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Wednesday, 24 October 1984
Page: 2327

Senator CROWLEY —My question is addressed to the Minister representing the Minister for Health. Has the Minister seen the article in yesterday's Australian Financial Review headed 'Surgeons' Incomes hit by fall in private patients'? The article refers to the accelerating tendency of hospital patients in New South Wales to be treated as public rather than private patients, thus threatening taxable incomes of top New South Wales surgeons. The article states:

To counter the loss of income, the private specialists have decided to demand that all public hospital patients paying Medicare levy be regarded as private patients.

Does that not indicate that Medicare is being properly and effectively understood and used by the people of New South Wales for whom, as for all Australians, Medicare was introduced? Is it not true that many members of the Australian Medical Association are appalled by their colleagues' behaviour? Is it not true that Medicare was established to guarantee that no person in this country would be denied access to our excellent health care because he could not pay? Is it not true that this Government and particularly its Minister for Health, Dr Blewett, have gone to great lengths to consult all parties affected by its changes? Finally, is it not true that the intention of the private specialists to force a return to a fee for service basis for a majority of public hospital patients is in absolute contravention of the aims and intentions of Medicare and contrary to some of the recommendations of the Penington Committee of Inquiry into the Rights of Private Practice in Public Hospitals?

Senator GRIMES —I am not aware that I have read the article in the Australian Financial Review, but I have certainly read many other articles about the doctors dispute in New South Wales. The significant thing about the dispute is that it is unashamedly and obviously about money. Many members of the Opposition and members of the medical profession would condemn trade unions for taking action on such a matter. Secondly, the dispute is disapproved of publicly by the official representatives of the medical profession in New South Wales, that is, the Australian Medical Association. They have been negotiating in good faith with the New South Wales Minister for Health and he has been negotiating in good faith with them. However, the doctors to whom the question refers are rebelling. What they want to do, and unashamedly say so, is to double their income from public patients in public hospitals in New South Wales. To do this they want public patients who are paying Medicare levy to be treated as private patients so that the doctors can receive fee for service for their operations in these hospitals.

If anything has been notorious in the past in health service delivery in this country it has been the manner in which some doctors-I repeat some doctors-have managed to garner for themselves enormous incomes from public hospitals, particularly at times when they were paid on a basis of fee for service. It is the view of the Labor Party and many members of the medical profession that the most appropriate method of payment for these services is sessional payments. At the risk of being accused by Senator Walters and other Opposition senators of being a doctor basher, I remind the Senate that there are members of the medical profession and members of parliament who claim that the only way to have a satisfactory doctor-patient relationship in the practice of medicine is to pay cash for that service. I call that the gypsy principle-as if patients will not get good service unless they cross doctors' palms with silver. That attitude is grossly insulting to every salaried medical practitioner, to every medical academic, and to anyone who has ever worked in a salaried position and given a good, fair and concerned service to patients in the health service. This small group of doctors in New South Wales is willing to do what the medical profession as a whole has not been willing to do in the past. Those doctors are putting at risk the comfort, good health and peace of mind of their patients, so that doctors can increase incomes which are already among the highest in the community. Those doctors will get no credit from the New South Wales public, they will get no credit from the Australian Medical Association in New South Wales, and they will do a disservice not only to their patients and to the health service in New South Wales but to their profession as a whole.