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Wednesday, 13 May 1970

Dr KLUGMAN (Prospect) - I take it we are still on clause 19. When we are talking about different kinds of specialists I would like to raise one matter which in some ways is interrelated with a later stags of the Bill - that part covered by the last stage of the guillotine. In effect, it refers to the Schedules which contain some thousands of items that we are supposed to discuss in 25 minutes tomorrow. There is no provision for the recognition of psychiatrists or the r representation on this committee. 1 would like to make the point that in those 25 minutes tomorrow we have to discuss 1,030 items for which there will be differential payments for specialists and general practitioners. The Minister for Health (Dr Forbes) :n his second reading speech I think referred to something like 300 items. He was wrong by only 736 as I counted them, and that was not a bad percentage. I suppose the same people who did the costing for the plan originally also counted the items.

There is no provision for the recognition of specialist psychiatrists in the sense of hav'ng a psychiatrist represented on this committee. And what do we find? We find that attendance by a psychiatrist will be treated, according to the Schedule, as professional attendance by a specialist, and for a second or subsequent attendance his patient is entitled to a refund of S4 in the State of New South Wales. The second and further attendance of a patient attending a psychiatrist are usually lengthy attendances, of at least 1 hour. The cost is about S 1 5 and the refund is S4. Yet according to the Minister who drew up this Schedule there will only be a specified excess of Si. 50. When he can show me the psychiatrist who will see a patient for an hour and only charge S5.50 1 will be very interested to meet him. He will certainly not be one of the specialist psychiatrists whom we will be recognising under clause 19. 1 think th s again shows that the people who drew up this Bill just tossed all specialist attendances into 1 big box to get the results from the computer. They did not realise that psychiatrists were in a different position. They did not realise that in some cases the second attendance is longer than the first attendance. They just assumed that the first visit to a doctor takes a long time and the second visit takes a short time. In the case of some specialists this is not so. We again have the farcical situation where nothing is done to help the people who attend repeatedly for treatment. I would like to know who the Minister's psychiatric adviser will be. I. do not mean that in any personal sense but in the sense of consultant psychiatrists who will be helping to decide who the specialist psychiatrist will be who sees patients on the second and subsequent occasions and charges only $4 an hour.

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