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Wednesday, 28 November 1973
Page: 4010


Dr EVERINGHAM (Capricornia) (Minister for Health) - I move:

That the Bill be now read a second time.

On 16 January last Cabinet authorised me to set in train arrangements for the establishment of a Hospitals and Health Services Commission. This Commission would study Australian health care needs and make recommendations to the Government on the allocation of capital and operating funds for the development and maintenance of health care delivery systems in Australia. The need to set up this commission is based on the recognition that a high standard of health care is one of the fundamental rights of every Australian, and that the Australian Government must accept its full responsibility in this regard. It is our belief that health is a family affair and a community affair and that communities must look beyond the person who is sick in bed or who is in need of medical attention. The need for health services begins at birth and continues throughout our lives.

In the past the emphasis in the delivery of health care has been on the provision of curative rather than preventive health and rehabilitation services. As an initial step it is the aim of this Government to correct this imbalance by encouraging the rapid expansion and co-ordination of community health services. The Government has committed itself to a policy of promoting the regionalisation and modernisation of hospitals, linked with the development of community based health services and preventive health programs. It is interested in the full range of services, facilities and funding arrangements required to promote a high standard of health.

To make an immediate start on the work envisaged for the Commission, an Interim Committee on Hospitals and Health Services was appointed within my department soon after this Government took office. This committee has already undertaken studies and made recommendations to the Government. As a result of those recommendations positive action has been taken to improve the health services of this country. It will be a feature of the Commission's examination of health needs for Australia to consult with the many authorities and organisations in Australia with deep interests in health care. And, of course, the Commission will have to rely heavily on the support that these bodies can give the Commission in ascertaining the existence and state of health services throughout the nation. As a practical example of this type of consultation and co-operation, the Commission is presently examining the hospital facilities position in Australia and is being actively assisted by such bodies as the Australian Medical Association, the Royal Australian Nursing Federation, the Australian College of Medical Administrators, the Australian Hospitals Association, the Australian Institute of Hospital Administrators, the Australian Department of Health, the Bureau of Census and Statistics and the health authorities in participating States.

Earlier this year the Interim Committee invited by advertisements in the press submissions and comments from bodies and persons. Over 600 submissions have already 'been received. This is a firm basis for commencement of the Commission's work and I believe that many more submissions are yet to be lodged. The Interim Committee's first report, A Community Health Program for Australia", was tabled in the House on 30 May last. This report has been exceptionally well received by health administrators in this country. That program has been endorsed by the Government and a sum of SI Om was allocated in this year's Budget to meet capital and net operating costs of approved community health projects in 1973-74. The program should provide the required impetus for the establishment of much needed, but often overlooked, community based health services and should encourage communities and regions to examine their own needs and priorities and to express them to the relevant health authorities.

To date assistance totalling $9m has already been approved under the community health program. This program is an indication of the enthusiasm and earnestness of the Interim Committee in tackling its responsibilities, and indicates the wholehearted approach and the concern for the health care of the Australian people that the Commission will bring to bear on its tasks. The appropriation of $10m appears in Appropriation Bill (No. 2) within the Department of Health appropriations. It is intended that the Department of Health will be implementing the program of approved projects and be expending the moneys on Australia's behalf. Following the passage of this legislation through the Australian Parliament I expect that payments to States and organisations can be speedily arranged and the full allocation of $10m spent by 30 June 1974.

The Interim Committee has also been busy on other fronts. It recognised quickly that its own efforts were not enough but that it was necessary to encourage all administrations within the health services community to plan, research and evaluate their activities. The Government has provided funds of Sim a year and has given to the Interim Committee the overall co-ordinating role for an initial 3-year program for health services planning and research. Australia will continue to suffer from periodic shortages of various health professionals until a systematic approach is developed which anticipates requirements in the various skills to enable training facilities to adjust accordingly, which studies imbalances in the distribution of personnel and generally ensures that they are being both trained and used effectively. A special committee, which it is intended will report directly to the Hospitals and Health Services Commission, is already starting to examine some of these problems.

As a first step in ensuring a high quality regionalised and rationalised hospital system across the nation, the survey of the Australian hospital system will focus on areas in which there are shortfalls of facilities and equipment. In the even shorter term, there is a need to remedy acute hospital shortages which exist in a number of areas throughout Australia and the Government has already provided funds for an immediate start in developing additional hospital facilities in hospital deprived suburban areas of Sydney, Melbourne and Brisbane. Meanwhile, the Interim Committee has involved itself with plans for accreditation of health facilities and services, and it has recommended that funds be provided to the Australian Hospitals Standards Committee for a draft plan of a scheme for accreditation of Australian hospitals for consideration by the Commission. The Interim Committee is co-operating on this. Australian Hospitals Standards Committee with the Australian Hospital Association and the Australian Medical Association.

This Bill establishes the Hospitals and Health Services Commission on a permanent and sound legal basis, enumerates its functions and gives it all the powers necessary to enable it to operate effectively. The Commission will consist of 3 full time Commissioners, including the Chairman and Deputy Chairman, and between 4 and 9 part time Commissioners. The period of appointment of full time Commissioners is up to 7 years, part time Commissioners up to 3 years. Its staff will be employed under the Public Service Act. The functions of the Commission in general terms are:

(a)   to make recommendations to the Minister in relation to the provision of health services by the Department of Health;

(b)   to ascertain the health care needs of the Australian community and to make recommendations to the Minister in respect of those needs;

(c)   with the approval of the Minister, to make grants, including conditional grants, to government bodies, persons or organisations engaged in health care or research into health care;

(d)   to investigate means of securing and, with the approval of the Minister, arrange for, representation of Australia or the Commission on governmental bodies involved in health care;

(e)   to promote and take part in planning in relation to health services;

(f)   to promote the provision of adequate health services;

(g)   to review health care delivery systems and recommend changes to States, organisations or persons concerned with those systems;

(h)   to undertake such other functions in relation to health care as the Minister approves.

The Commission is given adequate powers to allow it to perform its functions, including the power to hold private and public inquiries, and to engage outside consultants. Honourable members will note that the Bill contains provisions to ensure the confidentiality of information on the affairs of individuals which may be acquired in the course of the Commission's operations.

Establishment of the Commission is yet another step in the Government's progress toward a total approach to the nation's health care needs. The Interim Committee has already more than demonstrated its capacity for hard work and sound responsible judgement and recommended the means of tackling some of the inadequacies in our health care system. However, what has been achieved has also served to illustrate how much remains to be done. High quality health services do not just happen. Health care needs must be identified and services must be planned and financed in a co-ordinated manner. The establishment of the Hospitals and Health Services Commission by this Bill will ensure the continuation of the identification of those needs and provide the apparatus for planning and co-ordinating the resources necessary for their fulfilment. I commend the Bill to the House.

Debate (on motion by Mr Bonnett) adjourned.







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