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Thursday, 18 October 1956

Mr HOWSON (Fawkner) .- Before the dinner adjournment we heard the honorable member for Grayndler (Mr. Daly) attacking, to no mean tune, the social services policy of this Government. I should like to join issue with him in regard to much of what he said, because no government has done more for the welfare of the Australian people than has this Government over the last seven years. This bill is yet another example of the principle upon which our social service legislation is based. We aim to help those who are prepared to help themselves. That policy has been clearly demonstrated in the provision of homes for the aged. This Government has contributed to that scheme on a £l-for-£l basis with charitable institutions.

Under the bill organizations providing nursing services in town and country districts will be helped by both the State and the Federal governments - each will play a part. That surely must be a better method than Labour's old policy of conducting a completely socialized service under which everything is paid for by the Commonwealth Government and nobody need take any interest in whether the money is spent wisely or not. Therefore, I wholeheartedly commend this bill to the House as a far-sighted measure that fulfils a long-felt need. I would only say that in my opinion it possibly does not go far enough, but that can always be remedied in the future.

For many years I have felt the need in my own State of Victoria for expansion of the home nursing service. There is no doubt that a patient .is able to get better much more rapidly if he is being nursed in his own home. The matter of expense has also to be considered. I should like to examine the advantages of the bill from the point of view of the public hospitals, so many of which, in Melbourne especially, have beds occupied by old people who cannot be evacuated to their own homes for lack of an adequate nursing service. There is a tremendous need, in Melbourne and Sydney especially, for the after-care of patients who have been seriously ill. I have in mind particularly older patients. This bill, by helping to expand the home nursing service, will enable old people to leave public hospitals very much sooner after their operation, or period of acute sickness, with the assurance that they will be well looked after during their convalescence.

I should like to speak now as the president of one of the great teaching hospitals of Melbourne. We have for a long time had lengthy waiting lists of people seeking operations of particular difficulty. There are only a limited number of beds.

Mr Wheeler - Which hospital is that?

Mr HOWSON - 1 refer to the Victorian Eye and Ear Hospital, which deals with blindness, and certain diseases of the ear, nose and throat, which probably cannot be treated as efficiently anywhere else in the Commonwealth. If we could feel absolutely certain that some of our patients could be sent to their homes for nursing after an operation and be well cared for, we would be able to cope with the many applications for admittance. That is the main benefit that will accrue from this bill.

Turning now to the other main needs of the special teaching hospitals in Melbourne and Sydney, I should like to join issue with the honorable member for Isaacs (Mr. Haworth) on this matter of the high cost of building hospitals. Possibly he did not distinguish between the special needs of the teaching hospitals and those of the ordinary country and general hospitals throughout the Commonwealth. Already we have seen, especially in Victoria, that the needs of the country hospitals are really being taken care of. If the proposed augmentation of the home nursing service becomes a reality we can say that, within a reasonably short time, there will not be a scarcity of hospital beds in the general hospitals. But there will remain the special needs of the teaching hospitals.

As the Minister for Health (Dr. Donald Cameron) remarked in his second-reading speech, each bed in a teaching hospital costs about £7,000. In view of the tremendous number of specialized services that have to be provided that ought not to be considered an exorbitant sum. I refer to such things as the cost of special nursing, of the teaching of both doctors and nurses, and of the research that is always carried out in a teaching hospital. Those costs are inescapable if Australia is to remain in the forefront of medical practice.

Mr Haworth - How does the honorable member reconcile that with the costs in the United Kingdom?

Mr HOWSON - Research centres are separated from teaching hospitals to a much greater extent in the United Kingdom than they are here. I can only speak, of course, of the realm of ophthalmology. There is in London a special research institute, and it is financed independently of, say, the general eye hospital at Moorfields. In this country the funds for both research and general treatment must be found by one institution. The honorable member for Isaacs possibly did not realize this.

The main teaching hospitals are to be found in Sydney and Melbourne. Their costs are continually rising and the services that they now provide may have to be curtailed in the very near future.

Mr Galvin - Why does not the Government do something about inflation?

Mr HOWSON - I point out to the honorable member for Kingston (Mr. Galvin) that the provision of assistance to hospitals is chiefly a matter for State governments. This scheme is an indication of the way in which this Government is prepared to go out of its way to help the State governments to provide hospital services. The teaching hospitals are in need of assistance, and I want to put their case to the Government. If we want to maintain the present standards of medical teaching and research in Victoria, an extra £2,000,000 a year for the next ten years must be made available for building purposes to the eight main teaching hospitals. This Government and the State governments have done a great deal for the welfare of the people by providing hospital and health services, but it will be impossible to continue those services unless an' adequate number of doctors and nurses is trained - and that training can be given only in the teaching hospitals. The Eye and Ear Hospital in Melbourne may have to curtail certain essential services in the very near future. The Alfred Hospital, in my electorate, is in a similar plight. lt is finding difficulty in financing its day to day expenditure and its building programme.

We should not neglect any opportunity to bring the needs of the teaching hospitals to the notice of this Government. The work of training doctors must be carried out in conjunction with research work. No programme for teaching either doctors or nurses can be efficient unless, side by side with it, there is a research programme, because research enables a hospital to keep ahead of the needs of medical practice. Only if the needs of the teaching hospitals are met will there be available in future enough nurses to enable the scheme that we are now considering to be extended. The future efficiency of the scheme will be jeopardized if there are not enough nurses available to enable it to be expanded. I agree with the Minister that married nurses will be able to come into the new service on a part-time basis. They will fill a gap in the immediate future, but the supply of nurses must be maintained - and it can be maintained only by an expansion of the teaching hospitals.

I commend the bill to the House. It will help to reduce the present long lists of people waiting for admission to hospitals. When the scheme comes into operation, patients will be able to leave hospital much sooner than now because nurses will be available to look after them in their homes. In addition, many old people will be cared for at home and it will be unnecessary for them to go into hospital. A feature of the scheme that must not be overlooked is that patients who are cared for in their homes probably will get better much more quickly and much more happily than at present.

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