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Wednesday, 11 November 1959

Mr JONES (Newcastle) .- I do not very often agree with the honorable member for Chisholm (Sir Wilfrid Kent Hughes) but I agree with him to-night on a number of points. One concerns the nationalization which he so greatly fears. I hope that nationalization is ultimately brought about, not only in respect of hospital and medical services, but also on the coal-fields and in the economy as a whole. I support also the criticism and condemnation of the bill by the honorable member for Chisholm.

The purposes of the bill are threefold. First is the proposal to increase medical benefits on approximately 140 items out of 1,000 covered by the scheme. The second is the widening of the definition of hospital treatment to provide for those paying special rates to hospital funds. The third is the gradual extension in the list of pharmaceutical benefits. I believe that the extension of the list of pharmaceutical benefits is the only commendable feature of the bill, and the only one on which we can agree with the Minister.

The proposal to charge 5s. for each prescription dispensed is typical of the policy of this Government over a period of years. Before I proceed with that point, however. I wish to make reference to the remarks of the honorable member for Chisholm about the eradication of tuberculosis. Surely to heavens the honorable member is not seriously claiming for the Government credit for the success of the attack on tuberculosis. The present Government merely happened to be in office at the time when medical science, through the discovery of new drugs and new methods, was able to overcome the scourge of tuberculosis to the great degree that has been achieved. That is something that medical science did for this country, and I hope the same advantage can be taken to other countries, particularly the under-privileged countries, so that tuberculosis can be eradicated there too.

I turn now to the increased medical benefits in respect of 140 items. The Minister said in his second-reading speech -

It is, of course, a matter of great satisfaction to this Government that there has been such strong public support for the purely voluntary scheme which we initiated and fostered. There is no doubt whatsoever that a contributory health benefits scheme on a voluntary basis is the one most appropriate to Australian needs and conditions and that the future of this scheme is now assured.

Let me make an addition to that statement, with the words - " under a Liberal government but certainly not under a Labour government ". I add those words because we of the Labour Party are as much opposed to the scheme as the people opposite are in support of it.

Any honorable member opposite who wants to know how much the people of Australia support the Government's socalled voluntary scheme only has to look at the receipts of the various hospital and medical benefits funds throughout the "ears. The figures for past years, before the Government's scheme was introduced, for the New South Wales fund, which is possibly the largest hospital and medical benefits fund of all, will show how anxious the people of New South Wales were for this voluntary system. In 1933, the income of that fund was £33,757. and in 1949 it was £547,928. That figure shows how much the people were interested in a voluntary scheme, when it is compared with the last yearly figure of receipts for the fund which, as a result of the introduction of the Government's allegedly voluntary scheme of medical and hospital insurance, was £4,515,117.

Why have the receipts of that particular fund grown to this great figure? The reason is that people cannot afford to stay out of the scheme because, as a result of the Government's legislation, if they do not join these funds they will be deprived of the government contribution to their hospital costs, to which they are properly entitled because of the taxation they pay and have paid. So, they are under economic compulsion to join a fund.

As far as the voluntary nature of the Government's scheme goes, it is all right for people who were born with a silver spoon in their mouths. It is a very different story for the ordinary people. Let honorable members opposite go out among the industrial workers of this country and they will find out how many of them want this purely voluntary system.

I can tell you, Mr. Speaker, from experience, that the reaction of the people in industry to-day towards this voluntary scheme is complete opposition. Many workers in industry refused to join benefits funds because of their opposition to the scheme, but, as I indicated before, they were finally forced by economic pressure to join. They could not afford to stay out of the scheme, because, if they had done so, they would have lost benefits to which they were really entitled, having paid for them in taxes. I say to honorable members opposite: Do not ever get the idea that the hospital and medical benefits scheme is accepted by the people. The people as a whole are opposed to it. They always were, and always will be, just as the Labour Party always was and always will be opposed to such schemes which the Government introduces.

Later in my speech I will give the House facts and figures which will clearly show how lopsided is the scheme introduced by the Government under the guise of a voluntary scheme. I believe that facts and figures can be produced to show that the nature of this scheme is in conformity with the Government's policy of giving tax concessions to privileged people on high incomes.

Sitting suspended from 6 to 8 p.m.

Mr JONES - Mr. Speaker,I indicated earlier that this bill deals with the national health scheme under four headings. It will increase medical benefits, widen the definition of hospitals recognized under the hospitals special account scheme, greatly increase the list of pharmaceutical benefits, and impose a charge of 5s. for very prescription.

We in the Australian Labour Party view the national health scheme as a form of governmental assistance to which the people as a whole are justly entitled in order to ensure that the health of the nation is raised to the highest standard that is humanly possible. There is one way to bring this about. That is by a planned scheme in which every one participates. At the present time, we have a planned scheme of sorts. We believe that the Government should introduce a scheme in which all the people can participate on the basis of their need and not on the basis of their ability to pay.

