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Wednesday, 13 May 1970

Dr FORBES (Barker) (Minister for Health) - A number of points have been raised by the honourable members for Maribyrnong (Dr Cass) and Hughes (Mr Les Johnson). They asked why we do not include a representative of the Stale departments of Health. Contrary to what they would say, the reason is that it would appear to me to be inappropriate to include such representatives when we are only establishing a specialist register purely for the purposes of the National Health Act. This is all it is, a specialist register for the limited purposes of the National Health Act. State departments of Health play their parts in the committees set up in the States to perform a similar purpose where there is a State register of specialists. The honorable gentlemen will notice from the Bill that all medical practitioners placed on the State specialist register are automatically recognised for the purposes of the National Health Act, the health benefits plan, as specialists.

On the other point that was raised, there are currently 2 States - South Australia and Queensland - which have registers of specialists. Western Australia has a specialist register for the purpose of the Workers compensation Act. The 3 other State Ministers for Health have indicated to me that they propose introducing State registers in the near future. 1 would expect that in the State committees particularly at least some of the medical practitioners nominated under the procedures which we have laid down will be people who have been associated with the State committees doing the same job and who are responsible for standards. The honorable member also raised the question of recognition of oral surgeons. I make the point immediately that there was no intention and it is not proposed that these committees should deal with the matter of recognition of oral surgeons under the Act. In relation to specialist dentists the discussions which are being arranged with the dental profession are expected to lead to the adoption of suitable arrangements for agreements between the Government and the dental profession on the recognition of dental practitioners for the purpose of oral surgeon benefits. In the light of these discussions appropriate amendments will be proposed at a later date if it is considered that the arrangements being worked out ought to be formalised by legislative provisions.

Dr Gun (KINGSTON, SOUTH AUSTRALIA) - It will be a hotchpotch.

Dr FORBES - You cannot have it both ways. A little while ago the honourable member for Barton (Mr Reynolds) and the honourable member for Oxley (Mr Hayden) were complaining that they had not had an opportunity to raise matters that they wished to raise with me. Tn this case some Opposition members raised matters about which I believe they were sincerely interested in getting an answer and this is what I am trying to provide. The honourable member for Prospect (Dr Klugman), as I understand it, raised 2 points in respect of psychiatrists. The first was: Who is going to be responsible for recognising people who will be registered as psychiatrists under the Act? Of course, they will be registered in the broad group of physicians but the provision which enables a consultant in the specialist group involved to be added to the committee, if appropriate, would apply to that. The answer to his question is that undoubtedly in this case - in this case perhaps above all for reasons which he would well know - it would seem to be very important to have a clearly recognised member of that specialist group added to the committee in order to determine this question.

The second and, I think, unrelated point that he raised was the question of determination of common fees for psychiatric services. This was done in exactly the same way as common fees were determined for all other items under the Schedule and based on figures provided to the Government as a result of information obtained from medical benefit funds, from their records and from doctors' bills, and examined by the AMA. All the other groups - the 15 to 17 sub-specialists - are contained in the physician group. In this respect psychiatrists are no different from, for instance, neurologists who have the same sort of arrangements. The point I make is that we produced the best results in relation to common fees that were possible in respect of the available information. Undoubtedly, as I have said many times, when new or additional information becomes available this will be considered by an anomalies committee and we hope that the House will approve the taking of power under the Act to make by way of regulation changes in the Schedule. When factual information about fees charged by doctors becomes available and is considered by an anomalies committee we will be only too glad to make appropriate amendments to the Schedule.

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