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Thursday, 18 October 1956

Mr THOMPSON (Port Adelaide) . - This is a bill for an act to provide for the grant of subsidies to home nursing organizations. I am afraid that in the course of the debate we have wandered far from the bill. The honorable member for Fawkner (Mr. Howson) said that an additional £2,000,000 a year was required by teaching hospitals of Victoria for building. Thisbill will not go far in that direction. However, it does represent the first step along a. road that we must travel.

I compliment the Minister for Health (Dr. Donald Cameron) on this proposal to assist nursing societies which care for people in their homes. I do not know the position in Sydney or Melbourne, but I do know the position in South Australia. In that State, the organization that will benefit most under the scheme is the District and Bush Nursing Society. I do not know of any other organization of any size in the State that will be entitled to a subsidy. The District and Bush Nursing Society has had a very hard row to hoe. I have been a subscriber to the branch of the society in my district for the last quarter of a century. For years I was an active member of thecommittee in Port Adelaide. As a vicepresident of the society, I became aware of the difficulty of finding enough money to carry on with the work.

I should like to put a question to the Minister now so that, if he wishes, he can. reply to it later in the debate. Will this scheme apply to the District and Bush Nursing Society in South Australia as a whole, or will it apply only to the districts where the people raise funds for the nurses?' I assume that it will apply to the society as a whole. There is a central body in Adelaide, and the suburban municipalities have branches in their districts. In my electorate, we have the Woodville District and the Port Adelaide District, which covers the Semaphore area. I think there are only twonurses in each of those districts, so they have a lot of work to do.

The benefit to the community that will' accrue from the operation of this scheme, asthe Minister has stated, is that help will be given to people who need attention that cannot be given to them at home by their relatives, but who are not ill enough to require to be kept in a hospital. Some of the patients treated at home by the district nurses are suffering from heart disease. In some instances, the nurse has to visit them every day. Other people are suffering from the after-effects of strokes, as we call them, and are unable to look after themselves. Others are suffering badly from arthritis and need expert nursing attention frequently. The district nurses help those people considerably. Patients occasionally need injections, some of which may be given by relatives, but others must be administered by a qualified nurse or physician. Those nurses are kept very busy indeed. Over the years, our difficulty has been to raise sufficient funds to retain the nurses in our district. Continually rising costs have made this very difficult. As stated by one honorable member opposite, these nurses usually have small motor cars for transport purposes. Without them, the nurses would not be able to fulfil their duties and meet the calls upon them. It takes quite a lot of money to meet all the expenses, apart from the salaries of the nurses. In the poorer districts of the metropolis many patients are not able to make any contribution whatsoever for the services received. Others make small donations to the society or branch in return for the assistance obtained from the visiting nurses.

This measure represents a forward move by the Government, but it is only a first step. I do not think that initially it will make an appreciable difference to hospitals. Some effect, but not much, will be felt. The Minister spoke of extra hospital beds being made available and the saving of the cost of new hospital accommodation. He said that the capital cost for each bed averages about £7,000. I can appreciate that this scheme will help to a degree, but I would say, not in a carping spirit, that the effects of the Government's actions on hospitals in my own State will make it more necessary than ever for home-nursing activities to be intensified. Adelaide Hospital has, on an average, over 700 inpatients. It is quite a big hospital and for years accommodation and treatment have been entirely free. Through force of circumstances, South Australia has very recently - in fact, during the last few weeks - been compelled to introduce a system of payment by patients of the Adelaide

Hospital. This action has been caused partly by the provisions in relation to Commonwealth grants to South Australia. Western Australia, and Tasmania, whereby they have to charge for public services approximately the amounts charged by the bigger States. In order to qualify for a grant, they have been forced to come into line with the other States. In Adelaide Hospital every inmate, other than age pensioners, is being charged a fee, according to his means. There is provision for assistance to destitute people, but many persons who in the past have gone to Adelaide Hospital will not be able to go there now because they cannot pay the fees being charged. I stress that the hospital is not charging extortionate fees in comparison with the fees being charged elsewhere. The result, to my way of thinking, will be a greater need for district nurses than has existed in the past. The Minister may say. logically, that more beds will thus be made available in the hospital. The waiting list may be reduced to a degree, but the charge may also be the means of keeping out of hospital some persons who should be admitted for expert attention.

To support this bill is to support a course which many years ago I said the Commonwealth should take. In fact,, when I first came to this Parliament, I told the people in my electorate that if I were ever given an opportunity in Parliament to do anything at all for the aged and infirm, I would urge that action be taken. Although we provide social services benefits and pensions for aged and invalid persons, we could do more to assist in providing hospital treatment. It has been said to-day that hospital services are the responsibility of the States. I do not know whether the States would bc prepared to hand over to the Commonwealth control of hospital services, but 1 think that even under the Constitution in its present form the Commonwealth could provide for hospital treatment of age and invalid pensioners. On that point I may be contradicted, but I hope to see that step taken in the future. In introducing this legislation, the Minister acknowledges that the Federal Parliament is responsible, to a degree, for the nursing of the people and the subsidization of nursing services. This is a step in the direction that I have mentioned.

