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Friday, 5 April 1946

However, the cost of medical benefits is not the only problem. Pharmaceutical benefits are even more of a headache for their authors, as the following figures testify:

 

The Health Department soberly reported in 1 944 that " it is hard to resist the conclusion that many unnecessary bottles of medicine are prescribed ". This year it says, " This rise has occurred without apparent deterioration in the general health . . . and is very disquieting ".

It may be disquieting, but is it really surprising? Is it surprising that people are flocking into doctors' surgeries to be treated for minor ills? When people are detached every week from one-twentieth of their earnings, under the heading of social security, they naturally neglect no means of getting something back for their money.

So the chemists prosper (although no' one seems to mind about that) and the doctors prosper, and the public just pays its taxes and grumbles. Apparently, the Government to-day is back where it was in 1941. It is negotiating again with the medical profession in the hope of evolving some workable substitute for the present fee-for-service system.

Whatever scheme is adopted, there are certain to be weaknesses. For the doctors, as Mr. Nordmeyer has said, are no better and no worse than other people in the community, and if they are put on a salary they may be disposed to demand regulated hours of work, just like the more humble toilers. ,

The main lesson, perhaps, is that it is all very well to have high ideals, but a dash of practical common sense is still a very useful quality.

So much for the New Zealand scheme. I now quote from .the Christian Science Monitor of the 9th February, 1946, to show the experience of other countries -

Experience with socialized medicine in Europe shows it has led to inferior service and to economic and political problems.

In every country there has been a constant increase in the sickness rate after the introduction of health insurance. In Germany it trebled from 1885 to 1930. In England- the number of claims increased by almost 50 per cent, in a six-year period from 1921 to KI27. In both countries doubtless some of the increase was due to malingering, but an appreciable part was caused by poor medical service

Again, in England there has been much argument about the quality of medical caregiven -the workers. Some of the proponents of the system have insisted that they got better attention than they did in preinsurance days. Others disagree. Ernest Bevin has characterized the medical service given the industrial classes as " a tragedy of incompetence . . ."

The third and most insidious danger is the political one. Investigating doctors found much evidence about the quality of medical care. The increasing cost of the systems is a matter of record, but the growth in the political importance of the administrative organization has gone almost unnoticed in most countries until a crisis. Such an emergency occurred in Germany in 1933. One of the first things the Nazis did after they took over the reins of government was to seize control of the health insurance> funds and to convert the offices into governmental agencies to aid in regimenting the people.

I have made those quotations in order to show that the Government would be- pur-, suing a dangerous course in proposing to ask the people to grant it power to operate the very desirable social services that are now in operation together with undesirable services like the so-called free medical service. By lumping them together the Government is placing desirable social services in jeopardy. So I urge that the Government divide the proposal. It should -ask the people for power to place beyond doubt the validity of the existing social services. That would have our wholehearted support.

If the Government wants power to legislate in regard to medical and dental services it can put an additional separate proposal before the people

One has to search for reasons why the Government proposes a referendum on the subject of the organized marketing of primary products. In and out of season, the Australian Country party has sought amendment of section 92 of the Constitution in order that the Commonwealth might exercise control of marketing. In 1937 honorable gentlemen opposite opposed and succeeded in having defeated a referendum on that matter. In 1944, the Attorney-General refused point blank to include organized marketing in the referendum of that year. Now he shows a remarkable change of front, and the House is entitled to know why. The Australian Country party' believes in the continuance of the organized marketing that has been possible under existing and war-time powers of the Commonwealth. We believe that it should be carried out as far - as possible on the basis of sensible co-operation wit the States. Much has been learnt since the referendum of 1937. The success of the Australian Agricultural Council has demonstrated the wisdom of a policy of co-operation between the States and the Commonwealth. As the right honorable member for Cowper (Sir Earle Page) said in. his excellent speech last night, the Agricultural Council, which has years of experience, should be used to the greatest possible degree by making i t a statutory body. Organized marketing involves some degree of regimentation, but, by the greatest stretch of imagination, one cannot say that the Commonwealth Government can control the marketing of primary products, ambiguous as that term is, without having a say in respect of production. Does the Commonwealth Government intend to allow the States, which control the land on which primary products are grown, to have full control over production and to deal only with the actual marketing of those products? Either the Commonwealth must usurp State functions, and exercise control over production or chaos will result. This matter must be looked at in the light of what the Attorney-General said about section 92 of the Constitution. He said -

I have explained my view that section 02 does not altogether prohibit organized marketing. Some marketing schemes have been upheld, notwithstanding section 02, on the ground that they were directed not to the mere restriction of interstate commercial transactions but to the achievement of such objectives as the preservation of standards oF purity and quality, and the maintenance of supplies for consumers.

For the life of me I cannot understand why the Attorney-General with all his legal ingenuity cannot devise legal phraseology that would satisfy those specifications. I ask the Attorney-General what primary industry is incapable of coming within the specifications that he outlined in his second-reading speech. By exercising his undoubted legal ingenuity, the Attorney-General should be able to draft a marketing arrangement which would not "be ultra vires the Constitution. When the Lyons Government's marketing proposal was defeated at the referendum in 1937, the major primary industries were able to continue as the result of cooperation between the Commonwealth and the States. For example, the butter industry was able to maintain its conditions and retain producer-control through an arrangement between the butter producing States. The meat and wheat industries were able to formulate satisfactory marketing schemes. Therefore, I ask the Attorney-General tq inform me what particular primary industry will benefit from the Government's referendum proposals which cannot benefit under the specifications he enunciated in his secondreading speech?

In order to gauge the wisdom or otherwise of this proposal for orderly marketing, we must have an unambiguous definition of " primary products ". The Attorney-General said -

All Australians, for instance, would immediately recognize butter, cheese, flour and dried fruits as primary products, though not cake or bread.