I have taken the trouble to take out some figures relating to this matter. The report of the Commissioner of Taxation for 1957-58 indicates that deductions for medical expenses claimed by taxpayers totalled £80,368,745 in that year. This represents a claim against the Commonwealth Government. These figures are analysed and actual statistics are given in the report. People with a taxable income of £50,000 claimed an average of £93 for expenditure on medical treatment. Taxpayers with taxable incomes of £10,000 claimed an average of £71 in medical expenses; those with a taxable income of £5,000, £54; those with a taxable income of £2,000, £43; and those with a taxable income of £1,000, £27. Taxpayers with a taxable income of £500 could afford to spend the magnificent sum of £14 per annum on medical treatment. This is indicated by the amounts actually claimed in tax deductions.

I feel, Mr. Speaker, that in respect of any health scheme, figures like these must be closely examined and closely analysed to enable us to find out whether the people that have the most money are the ones that can afford these medical benefits - whether they are able to spend money on improving their health, whereas the people on the low incomes cannot afford necessary medical treatment. I have already indicated the position of the taxpayer with a taxable income of £500 a year. This, of course, is not the gross income, but only the amount on which tax is paid. This would be the level of taxable income of a tradesman with perhaps one or two children, and people in this category represent a very large percentage of the whole community. These statistics indicate, Mr. Speaker, that the large mass of the people 1p in the lower-income groups cannot afford i the medical treatment necessary to main- j tain proper health standards. That is why we say that a national health scheme should be non-contributory, rather than, like our present one, based on the payment of a set amount by all.

This brings me to the point at which I propose to discuss the cost of insuring with an organization in order to obtain medical and/ or hospital benefits. Contributions amount to approximately £8 per annum to each fund or scheme. What does this sum represent for people in various income groups? We know that it is allowed as a deduction in arriving at the taxable income. This means that the taxpayer with a taxable income of £50,000 a year receives what amounts to a rebate of £5 ls. 4d. The man with a taxable income of £5,000 a year receives a rebate of £4 8s. Then we come down once again to the large masses of the people in the tradesman and labouring group. The taxpayer with a taxable income of £500 a year receives the magnificent sum of £1 as a rebate in respect of his contributions. The net effect is that the man with a taxable income of £50,000 a year pays £2 18s. 8d. for £8 worth of medical insurance, whereas the man with a taxable income of £500 a year pays £7. Further, as I have already pointed out, the statistics of claims made for deductions for medical expenses indicate that the people in the higher-income groups are spending large amounts on their health and maintaining their well-being, whereas the people in the lower-income groups cannot afford medical treatment.

For these reasons, we say that this whole scheme should be reviewed. The present set-up should be abolished. Let us review the whole thing from scratch. We believe that the total deductions for medical expenses of £80,368,745, which are allowed by the Commissioner of Taxation, represent about £20,000,000 of revenue. Therefore, the Government would gain an additional £20,000,000 of revenue if the present scheme were abolished completely and these claims for deductions were no longer made.

On the Government's own figures, the hospital benefits section of the health scheme costs £14,802,290 a year, and the medical benefits scheme costs £7,779,451. So we could have a completely noncontributory scheme which would cost the Government only an additional £1,000,000 or £2,000,000. However, that would be getting right away from the policy which this Government has been putting into effect during the last ten years by granting overall tax concessions such as the recent all-round reduction of 5 per cent., most of the benefit of which goes to the people in the high-income groups. In fact, 9 per cent, of the taxpayers will receive the benefit of something like 90 per cent, of the total tax reduction. If the Government were to introduce a non-contributory scheme, as I suggest, and abolish the contributory scheme, the whole thing could be financed out of taxation.

I want to give the House an analysis of some other figures which can be checked and which cannot be denied. What does the Government's proposal to charge 5s. for each prescription represent in hard, cold cash in terms of taxation? In the final analysis, every 5s. fee paid for every prescription will be claimed as a deduction for income tax purposes. Let us have a look at the actual figures and see what they disclose. For every 5s. prescription fee paid, a person with a taxable income of £50,000 a year will receive what amounts to a tax rebate of 3s. 3d. so that the net cost of the prescription to him will be ls. 9d. A taxpayer with, a taxable income of £10,000 a year will receive a rebate of the same amount; so that the net cost to him also will be ls. 9d. A taxpayer with a taxable income of £5,000 a year will receive a rebate of such an amount as to make the net cost of the prescription to him 2s 3d. The net cost to a taxpayer with a taxable income of £1,000 will be 4s. Then we come to the bulk of the people - the masses. They will pay a net amount of 4s. 6d. for each prescription.

Mr Pollard - It is a fraud.

Mr JONES - As the honorable member says, it is a fraud. This sort of thing is typical of the policy of this Government. Its whole idea is that all, irrespective of income, will pay the same amount for a prescription.

Mr Bowden - They do not have to.

