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Wednesday, 3 October 1984
Page: 1513


Mr DONALD CAMERON(6.08) —Some aspects of the legislation currently before the House would be regarded as without political bite and uncontroversial . However, I wish to raise one or two points. It is a pity that the Minister for Social Security (Senator Grimes) is a member of the other chamber and has to be represented here by the Minister for Health (Dr Blewett). I refer to the decision of the Government to increase the subsidy on meals on wheels from 55c to 65c for a meal with vitamin C and to freeze the subsidy at 50c for those which do not provide vitamin C in accordance with the requirements. I notice that in the second reading speech the Minister referred to what is intended in the future. He said:

The Bill will increase the rate of subsidy for each meal . . . where the approved organisation meets new conditions of service delivery as from 1 January 1985.

There is nothing controversial yet. To continue:

These conditions have not been finally determined, but will relate to the operation and management of approved organisations concerning service delivery. An example of such a condition is that service delivery would have to be made on at least five days in each week. The new conditions would be published in the Commonwealth of Australia Gazette.

For the first time since 1970, when the Liberals introduced the concept of a subsidy, we are voting on legislation without knowing fully what the Government has in mind. Is the situation such that, if Christmas Day falls on a Monday and Boxing Day on the Tuesday and the local service does not provide five meals that week, the Government will gazette a decision to the effect that that group loses its eligibility for the higher subsidy for a full year? The Minister looks rather pensive at the moment. I make the point that I have been here long enough , on both sides of the House, to see things happen that are well intended but contain legislative traps. Once they are in the hands of the departments, which understandably are bound by the rules, they start implementing those rules and we sometimes see unjustified penalties being applied while the public servants simply say: 'We cannot do anything about that; that is the way it is'. I want a clear explanation of what the Government has in mind.

I also express a concern about what seems to be growing control imposed on these meals-on-wheels organisations by this socialist Government. I make one or two points here. It is all very well, I agree, for governments to feel that they must have controls over the expenditure of public moneys. There is no escaping the fact that the subsidies paid out, which probably amount now to $7m or $8m, represent public money and that therefore there is a need for control. I wonder what many of the people who design these regulations really know about the real life away from Canberra, in areas where the meals-on-wheels organisations operate. I wonder what the Minister who is responsible for the introduction of these regulations and his colleague in the Senate really know.

I wonder whether the Minister's Department, with the scores of people who engage in research, has ever done a profile on the meals-on-wheels organisation. Recently I commenced a profile on a number of such organisations in Queensland. Unfortunately, my results are not complete yet, but I can present to the House a profile of one group for which all the returns and questionnaires are back. This is a typical meals-on-wheels organisation. The women involved outnumber the men by more than 4 : 1, and that is understandable. Forty-five per cent of the people in this group are themselves over pension age. In another two weeks I could have given the House the results for several groups, but we have one which perhaps is typical of the others. These people have been delivering meals on wheels for an average of four to five years. One lady in this group is 76 years of age and she has been doing it for more than 25 years. On average they deliver about one and a half times a month. The average number of meals delivered per driver is 12 to 15.

I believe that the Government has not understood an area of real need. I dearly hope that the Opposition parties, when we are re-elected to power following this ill conceived, hastily called, near future election will do something about it. Some of these meals-on-wheels organisations have introduced their own subsidy schemes whereby they assist people with a financial contribution to meet the car running costs. The Government does not give these people a single razoo; yet here it is tightening up controls, with more red tape from this end. These organisations, as well as having to attend to the Government's paper work, about which we are not even told, are out raising their own money to try to assist financially, not paid people, not members of Parliament, not public servants, but the people who give of their time year in and year out to help others.

I remind the House that 45 per cent of this group are themselves of pension age . Twenty-four per cent of this group give back the petrol subsidy but three- quarters of them actually need the money. Only one-third of the group have spouses working full time. About 55 per cent fall into the description of people not being in the work force or not having a spouse in the work force. Of course, there will be some widows in that group. The remaining numbers are made up by people with a full time or part time job or with a spouse with a part time job. In delivering meals they travel an average of 15 to 20 kilometres a day in the metropolitan area. Two-thirds of them are members of a one-car family. A little under one-third belong to two-car families and, for some strange reason, some members of the group do not have a car at all. I have not quite worked out how they deliver meals on wheels, unless they borrow a car.

The Government is saying to these organisations: 'Unless you bow down to these new regulations, these new requirements, you will receive a subsidy only at the old rate; you will not qualify for the new rate'. I think we in this place have an absolute cheek to say to people who give so much: 'You shall do this and you shall do that'. One response from a 72-year-old lady was: 'I have been doing it for 15 years and I will keep on doing it while my legs are strong enough to carry me up the stairs'. That indicates the good will that exists in the community. Yet the Government was hardly in office before it unleashed more regulations and controls, more impositions and paperwork. I wonder what motivates Labor politicians when they are in office. They are heartless. I hope that the presentation of this profile will give the Government a better understanding of the thousands of decent Australians involved in servicing the needs of the 50,000 recipients of this service. Honourable members should remember that it was a Liberal government which introduced the subsidy system.

In the second half of my speech I wish to concentrate on the portfolio of the Minister for Health. We had an excellent, quiet presentation by the honourable member for Mackellar (Mr Carlton). That speech by a former Minister, now a shadow Minister, will make very interesting reading. I listened to that speech and I am quite sure that the shadow Minister will be listening to mine. As I have said previously, I believe that the Government is motivated, when it comes to health care, by a determination to destroy everything in the private sector. Last time I spoke on this subject I read an extract from that central Sydney newspaper, the Guardian, in which the present Minister was reported to have said : 'I have always said it will take two terms to get Medicare into place'. I believe that the second string to his bow, if his Party is successful in the next election, will be to destroy completely the private hospital sector.

