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Thursday, 18 October 1956

Mr DALY (Grayndler) .- I support the remarks of other honorable members on both sides of the House who have commended this measure. It is good to see that there is among them a great deal of common ground in their opinions on the problems of the aged sick and infirm which are highlighted by this bill. Although 1 commend it, I intend to offer some constructive criticisms in relation to certain aspects of it and of the Government's treatment of the aged, particularly in relation to their need for hospital treatment. At the outset I wish to commend and compliment the nursing profession on its great contribution to human welfare. I think no words uttered by myself or by any other member of the Parliament could suitably honour the profession for its contribution to social welfare in Australia and other countries. This measure is long overdue. I think that' if the Labour government had remained in office in 1949 a measure such as this would have been implemented forthwith. Although the bill is long overdue, it is nevertheless acceptable, and it will go some way towards meeting the costs of home-nursing services. But much more could have been done a great deal earlier.

I propose now to deal generally with the second-reading speech made by the Minister for Health (Dr. Donald Cameron), who at one point mentioned the national health scheme. I believe that every one in the community, whether rich or poor, is entitled to the best of medical attention in time of sickness, whatever scheme must be implemented to provide it. Any hospital scheme, whether or not it be a socialized scheme, that does not provide for the poor as well as the wealthy is not deserving of the support of the people of any country. If it does not give full benefits immediately a person requires medical attention, it lacks the essentials of a national scheme designed to meet the people's needs. The Australian Labour party's policy on this aspect of social services is well known. Labour believes that medical and hospital treatment should be available to all, and the Labour government, in the closing years of its term of office, made tremendous progress towards providing for all sections of the community medical and hospital services commensurate with the needs of all without regard to income. But to-day many people, both young and aged, are urgently in need of medical attention which they are unable to obtain because, as has been pointed out, there is a great shortage of hospital beds.

I happened to be a member of the Joint Committee on Social Security, which, on 15th February, 1944, presented to the Parliament a report on a Commonwealth hospital benefits scheme. Other members of the committee were Senator Cooper, who is now Minister for Repatriation, Senator Dorothy Tangney the present honorable member for Parkes (Mr. Haylen), the late Rupert Ryan, Sir Frederick Stewart, and Mr. H. C. Barnard, who was chairman. Sir Frederick Stewart and other members of the committee could not in any sense be regarded as socialists. Yet the committee presented a unanimous report recommending that the people of Australia should enjoy without the application of a means test, free treatment in public hospital wards! The committee recommended not only the provision of free hospital treatment, but also a scheme under which sufficient hospitals beds might be provided for the free treatment of the people of Australia. The committee's first recommendation was -

Payment by the Commonwealth from a fund raised by taxation for the purpose of a subsidy of 6s. 6d. per daily occupied hospital bed, for general medical, surgical and obstetric cases, conditional upon ... -

(a)   provision of public bed accommodation without additional charge to a patient . .; or

(b)   an allowance, equal to the rate of sub sidy towards the cost of an intermediate or private bed in a public or private hospital of an approved standard . . . ;

(c)   payment into a trust account for the ex tension and improvement of hospital services of any savings resulting to a State from the payment of this Commonwealth hospital benefit subsidy

It was estimated that by postponing the payment of Commonwealth hospital benefits for a year we should be able to build up a fund of approximately £4,250.000 to provide for the improvement and construction of the hospitals that would be needed to give treatment to all who would want it. It was considered that if the scheme were to be introduced immediately, not many people could not be provided for. The committee's report contemplated an expenditure of £10,000,000 on hospital services. At the present purchasing power of the £1 that would be equivalent to £30,000,000 to-day at a very conservative estimate.

Had the present Government implemented that scheme it would have relieved much of the distress that the Minister mentioned in his second-reading speech. This Government must stand condemned for destroying the free hospital treatment scheme by pointing a gun at the States as it were and denying them funds. The people of Australia to-day need a government pledged to give them free hospital treatment and social services without the means test, which is forcing people everywhere in Australia, except in Queensland, to pay heavily for hospital treatment in negation of the scheme that was introduced at the behest of all parties in the Commonwealth Parliament. The Queensland Government has stood firm on the question of free hospital treatment. It is interesting to note that this Government wishes to forget that it has denied the people free hospital treatment. Government supporters do not mention that to-day the people are paying heavy charges for treatment in the public wards of hospitals because this Government has repudiated part of its former policy and has refused to keep hospital costs down and to proceed with an extensive construction programme.

