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Wednesday, 13 May 1970

Mr HAYDEN - I will speak first and make my point on the need for this action and then I will ask for leave to move the amendments.If we did not take this action we would not be able to move these amendments. I hark back to what I said whenI opposed the motion moved by the Leader of the House (Mr Snedden) for the introduction of the guillotine. This is supposed to be a debating chamber where we seriously, with maturity, consider every point brought to the Committee. This is especially so with a complex Bill such as the National Health Bill 1970 which is one of the more important and complex

Bills with which we will be required to deal. We are being denied this right. It is more than a denial of this right to the Opposition. It is a denial of that right to the Australian public which expects adequate representation within this chamber. Having made that protest, I now formally ask for leave of the Committee to move the amendments which have been circulated in my name and in the names of other Opposition members.

The CHAIRMAN - Order! Is leave granted? There being no objection, leave is granted.

Mr HAYDEN - I move:

(3)   In clause 8, paragraph (b) (b) omit 'in an operating theatre of an approved hospital'.

(4)   At the end of clause 9 add the following proposed section: '13B. The schedule of fees shall be reviewed at least once every two years.'.

(5)   In clause 14, omit all words after 'repealed' to the end of the clause.

(6)   In clause 15, omit all words from and including 'amended' to the end of the clause, insert 'repealed'.

(7)   In clause 16, after 'amended' insert '(a) - '.

(8)   At the end of clause 16, add the following paragraphs: "(b) by omitting from sub-section (3.) the words 'may, in his discretion,' and inserting in their stead the word 'shall'; and

(c)   by adding at the end thereof the following sub-section: (6.) There shall be a right of appeal on the determination of the Minister under the last preceding sub-section by a contributor to the jurisdiction which determined or would have otherwise heard his claim for compensation or damage.'.".

(9)   Omit clause 17, insert the following clause:

17.   Section 23 of the Principal Act is amended by omitting sub-section (1.) and inserting in its stead the following sub-section: (1.) Commonwealth benefit is payable to any person for medical treatment of a nature covered by the First Schedule.'.".

The first amendment thatI have moved, which is No. (3) on the circulated list, relates to clause 8. We propose to amend this by omitting the words: 'in an operating theatre of an approved hospital'. This clause relates to specialist dental treatment. It is incredible that the Government should wish to proceed with the inclusion of these words. A number of reasons, which are readily apparent, exist as to why these words ought to be withdrawn. First, it is quite clear that dental specialists covered by the Act providing treatment for patients will tend to encourage their patients to enter hospital for treatment simply because in those circumstances they will attract the fund benefit. If they do not enter hospital they will not attract the fund benefit.

This is a stupid anomaly to write into the Act. I am assured by dental specialists that many of the specialists - probably most of them, if not all of them - have adequate equipment within their own surgeries to provide the forms of treatment which would be covered by the schedule. Particularly are we opposed to this clause and that is why I have moved the amendment.I might point out also that we will get anomalies such as the one where a patient requiring a certain type of treatment, if he is healthy could have that treatment provided inthe private surgery of the specialist. If the patient has. for instance, a cardiac problem, and some apprehension exists about his welfare, he would go into hospital for that sort of treatment. This could be a relatively minor procedure. Clearly this is an anomaly which ought not to be written into the Act.

I am not suggesting that any of the amendments that we have proposed and those which I have moved already are indicative of the way in which the Australian Labor Party would write its National Health Bill. Our approach would be quite different. All we are trying to do is to eliminate - at the least, to reduce - the deficiencies of the Act which are falling rather harshly on the same people who will be seeking benefits from the Act in future.

I turn to the amendment that I have moved in relation to clause 9. This is circulated amendment No. (4). We propose in this amendment that the schedule of fees proposed in the Bill shall be reviewed at least once every 2 years. This amendment has been moved as a matter of common justice. The reasons for moving it scarcely need any development. Practically every other group in the community earning salary or income has some sort of tribunal which considers the adequacy of its remuneration periodically. Doctors should not be deprived of this right.

I turn now to circulated amendment No. (5) which seeks to amend clause 14. Our amendment, if carried, will mean that there will be no waiting period qualification regarding the period when a person enters a fund and the time when he establishes eligibility for cover by benefit from that fund. Presently, a contributor entering a fund must wait 6 months to become eligible. If he becomes ill in that period, or has a preexisting illness, he in fact gets no benefit. The proposal from the Minister for Health (Dr Forbes) is to reduce that period to 2 months.

