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Thursday, 18 October 1956

Mr DUTHIE (Wilmot) .- There is a great deal of unanimity in respect of this bill. That proves to the general public that on all the really worth-while measures brought before the Parliament we do nol fight one another, but work together for the good of the community. It is interesting to note that 85 per cent, to 90 per cent, of the measures brought before the Parliament are agreed to by both sides, but the press has a field day when we disagree violently on a measure. This bill has our complete support, so far as it goes. It is a nervous but sincere entry by the Commonwealth into a new field of humanitarian work. I congratulate the Minister and the Director-General of Health on the introduction of the measure, but I think that both of them will admit that it is only a beginning. When the bill has been passed, we might say that we have reached the end of the beginning of a system which will, in years to come, be of inestimable value in rural districts where sickness, combined with loneliness and isolation, is so frightening. Reading this bill, one realizes that the Minister and the department are only feeling their way in the dark. The field is entirely new to them. In my view this measure is complementary to the Aged Persons Homes Act, which was passed by the Parliament in 1954, and which enables the building of homes for the aged on a subsidy by the Government of £1 for every £2 expended by organizations and churches proposing to conduct such homes. Many lovely homes for aged persons have already been provided as a result of that legislation.

Under the measure which we are now considering, it is proposed that Commonwealth aid be given to voluntary organizations in the nursing field. There is a great deal of practical Christianity behind the two measures. To me it is wonderful that the National Parliament can devote itself to the implementing of a Christian ideal through legislation. That in itself is good, but the practical day by day fulfilment of the ideal will be in the hands of individual persons, in the hands of humanity. In this instance it will be in the hands of nurses, who will render a great home service to the aged, the sick, and injured, and the convalescent. These are salient features of the measure. The subsidy to be paid by the Commonwealth will not in any instance exceed the State government subsidy paid to a nursing service. The Minister's approval must be obtained before an organization is granted a subsidy. All organizations which are granted subsidies will, quite rightly, have to supply the Director-General of Health with adequate information and properly audited accounts and reports. The Director-General will have to be satisfied in all cases that the nurses in respect of whom a subsidy is claimed are properly qualified. No attempt will be made by the Government to interfere with an organization's management and control of its affairs, except insofar as is consistent with a proper expenditure of public funds. 1 am inclined to agree with the point raised by the honorable member for Moore (Mr. Leslie) in respect of proper qualification. The term " properly qualified " is interpreted, of course, to mean nurses who have completed their training, and we are all aware of the scarcity of such persons in this country at the moment. The use of nursing aides for this work has everything to commend it. I suggest that the Minister examine that suggestion. I have been chairman of a hospital board in my own State for the last four years. The board had much to do with the engaging of staff, including matrons, single-, double- and triple-certificated sisters, nurses, and nursing aides. I have a tremendous admiration for the work of the aides. A remark made by the honorable member for Moore might well have caused us to sit up and take notice. He said that while he was in hospital for two years the greatest service rendered to him was given by nursing aides. They are rendering magnificent service and they are more qualified to-day than they have ever been before. We employ as aides young folk from our local towns. They undergo training for a year or two years under the matron and qualified sisters. At the end of twelve months they have a wide knowledge of nursing. If the position were otherwise, they would not remain in our hospitals. I earnestly support the suggestion made by the honorable member for Moore. There are too few qualified nurses to make the home nursing service the success which the Director-General and the Minister want it to be, and I submit that we shall have to bring nursing aides into the field.

I agree with the contention of other honorable members that married persons should be encouraged to go into the service. I refer to nurses who have completed their training, matrons and sisters who have married after giving perhaps half a life-time to the profession. They 'may have no children, or their children may have grown up. Here is an excellent opportunity for such highly trained persons to render service, providing that they can make happy arrangements with their husbands about the hours that they will be away from their homes, in the same way as politicians have to make similar arrangements with their wives.

I want to stress that this will be a scheme newly born. We must examine the possibility of using qualified nursing aides in the home nursing service. Nursing is a profession of the highest order, as we all admit. Many a person has been saved from death by the kindness, consideration, and constant attention of a sister or nurse. When a doctor's work has been done to the limit of his skill, it is nursing which really brings a person back to health. There is a stage beyond which a doctor cannot go in the treatment of the sick or injured. Beyond that stage the patient is in the hands, first, of the Lord, and, secondly, of the nurses. Nursing is a magnificent profession. Unless nurses are born to the work they cannot possibly last in the profession.

Mr Luchetti - lt is a vocation.

