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Thursday, 5 December 1974


Mr LLOYD (Murray) -As the honourable member for Hotham (Mr Chipp) has said the 3 Bills before us are the same as those introduced on 10 July and they are part of the Government's badly foundering health proposals. As day succeeds day, the only certainty in the whole of the Government's proposals for its health insurance scheme is that it will not be introduced. Of some particular interest is that on 10 July when the Bills were introduced for the first time there were 4 Bills and the fourth Bill was the National Health Bill to repeal or to have the ability to repeal the present National Health Act. There may be some significance in the fact that this Bill has not been reintroduced this time because the present legislation will be required for many years to come.

The Government does not need the 3 Bills to implement its health scheme. The 1.35 per cent tax levy that is the basis of these Bills can be replaced by taxation revenue and as time progresses the 1.35 per cent levy will be a falling percentage of the total cost of the scheme anyway. It is now well below one-half; it is possibly about one-third, if that, of the total cost to the Government. In other words, the majority of finance for this most expensive proposal will come from tax revenue, that is from every taxpayer's pocket. The honourable member for Hotham made the point so well that the 3 schemes- health, national compensation and superannuation- will require a 25 per cent increase on the present taxation level of this country. This makes a farce of the speech of the Prime Minister (Mr Whitlam) in which he said that next year he will be able to reduce taxes again. The statement itself was a farce because the taxation reductions were only for those on lower incomes and once one gets to the middle level of taxation in Australia where the majority of Australians are paying tax- that is, on earnings of $5,000 to $6,000-a person's tax actually increases. How these schemes can be implemented, if they are to be implemented, without massive increases in taxation is beyond the belief of those who have commented on it. As I have said, this makes a farce of the Prime Minister's statement.

The 'Australian Financial Review' of today's date has a most interesting editorial entitled: 'Paradise lost by bungling- not by external forces'. So even the 'Australian Financial Review' has added to the chorus of those who say that the present plight of Australia is not the fault of external forces operating on this country which we cannot control but is the fault of bungling. One paragraph in the editorial states:

In the process, Labor has taken what must be one of the best positioned economies in the entire world and turned it upside down.

If this increase in taxation that will be required for these measures is made, how much more upside down turning will take place?

I believe that the Government's scheme will not be introduced. The people of Australia are against it. Time after time gallup polls have shown that a majority of Australians are saying that they are satisfied with the present scheme. The health funds are against it as the honourable member for Hotham quoted from this morning's Melbourne 'Age'. In the short term the Government's scheme would require the expertise in the agency arrangements of the private funds. The private funds would be very stupid to agree to this because as has been said before, they would be only committing suicide if they did so.

The medical professionals who are required to service our health scheme are against it. I also believe that four out of six State governments will be against it. This scheme cannot be introduced without the agreement of those State governments. The Minister for Social Security (Mr Hayden) wrote to the States some months ago to get their acceptance of the implementation of these proposals. To my understanding there is possibly only one State at this stage which will be going ahead, and that will be South Australia. This is not direct information- it has been taken from letters written to the medical profession in that State from which I will quote in a minute. If four out of six State governments refuse to be taken over, and this scheme would be a takeover of what has been a State responsibility, I defy anyone to say how the scheme can be implemented.

I now wish to refer to the position in South Australia about which Dr Deeble, the special adviser to the Minister for Social Security has been writing to Dr Cowling, the head of the Australian Medical Association in South Australia. These letters have been written on notepaper of the Minister for Social Security. Dr Deeble has been putting the points on how the scheme would be implemented in that State. He referred to the payment of doctors. This raises a very curious situation. In Canberra at present an alteration is being attempted in the staffing arrangements of hospitals in which private access by specialists will be restricted and abolished and will be replaced by a salaried specialist force. Yet at the same time in relation to South Australia Dr

Deeble, when speaking of the implementation of this proposal, stated:

In metropolitan hospitals a fee-for-service system within the limits of a pool would operate amongst doctors who accepted an invitation to participate in the care of 'hospital patients'.

What a contradiction. What a farce of a supposedly uniform system which is claimed to be better than anything else when on the one hand in Canberra they are messing up an existing satisfactory arrangement and on the other hand in South Australia at the same time agreeing with a fee-for-service system as part of the supposed universal health scheme. What does the Government want? What does the Government really know about the implementation of its proposals.

The State Health Ministers, as the honourable member for Hotham said, have consistently at conferences recommended necessary but limited improvements to the existing scheme. Everyone acknowledges that improvements have to be made. But these should be made on an evolutionary basis not a revolutionary basis that will bring chaos to the health scheme. The honourable member for Hotham outlined the points that were made at conferences of Health Ministers. They are: Greater share of cost sharing for pensioner medical bed days- pensioners are an accepted Commonwealth reponsibility and it is right that we should not be loading the States at great cost to themselves with the cost of pensioners who are hospital patients; an improved subsidised health benefits scheme which would provide an automatic form of cover for low income people plus a greater degree of flexibility for family size; medical cover for outpatients; discussions on psychiatric patients and ambulance costs, etc.