If flour is a primary product, I "should like to know whether sugar is a primary product? Is a distinction drawn between raw sugar and refined sugar? And how will margarine, the great competitor of butter, be classified ? If flour is a primary product, can breakfast foods be so regarded? The manufacture of breakfast foods is no more intricate than the milling of flour. Therefore, honorable members on this side of the chamber want to know what precisely is the definition of " primary products ". I am of opinion that the Attorney-General recognized that the obstacle constituted by section 92 has been made more formidable by the judgment of the High Court in the recent Airlines case. Briefly, the. High Court held that the Commonwealth Government could not have a monopoly of interstate aviation. The wider the AttorneyGeneral makes the definition of primary products, the more he will break down the obstacle formed by section 92.

Obviously, the purpose of this proposal is to give effect to' the Labour party's fundamental policy of socialization. Trade unions and Communists have harassed the Government to implement its policy for the socialization of the means of% production, distribution, and exchange. The Government's banking legislation has satisfied the demand for the socialization of exchange. In addition, the Government controls distribution, because it has acquired power over transport. It has decided to conduct interstate air services in competition with private enterprise, and proposes to build a fleet of coastal vessels. Production is the only unfulfilled part of the Labour party's policy of socialization. I warn the people that the Government's proposal for orderly marketing, in its present form, is no more than the first step towards the 'socialization of the means of production.

If production is to be regimented, what will be the result? The AttorneyGeneral stated that safeguards, will be provided against industrial conscription, but will effective safeguards be provided against the socialization of the means of production, which is an indispensable part of marketing ? During the war, Australians experienced the effects of the regimentation of production. The Commonwealth paid primary producers 12s. an acre not to grow wheat, and the cost of that policy was approximately £1,500,000.

Despite food shortages throughout the world, potato-growers were instructed to reduce their acreages by 25 per cent. Those are two straws in the wind indicating that the Government intends to socialize the means of production. [Extension of time granted.] The Government's proposals for orderly marketing are too ambiguous. Orderly marketing can .be achieved most effectively, first, by co-operation between the Commonwealth and the States, and, secondly, by encouraging producercontrol, as the honorable member for Maranoa (Mr. Adermann) advocated yesterday. Those requirements have been proved since the rejection of the marketing referendum in 1937. Honorable members on this side of the chamber desire to know who will benefit from the Government's proposals for orderly marketing, and whether the benefit will be greater than primary industries derive under section 92, as outlined by the Attorney-General in his speech on the Constitution -Alteration (Organized Marketing pf Primary Products) Bill.

The Constitution Alteration (Industrial Employment) Bill provides-

Section fifty-one of the Constitution is altered by inserting after paragraph (xxxiv.) the following paragraph: - " (xxxiv.a. ) Terms and conditions of employment in industry, but not so as to authorize any form of industrial conscription:".

Why does the Government require that power? Does it intend to usurp the functions of the Arbitration Court and reduce to a dangerous degree the value of arbitration and conciliation? The Commonwealth, we have been told, requires this power in order that the Parliament" may fix wages and working conditions. In seeking this power, the Government had yielded to outside pressure groups, particularly the Communist element, which has agitated for a standard working week of 40 hours throughout Australia and an increase of the basic wage by £1 a week. In order to placate tho.se pressure groups, the Government has been forced to appeal to the people for constitutional authority to fix wages and determine working conditions. If that power be granted, the Government must interfere very dangerously with the functions of the Arbitration Court, and undermine the sound and desirable foundation of arbitration, and conciliation. Yesterday, the honorable member for Fremantle (Mr. Beazley) accused us of insincerity regarding the implementation of the policy of the Australian Country party. He stated that the party advocated stabilization, and that if we did not support the referendum proposals, we would be hypocritical because we would neglect an opportunity to remove a constitutional obstacle to stabilization. The inference to be drawn from the honorable member's speech was that members of the Labour party conscientiously desire to implement their policy, and in order to do so, must sweep away constitutional barriers. The policy of the Labour party for a shorter working week, which is contained in sub-division 9 of " Industrial Regulation ", states -

Working hours not to exceed 30 a week.

So it is not a 40-hour week that the economic structure of Australia will have to bear if the Government sincerely desires to implement the Labour party policy. The primary producers, whose commodities are sold in the markets of the' world, in competition with those of other exporting countries, must vote at the referendum with a full knowledge of the Labour party's goal.

Many eminent people, including Labour leaders, are opposed to the fixation of wages by parliamentary action. The Leader of the Opposition (Mr. Menzies) put a strong case in his usual lucid and logical way against this proposal. It must be obvious to all thinking people that parliamentary action in this respect is entirely undesirable. The determination of wages and working conditions is a delicate and complicated business which should not be left to the 75 members of this' House and the members of the Senate. It should be the work of experts acting in a judicial capacity. I bring to the notice of honorable members a statement made by Mr. Forgan Smith on this subject at the Emu Park Labour convention. I do not believe that any honorable member opposite will suggest that Mr. Forgan Smith is not a thoroughly good Labour man, in fact, as good as any honorable member sitting on the Government benches. Mr. Forgan Smith said -

In connexion with the points made by other speakers respecting what they called government reduction of wages, he, as a member, vas prepared to take his share of the responsibility for everything that had -been done. He stood for the maintenance of the Arbitration Court, free from political interference, and which would adjudicate untrammelled upon the facts laid down before it in accordance with the provisions of the act. Parliament was not in a position to fix wages . . . convention must face the facts of life as they existed. The system of arbitration adopted by the Labour Government was sound and just, and none would regret it more than the workers if this structure was destroyed.


Mr Conelan - When did he make those statements?







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