Honourable members have heard the attack today on private nursing homes. They are in front of the Minister's gun; they are for the high jump. Also, his long term aim is to have all doctors salaried.


Mr White —Why do you think he hates them all?


Mr DONALD CAMERON —I do not know. I go back to the fact that a previous speaker, the honourable member for Mackellar, referred to the system of section 3B certificates and the 35-day rule for hospital patients. The previous Government speaker, the honourable member for Perth (Dr Charlesworth), said that the shadow Minister for Health had raised this matter a number of times. The honourable member for Perth is a socialist. He could not be anything worse. He is probably also a member of the doctors reform group. He referred to the honourable member for Mackellar as having an obsession about the subject and how he has carried on over the months. I want to read to the Minister an article from a paper called the Sunday Mail. Probably he does not even read the Brisbane papers. On Sunday, 23 September 1984, an article appeared written by a woman called Sylvia. The headline is 'Throw the system out before it throws you out'. May I incorporate this article in Hansard? It would make very interesting reading but I think the new rules are against that?


Mr DEPUTY SPEAKER (Mr Rocher) —No, you may not.


Mr DONALD CAMERON —I will therefore need to summarise the article. In summary, the article states that the Government has reached a stage when it has only a couple of alternatives it can take once a patient's 35 days in hospital are up. A patient could still be so sick, yet a doctor is frightened to sign a certificate to say that he or she should be kept in hospital. Honourable members should remember that the doctor faces a fine of $5,000 or six months behind bars if he incorrectly signs a certificate. How the Government could introduce legislation that discriminated against a man's freedom to that extent I will never know. People who commit murder are sentenced to a few years imprisonment, yet the Government will put a doctor, who may have made an honest mistake, behind bars for six months. As the journalist points out, if 35 days have passed and the doctor is not prepared to stick out his neck the patient has the alternative of either going into a nursing home or going home.


Mr White —You can't get into those nursing homes.


Mr DONALD CAMERON —As the honourable member for McPherson correctly points out, people cannot get into them. Why? Because this Government, with its obsession and its hate of the private sector, has put a freeze on the number of nursing home beds. There will be no extra nursing homes beds available for a long, long time. The Government ground that area to a halt. The Government is saying that there are already too many nursing home beds in Australia and that we should spend time just looking at the matter. Trying to get into a nursing home now is in itself an acute problem. If one cannot get into a nursing home, what does one do? One goes home to be cared for by one's family.


Mr White —If you have one.


Mr DONALD CAMERON —The honourable member for McPherson is almost anticipating my every word. What if a person lives alone? A person can be very sick and still not qualify for hospital care or entry to a nursing home. A person could be so ill that he cannot walk. He could have both legs in plaster and that will not be categorised as an acute illness. The Government has introduced a system under which, at the end of a 35-day period, a person must leave the hospital. He must go home. The article's headline states 'Throw the system out before it throws you out' and relates some of the experiences mentioned by the previous speaker from this side of the house, the honourable member for Mackellar. I say this to the Minister: I believe he is in real trouble already to make Medicare pay without increasing the levy, and he knows it. If he gets back after the next election there will be a big hike in the Medicare levy. There must be a hike.


Mr Milton —You must be joking.


Mr DONALD CAMERON —The honourable member also is a socialist. He professes to be a member of one of the several groups that exist in the Australian Labor Party these days. If the Government cannot make Medicare pay without imposing restrictions on the aged it should give it away and abandon its socialism.


Mr Milton —Ha, ha!


Mr DONALD CAMERON —The honourable member laughs. The Government has introduced an assets test to screw money out of the aged and it is now throwing them out of the hospitals. I can tell the Government that in the community there is a growing concern about this issue, a growing fear of growing old because of the way in which this Government is treating the aged. We have already seen the development of long queues of people waiting for health care. Medicare is already cracking and the Government knows it. The classic words of Dr Chang from St Vincent's Hospital were that he came to a country that had the best health care system in the world. What has the Government given us? The ideals and hopes of the socialists have been implemented and we are seeing health care in this country grinding to a halt. I am the first to admit that the previous health care system had imperfections. But heavens, one does not throw out the baby with the bath water, and that is what the Government is doing.

In the last minutes available to me I make a plea to the Minister. If his real ambition is to destroy the private health funds, let him continue to do nothing. The speech that he delivered in the last couple of days revealed how he was monitoring or examining groups such as American Express International Inc. Some groups are being very selective in offering hospital cover at lower rates. They are groups which have walked away from community ratings and are channelling their advertising towards the younger end of the market, the well end of the market. This situation has been going on for months. I raised the matter in the first session of Parliament this year. The Minister knows that this is slowly choking the private health sector. He wants that to happen, does he not? The Minister cannot wait for the private health funds to disappear to enable him to get a monopoly and introduce his salaried system for the medicos. That is his long term plan. The Minister stands before groups and says: 'I am monitoring this situation'. While the groups are being slowly strangled the Minister just says to himself: 'Give it more time. Let them choke themselves and then I will move in'. If the Minister is fair dinkum he will do something about the situation immediately.


Mr DEPUTY SPEAKER (Mr Rocher) —Order! The honourable member's time has expired.

Sitting suspended from 6.28 to 8 p.m.