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Wednesday, 14 September 1983
Page: 829

Dr EVERINGHAM(11.52) —Mr Deputy Chairman, this vexed question of whether-

(Quorum formed).

The DEPUTY CHAIRMAN (Mr Rocher) —Order! Before I call the honourable member for Capricornia I remind honourable members-I particularly address my remark to the honourable member for Lowe-that when a quorum is being counted they should remain in their seats.

Mr Humphreys —Mr Deputy Chairman, I raise a point of order. If you are going to insist on Government members adhering to the forms of the House you should make sure that the honourable member for Denison does not walk out of the House. He walked in and walked out.

The DEPUTY CHAIRMAN —The honourable member is quite right. It did happen, but I did not notice it.

Dr EVERINGHAM —We have heard some very exaggerated and hysterical predictions that bush nursing hospitals will close when they have not even been categorised yet. The honourable member for Dundas (Mr Ruddock) has used a little more balanced and moderate language and has recognised that there is provision for assesment of special cases and of all hospitals. He has recognised that there are mechanisms for appeal. If the bush nursing hospitals have to work at a loss as a result of the categorisation that is initially put on them, they have from now until 1 February to put their case. They have already done so. The honourable member for McMillan (Mr Cunningham) has told us that he took the trouble to contact them when they put out a Press release. Not one member of the Opposition who has made hysterical noises has apparently bothered to contact them.

On the matter of the special case of the Mount St Margaret Hospital, the honourable member for Dundas has suggested that it is under the impression that all mental hospitals will be in category C. State governments have tried very hard to get all mental hospitals included in the same sort of funding arrangements as general hospitals. Federal governments of both colours have stoutly resisted this and said that it is a matter for the States. If the States are not prepared to meet the needs of those specialised hospitals, as the honourable member for Dundas calls them, which are in the private sector but which are providing servies that would otherwise have to be provided by State mental hospitals, the Federal Government is asked to pick up the bill. If it is already funding in the Mount St Margaret Hospital at Ryde under Medicare provisions, that hospital also will have the right of assessment and the right of appeal to determine in which category it falls.

Under the present system a number of hospitals now get $136 a day. When they are sorted into these three categories, as the honourable member for Dundas has told us, they will receive either $100, $130 or $160, depending on their costs, their structure and the services they provide. Obviously, some private hospitals are having a marvellous time, making quite large profits from their $136 a day when really they could make do with the $100 which would meet their costs. Many of those hospitals have patients who are virtually nursing home cases or who come very close to it. The previous Government saw fit to make a distinction between acute care patients in what most of us would call bush hospitals- certainly small country hospitals-where there are no nursing home facilities as such but where nursing home type patients are accommodated in the small local hospitals. The previous Government decreed that certain of those patients should be treated as nursing home patients. The hospitals do not get the bed day subsidy that would apply to a hospital patient. They have to meet some of the costs of accommodation. They may get half of the Federal subsidy and State subsidy that other hospitals are getting.

It is not a question of saying that bush hospitals will be closed. I am sure that the Minister for Health (Dr Blewett) will be just as sympathetic and just as easy to approach as was the honourable member for McMillan. Maybe the hospitals have not had an interview with the Minister as yet. They have until 1 February to make their representations. There is a mechanism in the Bill for assessment. There is a mechanism for appeal. No responsible government would close public hospitals when they are providing an essential service. A Labor Government would be the last to do that sort of thing. When we were in office in the Whitlam years we did more for the hospital system than the Liberals did in all their years in power after World War II. Not only did we give them Medibank funding to an extent which they had never had before, by way of maintenance provisions and maintenance costs, but also we provided a hospital construction program which for the first time gave them capital funds to upgrade their standard of buildings in hospitals and nursing homes. That was done on the basis of consensus with State governments of both colours.

Joint hospital works councils were set up in every State with equal numbers of State and Federal representatives, bureaucrats, who looked through the States' priorities and determined, in a co-operative way, in a consensus way, what ought to be priorities for hospital construction. Almost half of that money which has transformed the shortage of hospitals and hospital facilities and has upgraded and modernised hospital accommodation in every State including my own, Queensland, which has the lowest State contribution, came from a Labor government initiative. Is a Government of that calibre, of that philosophy, going to close down hospitals? It will do exactly the opposite. These hospitals will receive the same consideration from this Minister-who is the best health Minister we have had since Federation-as they received from the Minister for Foreign Affairs (Mr Hayden) when he was administering Medibank and they received from me when I administered the hospital capital construction program and the community health program, which the Liberals have decimated, eviscerated, cut down, wasted and wizened. The Minister will restore community health services and hospital services to something like the decent standards we had under Medibank.

Thursday, 15 September 1983