Note: Where available, the PDF/Word icon below is provided to view the complete and fully formatted document
 Download Current HansardDownload Current Hansard   

Previous Fragment    Next Fragment
Wednesday, 6 May 1987
Page: 2421

Senator POWELL(5.21) —I rise to address some remarks to the report from the Senate Select Committee on Private Hospitals and Nursing Homes. It has been a marathon effort. This report is welcomed because there is a great deal of concern in the community-and quite justifiably so-on a number of counts in the whole area of health policy and delivery of services to people in the community. It is a very comprehensive report and one which will exercise our minds and our attention for some considerable time into the future, my attention in particular since I carry responsibility in the Australian Democrats for the health portfolio.

I would like to look at some of the majority recommendations of the Committee and make some comments on them. I will also comment on some of the minority recommendations. Recommendation 1 from the majority of the Committee refers to the Australian Institute of Health and calls for the Institute to collect and publish private hospital statistics on a national basis. I believe that we will have coming before us legislation to change the status of the Australian Institute of Health for it to become an independent statutory body. I believe that that legislation will go a long way towards assisting the implementation of what I consider to be an excellent recommendation from this Committee. It is important that we do have collection and publication of all kinds of data in the health area. We have fallen behind. For the sort of country that we are, we are not very far advanced in this whole area. I certainly welcome that recommendation and also the proposals which will come before us shortly regarding the Institute of Health.

I turn to recommendation 7. The majority membership of the Committee recommended that adequate medical records consistent with the guidelines of the Australian Council of Hospital Standards on medical records be required of public hospitals by State health authorities and requested of each private hospital by State health authorities. I think it is terribly important that, along with a number of the other recommendations of a similar kind, the private hospital sector comply with this recommendation in the spirit of recognising that we do need this kind of statistical information in order that health policies may be advanced in this country in the best interests of all members of the community. It really should not be too much to ask of private hospitals as it is really consistent with their role as health care providers in the community. The State health authorities can only make requests. I certainly hope that the private hospitals will look upon that recommendation favourably and comply with any such requests which the State health authorities might make in accordance with this recommendation.

Recommendation 9 comes from that area of the Committee's inquiry which relates to patterns of ownership in private enterprise hospitals. Recommendation 9 (c) calls for prominent display in the foyer of the private hospital of the names of owners of the private hospital and, if the owners are companies, the names of the principal directors and shareholders of those companies and, if the owners are trustees, the names of the principal beneficiaries under the trust. This recommendation also calls for other information to be prominently displayed, but I stress this recommendation because I believe that if patients and members of the community are to have full knowledge of patterns of ownership and are to be able to make independent decisions about where they are being treated this sort of information is quite vital to them. This raises the whole issue of the ownership of private hospitals. It is quite a thorny issue and one which I am sure has exercised a great deal of the time of this Committee. It is one which also concerns members of the community.

At this point I move on to recommendation 12, which comes from the chapter of the report headed `Medical Practitioners' Pecuniary Interests', and make some comments on this general issue. I point out that Senator Haines did have a dissenting opinion on recommendation 12 of the report which actually brings out part of the problem when one is addressing the issue of ownership of private hospitals in particular. It is a desirable situation that individuals in this community should be seen as individuals. I say this particularly from the point of view of being a female individual. All too often we are not seen as individuals; we are seen as part of a group. It is in that context that Senator Haines felt it necessary to dissent from the general recommendation of the majority of the Committee. She believes that it is impossible to make the sort of recommendation made by the majority in terms of medical practitioners or their families. I believe that if there is a resolution to this dilemma it lies with the medical profession itself. The Australian Medical Association code of ethics deals quite clearly with pecuniary interests of doctors in relation to pharmacies. Paragraph 11.1.3 states:

A doctor should not have a financial interest in the sale of any pharmaceutical preparation he may have to recommend to a patient.

Paragraph 10 talks about a doctor not having a financial interest in directing his patients to a particular chemist and a number of other aspects of the relationships between doctors and pharmacies. It seems to me that if the medical code of ethics can address the issue of pecuniary interests in relation to pharmacies it can, should and, indeed, must address that same problem in relation to pecuniary interests of medical practitioners in a number of other areas, not the least being hospital ownership and ownership of, shall we say, chains of medical practices. Legislation can do a certain amount, and legislation must be enacted in many areas, but we would prefer to see voluntary community action or, in the case of a profession such as the medical profession, action in terms of its own ethics. There is no doubt that there is concern in the profession and in the community about a disturbing trend in medical practice. From my reading of the report, the Committee obviously put a great deal of time into looking at what has happened in this area overseas and taking evidence from people here in Australia who have concerns about this issue.

I note in a section of the report called `Business practices-v-medical ethics' that the Committee stated that Australia is rapidly moving down the United States path where health care services, including private hospitals, are run primarily as business ventures. This ought to be a major concern. The relationship between doctor and patient is, and should be, one of trust; the relationship in a business venture is based on the need to--

The ACTING DEPUTY PRESIDENT (Senator MacGibbon) —Order! The honourable senator's time has expired.