Mr DUTHIE - As my colleague says, it is a vocation of the highest order. In my view, a nurse must be called to her work in the same way as a minister of religion is called to the pulpit. Both render complementary services to humanity. How will these payments be worked out? No member has raised this matter. The Minister, in moving the second reading of the bill, said -

In general terms, the Commonwealth's policy will be to grant to non-profitmaking home-nursing organizations now in the field subsidies approximating the salaries paid to nursing sisters employed by them over and above the number ordinarily employed during the year prior to the commencement of the act. Thus, if an organization has ordinarily employed, say, ten nurses during the past year and increases its staff to twelve nurses when the scheme commences, it will receive a subsidy approximating the salary of the two additional nurses.

That means that the salaries of the two additional nurses will be met from this fund. If a staff of ten is increased to fifteen, the subsidy will equal the salaries of the five additional nurses.

Mr Daly - What if the staff is not increased?

Mr DUTHIE - 1 am coming to that. An interesting situation could develop. I have discussed the matter with the DirectorGeneral of Health, and he admits that it represents a difficulty. What will happen if, after an organization increases its staff from ten nurses to twelve, so that the employment of two nurses is subsidized, four nurses resign for various reasons within three months, reducing the number of staff to eight? How will the scheme work in such a case? When the Minister for Health replies to the debate, I should like him to say how he proposes to solve such a problem. Will the subsidy be withdrawn once the number of nurses falls below the number employed before the operation of this legislation, or will the subsidy continue? I know that, in the early stages, it is difficult to see how all the aspects of the scheme will work, but I suggest that that is something that should be clarified.

The Minister stated, in his second-reading speech, that there are 150 nurses employed by voluntary nursing organizations in Australia to-day. What a pathetically small number that is! Not a penny will be paid by way of subsidy under this legislation until that number has been increased, so that, as the matter stands at the moment, no organization is being assisted. 1 agree that the scheme will act as a stimulus to the voluntary organizations and will encourage them to increase the number of nurses, and, of course, that is one of the reasons for the introduction of the bill. One of its objects is to increase the number of nurses working in Australian homes. The Minister has pointed out that the work of these 150 district nurses reduces hospital running costs by at least £1,000,000 a year. He stated, also, that the total cost of keeping the nurses in the. field is less than one-fifth of that sum, or less than £200,000 a year, and he rightly said that, by increasing the number of district nurses operating in the homes of sick people, we shall, in a sense, reduce the total expenditure on hospital treatment. That is a good point. The scheme, in principle, is 100 per cent, praiseworthy and should benefit the community.

It is appalling to learn that there is a shortage of 2,500 nurses in Australia to-day, having regard to the total number of hospital beds and the number of nurses needed for those beds. I may say that I have obtained this information from the previous Minister for Health. I understand that there are approximately 62,000 beds in Australian hospitals at present, and that about 34,000 nurses are working in our hospitals. However, we need, as I say, 2,500 more nurses to staff the hospitals adequately. The result is that increasing burdens are being placed on hospital matrons. I know that the matron of the hospital at Longford, where I live, has to work a great deal of overtime. Although the staff is short of only one nursing sister, much additional work is thrown on the shoulders of the matron. I believe that a similar position applies in most hospitals throughout Australia. In Tasmania, we did something to overcome the nursing shortage which has since been adopted by the Tasmanian Department of Health. We made a direct approach to our Agent-General in London, Sir Eric von Bibra, and asked him whether he could engage the services of two double certificated nursing sisters. There is in England an organization known, I think, as the Colonial Nurses Association, which helps to provide nurses for countries overseas. We negotiated with Sir Eric for approximately six months, and he was completely co-operative. Eventually, not two but three nurses were selected to come to Australia. They arrived here in January last and since then have done magnificent work in the hospital at Longford. As I say, the Tasmanian Department of Health has since adopted this method. A Tasmanian hospital which needs qualified nursing staff applies to the department which, in turn, makes a direct approach to the Agent-General in London. Action of that kind is necessary if our hospitals are to be kept going. We must not reach the stage where wards have to be closed because nurses are not available. That would be a tragedy.

The thing that worries honorable members on this side of the House is where the additional district nurses are to come from, having regard to the limitations imposed by this bill. It seems to me that the State Departments of Health must try to recruit staff in new fields, and perhaps even the voluntary organizations themselves will have to try to obtain additional staff from overseas.

Mr Galvin - Does the honorable gentleman think that Sir Eric Harrison may be able to help?

