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Wednesday, 1 April 1987
Page: 1894


Mr HODGES(4.48) —We are debating the Appropriation Bill (No. 3) 1986-87, the Appropriation Bill (No. 4) 1986-87, and the Appropriation (Parliamentary Departments) Bill (No. 2) 1986-87 which will provide for the appropriation of a little more than $418m to a number of Commonwealth departments. Before addressing some comments to a matter specific to my State of Queensland concerning the Australian Federal Police and the Health Insurance Commission, I want to make one or two comments about the appalling state of the economy under this Hawke socialist Government. It is an economy in a state of decline. Something has to be done in the not too distant future to pull it out of that serious state.

Inflation is running at 10 per cent. Despite the refusal of the Prime Minister (Mr Hawke) to explain in clear terms to this House, after questions have been put to him, the inflation rate of 10 per cent is four or five times higher than that of our major trading competitors. Most of our major trading competitors such as France, the United States of America, the United Kingdom and Japan have inflation rates of less than 5 per cent. Interest rates in this country are putting businessmen-small business men in particular-and farmers out of business. High interest rates at levels of 18, 22 or 23 per cent are also causing great concern to home buyers. Many young couples in this country who have embarked on the purchase of their own home are walking away from those homes with nothing.


Mr Blunt —And there will be more of them.


Mr HODGES —More will be walking away unless something is done, as the honourable member for Richmond said. The massive deficits, both domestic and overseas, are causing grave strains on this economy. We have seen a government come to power in 1983 which brought down a 1984-85 Budget with a $7.9 billion deficit. That went to $6.7 billion in the next financial year, and $5.7 billion after that. Now we have a domestic deficit probably in excess of $4 billion this financial year. We have a Prime Minister who is known as the $100 billion man because Australia's overseas debt has risen in the last four years from $36 billion to $101 billion. The interest debt in government outlays is now No. 3 on the list of government outlays. Firstly, with social security at 27.8 per cent, 19.2 per cent of Commonwealth government outlays go to the States and 10 per cent of those outlays are taken up in interest payments. We are spending more on interest than we are spending on defence, education and health individually. That is after we were told some 12 months ago by the Treasurer (Mr Keating) that we were heading towards the conditions of a banana republic and told by the Prime Minister that we had a situation in Australia that was the equivalent of wartime.

It is against that background of a shocking and declining economy that I want to make one or two comments about some Australian Federal Police raids that were made in Queensland on 3 March and 4 March this year. The Australian Federal Police raided 17 premises of Optical Prescriptions Spectacle Makers Pty Ltd throughout Queensland, I think from Townsville to the New South Wales border. They seized documents, patients record cards, appointment books, duplicate receipt books, referral forms, correspondence, attendance-pay books, et cetera. OPSM conducts businesses in 34 separate premises throughout Queensland. It makes spectacles. It fills prescriptions from eye specialists and does certain repairs and other works associated with spectacles. The search warrants that were tendered by the Australian Federal Police claimed that OPSM had committed offences against the Health Insurance Act and the Commonwealth Crimes Act. The case came before Mr Justice Pincus in the Federal Court of Brisbane in early March and he handed down a judgment on 13 March 1987. The judge found that the search warrants were invalid. In simple terms, the warrants were deficient in their preparation. Let me quote from Mr Justice Pincus's judgment. He said:

Instead of stating the true object of the search in the warrant, it was, in substance, stated to be to look for some falsehood in a quantity of documents related to claims against the Health Insurance Commission. It does not appear too onerous a requirement that the warrants should have indicated, at least in a general way, what sort of falsehood was suspected and whether it was recent or ancient. If warrants in this form are permitted, that would also allow warrants for searches in patients' or doctors premises, looking among their medical records for quite unspecified illegalities connected with treatment for which reimbursement might have been claimed from the Health Insurance Commission. At least where the general character of the suspicion is capable of succinct statement, as here, it appears to me that the object of the search should be set out more specifically than by saying that some falsity is suspected.

Apart from the invalidity of the search warrants, OPSM was cleared of any improper action. In essence, the procedure adopted by OPSM, in some instances at least, was that it was referring customers to eye specialists using referral forms provided by the Department of Health in a rather routine manner. In other words, it was referring without the referring optometrists having seen the patients in the first instance. They had not seen patients or examined those patients before referring them to the eye specialists. If a patient goes direct to an eye specialist or, indeed, to any other specialist without a referral notice, the specialist gets a Commonwealth subsidised consultation fee which is about $10 less than he would otherwise get. In fact, the lesser fee is equivalent to that claimed by a general practitioner and not a specialist.

