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Wednesday, 14 September 1983
Page: 856

Dr BLEWETT (Minister for Health)(3.04 a.m.) —First let me comment on the last remarks of the honourable member for Mackellar (Mr Carlton). Given the enormous amount of urgent business which the Government has to do, I think that we have behaved extremely generously in the time provided for the debate. We have made no effort to prevent a full debate taking place, even though it has had to run into the early hours of this morning. The honourable member should compare that with the number of health Bills that were pushed through this Parliament in his time in government. If he does that, he will find that this Government, despite the urgency of this legislation and a number of other pieces of legislation, has been extremely generous in the provision of time for debate.

I refer now to the remarks of the honourable member for Bass (Mr Newman) who appears to act as the emissary providing a new shopping list for the Tasmanian Government in health matters. The reason there are some problems on this issue is that the Government, when it prepared this Bill, was clearly under the impression that the Tasmanian Government had abided by the decisions reached at the Premiers Conference. I just make two points in relation to that. First of all, speaking at the Premiers Conference, the Treasurer (Mr Keating) made it clear, and I quote him:

I emphasise that the Commonwealth's attitude towards the amount of any additional borrowing programs it is prepared to support will also be heavily contingent on the States agreeing to the proposals for compensating the States for new health arrangements under Medicare on the basis put forward by the Minister for Health on 15 June 1983, subject to the changes which we will be later proposing at the Premiers Conference.

So the whole borrowing program was based on an acceptance by the States of the health arrangements which were being put forward. Later at the Conference the following final communique was issued:

The Heads of Government agreed on the revised proposals for Medicare as outlined by the Minister for Health at the Premiers Conference including the basis for compensation grants to each of the States as outlined by the Minister.

So it was the Government's understanding, as a result of those agreements reached at the Premiers Conference in preparing this Bill, that the compensation payment provisions had been agreed to by each of the States. When we were aware that at least the Minister for Health in Tasmania did not share the same understanding on what had been decided at the Premiers Conference, we immediately offered officers to talk to the Tasmanian Health Minister and his departmental figures. That offer has not yet been taken up by the Tasmanian Government.

Mr Newman —Mr Deputy Speaker, I raise a point of order. I really seek some indulgence on this matter. The Opposition has not taken this legislation to the Committee stage. I agreed with this course of action because we want to terminate debate on the legislation. Perhaps it would clarify the matter if I could incorporate in Hansard a letter from the Tasmanian Minister for Health to the Federal Minister for Health dated 16 August because what is contained in that letter does not match up with what the Minister has just said. It is clear that in the middle of last month the Tasmanian Government made an offer for its officers to meet with Commonwealth officers. The Minister is saying now that the situation is the other way around. Either he is being misled by his officers or he is misleading us.

Mr DEPUTY SPEAKER (Hon. Les Johnson) —Order! I think-

Mr Newman —Mr Deputy Speaker, I seek leave to have the letter incorporated in Hansard. The House will then be able to make its own judgment. I think it is terribly important to have the letter on the record.

Mr DEPUTY SPEAKER —I think the honourable member is pressing the indulgence of the Chair.

Leave granted.

The letter read as follows-

File No. 89/51

16 August 1983

Dr the Hon. Neal Blewett, M.P.,Minister for Health,Parliament House,Canberra,A.C .T. 2600.

Dear Doctor Blewett,

Introduction of Medicare I have noted the points raised in your letter of 28 July 1983, but I believe you have made a fundamental misinterpretation of Tasmania's position regarding the cessation of the Hospitals Cost-Sharing Agreement.

I also believe that this error has occurred due to your assumption in reporting to the Premiers' Conference from the Special Health Ministers' Conference, that all States had agreed to the introduction of the Medicare arrangements, and that the two cost-shared States would move to the same arrangements as the other States.

This assumption by yourself was, and still is, fundamentally incorrect. All that Tasmania has ever indicated has been a willingness to examine any proposals put forward for consideration, to discontinue the Cost-Sharing Agreement prior to its expiry date of 30 June 1985.

Up to the present time, there has been no formal or specific proposal put forward by your Government to-

(a) discontinue the Cost-Sharing Agreement; or

(b) quantify the proposed amount of any financial grant to replace it.

Rather, there has been general discussion on the options.

Until such a proposal is received, preferably from the Prime Minister to the Premier, I do not see that Tasmania will be in a position to consider any such alternative arrangements, nor give a definite reply one way or the other.

In considering any such proposal, Tasmania would be looking to the financial advantages that may be available from accepting a change in funding arrangements , and not just to maintaining the 'status quo'. I would have in mind such things as compensation for the 'nil growth' policy adopted by the Commonwealth Government under the Cost-Sharing Agreement for several years; the need for the State to establish Rheumatology, Renal and other much needed services; the fact that the Commonwealth has shared the cost of building a new hospital at Launceston which is uneconomic without adding a further stage, and which remains largely unoccupied due to the unavailability of additional funding for the necessary staff and ongoing cost, the need to reorganise hospital bed provision by reclassification of many existing beds; the need for computerised management information services to enable statistics to be provided to the Commonwealth, etc. These are some of the matters that I would hope your Government would take into account in formulating a proposal for consideration by Tasmania to move away from the Cost-Sharing Agreement.

I would be quite willing for our officers to meet to further discuss these matters and I believe that the State Standing Committee would be an appropriate forum to consider such proposals in detail, and it may even be necessary to arrange one or two special meetings to further any negotiations. However, I consider that the initiative for such a meeting should come from your Department in order that any required documentation can be specified.

I also note that your Goverment is reviewing the arrangements for funding of the Community Health Program, which remains of concern to me, as previously mentioned.

In conclusion, I would again confirm that Tasmania is looking to the Commonwealth Government to put forward a firm proposal for the Cost-Sharing Agreement to be discontinued, and for a specific indication of the actual amount of any grant that would replace it. Until such a proposal is received, then we can only assume that the Cost-Sharing Agreement will continue until its expiry date.

Yours sincerely, JOHN CLEARY Minister for Health Question resolved in the affirmative.

Bill read a second time.

Message from the Governor-General recommending appropriation announced.