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Thursday, 12 November 1959

Dr DONALD CAMERON (OXLEY, QUEENSLAND) . - in reply - I do not want to detain the House very long in winding up this debate, so I shall refer to only a few matters. Many of the points raised by honorable gentlemen have been, I think, covered already fairly adequately in my second-reading speech and many others can be dealt with at the committee stage. However, I should like to deal with one or two points.

First, I want to refer to what may be a comparatively minor matter that was raised by the last speaker and other speakers. That was the point that I may have carried my negotiations with the chemists to a conclusion before introducing the bill. It may interest honorable members to know that the bill was introduced before negotiations had been completed with the complete approval and agreement of the chemists and the friendly societies. They agreed that this was an appropriate procedure. As I have pointed out before, the passage of the bill will not in any way impede the negotiations that are going on with those bodies and which I think I can say have been in many respects now largely brought to a successful issue. The subject of repeat prescriptions was, I think, made clear by the Treasurer (Mr. Harold Holt) when he first announced these proposed charges. He said that people requiring constant supplies of drugs in order to maintain their health will be safeguarded in the quantities made available to them without having to obtain frequent fresh prescriptions and pay repeatedly for those prescriptions to be dispensed. Of course, the quantity prescribed will vary from one drug to another, but adequate arrangements will be made to safeguard those people.

Let me briefly refer to patients in hospitals who are transferred to special account because they reach the age of 65. A contributor who is referred to special account and who goes to the hospital will get - and has for twelve months been able to get - whatever rate of benefit he insured for, until he exhausts his maximum fund benefit period.

Mr Thompson - It is usually thirteen weeks.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - It is about 80 or 90 days. After he exhausts that period, because he is in the special account he then drops down to the standard rate of fund benefit which is 16s. a day and which continue indefinitely. Prior to the introduction of the special account procedure he dropped down to no fund benefit at all so there is a very desirable advantage in this measure. If the contributor is hospitalized for a pre-existing ailment and is in the special account he is paid from the special account fund, benefit at the rate of 16s. per day indefinitely. Previous to the introduction of the special account procedure he was paid no fund benefit at all. So, surely it must be perfectly plain that the special account procedure has been of immense benefit to a lot of people.

Mr Thompson - Is that additional to the government payment?

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - It is in addition to the Commonwealth benefit which is paid and always was paid, making 36s. a day. In these circumstances it is a little strange to talk about the special account procedure preventing elderly people who are transferred to the special account from receiving any benefit. In fact, they receive a much greater benefit than they did before the special accounts were introduced.

The honorable gentleman asked about the payment of hospital benefit to patients in private hospitals. The hospital benefit is paid for hospital treatment. There are a number of quite worthy institutions which are registered by State governments as hospitals, for their own purposes - mainly for purposes of control. They are not all recognized by the Commonwealth Government for the payment of special account benefit and they were never, in the main, recognized by the funds for the payment of hospital benefit. But by the special accounts procedure, as it is now being amended, individuals in these hospitals, if they fulfil the conditions set out in the bill, will, on approval by the DirectorGeneral, be able to receive fund benefit from the special account. The conditions set out in the bill are, broadly, that patients are suffering from a condition which would normally require treatment in a public hospital and that they are, in fact, receiving treatment substantially equivalent to that which they would receive in a public hospital.

These are great gains and it is extraordinary to talk of them as though people were being deprived of hospital benefit. It is not appropriate to pay hospital benefit in respect of institutions which are, in fact, benevolent homes. They may be very worthy institutions but they are not hospitals and these are hospital benefits. This Government has made a great contribution to homes for old people. It has extended the social services available in these circumstances very widely.

