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Wednesday, 13 May 1970

Dr JENKINS (Scullin) - After listening to the comments of the Minister for Health (Dr Forbes) on these amendments and on various aspects of thi Bill, it almost looks as though this Bill is as open ended as the original contract for the Fill aircraft. Although previously I have indicated that I reject the principles on which this whole legislation is founded, one thing is certain, and that is that it is not going to work unless the most common fee concept is accepted. We all know that there is a considerable disquiet about this. Not only is there disturbance in the Australian Medical Association and in the Royal Australian College of General Practitioners, but the high fee group - I believe they call themselves the General Practitioners Society in Australia - is also in the act. So we have a situation where there is still enough doubt about the common fee schedule for us to be concerned. There is no firm composition for regular review of these fee schedules. 1 think this amendment should actually use the word 'schedules' because there are 7 schedules relating to fees.

With respect to a previous amendment, the Minister placed a great deal of reliance on the Nimmo Committee recommendations. I invite the Committee to consider paragraphs 4.65 to 4.72 of the Nimmo Committee's report where it deals with fee reviews. The report of the Committee states: . . one of the difficulties the medical profession has found in accepting the principle of a 'fee schedule' relates to the question of review of the schedule . . . in a period of rising costs and incomes.

Certainly the medical profession cannot control this and it would be unreasonable to expect the medical profession to give an open cheque on this. That is why the Nimmo Committee recommended in paragraph 4.71:

It is clearly desirable that common fees once established-

We hope they are established, although we have some doubts about that:

.   . should be stabilised for reasonably lengthy periods - we suggest 3 years. Frequent adjustment to contributions jar the system and make it very difficult for insurance organisations to operate effectively.

We accept that. The report mentions 3 years. We have decided that 2 years would be a more suitable time factor. But in the preceding paragraph the Committee describes the necessity for the review of these fees at regular intervals. In fact, the need for this review was 1 reason why the Committee put forward the concept of a national health insurance commission. Obviously a body would have to be responsible for gather ng together all the factual material and statistics on which adjustments to the schedule could be made. So if we consider this need for a fee review, as was suggested by the Nimmo Committee, if we accept its suggestions that there is a procedure that could be used to allow for this regular adjustment, and if we accept that the Government has accepted and used it as the Nimmo Committee has, as an argument in relat'on to many other aspects of the Bill, 1 think we of the Opposition are entitled to inquire why these recommendations have been totally disregarded. As 1 have said, judging by the Minister's remarks it looks as though we have an open ended Bill. If this legislation is be ng introduced wilh no firm commitment, with no firm assurance that the common fee schedule will be adhered to, we have no attraction for the members of the medical profession in the sense of guaranteeing to them a regular fee review. Do we know for certain that the AMA will be the responsible body to negotiate on this point? In that case, the introduction of this legislation al all is negligent in the extreme, particularly when we get to this stage and find it is lo be hurriedly rushed through the Committee singe when these details could be discussed.

It is not my intention to deal at any greater length with these amendments, because I believe this review of the common fees schedule is the most important aspect in stab lising this Bill - that is. if the Bill is desirable. I do not think that it is. Another matter which reinforces this opinion is the comment the Minister made in relation to dental procedures. We have him admitting that he has a definition 'n the Bill lo cover dental procedures, but as yet the Government does not know what dental procedures the Bill will cover. Docs this seem a responsible way of presenting legislation to the House and then p itting it before this Committee? I suggest that on those aspects alone the Government should bc condemned for a negligent attitude to this legislation.

Mr Les Johnson (HUGHES, NEW SOUTH WALES) - I rise to a point of order. I ask you, Mr Chairman, whether it is in order for this debate to continue while the Liberal Party is still thrashing the matter out in the Party room.

The CHAIRMAN (Mr Lucock - Order! There is no substance in the point of order. [Quorum formed.]

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