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Wednesday, 14 September 1983
Page: 775

Mr WHITE(4.31) —I enter the debate by taking up some of the remarks made by the honourable member for Prospect (Dr Klugman). He very generously compared me with General Eisenhower in the delivery and use of health care. I have no doubt that had I stayed in the Services I would have reached the exalted rank of general. But the fact is that, as my friend the honourable member for Bass (Mr Newman), with whom I served in the Army, will testify, I was called to higher things. I was called to this Parliament to take on the socialists in Australia. What we are really talking about today is the socialisation of health care in this country. In case there is any doubt let me make it perfectly clear that I am totally opposed to everything relating to health care that is being attempted by legislation in this House today. This legislation is yet another assault by this Government on private enterprise in this country. We are seeing the nationalisation and the socialisation of the health care services in Australia. One of the most curious of all the arguments put up here today is the economic argument. Attempts have been made to disguise this legislation under some sort of vague economic cloak. I quote: 'Medicare will play its part in economic recovery'. The argument in support of that statement entirely escapes me. What does not escape me is the complete disregard of honourable members on the other side of the House for the escalation of costs that this legislation will cause for the taxpayer in Australia. How the Government has the hide to say that the consumer price index will be reduced by 2.6 per cent by taking this area out of the CPI is quite beyond me. Apart from anything else, if the Government uses that sleight of hand trick all those who depend on proper indexation, such as the pensioners, will suffer considerably.

Overall, as other speakers have said, all this legislation, all this ballyhoo, will do not one single thing to improve the delivery of health care to Australians. In fact it is my view that it will lead to a significant decrease. The Government is following along the lines of what happened in the United Kingdom, and I will talk about that in a moment. Suffice to say for now that what happened to medicine and health care in the United Kingdom has been nothing short of a total disaster. It is not without interest, if one goes to the United Kingdom, to see that private health care facilities, private practices of medicos and private hospitals are escalating hand over fist. People in the United Kingdom are fed up with the second rate delivery of health care to them and their dependants.

Why, we must ask, has the Government embarked on this course? What are its objectives? Quite frankly, Mr Deputy Speaker, if you talk to some Government members you will find that they are at something of a loss to understand why they are committed to this particular ideological line. I suspect that the honourable member for Prospect, a practitioner himself, to whom I listened with some interest, is one of those people. I think he admitted today in the House that he has considerable doubts about several aspects of this legislation. But some honourable members on the other side of the House are in no doubt. They see Medicare as the supreme example of highly centralised control of Australian medicine. More particularly, they delight in the prospect that it will mean the enforced dependency of Australians on this Government.

Honourable members on the other side of the House have this firm ideological commitment-I do not say it is not genuine-to this highly centralist, socialist approach to government. I would like them to give an example, if they can, of any government or semi-government authority doing anything as well as private enterprise. I defy them to give me such an example. There are some very good reasons why we have semi-government authorities. There are some very good reasons for the existence of authorities such as Telecom Australia, for example. They provide services which private enterprise would not be able to provide, but there is no way that they are as efficient. The Government is taking all the private aspects out of the delivery of health care in Australia and concentrating them in this Medicare bundle, which will mean less efficient delivery of services and vastly increased costs.

It is beyond me why honourable members opposite insist on devaluing the quality of self-help amongst Australian people. We saw it in the confused thinking about the superannuation legislation which they are bringing down. The tax on lump sum superannuation is a complete disincentive for people to save, take their lump sum and establish themselves in retirement. We see the same dead hand of paternalism in the insistence of the Minister for Education and Youth Affairs ( Senator Ryan) on the destruction of the two school system-the private and public school system-in this country. For God's sake, why would honourable members opposite try to force people to send their children to State schools if they did not wish to do so and if they had the opportunity and wish to pay to send their children to another school? That is an example of what is being done here.

Until 1972 we had an effective health care system in this country. There was adequate cover for those who wanted it. Because a percentage of people did not choose to take out health care we turned the whole system upside down to force that minority into some health care system. Until that time the private enterprise system was working well. Then we started fiddling it. I must say in all fairness that when the Opposition was in government we did a bit of fiddling too. I speak with due deference to the honourable member who was the Minister at the time. The latest fiddle will cause the sacking of some thousands of people- probably the lower paid staff members-by the private health funds and the employment of another 2,500 fairly highly paid public servants who are eligible for superannuation. To me that is just no deal.

I shall take a few minutes to look at where the doctors fit into this scheme. The aim of the Minister for Health (Dr Blewett)-I would be delighted if he would refute this statement because it is firmly fixed in most doctors' minds-is to make doctors totally dependent on the Government. In other words, they will become form-filling public servants entirely dependent for their income on the bulk billing which, hopefully, will be paid once a month. It is interesting that on a couple of occasions during this debate today when I and others said to honourable members opposite 'You are trying to make public servants out of the doctors', nobody on that side of the House denied it. Nobody said: 'No, that is not what we are trying to do'. In fact, a few Government members have said: 'Yes , that is what we are trying to do. The Government will pay the doctors. They will be our servants'.

