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Thursday, 20 April 1972
Page: 1287

The PRESIDENT - Is leave granted? There being no objection, leave is granted. (The document read as follows): On 18th April 1972 in reply to a question from Senator Guilfoyle, concerning the optometrical services and the provisions of the National Health Act, I undertook to provide additional information on this subject. Section 4(4) of the National Health Act specifically precludes the payment of Commonwealth benefit for a professional attendance at which an examination of the patient's eyes is made in consequence of which spectacle lenses are prescribed. The decision to preclude payment of Commonwealth medical benefit in these circumstances was made to ensure that the medical benefits scheme did not discriminate against professions such as optometry which are allied to the medical profession.

By this exclusion the patient is in the same position regarding medical benefits whether the spectacles are prescribed by an ophthalmologist or by an optometrist.

This problem was considered by the Commonwealth Committee of Inquiry into Health Insurance which acknowledged that special problems arise under the medical benefits scheme because spectacle lenses are prescribed by both ophthalmologists and optometrists. While the Committee considered the relevant provision in the National Health Act to be unsatisfactory in that it penalised patients of ophthalmologists as compared with the patients of other medical practitioners, it was unable to suggest a more satisfactory means of achieving the result sought.

Honourable senators may recall that when the National Health Bill was debated in the Senate in June 1970 several amendments were proposed. One amendment proposed a change to section 4(4) of the National Health Act to remove the restriction against the payment of benefits where an examination of a patient's eyes by a medical practitioner resulted in the prescription of spectacle lenses. Another amendment proposed that benefits should also be paid for refraction tests carried out by optometrists. This amendment was to ensure that there would be no discrimination against the optometry profession that would arise from the first amendment.

These amendments, amongst others, were debated in the House of Representatives on 10th June 1970. Dr Forbes, then Minister for Health, indicated that the Government was not prepared to accept the 2 amendments. He indicated that, as the Act stood, optometrists were placed on the same footing as ophthalmologists so far as Commonwealth benefits were concerned. I would mention however that in reconstructing the medical benefits scheme in 1970 provision was made for referrals by registered optometrists and opticians to ophthalmologists so that the higher specialist referred benefit rate would be payable to patients when optometrists or opticians referred patients to ophthalmologists but spectacles were not prescribed. This is consistent with the Government's policy of non-discrimination against the optometrical profession. It has a beneficial effect for both the public and the optometrical profession. These measures which were incor porated in the 1970 amendment to the National Health Act, removed the necessity for patients of optometrists to seek referral to an ophthalmologist through a general practitioner in order to qualify for medical benefits at the higher specialist referred rate. At the same time, it provided recognition of the position of optometrists.

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