Mr JONES - The honorable member is not in the chair now. He should know better than to interject, and if he does not stop it, we shall get Mr. Speaker to put him out.

With the introduction of this overall charge of 5s. for every prescription, those that can least afford to pay will have to pay most. I ask the Minister to reconsider the imposition of this charge of 5s. on prescriptions. To forgo it will not break the Government but to impose it will have a very detrimental effect on those people who already can ill afford to go to a doctor to get a prescription. I have pointed out that a man on £10,000 a year who incurs medical expenses of £71, pays only £26 after making allowance for taxation rebate, whereas the man on £500 a year who has medical expenses of £14 receives a rebate of only about £2 8s. Yet the income of the man who receives the larger rebate is twenty times greater than that of the man who received only £2 8s.! When it comes to the purchase of the things that are so necessary for the well-being of a family, there is no comparison between the incomes of these two men; nor is there any comparison as far as their taxation rebates are concerned. It is on this point that I ask the Minister to reconsider this whole question of national health. Can we not get away from the principle of the man on £10,000 a year receiving a rebate of 3.3d. of the 5s. prescription charge while the fellow on £500 a year gets back only 6d. These points are important and should not be forgotten.

As I pointed out earlier, if the Government were to abolish the system of taxation deductions for medical expenses the money that it would save could be used to introduce a full non-contributory medical benefit scheme which would be a credit to the Government and of immeasurable advantage to the people as a whole. I am afraid that the Government is not prepared to do that because it does not believe in the equality of individuals. It believes in the class struggle. It believes that the wealthy should retain their wealth and that the poor should not be assisted.

I hope that the Minister will not permit a set of circumstances to develop in connexion with medical benefits similar to that which occurred some time ago. When the original scheme was introduced the Government provided that in respect of a doc tor's visit it would pay 6s., the fund would pay 7s. 6d., and the individual himself would pay ls. 6d., making a total of 15s. At that time, doctors were charging 15s. for a surgery consultation and 17s. 6d. for a visit to a home. But it was not very long before the doctors increased their fees from 15s. to £1 for a surgery consultation and to 25s. if they visited a patient at home. In addition, they imposed all sorts of penalty rates for visits on public holidays, Saturdays or Sundays or at certain times of the night.

I ask the Minister to ensure that when surgical benefits are increased, doctors will not immediately put up their charges1 for operations so that although a single contributor pays an additional 3d. a week and a married contributor pays an additional 6d. a week, no advantage will be gained from those higher contributions. I ask the Minister to take this point into consideration when he is conferring with the medical profession.

As I said earlier, the people of Australia as a whole do not want a contributory system. They have always been opposed to these alleged voluntary funds which the Minister talks about so glibly. They were only introduced by this Government for the reasons that I outlined when I cited the figures in relation to taxation. It is in conformity with the policy of the Government that the fellow in the high income group shall pay the same for his medical benefits as the man in the lower income group. The Minister did not give any indication of what he is going to do with the various hospitals that are classified, at the present time, as special hospitals. Is he going to have a more sensible and original approach to this matter? I do not suggest that the Minister should include various rest homes and places of that type. But many public hospitals will not permit chronically ill people to remain in their wards whether public, private, or intermediate. Relatives are told, " I am sorry but you will have to take your mother home. We cannot retain her in hospital any longer. She is incurable but she will last for a long time. We are certain that we cannot do any more for her." The young people find that, because of the nature of the illness, they cannot do a great deal for the patient. I am not speaking of hypothetical cases. I have a copy of a letter which has been forwarded to the Minister. I will not embarrass the people concerned by referring to names. But all the 25 people mentioned in this letter are in a condition that would entitle them to be admitted to a public hospital. They are in need of medical and hospital treatment. It is no fault of their own that they are in their present condition. They are all bed-ridden. Yet the Minister refuses to extend hospital benefits to them because the hospital they are in does not comply with his definition of what a hospital should be. This does not hurt the hospital itself. It still gets its fees. The relatives have to find the money to keep the patients in this hospital. So the Government is not hurting the hospital. It is only hurting the relatives by withholding the hospital benefit. So I ask the Minister, when he reviews this question, to give serious consideration, not necessarily to this particular hospital, but to this type of hospital. Patients are placed in these hospitals so that they will be looked after in a fair and reasonable manner. In the hospital of 25 patients, to which I have referred, there are eleven nurses who give them skilled attention.

There are many other points upon which I should have liked to touch but, in view of the limited time that is left to the Opposition to discuss this bill, I shall terminate my remarks. In conclusion, I ask the Minister to abolish this contributory scheme and reintroduce Labour's hospital scheme. Unfortunately, the British Medical Association, with the connivance of the Liberal Party, was able to frustrate the Labour Government and prevent it from introducing its free medical scheme. I ask the Minister to give everybody the right to free medical and hospital treatment and to abandon the principle that those who have should keep it and those who have not, should do without.

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