Dr Charlesworth —It is so ridiculous that we cannot be bothered.

Mr WHITE —Someone took up that point before. If the Government does not want to make the doctors of this nation public servants of the Government, why is it virtually forcing them into bulk billing? Why is it not allowing gap insurance so that people can at least take out some extra cover for which they have to pay themselves?

Dr Blewett —I thought that you wanted to control costs, a moment ago. There is utter confusion in your economics.

Mr WHITE —We are talking about doctors in private enterprise who will be forced into the Government system and who will become entirely dependent for their income on the Government. Why do we not give some encouragement to people who want medical services to make some personal contribution? What we shall see shortly after this system is introduced, because doctors are being forced into bulk billing, is continual checks and interference in their private practices. Already-maybe for some good reason occasionally-we are getting public servants telling doctors certain things. I give an example. In my electorate only last week a public servant, firstly, told a doctor that he was taking too much time with his patients, and secondly, told another doctor that he was seeing too many patients. What sort of judgment is that for a public servant to make on a professional man? That is what will happen more and more. Why does the Minister for Health go around the country telling doctors that he is planning to bring them to their knees? If he has not said that, let him deny it; I shall listen with interest. But that is what doctors in my electorate tell me he is saying.

Dr Blewett —They have as big an imagination as you have.

Mr WHITE —Let us see what the Queensland State President of the Australian Medical Association, Professor David Weedon, has said about it. I refer to an article in the Courier-Mail of 13 September, yesterday. It states:

The Federal Government had begun a 'doctor-bashing' campaign, the Australian Medical Association state president, Professor David Weedon, said yesterday. He warned AMA members that they would be committing 'economic and professional suicide' by bulk-billing the Government for their services.

That is what the Government is trying to force the majority of doctors to do. As regards patients, that people on low incomes and the disadvantaged need assistance is not in dispute; certainly not in this debate, and certainly not by me. The problem is that many people will abandon private health care because they already believe that they will be paying enough and that the one per cent levy will cover them for everything. Unfortunately, it will not do that. It will certainly not cover them for private hospital cover. The private hospitals will be under serious economic threat. As other speakers in the debate have said, 30 per cent of taxpayers will be paying more, and certainly that includes two- income families, who will be paying double. Patients will not gain. The delays in public hospitals will increase. They are bad enough in some areas now. I sensed again that the honourable member for Prospect seems to think that in many cases long delay will be the natural cure that will do patients good.

I turn now to the United Kingdom. I had the advantage of speaking to a couple of doctors in the last week who have just returned from that country. The health care system there is disastrous. It has been getting worse for some years, and in many respects it has now completely collapsed. People are flooding back to private health funds for cover for treatment and for hospitalisation because they want private treatment and efficient treatment. There has been a dramatic increase in the number of private practices springing up; a dramatic increase in the number of private hospitals, many of which are being financed with American money; and a dramatic increase in the return to health funds run by the trade unions. So that is what they think of the health system there. In the Government systems in the United Kingdom, it is freely acknowledged that the priorities go first to research, secondly to teaching and thirdly to patient care. In short, the system is not delivering. We must ask ourselves why, with all these lessons before us, we are putting in place in Australia the same system that has been so thouroughly discredited in the United Kingdom.

Let us take a brief look at the costs of this new system. Taxes will rise by an estimated $1.7 billion, which will inevitably lead to an increase in wages. There are to be an extra 2,500 public servants, as a start. There will be an increase in the number of inspectors and interference in private practices. There will be the loss of private fund jobs. There will be the destruction of freedom of choice. Firstly, there is to be a compulsory levy on all incomes; and secondly, the freedom of choice to take out gap insurance has also been taken away. There will be a temporary reduction in the consumer price index, which will have a dramatic effect on the indexation for pensioners. There will be a penalty on two-income families, a penalty on moderate wage earners, and a penalty on single people. Medicare will have a monopoly, which will inevitably lead to inefficient delivery. There will be pressure on private hospitals and probably the closure of some of them. There will be great pressure, which I believe will lead to further problems, on public hospitals because there will be a certain amount of over-use by patients and obviously a certaint amount of overservicing by doctors.

If one is a socialist, one can accept what is being put in place here today; as a socialist one accepts it and supports it and believes that it will be good, and one can justify any arguments in support of it. Many of the speakers in the debate and others on the Government benches are no doubt absolutely genuine in wanting to put this scheme in place, as is, probably, the Minister. But I do not accept that approach. I believe that it is the wrong approach, for all the reasons that I have outlined. I believe that on the Government benches there are many honourable members who, in their hearts, know that it is wrong-wrong for doctors, wrong for patients, and wrong for the Australian economy. I object to it. I want to go on record now as objecting to this system, because I know that it will not be any good. I want to be with my Party when it returns to Government and we take the necessary steps to get rid of a system which is no good for this country.