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Tuesday, 15 December 1992
Page: 5052


Senator TATE (Minister for Justice) (8.41 p.m.) —Senator Walters has raised—genuinely, but in a way which itself was laced with ideology—some questions which need to be addressed, but I will deal firstly with the more objective matter of waiting lists. I agree with Senator Walters in regarding it as a disgrace that a State in Australia is not able to describe the waiting list situation in the jurisdiction for which it is responsible. I think the fact that Queensland does not have such a list is a matter which ought to attract adverse comment—and obviously has.

  I think it will be extremely important, if we are to reduce the waiting lists—whether known with precision or just anecdotally—to an acceptable level, for that information to be made available so that proper programs of management can be put in place to reduce the waiting time. There is no doubt that the $70m over two years, which is not a huge amount, will help in that waiting list reduction program. But it ought to be seen in the context of the $1.6 billion over six years which will be put into the public hospital services of Australia under the Medicare agreements to be negotiated, which I believe will have a cumulative effect of reducing those waiting lists.

  I think it is worth mentioning that the Prime Minister (Mr Keating), at the heads of government meeting in Perth, cut the nexus which had been in place between in-principle agreement to the Medicare agreements and the provision of the waiting list moneys—the $70m over two years. He invited States such as New South Wales and Victoria immediately to enter into a subsidiary agreement, a completely separate arrangement, to allow those moneys to flow into their jurisdictions to help reduce the waiting lists in New South Wales and Victoria, even though in principle they may not be prepared at this moment to agree to the Medicare agreements.

  I would go one step further and say that if those States do not make that move to accept the waiting list money in the near future, given the instances which Senator Walters brought to the attention of the chamber, perhaps the Commonwealth should look directly to funding the hospitals concerned, bypassing the States with waiting list moneys. The money is sitting there. It is a human tragedy, and a fatal situation for some, that that money is not being expended. I believe that all the States ought to take up those moneys.

  As to the question of ideology, I think Senator Walters undervalues the contribution which she has made to the Australian health system simply by the payment of her taxes and the Medicare levy on the high income she has been earning over the last several years. That gives her an entitlement to go into the public hospital system to receive treatment for an illness or to undo the effects of an accident that she may have suffered.

   Senator Walters is not correct to use the terminology she did when she said that she would be somewhat embarrassed or would feel that she would be bludging on the system if she were to go into a public hospital. She is entitled to go into a public hospital. She has paid high taxes, and a high proportion further by way of the Medicare levy over many years, to help provide those services. I believe that she is entitled to go to the Royal Hobart Hospital if she so desires.

  Of course we cannot go into personal details, but Senator Walters chose to go to a private hospital, I take it, in order to have the treatment she required. That is a choice that the honourable senator made. She made it because she had chosen to take out private health insurance. Once again, I believe that is the correct ideological position. We favour choice. We favour the fact that one should choose, if one so wishes, private health insurance. I admit that I made an error in my rather flamboyant reply in the chamber the other day about the question of Fightback and private health insurance.


Senator Brownhill —It is not like you to be flamboyant.


Senator TATE —I was carried away. But I do think it is still true to point out that under the Fightback package a person with the income of Senator Walters would be penalised through the tax system if she did not take out private health insurance—and I think Senator Walters would agree that that is true.


Senator Walters —That is true.


Senator TATE —So there would be a tax penalty.


Senator Walters —Yes.


Senator TATE —Yes. We have not reached that stage. We believe that Senator Walters is certainly free to choose to take out private health insurance. It is the right of Senator Walters in a free society to do so and give herself that further possibility, therefore, of taking the treatment that she wishes in a private hospital for the sort of surgery that she requires. But we do not believe in a form of coercion by financial penalties which are involved in the Fightback system at the higher end of the tax scale.

  Finally, I think it also has to be said, on behalf of some of our very well regarded public hospitals, that the reason a person might choose and want to be treated there rather than at a private hospital is simply because of the reputation of the public hospital. Perhaps it has a clinical school attached to it and is a teaching hospital. It may well be that a person would make a very positive choice to be treated in the public hospital rather than in the private hospital and to exercise their entitlements, as I say, which they have as a taxpayer and Medicare levy payer to be served there as a public patient.

  That is the brief answer, and I think we could go on all night about the personal reasons which underlie our commitment to a particular form of the provision of hospital services and their financing.  Senator Walters has given her personal anecdote; I might just give mine. In 1963, when at first year uni I had a massive car accident, my parents were on the top of the MBF table. Like most Australian families after the war, my father had paid in at the top rate to protect his family. I forget what it was, but I think it was after a hundred days, or maybe it was 10 weeks, the MBF payments ceased and we were thrown back on to the financial resources of a family of two parents and three young children all being educated. Quite frankly, those resources were stretched to the absolute limit to deal with a situation where one was in hospital for month after month after month, year after year after year. It caused financial trauma, on top of the need to be healed physically so far as the family was concerned.

  I determined then that if I were ever in a position to ensure that regardless of apparent income a person would be entitled to hospital services of a high quality without having to be financially traumatised by having to face very high hospital bills or the need to take out very high premium payments in order to protect oneself against an eventuality, I should look for something better than my family and I were confronted with at that time. That is the reason I have always been a very strong supporter of Medicare; and I believe that these particular principles and commitments are deserving of the support of the Parliament.