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Wednesday, 11 November 1959

Mr E JAMES HARRISON (Blaxland) . - This debate is of considerable importance to any one concerned with the health of the community, and any person who has listened to it and has studied the bill must be reminded of the policy that was followed by the Labour Government that preceded the present Government. We believed that free public hospital treatment was essential for the Australian community.

I believe that the speaker to whom we have just listened, the honorable member for Corangamite (Mr. Mackinnon), who said that we should first consider the taxpayer's capacity to meet the financial requirements of the national health scheme, should certainly take his mind back and then ask himself why it is that we are not still providing free hospital treatment, at the public ward level, for those most in need of assistance. It is the family man, of course, the man who has not the wherewithal to consult specialists, who requires assistance to provide medical treatment tor his family. After all, if we are conscious of our moral responsibility to the Australian community, then we must consider first the family man. We must consider those who are bringing up the future generations of Australia. Therefore, in looking at this legislation, we should ask ourselves the very pertinent question: What does this bill propose to do for the man who is rendering the most valuable service in the community? What does it provide for the man who is rearing his family? What assistance does it give to those who are most likely to be affected by illness, suffered either by themselves or by members of their families?

Let me deal, first of all, with a particular matter in which the Minister for Health (Dr. Donald Cameron) appeared to take some pride. He said, referring to the negotiations preceding the drafting of this measure -

I am happy to inform the House that they have led to the formation of a plan under which medical benefits will be substantially increased for many surgical operations and other costly medical services.

This appears to be a kind of individual legislation, which does not take us very far in a real health programme. Perhaps we could call this corrective legislation. Let me direct the attention of honorable members to a document that was circulated by the Minister, headed, " Proposed Amendments to Medical Benefit Schedules - 1959", I refer particularly to page 11. Every person concerned with this kind of legislation must be impressed immediately with the kind of selection adopted by the Minister or his advisers in determining the small number and amount of increased benefits. I shall go no further than page 11 of this document, a perusal of which will show no less than twelve different surgical operations for which an amount of £11 5s. was provided under the old scheme as Commonwealth assistance. Is it not logical to assume that if, at some stage, the Government intended to adopt a basis of priority for legislation that would provide the maximum amount for serious operations, the same policy would be maintained? But that is not the case. Under the old schedule there were no fewer than twelve items listed at £11 5s., but in the new legislation these items have been divided .into three sections. The Minister said he was pleased that the Government had been able to do something like this, but he should have told us that in respect of these twelve only two are deemed to be so serious as to fall within the category of major operations and attract the higher fee. Some have gone from £11 5s. to £15, some to £18, but only two to £22 10s.

Last night, I heard an interjection to the effect that the Government was indulging in a confidence trick. If the Minister is pleased with this type of legislation dealing with such an important problem, he has every right to have all the happiness he can get out of it, if he can get any at all.

I leave that side of it by repeating what I said at the commencement: Would it not have been much better to devote these extra amounts that the Government now feels disposed to spend in this direction to free hospital treatment for the family man and the person who needs help most? But every action that this Government takes, day after day and week by week, points to the utter neglect of the man with the family or the person on the bottom rung of the ladder. Every step that it takes with regard to taxation or matters of this kind shows a neglect of the Government's real moral responsibility to the family man in our community.

The same principle applies to the fee of 5s. for every prescription. When the Minister speaks of imposing something of this nature, he is not clear. When legislation of this sort comes before the House, members are entitled to know just what is intended by it. Speaking of pharmaceutical benefits, the Minister said that it was intended to bring the new list somewhat into line with the list that is already provided for pensioners. He said -

In any scheme conducted by any government there would necessarily have to be some limitation of the range of drugs falling within it

When this Parliament is called upon to agree to legislation of this kind members are entitled to have clearer details for their information than the Minister has provided on this occasion. We are entitled to know just what the Minister intends by this amendment. We should be informed of the list of items to which this 5s. fee is to be applied.

Mr Wight - Would you like all the drugs in the British Pharmacopoeia included in it?

Mr E JAMES HARRISON - I will not be distracted by interjections of that kind. When the Minister is not prepared to say more than he has said in his second-reading speech, which shows that the Government cannot supply the lot, how can a backbencher try to tell us what the Government can supply? The Minister does not know what the Government can supply. He is dependent upon some " hush hush " committee to tell him from day to day what drugs will be on the list and what will not be. The list is subject to alteration all the time. It is controlled by a committee which has no responsibility to this House whatsoever. In replying to every question that is asked in this House on the issue of health, the Minister uses this committee as his first line of defence. The Minister has said -

In any scheme conducted by any government there would necessarily have to be some limitation of the range of drugs falling within it.

He should give a clear explanation as to just how far this 5s. fee for each prescription will apply.

It is not sufficient to say that the new list will be the same as that covering pensioners at the present time. On about five different occasions I have asked the Minister questions about pensioners who are excluded from medical benefits because of the 1955 means test imposed by a miserable government. The Minister spent some time throwing bouquets at the right honorable member for Cowper (Sir Earle Page) and referring to the work that he did some years ago for the national health scheme. It was some years ago that the right honorable member for Cowper said that if people had to pay for something they would appreciate it all the more. I have yet to meet people who appreciate being sick because they have to pay heavy medical fees in order to get well.

