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Thursday, 6 December 1973
Page: 4436


Mr McVEIGH (Darling Downs) - The Bills before the House surely must hasten the day of reckoning for their supporters. The hastening will be accentuated by the growing impetus of opposition to what is not a health scheme but a political philosophy with scant regard for the quality of the health care of our 13 million people. The propositions of the Minister for Social Security (Mr Hayden) are the result of a very stubborn and selfopinionated customer, based on political and amateurish financing. We submit that this grandiose scheme of nationalisation is not necessary. All that is necessary is the polishing of the present scheme in the areas of pensioner care, subsidised health benefits and paramedical procedures. We submit that the Minister can still retire from the scene with some grace, rather than allow this worst thing to befall us. This is one of the most celebrated frauds, among a host of frauds, perpetrated on the Australian people by the Labor Government. During the course of this debate the Country Party and our colleagues, the members of the Liberal Party, will bring to this national forum a glimmer of sense. We are sick of the various parcels of gossip from the Minister in his Press statements and television appearances, we are tired of his masquerades as one claiming to be the mainstay of people in trouble, and we aim to expose the festering sore of absolute control that he is endeavouring to impose. We charge him with either not knowing the facts or deliberately misrepresenting the position. This is deceptive and treacherous legislation, and there is no doubt about that. When the Opposition in this chamber and in the other place - a place of great responsibility and integrity - are finished with these debates, the Minister's scheme will be shattered. No doubt this has brought a tinge of surprise to those who sit opposite; they can be assured that this tinge will give way to signs of mass hysteria when the superstructure of artificiality collapses because it has no sound foundation.

In Opposition the Minister uttered platitudes about his health proposals; he had a cut and dried concept. We now find that never before in the history of this Parliament, or of any other parliament in the world, have we ever had such hotch-botch legislation. We have a whole range of Bills - and more to come in the autumn session - and even then finality will not be reached. Never before has so much been said to convey so little. One is reminded of the demagogues of old.

Any discussion on health must consider the following 5 areas: Firstly, the individual and his family responsibilities - I know that the Labor Government denies anyone individuality; it thinks people are mere cogs in a machine; secondly, the medical profession in its widest application; thirdly, hospitals - public, private, religious and charitable; fourthly, government responsibility; and fifthly, health insurance schemes. It is appropriate to dissect the present Bill and detail how it affects the above areas and how it fails to make a meaningful contribution to the improved quality of health care compared to the present free enterprise system. My particular area of responsibility in this debate is to relate the above items to the position in Queensland. At the present time every Queenslander has the right to exercise freedom of choice as to doctor, hospital and voluntary health insurance.


Mr Adermann - The best State of all.


Mr Corbett - That is right.


Mr McVEIGH - I thank my colleagues, the honourable member for Fisher and the honourable member for Maranoa, for their words of wisdom. It is the best State of all. Every Queenslander can, and does obtain, top quality medical attention in public hospitals and outpatients departments in almost every area of the State, from the gulf in the north to Wallangarra in the south.


Mr Adermann - Absolutely free.


Mr McVEIGH - Yes, it is absolutely free, as my colleague the honourable member for Fisher says. Waiting time for surgery and hospital beds is at an absolute minimum. Those who so desire can go to the doctor of their own choice or be admitted to private or intermediate accommodation, and they can insure with benefit funds to meet the cost of these services. The essence of this is that the individual is free to exercise his choice; there is no compulsion, and he is covered in any emergency to meet any exigencies at no cost. There is no means test. This is a free system, a good system, a system which has the highest bed ratio in Australia - 7.3 beds per 1,000 population. It incurs the lowest cost per occupied bed.

Any costing proposals must be current. It is difficult to obtain information or statistics relating to incomes in Australia, and any attempts to rectify this deficiency was thwarted by the removal of questions on incomes in the 1971 census of population. So it is virtually impossible even to estimate the effect in monetary terms of the proposals in the White Paper. On 22 November last I asked the Minister to table in this House the documents and calculations on which he based his assertions that health insurance under his proposals will be cheaper for 3 out of 4 families and 7 out of 10 single persons. He refused, and Australia wonders why. Is he not honest enough to expose his calculations to official scrutiny? Until he does we can only assume - and rightly so - that his exercise is wrong, and he knows it. Is he so recreant to the trust placed in 'him that he will not admit his errors of calculations? If he had nothing to fear, he would make the calculations available. The Minister deliberately misrepresents the position in Queensland. The proposals will not be cheaper for anyone in Queensland, but a lot dearer for everyone. The total taxable income of individuals in Queensland for the income year 1970-71 was $2,057.7m and the taxable income of individuals whose incomes were less than $1,000 per annum amounted to $41. 447m, leaving a difference of $2,016.253m.

