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Wednesday, 14 September 1983
Page: 837

Mr RUDDOCK(12.43 a.m.) —I appreciate the comments of the Minister for Health (Dr Blewett) particularly his last remarks, as they were directed specifically to some of the questions I raised. But I would like to have some further elaboration on the matters that have been of concern to me. I appreciate his acknowledgement that cost containment was very much the principle that was involved in the establishment of these categories, along with the expectation that there will be a reduction in the income of some hospitals. I pointed out in my remarks that that could in some cases cause very considerable hardships.

While I recognise that the Health Insurance Amendment Bill will allow for appeals-I recognise also that the Minister has certain responsibilities-I am concerned at the lack of information that I have received. I do not know whether the shadow Minister for Health, the honourable member for Mackellar (Mr Carlton) , has been provided with a copy of the principles that are to be involved in the categorisation of hospitals; I have not seen that information. Yet I learn that it has been made available and is apparently ready to be seen by the State governments and by private hospital organisations. I am not complaining about the fact that it has been made available to them. My concern is that those principles that are very important to the way in which hospitals in my electorate, for instance, are likely to be assessed and to understanding the way in which these clauses of the Bill will operate have not been made available. I appreciate that they have been made available to the Private Hospitals and Nursing Homes Association of Australia, the State governments, and now the bush nursing hospitals, but I have not seen them.

A question arose in my mind as I listened to the assurances by the Minister for Health that those hospitals operating particularly in the psycho-geriatric area were going to be especially examined. Do these principles that have been circulated to the Private Hospitals and Nursing Homes Association of Australia and the State governments state that psychiatric hospitals are all to be in one category? I suggest that from the way the Minister answered the question perhaps that is the case. My concern and that of the hospitals is very real. Whilst I accept that the Minister has indicated that he now appreciates that there are special cases that need to be examined-no doubt there will be a number of other special cases that need to be examined-I would like to know whether or not principles are to be amended if, as I have suggested, the Government says all psychiatric hospitals are to be category C. I also extend to the Minister a personal invitation-I know he has received one from the Sisters of the Little Company of Mary-as I have extended a personal invitation to the shadow Minister for Health, the honourable member for Mackellar, to visit the hospital in my electorate which, as I have said, is involved in teaching psychiatric nurses.

When I spoke earlier I did not give to the Committee some information about the nature of the program in which Mount St Margaret Hospital is involved as a nursing training school. It has been conducted as a non-funded training school for something over 50 years. That may be because the funds have been used for training psychiatric nurses and it may be the view that they are making too much profit. It may be the view that it is not appropriate for a private hospital to be involved in training. I would argue to the contrary. I think it is a very proper role for the hospital to play.

The hospital is affiliated with the Western Metropolitan Educational Centre situated in Parramatta. During its time, over 200 students, not including the religious staff, have graduated from the hospital. Some 27 students are presently involved in that school. For many years-not only in the last two years -graduates from the school have topped the State and have also been recipients of the Norton Manning medal for nursing excellence. That is an indication of the quality of teaching that is offered at Mount St Margaret Hospital and very much reinforces the view I spelt out in my earlier remarks as to why this hospital needs to be considered especially.

I know that other hospitals have special problems that will need to be looked at. I have visited a hospital also in my electorate where young babies are cared for. It is a hospital only for babies. It is a unique private hospital, the only one I know of that is very much involved in that work. It has a very different sort of program from those of other hospitals. Of course, hospitals that have a surgical capacity and operating theatres and so on have additional expenses that the categorisation is obviously designed to take into account. But there can be other special facilities hospitals provide that are not of that character that need to be taken into account. That is why I think it is very important that honourable members are able to see these principles, that we are able to look at them and understand, against our own knowledge, the way in which hospitals in our electorates operate and the sort of factors that will be taken into account.

I am very concerned that if the extensive appeals procedures that are outlined in the legislation are to be availed of, if hospitals are made uneconomic by the way in which they have been categorised and they have to use these appeals procedures in order to test the decisions that may have been reached by the Minister in concert with his officers, we could run the real risk of some of these hospitals closing. If hospitals are made uneconomic as a result of these categorisation proposals, and if hospitals close, it is very unlikely that those facilities will be re-opened. I think it is important that the principles as well as the decisions reached under those principles be tested, although that is not a matter I have looked at in any detail. I certainly hope that is so. It is important that any appeal be treated expeditiously because, if hospitals are forced to close, it is most unlikely that other entrepreneurs will involve themselves in the expense of opening hospitals and building hospitals. If we are without those facilities, the pressures that might be placed upon our public hospital system will be enormous.

In the western region of Sydney we have some very fine public hospitals. I do not want my interest in private hospitals to indicate that I lack an interest in public hospitals or have an unwillingness to use them. I was recently hospitalised.

Mr Uren —In a hospital funded by a Labor government?

Mr RUDDOCK —The Minister will be pleased to know that my experience was in Westmead Hospital which was planned by a Liberal government in New South Wales and which, at a period when the Labor Party was in office, received some funding to enable it to continue. Of course, it continued to receive funding from Liberal governments over a period until its recent completion. The fact is that both Liberal and Labor governments have been involved in the funding of that hospital. It is a very fine hospital. Of course, I regret that another very fine hospital, the Parramatta Hospital, had to change its role, which caused very considerable anguish in the western suburbs of Sydney.

I do not want my interest in private hospitals to indicate a lack of interest in public hospitals, but I want it to be known that that very fine Westmead Hospital in the western suburbs of Sydney is in considerable difficulty in meeting needs because of a shortage of beds and has to postpone elective surgery because it cannot meet present demands. If the surgical hospitals in my electorate were forced to close because of these categorisation proposals, very considerable demands would be put upon Westmead Hospital and other hospitals where there clearly is a shortage of beds. I am very much aware of this problem. I want the Minister to be aware of it. I want him to be aware that I, along with other members, will be monitoring closely what happens. If there are any problems in relation to these matters, I will certainly be prompt in ensuring that they are raised with him not only privately but also in the House.