health data is not just a matter of collecting statistics; it involves very difficult debates about how we categorise these statistics. For instance, we have been bedevilled for years in this country by definitions of the Aboriginal population so that we can get Aboriginal health statistics. In this very complex area we need top class people with top class research backgrounds. It is much more difficult to attract them into a health department, into a sort of basic Public Service operation, than it will be into an independent statutory authority. That is the third reason we have moved in that direction.

Of all those reasons, to my mind the overwhelming justification is the fact that we are dependent on the States. Without these guarantees of independence and separation from the Commonwealth Health Department we will not get adequate statistical material. Therefore, it seems to me that the argument overwhelmingly is that we should move in this direction. I ask the House to support these proposals and I hope that those in another place who consider the arguments that have been presented in this House will opt in the same direction.

Question put:

That the Bill be now read a second time.