I want to touch on one other matter which was brought up by the honorable member for Eden-Monaro when he first spoke in this debate. He referred to a document which he alleged had been sent to State governments making certain demands. So that there will be no mistake about this, I shall read to the House his exact words. He said -

Nevertheless, the fact is that the Commonwealth is now demanding that every hospital patient must pay the new tax in future, whatever his means and whatever ward he may be in. It is no use the Minister denying this because I understand that the Commonwealth has already, in writing, informed various State governments of its determination in this respect. This means that unless State governments bear the cost themselves, a new charge will now have to be imposed, probably for the first time in hospital history, on patients in public wards, for drugs which have never previously been charged as extras in public wards

At that stage the honorable member for Lalor (Mr. Pollard) interjected, " Outrageous ", and the honorable member for Eden-Monaro went on -

It is outrageous, as the honorable member for Lalor says. Similarly, a new and additional charge will have to be imposed upon outpatients in public hospitals. For them, in the past, drugs have generally been provided at cost, or less than cost, and in many instances no charge at all has been made. But now the Commonwealth Health Department has served notice on the State governments that, in future, this practice must cease. The poor must be made to pay to the last penny.

I then interjected, " That is a pure flight of fancy ". The honorable member went on -

I declare this to be based on an official statement by the Department of Health in writing.

A little later in the same debate, after an interchange with my colleague, the Minister for Labour and National Service (Mr. McMahon) the honorable member for EdenMonaro said -

I challenge the Minister to go back to his department and to produce for the benefit of this House the actual document, signed by the Commonwealth Health Department, that has been sent to the various State governments.

Those are the words of the honorable member for Eden-Monaro. I want to say, categorically and specifically, that there is no such document. Not only is there no such document, but no such demand has been made to State governments. With one trivial exception which I shall explain to the House, there has been no correspondence betwen the Commonwealth and the States on this matter. The trivial exception is that on 31st August, the secretary of the Hospitals and Charities Commission of Victoria wrote to the Commonwealth Director-General of Health pointing out that the new arrangements would raise some problems for hospitals and saying -

We shall be glad if you will kindly consider these matters when preparing the amended pharmaceutical benefits scheme and ensure that the special position of the public hospitals in the scheme is safeguarded.

To that, one of my assistant directors quite properly replied - and this is his whole letter -

I refer to my letter of 31st August, 1959, in which you raised certain questions regarding the application of the new pharmaceutical benefits proposals to public hospital patients. We have given this matter some thought and we would like to discuss it with you at some mutually convenient time within the next few weeks. We will telephone you within the next day or so and make an appointment if this is convenient.

That is the entire letter. There was no threat, no suggestion, and no direction - nothing of that kind at all. It was in a perfectly proper and precise form. I want to repeat that that correspondence is the entire correspondence which has passed between the Commonwealth and the States on this matter.

Last night, when my colleague the Minister for Labour and National Service spoke in this debate he again pointed out that the document to which the honorable gentleman from Eden-Monaro had referred did not, in fact, exist. The honorable member for Eden-Monaro, by interjection, said that it did exist and that he had checked it.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - I checked the facts and I got them absolutely right and you know it.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - I shall quote the statement of the Minister for Labour and National Service accurately. He said that the honorable member for Eden-Monaro had said to me -

It is an official statement by your department. The Commonwealth Department of Health has informed the various State governments that it requires the payment of 5s. on each prescription dispensed in hospitals.

As I have just indicated by my quotation from another part of " Hansard ", the honorable member for Eden-Monaro not only declared that the demand had been made but also that it had been made in writing. The honorable member for EdenMonaro replied to my colleague -

I checked on that to-day with the New South Wales Minister for Health, and it is correct.

This morning, I myself rang up the New South Wales Minister for Health and I put it to him that there was no such document from my department. The Minister said to me that he had a document, prepared for him by his own officers, which he had used as the basis of replies that he had given in the Parliament of New South Wales. He was not in his office when he spoke on the telephone and he did not have the document with him. I therefore asked him had I his permission to speak to his officers direct, and he willingly gave it to me. I thereupon, with his permission, spoke to the chairman of the Hospitals Commission of New South Wales. That officer informed me, Sir, that he had not received in writing any proposal at all from the Commonwealth. Furthermore, he said that he had had no written communication from the Commonwealth on this matter. I then asked him had he received any request from, or been subjected to any pressure by, the Commonwealth to impose this charge of 5s., to which he replied, " No ".

When the honorable member for EdenMonaro spoke on Tuesday night, he said that if he was wrong he would willingly apologize. I suggest that he might now do so.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - I wish to make a personal explanation.

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