I notice that the Government says that it is necessary to pay subsidies to homenursing organizations because the cost of treatment has increased greatly. The Minister pointed out that new hospitals cost at least £7,000 a bed to construct, and that it costs £3 a day to maintain a bed in a hospital. I accept the figures as accurate, for that certainly seems to be the state of affairs. But the Government deserves no commendation for its administration of hospital finances. In 1944, when the Social Security Committee presented the report that I have mentioned, 6s. 6d. a day represented approximately 50 per cent, of the cost of maintaining a bed in a hospital, which was then 12s. lOd. a day. We are now told by a government which boasts of its social services programme and its sound economic policy that since 1944 costs have increased by several hundred per cent. The Government must accept the full responsibility for its failure to take effective measures to keep costs down. Its approach to these problems throws overboard the principles enunciated in the report of the Social Security Committee, which was supported by honorable members on both sides of the House. This Government has turned its back on programmes that were implemented by the Chifley Government as a result of that report. Had that report been given effect with respect to subsidies since the Government assumed office, had effective measures been taken by the Government to provide a sinking fund for hospitalization, and had economic measures been introduced to keep down the costs of hospitalization, we would not have been in the parlous state that we are in to-day.

I agree that some measure is necessary in order to relieve the demand for hospitalization. In my own constituency many thousands of aged, sick and infirm people are unable to get hospitalization. Whilst I do not disagree with the speeches of the honorable member for Balaclava (Mr.

Joske) and the honorable member for Moore (Mr. Leslie), it is not correct to say that this scheme is designed for people who do not require hospital accommodation. The Minister for Health, in his secondreading speech, said -

The majority of patients nursed are those with long-term illnesses such as patients suffering from cardiac disease, arthritis, incurable carcinoma, and so on. Many of these patients are very ill and would be transferred to hospitals and other institutions but for the serious shortage of hospital beds.

What I fear is that this legislation represents a side-stepping attempt by the Government to escape its responsibility to build many more hospitals in this country, to give funds to the States to provide beds and to provide for cases which cannot be adequately catered for in homes. I do not make that statement as destructive criticism. But I hope that Government supporters will not accept the bill as being all that is required because it provides for the payment of a small subsidy, and escape the grave responsibility of seeing that hospitals are built to provide for all who may be aged, sick and infirm.

Mr Hulme - That is a State responsibility.

Mr DALY - It is a State responsibility, admittedly. But the people who control the purse-strings of this country are the members of the Commonwealth Government and the Commonwealth Treasurer. This Government has seriously curtailed the loan moneys and other moneys available to the States and has demanded that they cut down on hospital building. The Government will not give the States enough money to enable them to build hospitals, and the States, as the result of this Government's maladministration, cannot meet the high cost of building. The Government should get back to tors on that question. It is all very well for the Government to say, " That is a responsibility of the States. They should be building the hospitals ". The Government tells the States, at every conference of Commonwealth and State Ministers, to cut down expenditure on schools and hospitals.

Sir Philip McBride - That is not true.

Mr DALY - I know it is true. It serves the Minister for Defence (Sir Philip McBride) no good purpose to interrupt because he has plenty on his mind with the aircraft industry and Sir Frederick Shedden. I point out these matters in order to show the Government that, whilst this is a necessary and a good measure, the Government has certain responsibilities which, I hope, it will not side-step as the result of the implementation of this legislation.

The Minister for Health has estimated that the Commonwealth will save, under this scheme, £4,000,000 per annum on the maintenance of beds, and £20,000,000 in capital expenditure. Like the Minister, I am inclined to think that these savings have been very conservatively estimated. We may save four times that amount. In view of the million or so pounds which, I presume* are involved in this scheme and the tremendous benefit to the Commonwealth Treasury from the saving on the maintenance of beds, the Government should apportion that sum of £20,000,000 to the States in order to provide hospital beds for the people who urgently require them.

Again, I point out these matters in order that honorable members will see that, whilst the measure is good as far as it goes, it is belated. In addition, the Government has certain responsibilities which, I hope, it will not endeavour to escape. Many of our aged, sick and infirm people are housed in rest homes. With other honorable members, I say that some rest homes are very well conducted and that the sick and aged are well cared for in them. At the same time, I think that there are a lot of rest homes, particularly in my own State, which should be looked over very carefully, because some people undoubtedly exploit the aged and infirm in order to make a few pounds out of their suffering. That kind of thing must be removed if we are to do justice to these people. The Commonwealth, by granting to the nursing organizations the assistance proposed, will make a contribution to the -solution of this problem.

