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Thursday, 19 March 1987
Page: 1165

Mr DONALD CAMERON(4.54) —It does not matter when this Government puts on a debate on health-I am ready. When I came to this place 20 years ago the nation's Budget was $6 billion and the average wage earned by the people of Australia was $60. Since then the average wage has risen seven times, but the Budget has gone up 12 times. That explains in a very simple way why people are feeling the impact of taxation to the extent that they are. I relate this to the present Government's expenditure on health care. In the mid 1970s during the Whitlam era we had the first taste of socialised medicine. I recall the present Minister for Foreign Affairs (Mr Hayden), as Minister for Health at that time, introducing a national health scheme.

Government members interjecting-

Mr DONALD CAMERON —It is about time Labor members listened to an explanation of why this country is going down the drain, instead of sitting opposite in little groups. Since the present Government came to power expenditure on medical services and benefits has risen from $2.5 billion in 1984-85 to almost $3.5 billion in current year projections-that is, about another billion dollars that must be met from taxpayers' pockets. One of the things that the Australian Labor Party fails to understand is that every time it gives something away on the pretence of equalising opportunities for people, it is those very same people who end up paying for it.

Let me give another example of the way in which health costs have rocketed since Medicare came into being. The average fee for basic hospital cover across all States in regard to all private health funds, including Medibank was $6.06 a week. That is what a family needed to pay over and above Medicare for basic hospital cover. In the period of just three years that figure has risen by over 40 per cent to $8.51. Despite the huge increase in that period, more Australians than ever before are opting to take private health cover. They are seeing for themselves, particularly in the southern States, that if they take ill, they will have to wait many months before they get a hospital bed for elective surgery. By the time they get to hospital, instead of having one or two ailments they will have three or four. When people carry an ailment as long as a socialised health system requires them to do, illness and problems are compounded. The Bureau of Statistics, one of the most wonderful organisations in the country, has provided figures showing that 46 per cent of families on incomes of less than $126 a week are paying for private health insurance. Despite the fact that their incomes are less than $126 a week, they are prepared to pay out $8.50 a week to ensure that they do not have to join queues for hospital beds.

The Minister for Health (Dr Blewett) has not satisfactorily explained in this Parliament, in Question Time or in the many debates in the last year, why, if the health system is so marvellous, in the southern States there are queues of 100,000 people waiting to get into hospitals, waiting for elective surgery. The Minister has never explained that. He has given excuses, but they do not remove the queues which grow longer every year. I draw attention to the case of a Western Australian, Garry Caple of Coolbellup.

Mrs Kelly —Why don't you look after your own electorate?

Mr DONALD CAMERON —I remind the honourable member for Canberra that I come from Queensland.

Mr DEPUTY SPEAKER (Mr Mildren) —Order! I ask the honourable member for Moreton to address his comments through the Chair and to ignore interjections.

Mr DONALD CAMERON —They are a very lively audience, Mr Deputy Speaker. However, I prefer to direct my remarks to you. Garry Caple has been waiting eight months for surgery for the removal of kidney stones. I do not know whether the Minister knows Garry Caple, but I remind him that there are 100,000 such people out there-people not necessarily with kidney stone problems but waiting for the opportunity to get into hospital to have operations. The Minister lulls the nation into a feeling of false security by telling people that socialised medicine is the panacea for all illnesses, telling them: `We will look after you'. But typically, as with all socialist schemes, it is crumbling and people are not getting the care that the Government promised them in 1983 and again in 1984. Remember 1984-the promise in that election campaign that there would not be an increase in the Medicare levy, just as there was a promise in 1983 that there would be no capital gains tax. The Government has increased the levy from one per cent to 1 1/4 per cent, but even so it has to put its hand into the coffers for some $2,000m just to top up the costs of meeting the expenses of running socialised medicine.

For the life of me I cannot understand why the Australian Labor Party, after the failure of the mid-1970s, has indulged in the extravagance of socialised medicine again. I do not believe that because something is old it is necessarily good. I do not mind facing change or even looking at pre-existing schemes. But I point out to the Minister for Health that the scheme that was in place in this country in the late 1960s and the early 1970s was virtually the best health scheme this country has seen--

Mrs Kelly —Come on! Old men with old ideas.

Mr DEPUTY SPEAKER —Order! The honourable member for Canberra will cease interjecting.

Mr DONALD CAMERON —The honourable member says: `Old men with old ideas'. It is a pity that she is so young that she cannot recall that time and that she has so little interest in history that she is not prepared to go back and look at the systems which existed in those days and which really worked. We had 89 per cent of Australians adequately covered. The honourable member for Oxley (Mr Hayden) used to campaign on the basis that 11 per cent of Australians were not covered. But 8 per cent of the uncovered people came from Queensland where we had a free hospital scheme and the other 3 per cent were people who never stayed very long in the same place; they wandered about. Most Australians had a form of cover but when this Government came into office it ended up tipping out the baby when it emptied the bathwater.

The shadow Minister for Health, the honourable member for Barker (Mr Porter), will verify that what I am about to say is correct-that when our policy is revealed it will show that bulk billing, except for the poor and disadvantaged, is on its way out. We have seen the emergence of Edelsten-type clinics-and I am not passing views on the ethics or otherwise of such clinics at this point-based on the premise that if people go through their doors they will find velvet lined walls, grand pianos in the corner and mirrors on the ceiling. They are told that they will be looked after and they are made to feel welcome. They are told that they will not have to pay a cent because the clinic will bulk bill the Government. People like those circumstances, they like such surroundings. Therefore, if they get a double splinter in their finger, instead of reaching for a needle, they go to the doctor and let him pull it out. Why? Because `it ain't going to cost them anything'. This is the great weakness of the bulk billing system. The moment that people lose a vested financial interest in making a judgment on the necessity to go to a doctor, many in the community will opt for going to the doctor for any ailment, no matter how minor it might be.

