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Wednesday, 26 October 1949

Mr HOLLOWAY (Melbourne PortsMinister for Labour and National Service) . - by leave - I move -

That the bill be now read a second time.

The main purpose of the bill is to amend section 6 of the National Health Service Act 1948. In its present form section 6 provides that the regulations may make provision for a scheme for payment by the Commonwealth on behalf of persons to whom professional services have been rendered by medical practitioners participating in the scheme. The payment would be a stipulated portion of the fee prescribed for the particular purpose. Honorable members are aware that the Commonwealth proposes to pay direct to the doctor 50 per cent, of the fees charged by him for services given to the patient. The Government also proposes to prescribe a schedule of maximum fees chargeable by doctors who voluntarily participate in the scheme. The Government is anxious to introduce the scheme as early as possible so that its benefits may flow to persons who need medical attention, and much of the detailed work has already been done. In framing the regulations, however, it has become apparent that if section 6 were left in its present form payment for medical services would be rigidly and literally limited to those items which are expressly referred to in schedules of the regulations. From an administrative standpoint such an inelastic system has serious disabilities. It is hot considered feasible to draw up a complete and comprehensive schedule embracing every possible medical condition or combination of conditions that would be met with in practice. Furthermore, it is doubtful whether any set of regulations which attempted to conform strictly with section 6 in its present form could provide for the exclusion of certain patients - for example, compensation cases and persons living in areas in which other classes of medical services are provided - or permit the making of special arrangements, if thought desirable, where agreements for the provision of medical services exist between doctors and particular groups such as friendly societies and industrial and other medical schemes. There is also some doubt about whether section 6 permits a mileage allowance to be prescribed which would have regard to the actual mileage travelled by doctors to render professional services in rural areas.

The measure now before the House is designed to provide the flexibility which will ensure that the regulations shall be so drawn that the benefits contemplated will reach the people to the fullest extent. At the same time it has been thought desirable to extend the section to show in outline the general nature of the scheme.

Clause 3 of the bill provides for the repeal of section 6 and the substitution of a new section which will enable the Minister to make special arrangements of the nature already referred to, where such a course is desirable. Another important feature of the clause is that it provides that three months' notice must be given before any fee can be reduced. Clause 4 provides for the deletion of the word " advisory " from section 16 of the act. Section 16 enables the Minister to establish such advisory committees as he thinks fit for the purposes of the act. It will probably be found desirable to establish committees other than those of an advisory nature and the section in its new form will be less restricted. Clause 5 extends the power which may be taken under the regulations by providing for the investing of any court of a State with federal jurisdiction over matters arising under the scheme. I commend the bill to honorable members.

Debate (on motion by Mr. Harrison) adjourned.

Sitting suspended from 5.4-7 to 8 p.m.

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