When the Minister was talking about mental institutions he made the admission that mental health is one of the most important problems in our community at the present time. He went on to say that the Commonwealth Government had made £10,000,000 available to the States, not to use in whatever way they wished, but for buildings only. Not long ago a debate took place in this House on the great work that had been accomplished, not as a result of providing buildings, but by providing assistance to combat tuberculosis. As a result, the scourge of tuberculosis in this country has been reduced by not less than 60 per cent.

Last night the right honorable member for Cowper dashed aside the question of mental hospitals and their upkeep; but he knows, as a medical man, that in doing so he is rendering a great disservice to a very needy section of people in this community. In New South Wales, as a result of the Labour Government's legislation, mental hospitals are no longer known as mental institutions; but under the Commonwealth legislation the mentally ill are treated as though they never existed. They become forgotten persons. Their pensions cease, no matter what is their age. The Government does not pay them even a shilling to enable them to buy a small packet of cigarettes or anything to give them some enjoyment. The right honorable member threw aside the opportunity to say something about the medical needs of this great section in our community. Until the Government realizes its responsibility to those who are mentally afflicted and appreciates the fact that they are merely ill - the same as anybody who has tuberculosis or cancer or any other disease - it is neglecting a great section of the community and that is a standing disgrace to the Government.

In no other part of the world does a national parliament brush aside this question as this Parliament has done. In every other country governments are really trying to do something and with the assistance of new drugs many mentally afflicted persons have been cured over a period of years. Surely, when we come face to face with those who are trying to rehabilitate themselves, who have been restored to a measure of health by these new drugs, after having been confined to mental institutions for ten, fifteen or twenty years we should do something to help them. But this Government does not lift a finger to help these people by way of rehabilitation, sustenance or pension or in any other way!

The right honorable member for Cowper, when he talked as he did last night and pointed out that the Government had made £10,000,000 available for buildings, if they were wanted, and left it at that, brought no credit to his profession. I say to the present Minister that until a realistic approach is made to this problem, the needs of the mentally ill will be a standing blot on the community. I know that the Government which preceded the present regime did only something minor for the mentally ill, but at least it did start something and provided some small help towards approaching this problem. The need was not so acute then as it is now. I say to the Minister and to the right honorable member for Cowper that there is a moral obligation on those who control health in this country to assist, whatever the cost, to rehabilitate people who have recently been released from mental institutions as a result of cures effected by modern drugs. Surely, although the Minister has been in the Parliament for some years now, he has not lost touch with the moral responsibility that attaches to members of his profession and to the Government in relation to this problem. I say to the right honorable member for Cowper that, until he adopts an attitude towards this problem different from the attitude he adopted last night, he is rendering a disservice to his profession and to the Parliament.

Now let me return to the expenditure that is involved in this legislation. The Minister said that it would possibly reach £30,000,000 unless something was done. The Minister is a very honorable member of a profession that has an organization which is more powerful than any trade union in Australia. He is a member of the British Medical Association. If that association directed its members, as I believe it should, to avoid waste in the issue of prescriptions, the need to impose a charge of 5s. would never have arisen. I ask the Minister whether the imposition of this charge will correct the position. The imposition of a charge of 5s. will have no more effect than did the imposition of a charge of ls., or even 6s., which now applies in Great Britain.

Mr Pollard - They know that, but they are after the £5,000,000.

Mr E JAMES HARRISON - I am not so sure that that is so. I am not so sure that this is not just another attack on the man with a big family to keep, who needs a doctor more frequently than does the man who is better placed in society. I am not so sure that this Government is not becoming completely unattached from the great section of the community which should be given first priority if we really believe in " Advance Australia Fair ". Every point that it makes is an attack on the family man. The income tax reduction of a flat 5 per cent, meant 3d. for the family man and a big whack for the chap on top, and, on a comparative basis, I include politicians in the latter class. But when it imposes a flat rate charge on prescriptions in this way, surely the cover is torn off and the Government is exposed for what it is. The Labour Party opposes this measure, and I am proud of its opposition. Step by step, this Government is marching towards a situation in which the men with family responsibilities will realize that they have in Canberra a government that is not at all concerned with family life.

This kind of legislation can have only one effect, in the long run. If the Government had cared to use the organizations that are available to it - the B.M.A. and the Pharmaceutical Guild - it would have found out quite conclusively, even from friendly societies alone, that the people who have most prescriptions are the people with the largest families. This type of legislation, which is singularly directed against families, should surely make Government supporters blush when they attempt to justify it. I agree with the honorable member for EdenMonaro (Mr. Allan Fraser), who is leading the fight on behalf of the Opposition. He said that we will fight this to the bitter end. We fight it not because of the charge of 5s. but because of the principle that is involved and because we know that this is a further attack on those Australians, with their families, who are least able to bear the burden of legislation that this Government consistently brings to the statute-book.

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