This is a very wide-ranging debate and I have listened to a number of earlier speakers. Now that the Minister for Health is at the table I take this opportunity to raise another matter. In my city of Brisbane and my electorate of Moreton I am aware of hundreds and hundreds of elderly people who are trying to gain admission to nursing homes. Yet I have learned in recent days that the Government has decided that the city of Brisbane has too many nursing home beds and it is arranging the transfer of those beds out of the city to the outskirts of Brisbane. The Government is compounding the current problems. I am glad the Minister is taking notes; I hope that he will respond to these concerns at a later stage. With all my heart I say to the Minister that when one goes to a nursing home one can see how the aged are more frail than they used to be. If the Minister is saying that his goal is that elderly people must stay longer at home before they can go into a nursing home, he is certainly achieving that because the waiting period for admission is now longer than it has ever been.

Mr DEPUTY SPEAKER —Order! I have given a fair amount of latitude in the debate on this Bill, but at the moment the honourable member is not even talking about anything in the Bill. Given that this legislation is about pharmaceuticals, I ask the honourable member not just to return to the Bill but to begin making relevant comments about it.

Mr DONALD CAMERON —I can do that very easily, but I draw your attention, Mr Deputy Speaker, to the fact that this is a health--

Mr DEPUTY SPEAKER —I also ask the honourable member not to argue with the Chair and to take heed of what the Chair says.

Mr DONALD CAMERON —Well, Mr Deputy Speaker, you are in control and I acknowledge the request that you have made. This Bill refers to Medicare and there was a precedent today for discussing matters such as pathology treatment and the Government's decision some months ago to wipe off or to reduce by some 25 per cent the payments that certain services would attract. I draw the Minister's attention to an article which appeared in the Brisbane Courier-Mail on Tuesday, 17 March, in which a spokesperson for one of the major pathology laboratories in Queensland warned that in Queensland the services which are being provided to country people are being severely reduced. Although I represent a metropolitan seat, I cannot let this opportunity pass without suggesting that the Minister has perhaps been over-severe. This group of pathologists has already dismissed 130 persons from its staff because of the reduced income resulting from the cuts that the Minister has brought about, and it is now being forced to look at a further reduction of services. Can the Minister tell whether he has any plans in this regard? I acknowledge that in some areas of pathology there were people with their hands in the till but I do not believe that that was the case in Queensland. Has the Minister any thoughts of a review? Now that his reductions are in place does he intend to look again and see whether he has overdone it? I suggest that he should.

While I am talking about pathology, I have another matter which should be raised here. There is one weakness in the Medicare or health fund system in that if someone goes into hospital and has an intravenous set-up placed in his body, if a doctor actually places the needle in that person the doctor is entitled to charge $20. The Government has decreed that, if a nurse places that needle in the person's body, the refund which a private health fund would be entitled to give is not applicable. It applies only if the doctor performs the task. We are in a bit of a quandary here. I might add that if a person goes to hospital after hours, the doctor is entitled to charge a late fee or an out-of-hours fee. By standing to one side and doing nothing about this, the Minister is causing a situation in which, if a person is in hospital and a doctor comes in and carries out the service, the patient gets almost all the money back. However if that patient is unlucky enough to have a nurse, even representing the doctor, conduct that service-and I am not reflecting on the ability of such a person to perform that service-he or she gets wiped by the health fund. I am saying to the Minister for Health that the Government has to acknowledge that, if a nurse can carry out this procedure and does so instead of the doctor, that person should be entitled to a refund. Alternatively, it might be even smarter if the Government bit the bullet and said to doctors: `The fee structure has been set in return for a service that you provide, and if doctors are supposed to do it and don't we will outlaw your use of nurses or restructure the fee and reduce it dramatically'.

The constituent who came to me is faced with an account of some $30, after paying out a lot more money because of the shortfall on services, just because the nurse came in on the Saturday afternoon instead of the doctor. Yet the Government closes its mind to it. It has been explained to me that in the Health Insurance Commission the view is that it is far better that the professionalism of doctors not be undermined by recognising the service being provided by a mere nurse. My view, I repeat, is that if a nurse can do it, or does it, why do we have to pay such a high fee to acknowledge that the doctor does it if, most of the time, he is relying on the services of a nurse?

I conclude, as I commenced, in underlining the fact that one of the great tragedies of this nation is runaway costs. They are always associated with socialised medicine. The rest of the world is in the midst of walking away from socialised medicine. But what does Australia do? Being removed from the rest of the world is perhaps an excuse, but people travel and see, and the lessons of contemporary history are there. We go down the same path which others have tried and which has failed. When we have a return of a Liberal-National Party government after the next election--

Mr Blanchard —Ha, ha!

Mr DONALD CAMERON —The form of socialised health will go out the door. The honourable member for Moore need not laugh because the next election will most surely ensure that his Government is put out of office for the reason that I outlined at the beginning. As I said, in Australia 20 years ago we had a Budget of $6 billion but today we have a Budget of more than $72 billion. That has gone up twelve-fold in 20 years, yet salaries have gone up only sevenfold.

Mr DEPUTY SPEAKER (Mr Mildren) —Order! The honourable member's time has expired.