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Wednesday, 20 August 1980
Page: 570

Dr Klugman asked the Minister for Health, upon notice, on 14 May 1980:

(   1 ) Do certain forms of aggressive chemotherapy (such as that for carcinoma of the breast) sometimes produce baldness.

(2)   Can affected patients obtain (a) wigs as standard ward public hospital patients or (b) a refund for the purchase of a wig if appropriately insured with health funds; if not, why is this matter treated differently to the acquisition of a mammary prosthesis.

Mr MacKellar - The answer to the honourable member's question is as follows:

(1)   Yes.

(2)   (a) Under the hospital cost-sharing agreements between the Commonwealth Government and each State Government, whereby the Commonwealth Government meets SO per cent of the agreed net operating costs of recognised (that is, public) hospitals, the States have undertaken to provide surgical aids and appliances free-of-charge when these are considered necessary by the hospital in the ongoing treatment, care, rehabilitation, etc. of in-patients and registered out-patients of recognised hospitals. The types of aids and appliances supplied differ to some extent among the States.

In this regard each State has decided on items which are generally provided to patients of its recognised hospitals and those items have been accepted for the purpose of the costsharing arrangements. As the States have the responsibility for the provision of hospital services, and are aware of the various forms of assistance available to the community, any changes to these lists are mainly initiated by the respective States. The Commonwealth has always given consideration to any reasonable State request to extend or vary the list of agreed items.

According to the agreed lists, the position in each State regarding the supply of wigs and mammary prostheses to patients of recognised hospitals is as follows:

New South Wales

Wigs - listed as not available. (However wigs are available on a means test basis from the New South Wales Department of Youth and Community Affairs).

Mammary Prosthesis -initial prosthesis provided without means test.


Wigs - provided when prescribed for medical reasons and purchase would cause hardship to the patient.

Mammary Prosthesis- initial prosthesis provided without means test.


Wigs - provided subject to the application of a means test.

Mammary Prosthesis- not included in the 'agreed list'.

South Australia

Wigs - provided to inpatients and former inpatients without means test - means test normally applied to non-inpatients.

Mammary Prosthesis - initial prosthesis provided without means test.

Western Australia

Wigs - provided without means test.

Mammary Prosthesis - initial prosthesis provided without means test.


Wigs- provided without means test.

Mammary Prosthesis - initial prosthesis provided without means test.

The variations between States concerning the supply of wigs and mammary prostheses in public hospitals reflect the policies adopted by the individual States in this area. I am unaware of the reasons as the States do not, nor are they required to, keep me informed.

(b)   Benefits for wigs are generally not available through registered health benefits organisations. They are not covered by the Medical Benefits Schedule and are therefore not covered by basic medical benefits.

The position is that there is no specific legislation governing the benefits an organisation may offer under supplementary benefits tables. The Government's role in this area is essentially one of the approving the benefits and relevant contribution rates in the context of the financial viability of the table.

As organisations are free to decide the nature of the item or services which will attract supplementary benefits, the question of providing benefits for wigs or mammary prostheses, or any other aid or appliance, is a matter for individual organisations to determine.

Given the competitive environment in which organisations operate, they are influenced by consumer demand for particular benefits. An important consideration in any review by an organisation of its supplementary benefits offered would undoubtedly be the effect on contribution rates of the introduction of new benefit items.

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