The referral system discourages people from automatically going direct to a specialist. The first point of contact by the patient is the general practitioner, an optometrist, an optician or a dentist, as is appropriate. I want to refer to Regulation 10 of the Health Insurance Regulations of 1973. It sets out the procedure for referral by general practitioners, et cetera, to specialists. This document talks about the prescribed information being provided on the referral. The information provided by the optician, optometrist, the general practitioner or dentist must state the name and address of the medical practitioner, the registered optometrist, the registered optician or registered dentist who is referring the patient to the consultant physician or specialist. It must have the name and address of the patient, the name of the consultant physician or specialist to whom the patient is being referred and, importantly, it must also be signed by the referring practitioner. It is clear from these regulations that it is not required by the referring doctor, optician, optometrist or dentist to see the patient that he is referring. Therefore, a referral to a specialist without examination is not in breach of the referral regulations. That is the important point that came forward in this particular case.

I turn to the Commonwealth Department of Health's medical benefits schedule book. Item 310 (f) states:

Medicare benefit is attracted for an attendance on a patient where the attendance is solely for the purpose of providing a letter of referral. However, if a medical practitioner issues a letter of referral without an attendance on the patient, no benefit is payable in respect of that service.

I think it is quite clear that no benefit is to be paid or claimed by that particular general practitioner, optometrist, et cetera, if he or she does not see the patient at the time of referral.

The matter in question concerning Optical Prescription Spectacle Makers is quite clear in that its method of referring patients was, in some instances, for those patients to see their optometrists but, in others, without an optometrist having even seen the patient. There is nothing unusual in a patient ringing a doctor and asking that doctor or optometrist to refer him to a specialist. It is not necessary for the optometrist or doctor to see the patient-that is the crux of this whole case-provided no fee is charged. Occasionally, doctors will charge an administrative fee of $2 or $3 to write that referral form. In the case of OPSM no fee at all was charged, either an administrative fee or a fee on the Health Insurance Commission. Indeed, OPSM having referred patients has no guarantee that those patients will return from the ophthalmologist-that is the eye specialist-with a prescription for glasses. If they have a prescription, that prescription may be taken by the patient to another optometrist, or the patient may require some other medication for the eye which would normally be provided by a pharmacist. So there was no guarantee to OPSM that it would receive any business back once the patient was referred to the ophthalmologist. The case was clearly put forward by OPSM in this matter before Mr Justice Pincus in Brisbane in the Federal Court. There was no doubt in the mind of the judge that OPSM was not in any breach of the Health Insurance Act or the Commonwealth Crimes Act.

I should put on record some facts about OPSM because it now has to live with the stigma of the raids that were conducted on 17 of its 34 premises in Queensland. It has been operating in this country for 50 years. It is a highly reputable public company. It has 257 outlets throughout Australia. It has branches in the United Kingdom, Ireland, France, West Germany, Denmark, the United States of America and New Zealand and it exports to 50 countries. It employs thousands of Australians. I am led to believe that the Health Insurance Commission had made no approach to OPSM expressing dissatisfaction with its procedures for referrals. It is my understanding that the procedures for referrals were the same at the time those raids were conducted as they had been in past years. I say to the Minister for Health (Dr Blewett) that if the Health Insurance Commission, he or his Department was unhappy with the health insurance procedures, they should have amended the Health Insurance Act and Regulations providing for the referral of patients by general practitioners to optometrists.

How was this investigation carried out? It was done in a fairly efficient manner in terms of the raids. Scores of patients were interviewed at their homes. Eye specialists' premises were visited and documents were seized. I understand that interviewing teams prejudged and accused OPSM of impropriety in its operations. The exercise was embarrassing for the public and for OPSM. The Health Insurance Commission and the Australian Federal Police were made to look like real asses. I understand that the raids were carried out in the morning. Officers of the Australian Federal Police arrived, warrants were produced, doors were closed and customers were kept waiting outside for some time, peering through the doors, wondering what was going on.

I believe that this has had a very damaging effect upon OPSM. There were newspaper reports throughout Queensland and I quote some of the headlines: `Police launch raids on optometrists'; `Eye test raid papers must be returned'; `Spectacle maker under eyes of law'; and, in the Townsville Daily Bulletin `Optometrist under police scrutiny'. Another headline was `Police investigation' and so it goes on. That is very damaging to a reputable company. This ham-fisted approach by the Australian Federal Police ought not to go without some apology from them and from the Health Insurance Commission. I believe that the Ministers concerned, the Minister for Health and the Special Minister of State (Senator Tate), should offer a public apology and write individually to the eye specialists and patients concerned. I understand that the records of many hundreds of patients were involved.

This gets back to the whole question of the cost, because we have the economy in a sad state and tens of thousands of dollars wasted in these raids. It is embarrassing to the Government, surely, and embarrassing to OPSM and to all of those people involved in the raids. Money was spent for staff and air fares throughout Queensland, and one has to ask a number of questions: Was the Attorney-General's Department consulted for an opinion before these warrants were drawn up; and who was responsible for the bungling raids that went on? I suggest to the Minister for Health and the Special Minister of State, who is responsible for the Australian Federal Police, that they conduct an inquiry into this matter and that some heads should roll. It is just not good enough that people in responsible positions in those departments should go about their business in this way, wasting public funds and causing the amount of embarrassment that they have to so many people throughout Queensland and the ultimate embarrassment, in my view, to eye specialists and to OPSM.