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Wednesday, 13 October 1971
Page: 2277


Sir JOHN CRAMER (Bennelong) - I think the honourable member for Kingston (Dr Gun) must have had an anaesthetic before he came into the chamber tonight because to me he seemed to be talking from memory. The honourable member's speech was interesting and I think that we would all agree with a lot of what he said. He simply said the obvious. He did not, of course, tell us where we would get the money to do the things he suggested, but this is another matter. I do not think that this Bill now before us necessitates very extensive debate at this time, but 1 want to say a few more words about it. Nobody seems to have mentioned the Bill itself so far. I have listened to the arguments but nobody has talked about the Bill. The Bill is divided into 4 parts. This Bill provides for an increase in patient benefit for ordinary nursing homes from $2 a day to $3.50 a day. This means a rise from $14 per week to $24.50, and that is not an insignificant rise. That increase relates to the average patient. For the intensive care patient the increase will be from $5 a day to $6.50 a day. Previously this benefit was $35 per week but it has now been increased to $45.50. Again this is quite a substantial increase and therefore it must be of considerable advantage to those people who will receive this benefit.

Another matter dealt with in this Bill is an increase of 50c to a total of $1 for pharmaceutical benefit prescription. This increase is quite understandable because the amount charged for a prescription has not risen since it was introduced in 1960. Other matters contained in this Bill only confirm certain regulations varying the medical benefits schedules. The Opposition has seen fit to move an amendment to the motion before the House. I will not detail that amendment, but the honourable member for Oxley (Mr Hayden) in moving the amendment pressed his point of view. The honourable member has the idea that this Bill penalises the sick. I do not quite understand his view. The provisions of this Bill will make the position of the sick better than it is now. Perhaps these people should get more; but this Bill will improve their situation. I cannot see where a penalty comes into this. The honourable member for Oxley spoke about uplifting the standards of general practitioners. He announced that if the Australian Labor

Party came to power we would have an Australian Hospitals Commission. It is the same old story.

He spoke about universal participation in the health scheme and said that up to 15 per cent of the people do not take advantage of the voluntary health insurance scheme. This is because the people have decided for themselves whether to participate and surely they should be free to decide what they want to do. This is no criticism of the scheme. The honourable member for Oxley tried to advocate the Labor Party's idea that everything should be compulsory. The honourable member spoke about the failure to uphold the common fee system. We all know that there has never been - and the honourable member for Kingston knows this full well - complete uniformity on the common fee. I do not think anyone would have reasonably expected this uniformity but generally speaking doctors in Australia are coming to the situation where they are observing the common fee and by far the great majority of the doctors do observe the common fee at this point of time. The honourable member for Oxley believes that nursing homes should be part of a whole health scheme. Of course it would be great if this were so but if it were so it would, of course, result in quite considerable increases in insurance charges.

The Opposition does not oppose the Bill and I do not see how it could oppose it. Opposition members have taken the opportunity in this debate to range over a host of matters concerning the health scheme. They have used this occasion for propaganda purposes to put forward their socialist ideas for a health scheme. They want to let the people know what their scheme is, and we all know what it is. If the Opposition were to come to power - and for the sake of Australia. I hope this never happens - it would introduce a centralist scheme of control over all health matters. This is the way they would work it. They want everything done in regard to health to be on a compulsory basis. There would be no voluntary scheme whatsoever. The Opposition wants, hospitals, nursing homes and all related health facilities to be Government-owned and Government-controlled, including the doctors themselves. As the honourable member for Kingston has just admitted- arid he is a doctor himself - Labor's idea is to nationalise the doctors so that all the members of the medical profession would become employees of the Government. I do not think that the people of Australia want that. I do not think this is the way to get the best medical service. If the honourable member were honest about it he would agree that that is not the way in which to get the best medical services.

If I had sufficient time in this debate I would go over the whole history of health services in Australia but unfortunately time does not permit. Prior to this Government coming into power literally nothing was done in regard to health from the Commonwealth viewpoint. It is only in the last 22 years that this Government has been in power that all these major changes have been made. In the early days prior to this Government coming into power the major hospitals got together and created a voluntary fund in New South Wales called the Hospitals Contribution Fund. I was a member of the original board of that fund and I helped to form that organisation. I represented the Mater Misericordiae Hospital at North Sydney. These hospitals still run the funds. I was looking through some of my old papers only the other day and I saw that a special committee was set up by Labor Government which was in power in New South Wales at the time the voluntary fund was established. The then Minister for Health in New South Wales, Mr Sheahan, set up that committee to investigate the possibility of creating a compulsory hospital insurance fund. The report of that committee is very interesting. It recommended that it was impossible or impracticable to introduce a compulsory scheme. I point out that this was an investigation by the Labor Party itself. If anybody looks back into our history they will find that this was the position.