We believe that if the Government is genuine about trying to establish a national health insurance scheme it will cover people who are ill, whether they have pre-existing illnesses or illnesses which arise within that period of 2 months. If a person is sick, that person is entitled to this sort of protection. That person is entitled to the benefits of the scheme. The Australian Labor Party's scheme would not discriminate against people in this way. We would give comprehensive cover to all people in the community including all those who have pre-ex 'sting illnesses. This is a ridiculous bar to apply against people, lt should not be tolerated in an enlightened civilised society because it is a discrimination against those who suffer ill health and. in effect, imposes a greater burden upon them.

J come now to our circulated amendment No. (6) which relates to clause 15. This clause deals with professional services provided at hospitals. A person who attends an outpatient section of a hospital for treatment, although he has to pay for that treatment does not obtain any benefit under the present Act. lt is our proposal that such a person should obtain a benefit. We can think of no cogent argument why it should be otherwise.

Circulated amendment No. (7) deals with clause 16. This clause is concerned with compensation payments. The present situation is a most unhappy one. In some cases at least, persons with compensation claims pending have been deprived of any hospital or health benefit. The honourable member for Capricornia (Dr Everingham) has, I believe, had some cases where this has been so. Quite serious hardships have been imposed on the persons concerned. Because of this pract'ce these people have been unable to pay hospital and medical bills. What happens in effect is that medical practitioners and hospitals must bear the burden of this cost which is built up until the compensation claim is met. Hospital insurance funds have reserves totalling $76m. 1 think that this amount represents about 10 months contributions. Medical insurance funds hold $44m in reserves. This is all dead money. That $44m represents 8 months contributions. There is no reason why these funds should not cover these people. The amendment that we seek to have written into this Bill is that the Minister for Health in fact shall arrange that these people can be provided with the fund benefit.

I turn now to a further provision in the Bill with which we are not dealing by way of amendment but to which I wish to refer. This provision makes allowance for a person who receives a benefit, while a compensation claim is pending, to refund, upon the settlement of the claim, the amount of the benefit paid. This will still apply under the Act as amended. This is quite a reasonable and humane approach to this problem.

The Opposition is proposing a new subparagraph (6.) to paragraph (c) of clause 16. This is the subject of circulated amendment No. (8) which relates to clause 16. This reads: (6.) There shall bc a right nf appeal on the determination of the Minister in relation to what amounts should be paid by a recipient of compensation payment's or repaid by a recipient of compensation payments to cover funded benefits.

At the present time there is no determination as to what amount of the total amount is to cover medical and hospital expenses: An arbitrary power is placed within the hands of the Minister. No right of appeal exists against the decision of the Minister. It is our proposal that there should bc such a right of appeal and that the right of appeal for the contributor concerned should be to the jurisdiction which determines or would have otherwise heard his claim for compensation or damage.

Finally I turn to circulated amendment No. 9 which deals with clause 1 7. Clause 17 relates to section 23 of the Principal Act. We are proposing that the Commonwealth benefit should be payable to any person for medical treatment of a nature covered by these items detailed in the First Schedule. This is public money which is used for Commonwealth subsidy. A system of using public money should not be developed in a way to coerce people to join private funds. This is public money raised from the taxpayer which is made available for some people only. Those people who bow to the pressure that is written into this legislation and join a private fund are those to whom I refer. This is completely wrong. It is our firm belief that every person who requires medical treatment should be entitled to the full Commonwealth benefit. If they decide to join a private fund, that is a matter for them. They should then get the fund benefit. But the Government should not fulfil the role of coercive agent forcing people into inflated, inefficient and unnecessarily costly health insurance funds. Incidentally, this is not our scheme. The amendment is not the sort of provision we would write into our scheme, which is completely different, as we have discussed on other occasions. 1 should like to discuss our scheme to some extent during this debate but all we are being permitted is to have 2 speakers from the Opposition each with 10 minutes to discuss these important provisions. This is a quite unreasonable requirement of the Government. However, these are the amendments which the Opposition presents and which I have formally moved.

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