What amount is involved in this bill we are not exactly told, and I realize that it is very difficult to estimate. But it is beyond doubt that only a very small amount will be allocated to this important section of our social legislation. As the honorable member for Wilmot (Mr. Duthie) said earlier, there are only about 150 nursing -sisters engaged in this calling throughout the length and breadth of Australia. That is a small number, when one considers that there are 9,000,000 people in Australia, and that many thousands of them are aged, sick and infirm. I hope that this bill, even if it does nothing else, will bring into this section of the nursing service many more nurses who could be fully occupied, not only throughout the metropolitan areas, but throughout the country districts. If the bill does nothing else, I hope that it will encourage people to join this service so that the organizations may meet their commitments. I cannot see much reason why the Government could not subsidize every nurse engaged in this service if there are only 150 of them. A tremendous amount of money would not be involved. Of course there are the difficulties, as the honorable member for Wilmot has outlined, in respect of an increase of this nursing service and, at the same time, there may be several difficulties which it might be administratively impossible to overcome. Undoubtedly, the department realizes that, and may yet find that it will be advisable to amend this bill in order to cover all nurses involved, instead of only one or two of a particular type.

I do not wish to speak at much greater length on this bill, but I make these comments in order that honorable members may know that all is not well with respect to the social services programme. A great responsibility devolves on this Government to introduce further legislation which will benefit the people whom we seek to benefit by this legislation - the aged, the sick and the chronic sufferers. I do not want to be uncharitable to the Government. I think that the Liberal party and the Australian Country party in this Parliament' are no different from the conservatives in other countries. They do not believe in social services legislation. They introduce it only because they know that they will not be re-elected unless they give effect- to social services programmes. There may be some humane members amongst Government supporters. I believe that the honorable member for Moore is a charitable person. But the history of Liberal-Australian Country party governments reveals that they have given effect to social services legislation only because they know that the people will reject them unless they introduce legislation of the kind that Labour has pioneered for the benefit of the people in the social justice sphere. Throughout, it will be found that the socail services legislation of Liberal-Australian Country party governments has been to a great extent piecemeal legislation. I should like this bill to be amended to enable every nursing sister to be covered by it.

I will summarize my views by saying that 1 hope the Government will not sidestep its responsibility in regard to hospitalization. 1 hope that additional grants will be made to provide adequate hospitalization for everyone who needs to go into hospital in the great country centres and the great metropolises of Australia. In my own electorate I have known cases in which people have died because of lack of attention. We must have beds for chronically ill people. The nursing services will find it impossible to cater for chronic cases in certain instances. Unless beds are made available for them, those people could die much earlier than would normally be the case. Therefore, whilst commending the measure as far as it has gone, whilst realizing that the Government is endeavouring, in this case, to do something for the aged and sick, and whilst realizing that the aged and the sick - particularly those who cannot get into hospital yet desire to do so - will receive some benefit from the bill, at the same time I think that it only goes a fraction of the way that it could go to provide an over-all cover. I think that the big problem of social services in this country is that too many people pay too much attention to the question of the pounds, shillings and pence associated with the provision of such services, instead of supporting the introduction and implementation of- legislation to make social services available on a wider scale. The Government can find plenty of money for atom bombs and hydrogen bombs, and for war needs or defence needs, and I am no' quibbling .about that; but surely it is not too much to expect that a fraction of the amount expended on the means of war could be put aside for expenditure on building hospitals and on providing hospital beds even at a cost of £7,000 each, and also on providing free hospital treatment for people who need it. Surely it is not too much to expect that 150 nurses throughout Australia can be paid more than the bill provides for. particularly when we consider that the budget provides for an expenditure of £1,200,000,000, and that the Treasurer is budgeting for a surplus of £108,000,000 - a surplus which will probably be distributed as tax concessions among the wealthy supporters of the present Administration.

With these few constructive comments, and with my criticism of the Government's policy on social services, my commendation of what has been done, and my compliments to the nursing profession, which will benefit by this bill, I close my general remarks, but I wish to express a hope thai the Minister for Health, whom 1 regard as a sincere man, and therein quite different from many of his colleagues, will consider expanding the programme provided for in the bill so as to cover a wide field of social services. Whilst I am not very hopeful, I have some little hope that I will be in this Parliament when some party introduces legislation giving social services cover to every person in the community, because I believe that the sick, the infirm, the people who fall on evil days in respect of health and require medical attention, are entitled to it. Any government that does not give effect to a policy of providing a full cover of this sort in social services is not deserving of the confidence of the people and will not get that confidence.

Sitting suspended from 5.58 to 8 p.m.

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