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Thursday, 12 November 1959

Mr TURNER (Bradfield) .- The honorable member for Lilley (Mr. Wight) has already answered the arguments that have been advanced by the honorable member for Grayndler (Mr. Daly). This matter is really very simple. A charge of 5s. will be imposed on a lot of prescriptions on which previously the customer had to pay an amount greatly in excess of 5s. To that extent, this proposal will be highly beneficial to the poor people about whom the honorable member for Grayndler has been speaking. However, there is now to be a small charge of 5s. for medicines that formerly were free. So it is true that the proposal is an imposition, on the one hand, and an advantage, on the other, but it is quite clear on the overall figures that there will be a net advantage to all the people in this country, including, those in the poorest circumstances. The matter is as simple as that, and I do not propose to waste any more time on it. Confusion has been injected into this matter quite deliberately by the Opposition in the hope of misleading the people and attracting some votes to itself. This, of course, will not happen because the people will soon find out that they are better off under the new scheme. The attempt to confuse them will not succeed.

However, I did not rise to talk about that matter but about another aspect of this clause which provides for the charge of 5s. for each prescription. Will the Commonwealth Government impose this charge upon patients in hospitals? What, in She past, has been the basis of charging for drugs in hospitals in New South Wales and, T presume, in the rest of Australia? Patients in public wards have not been charged at all although patients in intermediate and private wards, and out-patients, have been charged. No doubt the hospitals received free of charge the drugs that were on the free list, and no doubt the hospitals did not charge the patients for them. But in the case of other drugs - and vast quantities must be consumed in a hospital - the hospitals have had to pay the full price to the wholesale chemists and then, to reimburse themselves, have had to charge the patients who used them, except, of course, those patients who were in public wards. In those cases, the hospitals bore the cost themselves. Therefore, you can add to the cost of running a public hospital the cost of drugs that were supplied free of charge to patients in public wards. In addition, the prices that were charged for the drugs used by private and intermediate patients may not have met the cost. No doubt negotiations are going on. I do not know, but it may well be that the Commonwealth has said to the hospitals in New South Wales and elsewhere, " In future we shall make a small charge for the drugs that we previously supplied free but, in future, we will charge you only 5s. for those drugs for which you previously paid the full price". On the balance, therefore, the hospitals may be better off under this new system than they were previously. What the hospitals choose to do about their charges to patients, whether they be in public, intermediate or private wards, is a matter for themselves.

I know the Labour politicians in my State of New South Wales and I have a hunch as to why this matter appeared to be in dispute. I know them so well. These people are adept at buck-passing. They are always astute enough to make the worse appear the better reason. They are experienced in deceit. These people are skilled practitioners in bamboozling the public. These people are politicians in the most offensive sense of the word.I wish I could think of terms to describe them adequately, but I cannot. What are they trying to do? The honorable member for Eden-Monaro understands very well, because he is a very able man, that what they are trying to do is to persuade the people that the charges the hospitals will continue to make, as they have made charges in the past - and rightly so - are charges imposed, not of their own free will, as in the past, but are charges forced upon them by the

Commonwealth Government. This buckpassing is a familiar part of the political scene in New South Wales. I know it so well. I have witnessed it from the Opposition side of the New South Wales Parliament for years. It is a deliberate attempt to pass the buck to the Commonwealth Parliament as the New South Wales Labour politicians have done time and again. I hope that this particular manoeuvre, this gambit, to which the honorable member for Eden-Monaro has lent himself, will be defeated in due course when the Minister reveals the result of the negotiations and the cost, in fact, to the hospitals of the drugs that they have to buy now as compared with the cost of the drugs they had to buy in the past. It is perfectly clear that the charges the hospitals either do or do not impose are purely a matter for themselves.

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

The CHAIRMAN - Does the honorable member claim to have been misrepresented?

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - Yes, I claim to have been misrepresented by the honorable member for Bradfield, and I do not propose to allow myself to be misrepresented on this matter by any member of this Parliament. So, for the third time, I rise to quote to honorable members this particular document. The only mistake I made was that the document was prepared in the office of the State Department of Health, and not by the Commonwealth Department of Health. Here is the official statement -

The officers of the Commonwealth Department of Health have already held discussions with representatives of the Health Department and the Commission, and it has been intimated that the changes will be -

1.   The schedule of drugs covered by the general scheme would be widened to include therein most of the benefits at present available only to pensioners.

2.   A flat charge of5s. would in future have to be paid by the patient for each pharmaceutical benefit prescription.

Mr Turner - That is the decision of the State Minister of Health, not of the Commonwealth Parliament.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - This is the announcement, the communication, from the Commonwealth Department of Health to the State Department of Health. Sir, I will not be misrepresented on this matter. I will continue with the document. It goes on -

In regard to public hospitals the Commonwealth has intimated that, irrespective of the attitude of the State towards collecting the 5s. from patients, the Commonwealth will not in future meet the full cost of pharmaceutical benefits applied to patients, but will expect recognition of the principle that the person receiving the benefit is expected to contribute Ss. towards its cost.

That is from the official record of the conference between the Commonwealth officials and the State officials on this matter.

Dr. DONALDCAMERON (OxleyMinister for Health) L'4.59].- Since the honorable member for Eden-Monaro (Mr. Allan Fraser) has brought up the question of a conference between my officers and those of the New South Wales Department of Health, let me put the record straight. He says that my officers intimated that in future the charge must be paid by the patient. They did not put any pressure on the State, nor intimate that the charge must be paid by the patient in a public ward. I repeat what I said to-day, that, with the consent of the New South Wales Minister for Health, I spoke on the telephone to the chairman of the Hospitals Commission of New South Wales, who assured me that no such demand had been made, and no pressure had been put on any officer in the New South Wales Department of Health.

Now, Sir, in the course of the discussions with the officers of the New South Wales Department of Health, my officers may have used the expression that the patient would in future pay 5s. But that, of course, does not mean that the patient in a public ward has to pay. It means that as a general principle - and, of course, this is what the clause provides - 5s. will be paid by the patient for each pharmaceutical benefit. Everybody knows that. Now, what my officers did put to the officers of the New South Wales Department of Health was - 1, that the wider range of drugs would cover a large area which the State was now supplying to out-patients and public ward patients; 2, that the new charge of 5s. per prescription, applied overall, might reduce the net amount payable to the States.

My officers then emphasized that the Commonwealth did not wish to reduce the level of payments to the States under the present scheme, but had no definite information at that stage as to the new basis. The State officers were invited to suggest a reasonable formula.

At a second meeting the State officers said that they would have to make a survey of hospital practice in the prescribing of drugs before they could ascertain the cost of drugs in this new area - that is perfectly normal and sensible - or what should be the average cost of prescriptions. What the State officers said to my officers was that they would probably - although this is a matter for the State Government and not for the officers to decide - put the charge of 5s. on to private and intermediate patients and institute some system giving out-patients and public ward patients their medicine free. My officers told them that what they did about charges was entirely the affair of the New South Wales Government.

I now repeat what I have said before. This morning, I was assured by the chairman of the New South Wales Hospitals Commission that in no way, either verbally or in writing, was any attempt made by the Commonwealth to put pressure on New South Wales to charge patients in public wards. Do not let the honorable member for Eden-Monaro try to get out of the fact that he said there was a Commonwealth document in specific terms. Earlier, I quoted the " Hansard " record of his remarks. The document to which he refers was not written and signed by the Commonwealth Department of Health. He said that this was a document signed by the Commonwealth Department of Health. There was no such document, and he knows it. He knows that there was no attempt by my officers to put pressure on New South Wales.

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