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Tuesday, 13 June 1989
Page: 3919


Senator PUPLICK(10.32) —While the Minister is getting that information I draw attention to a couple of matters which arise from his previous answers. I think they reveal the validity of having decided that this matter should be sent to a Senate committee for further investigation. In essence, the Minister has told us that the Government proposes to introduce a scheme the basis of which is a working paper. It is not even a negotiated, concluded formalised agreement; it is a working paper which has allegedly been circulated to all sorts of general practitioners. Needless to say, this chamber, asked to vote on this legislation, has not had the courtesy of being provided with copies of that agreement or working paper. Senator Walters has asked for a copy. Undoubtedly, she will be provided with one, and I hope that courtesy will be extended to all senators who have taken part in this debate.

There is little surprise on this side of the chamber at the enthusiasm with which Senator Cook is commending this closed shop agreement. That is what it amounts to. I understand the warm inner glow which Senator Cook has for closed shop agreements, negotiated with the Government by a particular minority in one field of medicine to the exclusion of other parts of the medical community, to the exclusion of some of the other general practitioners and, of course, to the exclusion of the proper interests of patients. It will be recalled that Senator Cook did not in any sense answer the question which I put to him as to what is the benefit to individual patients. He said that this was a matter of promoting better quality patient care. We do not promote better patient care simply by paying some doctors more than others unless the Government is prepared to accept the corollary of that proposal; namely, that those people who are provided with medical services by people who are not vocationally registered, for whatever reason, should accept that they are being provided with lower quality health care. That is the corollary of the proposition which the Minister has put to us this evening. We have not had an answer to Senator Walters's fundamental question as to why people in the sort of situation she described would bother constituting themselves into a general practice anyway in terms of the arrangements which the Government is now putting before us.

Finally, the Minister has not been prepared to indicate to the chamber the full details of the Independent Peer Review Organisation. We are all in possession of a document entitled `Independent Peer Review Organisation-Operating Principles'. The Minister should either tell us that this is a forgery, a bogus document, a nonsense document, or the basis upon which the auditing and monitoring functions will be carried out. If it is the latter, the Minister should table it and make it part of the formal public record so that we can debate it; otherwise, we will go through the charade of people reading out sections of the document claiming that they represent the concluded agreement or that they are operating principles. The Minister should tell us what it is. We all have the document. There is no great mystery about it. If the Minister is not prepared to table it, we will table it. He should tell us whether the concerns which have been raised about the way in which certain principles will operate are legitimate. He should tell us what the Government says these particular matters are. He should come clean with the answer to the question Senator Patterson has raised so that we will be able to make some progress, otherwise we will go through the process this evening of having a look at these 25 principles. It will be like drawing teeth. The Minister should tell us what they are.