Another benefit which will flow from me extension of nursing services may be felt by aged persons, whether pensioners or not, where one partner is sick and the other is not able to look after the sick one, and they have to go into a government institution. There are a few places where husband and wife may enter the same government institution; generally there are separate wards for men and women. Some years ago I happened to be in Queensland and I went by boat to an island, the name of which I forget.

Mr Luchetti - Was it Magnetic Island?

Mr THOMPSON - No, it was an island in Moreton Bay, near Brisbane, on which was established a home for old folk. I understand that the institution has since been removed to the mainland. The superintendent met our party and he took my wife and me and a member of the Queensland Parliament over the institution. He showed us the barriers between the female and male sections. The wives were behind an iron curtain, as it were, on one side and the husbands on the other side. 1 thought that such segregation was inhumane. The same conditions prevail to a degree, perhaps without dividing fences, in other States. Persons have come to me and said, " We do not know what to do. We have become so old that we cannot look after ourselves at home. If we enter an institution we shall be parted and we want to remain in our own home ". I think that that sentiment expresses the desire of old people generally. We need adequate provision for the care in their own homes of old people who are sick. I believe that this measure will help towards that end. I am concerned to know how this scheme will apply to people in rural areas. Let us lake, for instance, a small country town. I do not know that many such towns have voluntary nursing organizations. Some may be visited by district nurses periodically, but I do not think many of them would have organizations to provide daily service. lt seems to me, therefore, that although the scheme will be of assistance, it will be of greatest assistance in the cities and large towns.

On perusing the second-reading speech of i he Minister for Health-

Sir Phillip McBride - And a good speech, loo!

Mr THOMPSON - I do not deny that. I am complimenting the Minister for bringing this bill forward, and I think that' the Minister for Defence (Sir Phillip McBride) appreciates that 1 am doing so. The Minister for Health stated -

In general terms, the Commonwealth's policy will be to grant to non-profit making homenursing organizations now in the field subsidiesapproximating 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.

That means, as the Minister has said, that the degree of subsidy will depend on the number of nurses employed by an organization. The Minister went on to say -

Thus, if an organization has ordinarily employed, say, ten nurses during the past year and increases ils staff to twelve nurses when this scheme commences, it will receive a subsidy approximating the salary of the two additional nurses; if it increases its staff to fifteen nurses it will receive a subsidy approximating the salary of five additional nurses.

Again, I ask the Minister whether, if an organization increases its staff from ten nurses to fifteen nurses and the subsidy paid by the State government is not sufficient to meet the cost of those additional five nurses, the full cost will be met by the Commonwealth. I understand that it is the intention of the Government, under this measure, to provide an amount of subsidy not exceeding that paid by the State governments. Therefore, if the number of nurses were increased from ten to fifteen, or by 50 per cent., would not the amount of the Commonwealth subsidy depend on the subsidy being paid by the State government?

I know that the Minister is not responsible for statements made by other honorable members during the debate, but he will remember that the question of eligibility for the subsidy has been raised. Clause 5 (1.) of the bill states -

Subject to this section, an organization which conducts a home-nursing service and is carried on otherwise than for the purpose of profit or gain to its individual members is eligible for a subsidy.

So far as I can see, that is the only kind of organization that is eligible to receive the subsidy. As I stated earlier, it seems to boil down to the fact that, in South Australia,- the only eligible organization will be the District and Bush Nursing Society. The Minister went on to say that if new organizations were formed they would be entitled to subsidy, in respect of the new nurses "employed by them, equal to approximately half the salary paid to each nurse employed on home-nursing duty. I suggest to the Minister that the formation of new organizations will depend largely on whether they are eligible for subsidy by the State governments.

Sir Philip McBride - Surely the State governments will come to the party.

Mr THOMPSON - Yes, I imagine that they will subsidize such organizations, but I maintain that the extension of this form of nursing depends largely upon the degree of State subsidy.

I am not criticizing the Minister in relation to this matter but am merely putting forward points that I think should be clarified. I do not want to debate this bill simply for the sake of doing so. I have been trying to make constructive suggestions with a view to extending the steps which the Minister has already taken. I should particularly like to know what the position will be in areas where there are no day nursing organizations, and I point out that it is not possible to have a daily home nursing service unless there are nurses on the spot all the time. I should also like to know whether the Minister has in mind the provision of assistance in areas remote from the head-quarters of the nursing organizations. In conclusion, I support the measure. It is a departure from previous practice and should receive the commendation of the House. At the same time, we on this side of the chamber would like to see a wider and better scheme than that proposed by the bill.

Debate (on motion by Mr. Pearce) adjourned.

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