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Thursday, 18 October 1956

Mr EDMONDS (Herbert) .- As honorable members are aware, the object of the bill is to authorize the Government to give financial assistance to approved organizations which conduct home-nursing services. In the words of the Minister for Health (Dr. Donald Cameron) in his secondreading speech, this means that in general terms the Commonwealth's policy will be to grant to non-profit-making home-nursing organizations now in the field subsidies approximating the salaries paid to nursing sisters employed by them over and above the number ordinarily employed during the year prior to the commencement of the act. I support the measure mainly because it is based on humane principles. The honorable member for Adelaide (Mr. Chambers) has suggested that the Minister is personally responsible for this bill. I do not know whether he is or not, but I congratulate and commend him, and also the Director-General of Health and the other officers associated with the measure, on its introduction.

The bill takes on a far wider significance than the simplicity of its clauses would indicate. Perhaps quite a lot of people, both in this House and elsewhere, will say that it is designed to prevent people who would normally seek hospital treatment from receiving it. I want to make it quite clear that I do not and never would share such a view. 1 do not believe any doctor in Australia would prevent a person who needs hospital treatment from receiving it, but I am afraid that such assertions and charges will be made by some people. Homenursing services provide treatment for people who are not ordinarily seriously ill. The Minister made it quite clear in his secondreading speech that the persons treated are mostly people 60 years of age and more. Those of us who have had experience with old people who are ill appreciate just how dogmatic they can become. How many old people have we known who would throw one out immediately one suggested hospital treatment of an illness? lt is far from true to say that this measure will prevent old people from obtaining hospital treatment. It will calm and soothe elderly people who are ill and who perhaps would have to enter hospital if home-nursing services were not available, and will greatly assist in their recovery. For that reason, I consider the measure is a good one. lt is based on humane principles, and every one associated with it in any capacity has earned the everlasting thanks of the Australian people.

I suppose I have been going too well to continue in the same strain for ever. The only complaint I could make - I would say rather that it is an honest and sincere comment - is that the bill does not go quite far enough. I know it is easy to suggest how some one else should allocate his expenditure, but the Minister, in his second-reading speech, gave me some help in making the point I propose to raise now. Not only should the Commonwealth, together with the States, subsidize home-nursing services in respect of nursing sisters in excess of the number employed at the present time, but' also it should go further and pay subsidies in respect of at least half the present number of nursing sisters engaged in this work. The Minister has assisted me in making this point by comparing the cost of hospital treatment with the cost of home-nursing treatment. He stated that new hospitals cost £7,000 a bed to construct, and that the cost of maintaining a hospital bed is very rarely, if ever, less than £3 a day. He said also -

Can I give the House a further example? If in a few years' time home-nursing were to expand to four times its present level there would be, on these considerations, a saving of 3,600 beds, resulting in the following financial savings: -


He had said earlier that the cost of homenursing services is approximately 7s. a visit.

I do not wish to take from the Minister any of the credit for initiating this measure, but I suggest that if home-nursing treatment saves the use of a hospital bed for every patient so treated, and the cost of home nursing is only 7s. a visit, the Government should be big enough and rich enough to go further. I do not want to take from it any credit, but. now that it has thought of the idea-, it would be advisable, and it is certainly financially possible, to be a little more generous to home-nursing services. I do not say that in condemnation, or even critically. It is merely a suggestion for the improvement of an already humane measure.

I find myself at variance with some remarks made by previous speakers about Australia's hospital system. By that I do not mean that I will argue with any one about the position in some States, but I think I should fail in my duty if I allowed such statements to pass without comment. I am not taking a party political line on this matter, because some of those statements were made by Opposition members. I think I should fail in my duty as a Queenslander if I did not contradict the statement that Queensland's hospital system is intolerably bad and atrociously inadequate. I assert with all the vehemence at my command that, on the contrary, it should earn everlasting credit for the Queensland Government and hospital administrators in that State. I will go further and say that not one person in Queensland in need of hospitalization cannot get it. That is not a new position. It is not a position that has arisen overnight. It is a position that has existed for a considerable period.

I know, of course, that a lot of private and intermediate beds and wards are provided in the general hospitals. < But no person requiring public ward treatment in Queensland has ever had to wait any longer than it has taken him to get from where he was to that hospital ward. That position does not apply only in the metropolitan area. It applies throughout the length and breadth of Queensland. My colleague, the honorable member for Dalley (Mr. O'Connor), said that it would be better if this Government provided hospitalization, and I agree completely with that view. But the extraordinary fact about Queensland is that not only can people get hospitalization in public wards when it is necessary, but it is completely and utterly free.

I do not want to start anything in this chamber in connexion with this matter, particularly because you have been verytolerant, Mr. Acting Deputy Speaker. My remarks have not been completely relevant to the bill, except that they relate to something that has been mentioned in the course of the debate and which I feel I have a bounden responsibility to answer. I know from personal experience that the position in other States is very bad; but such is not the position in Queensland.