Mr DUTHIE - Perhaps. After all, the right honorable gentleman said recently that he would do everything in his power to help Australia as a whole, regardless of political parties.

The Minister for Health has said that the main field of operations of the voluntary district nurses is in respect of people of 60 years of age and over, who suffer from chronic illnesses, such as arthritis, one of the greatest scourges in Australia to-day. It is a disease which is increasing year by year, and it seems that very little can be done for the people who are crippled by it. They are maimed and immobilized until, finally, they become pathetic invalids in wheel chairs. The work of the nurses also is concerned with people suffering from cardiac disease, incurable carcinoma, and other ailments that demand special nursing.

The women who take up this calling have to be strong, both physically and spiritually, because their task is arduous. It is a timeconsuming job, as the Minister has said, and it involves both detailed and routine work.

One of the tragedies in Australia to-day is the neglect of aged people by their children. Recently, a survey was made in Melbourne of the problems of the aged, as a result of which it was discovered that a great number of aged people are neglected entirely by their children and are forced to live the last years of their lives in loneliness, forgotten and destitute. They . are mainly pensioners who live in dreadful hovels. In some instances, their children do not visit them once a year, not even at Christmas time. They have become forgotten people.

Mr Hamilton - Where were these discoveries made?

Mr DUTHIE - They were revealed by a survey in Melbourne, but unfortunately, similar conditions are becoming apparent all over Australia. They are a tragic reflection of the materialism that is eating the heart out of our nation to-day. When Australians neglect their parents for their own selfish ends, they are really reaching a grave situation.

I want to mention just one point that will apply to Tasmania. Tasmania has a bush nursing service and a similar service is to be found in New South Wales, but bush nursing services will not come under the provisions of this bill, because they are government-run and government-controlled. Clause 5 (2.) reads -

An organization conducted or controlled by the Government of a State is not eligible for a subsidy.

That provision will exclude all bush nursing organizations as they are constituted at the moment. The organizations in New South Wales and Tasmania are government-run and government-controlled. I spoke to the Tasmanian Director of Health by telephone just before I began this speech, because I wanted to find out one or two things about the organization there. He informed me that a bill would be introduced in the Tasmanian Parliament when it met on 29th October. Honorable members will recall that the Cosgrove Government was returned to office last Saturday.

Mr Hamilton - What about Mr. Bramich? Where is he?

Mr DUTHIE - He will be there too. The Director of Health is altering the set-up of our bush nursing organization. The measure he mentioned will divide the present bush nursing organization into three sections - first, district nursing centres; secondly, resident district nurses; and thirdly, tourist nurses. But, as the organization is constituted at the moment, although it accords with the spirit and letter of this bill, it will not be entitled to Id. subsidy from this Government.

Mr Pearce - What is wrong with that?

Mr DUTHIE - I will tell the honorable member what is wrong with it. Tasmania, like all other States, has been allocated less loan money than before. The Director of Health has been told by the Premier that he must reduce expenditure in his department. The district nursing centres will suffer. Only a limited number of centres will be established in the coming year and only a limited number of district nurses will be appointed. That is a tragedy. It is a pity that this bill does not cater for bush nursing work like that done in Tasmania.

Mr CHANEY (PERTH, WESTERN AUSTRALIA) - Are there any voluntary organizations in Tasmania?

Mr DUTHIE - I do not know why the honorable member has asked me that question. We have no voluntary organizations of the kind mentioned in the bill. All the work in Tasmania is done through the Government and the Department of Health. The St. John's Ambulance Corps is the only really voluntary organization in the State. The honorable member for Perth (Mr. Chaney) has made an interesting comment. He suggests that the lack of voluntary organizations in Tasmania is a credit to our State. It may be.

Mr Chaney - No. The honorable member has misunderstood me. I said just the opposite,

Mr DUTHIE - 1 do not suggest that there are no people in the State willing to do this kind of work, but in the past the organization has been a State organization. The set-up throughout Australia should be considered. Western Australia has the Silver Chain organization, of which it can be proud. But there are only 150 nurses in voluntary organizations in the whole of Australia. Therefore, other States must be in the same position as Tasmania. I hope that the measure mentioned by the Tasmanian Director of Health will so alter the organization in Tasmania that resident district nursing there will come within the scope of the scheme envisaged by this bill. I hope that the new organization will be such that we shall get a subsidy for the nurses operating in the field of district nursing. I ask the Minister to see whether he can bring bush nursing organizations within the ambit of this scheme.

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