Page 64 of the White Paper on health insurance shows that the proposed rate for 1974-75 is 1.35 per cent of individual taxable income. The first qualification to this proposal is to exempt those whose taxable income is $1,040 or less per annum. The nearest I can get to the number in this group, from taxation statistics, is the 62,743 taxpayers in Queensland whose incomes are less than $1,000 per annum. Leaving these people out of the calculations and taking 1.35 per cent of the remainderthat is 1.35 per cent of $2,016.253m - the amount raised from Queensland through this iniquitous proposal of the Labor administration would be about $27.2m. The Minister will rip like a thief and a burglar in excess of $27m from Queenslanders to give them a service not as good as that which they have now. To obtain the equivalent of the position as it is now, they will also have to cover themselves through voluntary insurance for the difference between $112 a week and the cost of intermediate and private hospital accommodation. The Labor Government's proposals will increase the cost of medical and hospital care to Queenslanders.

To summarise, it will cost the individual in Queensland more, he will not have his freedom of choice, and he can look forward to long watts for consultations, surgery and hospitalisation. The best judge of the necessary medical attention is the patient's doctor - best of all the family doctor. He is part of the Australian scene. There is a delicate personal relationship between doctor and patient. The medical profession's duty is to do its best for the patient. That is not a matter of economics, it is a matter of medicine. The Hayden scheme is the thin edge of the socialist nationalisation wedge, despite the Minister's repeated and rather hysterical protests of constitutional impossibility. The Minister intends to do this by socialism by stealth. Firstly, he intends to control doctors' fees by bulk billing becoming established practice. Once he achieves this he will dictate the refunds. He strives to make health public by destroying the very special relationship between doctor and patient by sending accounts. Giving details of the conditions treated to people other than the patient is an infringement of professional secrecy and ethics. What the patient does with his account is his own concern and only he is free to divulge details to other parties.

We want more doctors, particularly in country areas. There is a drift away from general practice. No wonder it will be accentuated under the proposals in this Bill. Bulk billing is a disadvantage to general practioners, who lose 15 per cent. The specialist, however, often loses only 2i per cent, for example, $5 out of a specialist's fee of $200. These Bills seek to control the medical profession both through fees and through control by hospital administrators as far as hospitals are concerned. They seek to do away with private practice and institute a system of salaried staff or sessional service. The Government completely ignores the fact that doctors work long hours and are a credit to the oath of service. If they are to be reduced to a salaried service, the quality of health care will suffer. We will reach the situation as in other countries where one has to wait months and years for even minor operations. We are already 3,000 general practitioners short in Australia. The system we have is good and the quality of health care is excellent. Under the Labor proposals people will be denied freedom of choice of doctor in a public hospital. The Minister, of course, again is not very specific when he refers to sessional payments for doctors. Does he include the following, which are accepted by all unions as part of the recompense: superannuation, sick leave, holiday leave, sabbatical leave and after hours work?

Medical care should be based on complete freedom of choice for the patient in all matters pertaining to and at all levels of medical, hospital, and paramedical care. The patient should also be free to decide how he pays for it. He has accepted the present system in Queensland, and the vote achieved by the Labor Government in Queensland at the last Federal election, when one of the election issues was health, indicated that the people of Queensland will not have a bar of this scheme. The honourable member for Maranoa said: 'Let them call a double dissolution and we will see how clear it is next time'.

The best that can be said about the Minister as far as hospitals are concerned is that he runs true to his trackwork - utterances based on a system designed to mislead the public. I refer to page 42 of the White Paper and the estimated contributions to operating costs by the Australian Government and State Governments and to answers he gave to questions I asked about Queensland hospitals on 12 and 14 November. The Minister stated that Queensland will get $35m more than it would have got under the previous scheme out of a total of an extra $80m contribution from the Commonwealth. What a red herring of a statement! The Minister has used a cheap political trick, that is, dishonest practice to endeavour to hoodwink the public of Queensland. He knows he cannot sell his socialist scheme in Queensland.

The Minister endeavours to make capital out of Queensland's share of the extra Commonwealth contribution. An analysis of page 42 will show that the Commonwealth Government will contribute an extra $290m for public hospitals out of which Queensland .will obtain a paltry S3 Om extra which will result, when allowances are made for fees received, in a saving of $35m to the Queensland Government. I submit that the White Paper should be corrected and the word 'gains' at the top of the last column on page 42 should be savings'. Other States will get a massive injection of Commonwealth funds, but Queensland on a per capita basis should be getting $66m instead of $55m out of the total Commonwealth allocation to the States of $460m.


