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Wednesday, 13 May 1970

Dr FORBES (Barker) (Minister for Health) - I regretfully say once again that the Government must reject this amendment, largely because I believe it to be meaningless in relation to the practicality of the way these things happen. J was not quite clear from what the honourable member for Hughes (Mr Les Johnson) had to say precisely what he was directing the amendment to. On the one hand he said that the review should take place to benefit people who received medical services under the pensioner medical service and on the other hand he spoke as though it were necessary to benefit the medical profession which worked under the pensioner medical service. The first point, that is, the necessity to have a review every 2 years in order to ensure that the pensioner medical service is functioning properly in respect of the needs of pensioners, I would regard as being unduly restrictive. Indeed, if I had confined myself in the conduct of my administration of this portfolio to having a look at the pensioner medical service from this point of view only every 2 years I would believe that I had failed in my responsibility.

Mr Les Johnson (HUGHES, NEW SOUTH WALES) - I rise on a point of order. The Minister is misrepresenting the amendment, which is in specific terms. It is printed and it says quite precisely that a review is required at least every 2 years.

The CHAIRMAN - Order!

Dr FORBES - I still believe that once we provide for a period of 2 years this becomes an excuse for looking at it only every 2 years. The practice has been to keep the provisions of the pensioner medical service under continuous review. I take as a case in point the matter that he raised as an illustration. We have had almost continuous discussions with the medical profession over the last year or 18 months on the possibility of extending the pensioner medical service to domiciliary specialist services. The definition of the way in which this could be provided has not reached the point where it would be possible for me to take it to the Government. All I say is that this is a continuous process and therefore in respect of that particular aspect I just do not believe the amendment to be necessary and it could prove to be restrictive. Just to put the record straight, I might add that pensioners are not denied the services of specialists under the pensioner medical service because of arrangements made by the State governments in relation to both inpatient and outpatient services at public hospitals.

Mr Les Johnson (HUGHES, NEW SOUTH WALES) - With all governments?

Dr FORBES - Yes. All State governments in Australia operate under this arrangement and therefore, as I say, pensioners are not denied under the pensioner medical service the services of specialists. As to whether this is necessary in respect of pensioner medical service fees, again I deny the necessity. In fact since 1965, as a result of an agreement between the Government and the Australian Medical Association, we have undertaken a biennial review of fees paid under the pensioner medical service. Since 1965 fees under the pensioner medical service have been moved and increased every 2 years in accordance with this agreement on the basis of looking at economic indicators. I know that there is dissatisfaction in the medical profession about the level of pensioner medical service fees, but I make the point that that is not due to this cause; it is not due to the fact that there has not been continuous review. Since 1965 there have been 3 reviews under the 2-year arrangement and on each occasion pensioner medical service fees have been increased. On each occasion they have been increased by considerably more than the increase in the consumer price index in the period.

Not only since 1965 but since the inception of the pensioner medical service I have taken out some figures which may be of interest to the Committee. Since the inception of the service pensioner medical service surgery consultation fees have increased by 208% and fees for domiciliary visits have increased by 213% as opposed to an increase of 88% in the consumer price index and as compared with an increase of 200% in average weekly earnings over the period of the scheme. So I claim, on behalf of the Government, that not only would the amendment be unduly restrictive but that it is unnecessary. In addition I again make the point that I made earlier, that it is proposed to negotiate with the Australian Medical Association an updating arrangement - if I can use that term - in respect of the movement of common fees on which our medical benefits schedules should be based. It seems to me to be entirely appropriate that the same procedures that are worked out in respect of the updating of common fees in the medical benefits schedules should be applied to the updating, where updating is appropriate, of pensioner medical service fees. For these reasons the Government rejects the amendment.

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