Getting away from that subject and returning to the bill itself, I am terribly afraid that this measure, in itself, will not solve this problem. I know the great value of the home-nursing service. I know the great work that is done by those nurses who visit private homes. They are more than nurses. They provide more than medical attention. They do not merely wash and give medical treatment to the people. They have to be prepared to listen to the troubles and the sorrows of people, especially the aged and infirm.

Mr Chambers - They are their friends.

Mr EDMONDS - They are friends. In many cases, they act as housemaids. They do all sorts of work when they go to private homes.

I want to refer to remarks that were passed by the honorable member for Perth (Mr. Chaney). Whatever these nurses get is not half as much as they deserve for the work that they do. But just because a subsidy is to be given to these nonprofitmaking organizations, that doss not mean that they will get more nurses. The honorabb member for Adelaide, in opening the debate for the Opposition, said that the only people who could be expected to do this work were trained people who, at one time, may have been nurses in hospitals and who had subsequently married but whose occupation was now described on the rolls as " domestic duties " or " housewife ". In order to supplement the income of their husbands those people take on this work. They are also usually people with merciful minds, and merciful hearts who want to do something good and kind and charitable for the sick and more unfortunate sections of the community.

But nurses will not be attracted - and 1 hope that they will not be attracted - away from hospitals, whether private or public. That would denude, or partly denude, those institutions of nurses whose services are probably more necessary in the hospitals than in the private homes. When 1 make that statement, I do not want to throw a wet blanket on the bill. I sincerely hope that it will have the effect of enabling these organizations to employ more nurses. But the problem will not necessarily be solved merely because they will get some money with which to employ more nurses. I do not know what the position will be. Time will tell. We shall find out, eventually, exactly what the position will be.

I shall finish on this note, because it was not my intention to speak, and I shall not take up very much of the time of the House in my contribution to the debate. The honorable member for Perth, who seemed to have volumes of reports and statements of all sorts in connexion with this very simple matter, seems to think that the nurses are doing all right in respect of their award rates and conditions. He has said that the figures prove that there has been a marked improvement in the conditions of and the salaries and wages paid to members of the nursing services in the States. There has been an improvement. But the conditions of nurses, only three or four years ago, were so intolerable that we are lucky to have any nurses in the hospitals at all. The honorable member referred to the improvement of quarters for nurses. I have heard complaints, even in my own electorate, to the effect that the State government spent too much money on the provision of what were called elaborate quarters for the nurses.

I do not believe that any money spent for the purpose of encouraging people into this work would be too much. But regardless of the living quarters and nurses' conditions, and regardless of whether there was one nurse to a patient, two nurses to a patient, or one nurse to two patients, the salaries that the nurses received a few years ago did not permit them to live in the same manner and enjoy the same amenities as any other female section of the community. . So wages and salaries had to be increased. I, personally, consider that their salaries are not nearly enough yet. They are not adequate, and we can not expect that girls between sixteen and twenty years of age will submit themselves to the most onerous work of nursing. When I say that, I do not mean that it is onerous for any girl to attend to a sick person. I do not want my remarks to be misconstrued. But the general conditions, atmosphere and environment of a nurse are probably worse than those of any other female employee. We must make the conditions of employment such that there will never be any hesitation on the part of girls in that age group to train as nurses and to accept the responsibilities associated with nursing.

I am surprised that the honorable member for Perth seemed to get such satisfaction from the improvement of the rates of pay and conditions of employment of nurses. They have improved. They had to improve! But I suggest that they have to improve far more yet before we can hope to get sufficient nurses for our hospitals.

I come back to the point at which I started. I congratulate all those responsible for this measure. I do not believe, and I sincerely hope I may never be disillusioned in this respect, that this measure could have the effect of preventing anybody in need of treatment in hospital from receiving it. If that ever happens I am satisfied that we will lose, once and for all, our faith in human nature. 1 cannot believe that it will happen. I know the sort of persons who will be mostly affected by the measure. They are persons who are in need of treatment by trained nurses, but want to have that treatment in their homes. There is no doubt that when people are seriously ill the only place in which they can be properly treated is a hospital. But people who are getting on in years sometimes hate the thought of hospitals. Not that they hate doctors and nurses; but they hate the thought of being taken away from their homes, the familiar environment in which they have lived for so long. This bill is the answer to the needs of these people. I suggest that, rather than hinder the progress of such people to good health', the scheme will help it, because they will have easy minds when they are sick, knowing that they will be able to receive efficient nursing service at home which will be as good as, if not in some respects better than, the treatment they would receive in a hospital.

I support the measure, and I sincerely trust that the Minister will consider my suggestion that, having regard to the enormous costs of the provision of hospital beds and services, compared with the very nominal cost of nursing services, he could go just a little further than he has gone on this occasion.

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