Mr Katter - The Brisbane line again.


Mr McVEIGH - Yes. Queensland is being penalised on account of its efficiency by Slim. Queensland's Government last year contributed $71,312,958 out of a total health vote for running the State's hospital system. Commonwealth payments met the balance of the total expenditure on hospitals of $108m. State hospital rates for private and intermediate wards are the lowest in Australia - $19 private and $16 intermediate a day all inclusive. This enables many people to take advantage of privately operated hospitals and still gain full benefit return from insurance.

The proposals are criticised because they have as their aim the standardisation of hospital care without endeavouring to improve the standards. Encouragement is given to standard accommodation rather than to improving the quality of hospital care in private and intermediate wards. This must have a disastrous effect on the quality of health care. We must set our sights at the highest possible level consistent with economic responsibility. Again, as far as private, religious and charitable hospitals are concerned, the Minister is using the practice of communistic ideology in subtly destroying them, by making them dependent on a centralised government department and then sapping their financial bloodstream. These proposals will lead, as inevitably as night follows day, to a clogging of the system of hospital beds by people who will be visiting hospitals just to get their money's worth under the Hayden scheme.

The public hospital system initially will be swamped by people who,- being forced to pay an extra tax, will drop medical and hospital insurance and use a free system. Planning cannot anticipate what this will be, or provide any rapid counter to accommodate the obvious increased usage the present structured system will face. These radical measures are not being introduced with any finesse; the broad concepts are being implemented, but there is no sign of grass-roots planning. Will the States be able to recruit sufficient staff for the added influx? Australia and the world at large face a critical shortage of doctors and nurses and these are not easily recruited. Instead of working 18 hours a day, as they do at present, and as do members of the Country Party, they will work only 8 hours. It will be chaos.

Hayden's scheme will become bogged down with a dispirited corps of doctors who are trained to be independent in their practice management, but who will be denied that independence under these proposals. They will be up in arms to be forced to work under the control of hospital administrators, who in many instances will not be medical people but mere economists. But this is what the Government seeks to achieve to create chaos as a principal weapon to gain control. Private beds will be empty, public beds unable to cope, and the private, religious and charitable groups will be forced to become public and offer a lower standard of hospital care. This is what we object to, to deliberate aims to remove the dual system. Once the private hospitals make an approach to be recognised as having public beds the Minister has complete control. He controls the purse strings so he can dictate policy.

These hospitals will lose their identity, the owners will become mere trustees, will lose control and we will have impersonalised medicine completely removing from the scene dedicated people such as nuns, cultured women and others who work without reward to express their personality. The end result will be one system - and it will not be the best; it will be the worst. Try as he might to camouflage his intentions the Minister seeks to destroy private enterprise as far as hospitals are concerned. We are concerned for these hospitals - the co-operative hospitals, the religious and charitable ones. We acknowledge their great contribution to healing; they must continue. Can they do this in face of this relentless monster of socialisation which seeks to destroy them?

The Minister has not spelt out whether the $16 a day is to be increased in the face of rapid inflation fanned by the flame of complete irresponsibility of his Government? This is not developed in the White Paper. We want to be assured that this is a payment to the individual in moral and distributive justice, as part of his payment to social security. It must move in line with increases in costs. Queenslanders are aware of what you are up to in regard to hospitalisation in our State. We will not tolerate your nominal dangling of political plums. Coercion is foreign to trust, and it is objectionable to us.

The fourth item I would like to develop is government responsibility. We submit, from the Country Party, that the benefits need to be extended in the pensioner, low income and unemployed areas. There is a need to develop contributions in optical and physiotherapy benefits. But this can best be done by updating the present scheme rather than the complete upheaval designed by the Minister. Mr Speaker you may rest assured that the Prime Minister is the last person in Australia about whom I wish to speak, but comparing his contribution to medical care with that of his driver, you must remember that the Prime Minister pays much more income tax than his driver does and we even admit that he might just work a little harder.

We accuse the Minister of complete distortion of facts. He is trying to hoodwink the Australian people into a policy of help that completely denies freedom of choice and freedom of the individual. We of the Country Party are not willing to stand idly by while he tries to force through this uniform grandiose scheme on us. The scheme will be impossible to alter in the future. We will be unable to unscramble the egg.







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