We in government will co-operate with the State Health Ministers to allow them and us at the same time to meet the health arrangements which the majority of Australians have so clearly demonstrated they want. In a number of discussions already held with the majority of State Health Ministers I believe we have already shown our willingness for Federal-State cooperation on this most important health issue. The honourable member for Hotham in a significant statement 2 days ago, which was not reported, made reference to the Health Insurance Commission in which at the present time thousands of people are being employed in addition to the Department of Social Security at a cost of some millions of dollars to the taxpayers of this country- we say unnecessary cost. I want to quote 2 paragraphs from the statement by the honourable member for Hotham because I think they are important. He said:

The Liberal-Country Party Government would disband the Health Insurance Commission, if returned to power at an appropriate time, Mr Don Chipp, Shadow Minister for Social Security, said today.

Mr Chippsaid he was making this statement now so that present and potential employees of the Commission would know where they stood. The Opposition's intentions also needed to be made public in fairness to contributors to voluntary health insurance funds, staffs of these funds and their managements.

This also raises the interesting question of the Medibank publicity program. Starting in January the Government will spend more than $1.5m, Mr Deputy Speaker, of your money and of the taxpayers' money on publicising the scheme which is not off the ground and which I believe will not get off the ground, which I have shown is internally contradictory, and which will require the co-operation of the States and variations between States for its implementation. What sort of constructive publicity can be mounted in such a confused situation? I believe it will be Party propaganda paid for by the taxpayers of Australia to the tune of more than $l.Sm. In this time of a Queensland election some curious statements have been made about health.


Mr Stewart - You should be telling the Broadcasting Control Board that.


Mr LLOYD -Is that a fact? I do not think so. These statements have been made about Queensland accepting or not accepting money for health services. I remind everybody that of the total Queensland health bill- this includes pharmaceutical benefit payments etc.- only 16 per cent comes from Commonwealth Government sources. The vast bulk of expenditure on health in that State comes from Queensland itself. So for the Commonwealth to talk about what Queensland is not doing or what Commonwealth funds it is not spending on health is rather farcical. In fact this BUI will hurt Queenslanders more than people of any other State. Queensland already has a free public hospitals system. If these Bills are passed Queenslanders will be taxed 1.35 per cent of their taxable incomes, which they are not taxed at the moment. In other words, Queensland and Queenslanders will actually be harmed by the introduction and passage of this Government legislation. The ordinary working family will be taxed twice if both husband and wife work; so the average family with both husband and wife working will also be harmed.

On Tuesday in this House the Minister for Health (Dr Everingham) said in reply to a question from the honourable member for Bowman (Mr Keogh) ... we have now managed to get the agreement of all States to the establishment of joint works councils to look at hospital building priorities.

The Queensland Minister for Health has asked me to tell the House and the people of Australia that that is not correct. The Prime Minister, as reported in the 'Courier Mail' of 4 December stated: ... the Joint Hospitals Works Council for Queensland had discussed this on November 19.

He was referring to the Mt Gravatt hospital. I repeat that the Queensland Minister for Health said that no works council has been agreed to by Queensland. Exploratory discussions have taken place but as yet there is no council. Yesterday in Victoria exploratory discussions took place between representatives of the Hospitals and Health Services Commission and the Victorian Hospitals and Charities Commission on the possible establishment of a works council for that State. But Queensland and Victoria do not have hospitals works councils, in contradiction of what both the Minister for Health and the Prime Minister have said.

The point is that, particularly at this time when referring to health care in Queensland, one should be careful about what are the facts. The facts are not as suggested by the Minister for Health and the Prime Minister. One can look also at another curious situation in Queensland. It is stated that Mt Gravatt hospital should be built as a Federal Government hospital. This was a great announcement together with that dealing with Melbourne and Sydney hospitals some months ago. There has been curious silence about this ever since. I believe the Government has discovered- perhaps not the Government; perhaps most supporters of the Government did not want it anyway- or at least the Prime Minister has discovered that one just does not build a hospital overnight. It takes years of planning. One does not just move in as an Australian Government without the administrative backup that the States already have and take over the running of hospitals. The Queensland Government, as a constructive proposal, suggested that instead of Federal money being put into building the Mt Gravatt hospital at a greater rate than it needs to be built- the Queensland Government is building Mt Gravatt hospital anyway- this money could be far better used for the people of Queensland by rebuilding the Mater Hospital in

Brisbane. I am glad the Prime Minister acknowledged this in the 'Courier-Mail' report which states:

He said consideration was being given also to a Queensland proposal to rebuild the Mater Hospital on its present site in South Brisbane.

I think this reveals the more accurate position of health proposals as between the Commonwealth and the Queensland Governments at present. The Commonwealth Government is accepting the reality and some of the wisdom of these suggestions. I hope this is done as it would mean that Commonwealth money will be made available for rebuilding the Mater Hospital. If not, I suggest the Commonwealth still has its priorities wrong.

To conclude, as the honourable member for Hotham has said, the Opposition is opposed to these Bills now in the same way as it was opposed to them when they were introduced on 10 July. If the Government wishes to create a double dissolution situation on this matter and on health matters generally we will be happy to accommodate it.







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