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Wednesday, 14 September 1983
Page: 834

Mr CARLTON(12.24 a.m.) —Before making any specific points about the clause that I want to refer to, I would like to respond to what the honourable member for McMillan (Mr Cunningham) has said. It is really most unacceptable to be lectured by the honourable member in this manner. If he had been in the chamber when I dealt with the matter of the Victorian Bush Nursing Association in my speech in the second reading debate he would know that the Minister for Health (Dr Blewett) had not responded to representations from the Bush Nursing Association over some period. The Association claimed that its representations had been lost somewhere in the Department of Health. It sent other representations. I checked this morning with the Executive Director of that Association before I came into the House to make certain that I was up to date with information as to whether the Minister had agreed to see that Association. It is claimed that the Association did not call on Australian Labor Party members in certain electorates. Yet the honourable member for Cunningham produced material tonight in the chamber which he said he got in July.

Mr Newman —No, it was produced in July. He did not get it until last Wednesday.

Mr CARLTON —I am informed that the honourable member got material from the local hospitals of the Victorian Bush Nursing Association last Wednesday. He still failed to make contact with his Minister or, if he did, his Minister failed to get back to the Bush Nursing Association. If there is any embarrassment about this matter in the House today it is embarrasment of the Government, certainly not of the Opposition. It is up to the Government to sort out the matter of the Bush Nursing Association.

The other point that I would like to make about this, and it is more general, is that these clauses represent a further development of Commonwealth bureaucratic control of the private hospital system. If there is a problem in regard to payments to private hospitals around Australia and, as would any sensible person, I accept that there could be in respect of some of the payments being made by private funds-most are made by such funds because there are relatively small Commonwealth contributions under the existing scheme-it could be approached by re-ordering the private insurance schemes. But I suggest that to have the Federal Minister and his Department involved to this degree is, going in the wrong direction. If we needed any illustration at all of that we have seen how difficult it is for the Minister to respond in a Federal Parliament to matters concerning individual hospitals when, obviously, there are differences as from one place to another and the Federal department does not even appear to acknowledge the existence of this Bush Nursing Association, for instance. That merely suggests that this whole group of clauses relating to private hospitals is going in the bureaucratic direction in which this Minister likes to see health care delivery going.

I want to raise a specific point on clause 40 of the Bill, which repeals existing section 33 of the principal Act and inserts a new section 33 which provides for the making of daily bed payments by the Commonwealth to the proprietors of private hospitals. Sub-section (1) of new section 33 provides for a daily bed payment to be made to the proprietor of an approved private hospital for each day on which an eligible person is an in-patient for a period of more than 12 hours. I am informed that the provision of a 12-hour minimum stay for a day patient has been put in the Bill without adequate consultation, if any, with major private hospital groups. I was speaking to one of these people today in the course of my checking process to make sure that I would be up to date upon coming into the House. I was told by the executive officer of a major group that would expect to be consulted on the matter that there had been no consultation and the 12-hour period had been set arbitrarily.

I sincerely ask the Minister to review this provision. It ought to be amended. Perhaps I could state just three of the problems in relation to it. If a 12-hour minimum is to be set down-currently there is not-it will ne necessary to have more than one shift of staff involved. The costs of dealing with day patients will increase enormously if their stay goes across two shifts. From the patient' s point of view it is a very bad provision because normally, for most of these surgical procedures done on a day basis, patients come in at 7 o'clock in the morning and like to get home by 5 o'clock in the evening. Now, unless they stay until 7 o'clock they could get a bill for $70 or $80 which would not be covered by insurance.

Mr Leo McLeay —What happens at half past 12?

Mr CARLTON —I do ask the honourable member for Grayndler to treat this matter seriously. Previously he demonstrated an extraordinary ignorance of bush nursing hospitals. Someone who has chaired a committee inquiring into the care of the elderly should display more responsibility concerning these matters.

Mr Leo McLeay —The Opposition spokesman will be going at half past four--

The DEPUTY CHAIRMAN (Mr Millar) —Order! Honourable members will remain silent. An important matter is before the Committee. I suggest that they address it seriously.

Mr CARLTON —I shall continue although I am perfectly happy to resume the debate in the morning. The business of the House is in the hands of the Government. If it wishes to have these important matters debated at sensible hours it can take the necessary steps. It is the duty of the Opposition to raise these very important points. If the Government does not wish us to question a provision which requires a minimum of 12 hours for day patients in private hospitals, let it say so and let it be counted on it. Let me go on to the concern about the patients who are required to come in for a minimum of 12 hours for day procedures rather than the shorter period of eight hours. If they come in at 7 o 'clock in the morning they would usually be ready by 5 o'clock to leave in the ordinary course of events. This would require one shift of the staff. Unless they stayed until 7 o'clock in the evening they would get a bill of $70 or $80 not covered by private insurance. To keep them in unnecessarily for two hours is just lunacy.

The third problem is that there is a question of allocating the bed. If the bed had to be allocated until 7 o'clock on a 12-hours basis, the hospital could not admit another patient overnight for other overnight procedures. There may be an operation on a patient the following morning. The patient could be admitted to the same bed after a previous patient had left, say, at 5 o'clock, but that would not be possible. They are just three cogent reasons why this minimum period of 12 hours should be revised. I earnestly ask the Minister for Health ( Dr Blewett) to consider an amendment to that particular clause.