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Thursday, 11 June 1970

Dr FORBES (Barker) (Minister for Health) - I move:

That amendment No. 11 be disagreed to, but that, in place thereof, the following paragraph be inserted after paragraph (g) of sub-section (2.) of the proposed new section 76a: (ga) details of how the reserves of the fund have been invested; and'.

This amendment would add 2 additional items of information to the 7 already included in the new section 76a, set out in clause 27 of the Bill, which insurance organisations will be required to furnish to the Director-General and which the Director-General will subsequently include in a report to be tabled in the Parliament. The 2 new items of information that the amendment would add to sub-section (2.) are: (ga) details of how the reserve fund has been invested;

And: (gb) details of direct or indirect interest in shareholdings held by directors of the fund in organisations to which the fund's reserves have been invested; and

As I said in the House on 14th May it is relevant to keep in mind the various types of organisation that are registered under the National Health Act. Numerically the main group of organisations are those registered under State law as friendly societies. The second important group includes the larger organisations registered under State law as guarantee companies. Other State law exists, such as legislation applicable to co-operative societies, charities and benefit associations, which applies to organisations which are not friendly societies or guarantee companies. It follows that the majority of organisations, and certainly the larger ones, are to a greater or lesser extent subject to dual control under the National Health Act and under appropriate State legislation.

It is also relevant to point out that provision has been made in the draft section for the Minister to require organisations to submit additional information and for the Director-General to include such additional information in the report. This provides for the flexibility that is so necessary, and means that all the information that subsequently proves to be desirable to have included in the report can be included. Because of this provision it was not necessary to provide for an exhaustive list in the Bill at this point of lime, lt is agreed that the first amendment proposed relating to the investment of reserves would add to the value of the report which will be tabled in the Parliament and for this reason the Government is willing to accept the amendment. However, while if is the Government's intention to exert close supervision of the activities of registered organisations, the second amendment goes further than can reasonably be tolerated in our society. lt is a serious and unwarranted intrusion into the private affairs of the directors of the funds who are public spirited men working, in large part, in a voluntary capacity. They give up a great deal of their time lo these organisations and it would be inequitable to have their affairs published annually in the report of the activities of the organisations. I cannot state too strongly the Government's opposition to and rejection of this amendment. Recently there has been a lot of talk about the possibility of using fund reserves for ancillary benefits. This amendment is partially related to funds reserves. I am reminded that the honourable member for Barton (Mr Reynolds), when this Bill was before the House on a previous occasion, raised in a very trenchant manner the question of the timetable proposed by the Government for its undertaking in respect to a review of the various services or a review of the possibility of bringing into the national health scheme those services which are paramedical in nature. This matter came' up in particular in respect to refraction tests done by optometrists and the relationship to refraction tests done by ophthalmologists. ) should like to take this opportunity to say ro the honourable member that the Government is sincerely undertaking this review as a matter of urgency. However, there are considerable implications involved not only in relation to whether or not one should bring optometrists into the scheme but to the whole range of paramedical services - and there are quite a number of them. Considerable cost implications are involved and many problems related to cost and which might involve over-servicing. Also, consideration must be given to the means by which it would be most desirable to bring these matters into the national health scheme, should the Government eventually decide to do so. Therefore 1 cannot give any undertaking to the honourable gentleman that this will happen quickly. 1 can say, however, that we are giving a great deal of time to the matter and I shall take the curliest opportunity to put the results of this review before the Government so that it may decide ils attitude to this possible expansion of the national health scheme.

Dr CUN(Kingston) [8.I4J- Mr Chairman, I oppose the Minister's motion. Should the Committee vote against the proposal I shall follow up by moving that the Senate's amendment be accepted by the Committee. This is a rather sad remnant of the original amendment which 1 moved when this Bill came before the Committee some weeks ago. The original amendment, which concerned inclusions in the report tabled in the Parliament, was:

(21)   In proposed section 76a, subsection (2.) omit paragraph (h). insert the following paragraphs: (hi names of all shareholders in the fund and the equity held by each in thai fund and the names of all directors of that fund;

(i)   details of how the reserve fund has been invested;

(j)   details of direct or indirect interest in shareholdings, held by directors of the fund in organisations in which the fund's reserves have been invested: and

(k)   such other information as the Parliament requires to be included.

The Senate saw fit to delete 2 of those items from the amendment, and the amendment as returned to this Committee contains only the 2 sections dealing with details of how the reserve funds of each insurance organisation have been invested and also whether there is any common directorship between any insurance fund and any fund in which the reserves of the insurance organisation have been invested.

I shall not go through all the reasons for which this amendment was moved in the first place but, briefly, it followed an investigation I made on my own behalf of an insurance organisation in South Australia. 1 was concerned that the identity of shareholders of that fund was not open to public scrutiny. 1 concede the points the Minister makes about intrusion into a person's private life, about what shareholdings people have got and about what equity they might have. If this were just a matter of an ordinary public company this might be a fair attitude. It might also be a fair attitude if this were voluntary health insurance in the true sense, but it is not. The contributor, that is, the patient, is compelled to contribute to a voluntary health scheme if he is to receive any benefit from the Government. A patient is compelled to belong to a private insurance organisation in order to receive his rebate from the Commonwealth Government - for which he has paid by way of taxation. That is why I feel justified in saying that the contributors to each fund should know exactly who it is who controls their moneys. I was disappointed that the Senate saw 'fit to delete the first sub-clause of the amendment relating to the names of all shareholders in the fund and the equity held by each shareholder in the fund. It would be interesting to know how much equity each shareholder held in the fund for his right to direct where the reserves - the contributors' funds - are going to go. For all we know each might hold only one 20c share in a particular insurance fund yet this would give him the right to control many hundreds of thousands of dollars which accumulate as reserves of the fund.

Dr Klugman - In 1936 it was £2.

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