The health scheme at present operating was established by Sir Earle Page when this Government came to power. This scheme had been a magnificent one in the interests of the people of Australia. Labor's health record is pitiful. It tried to establish a compulsory scheme but the doctors refused to co-operate. Honourable members will recall that Labor tried at that time to negotiate such a scheme but failed in its negotiations. So it passed an

Act for the introduction of a health scheme of a compulsory nature, but that Act was challenged in the courts and found to be illegal. Labor ended up its term in office doing precisely nothing for the health of the people of Australia.

But the present Government's record is, as I said before, really magnificant. In this regard one should think of not only the hospital and medical funds but also the pensioner medical service which was a magnificent conception of assistance to people in need of help. It is, of course, free to all pensioners in Australia. This Government originated the idea of and introduced free hospitalisation and the supply of pharmaceutical drugs to elderly people. The subsidised pharmaceutical benefits scheme has, even though the prescription charges has been increased to $1, saved the people of Australia millions of dollars and has been of great assistance to them. It is necessary to have some sort of deterrent in relation to the pharmaceutical benefits scheme, otherwise people will place no value on the medicine which is provided to them and some of the expenditure which is sustained by the Commonwealth in this regard will be to' no good purpose at all. This Government established the homes for the aged scheme, which has subsidised the building of homes for tens of thousands of elderly people throughout Australia. I could speak for a long time about the research it has encouraged into cancer, heart disease and various other diseases. The subsidisation of nursing homes is quite a recent innovation.

Care of the aged is without doubt one of the most complex and most difficult problems which have to be faced. Age brings not only illness and infirmity but also loneliness and mental problems. People usually experience more family problems in the latter part of their life than in the earlier part of their life. There are certain economic adjustments which have to be made, too, as people get beyond the stage at which they can earn an income. But these problems are not confined to people in the low income group. Elderly people in the middle income group also have problems. Even elderly people who are reasonably wealthy have problems. These problems can in many ways be relieved by assistance from us. But elderly people need guidance, advice and, in many ways, rehabilitation in certain times of their life.

As the Prime Minister (Mr McMahon) said, the Bill is only an interim measure; R is not intended to be the final say on our health scheme. However, it is necessary to do something at this stage to relieve the nursing homes at a time when they are experiencing increased costs. The private nursing homes, the nursing homes run by churches, charitable institutions and the public hospitals, State or municipal, need some assistance. I agree that there is a need to check the standard of the service and care given to elderly people. One wonders whether something should be done about the establishment of clinics in association with the senior citizens movement for the provision of certain assistance to elderly people. Perhaps consideration could be given also to the extension of the scheme to the building of hostels, which is a matter of importance. I am very firmly of the opinion that it is necessary to go ahead at a very fast rate with increasing the domiciliary care that is provided to older people. I think that that is an important matter that must be considered very shortly. I have no doubt that the Government will be considering and making a decision on matters of this nature in the future. As the Prime Minister said, this legislation is only an interim measure. There is also the question of the provision of an annexe to major hospitals where one can get particular forms of assistance. This matter should be looked into in the building of major hospitals.

Another matter is the provision of community aid. A magnificent community aid scheme has been established in Lane Cove, which is in my electorate.- Voluntary help is given under this scheme to assist the elderly people with their troubles. As I said earlier, it is not necessarily the elderly people in the poorer section of the community who need community aid. A great variety of problems afflict people in their old age. This is when they need assistance. I think this Government can be trusted - certainly Labor cannot, be trusted - to make a further extension to the assistance which is provided under the national health scheme. But in my opinion it should be a voluntary scheme and not a compulsory one. It should not be centralised in Canberra, as Labor wants it to be. Give the people a chance to decide what kind of health assistance they want.

Dr GUN(Kingston) - Mr Speaker, I wish to make a personal explanation.'







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