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Tuesday, 23 September 1958

Mr MAKIN (Bonython) .- -The House is now dealing with the National Health Bill 1958, and honorable members have just had the advantage of hearing the right honorable member for Cowper (Sir Earle Page), who is certainly entitled to be heard with attention on this subject. . He has expressed himself upon this health scheme, of which he has been the principal architect. We can understand the right honorable member offering a very stout defence of the provisions of this measure which governs the medical services to the Australian community.

I feel that we do not always approach this subject with a proper appreciation of our obligations. Our understanding should not be governed only by broad humanitarian principles; we should have regard also to the methods by which we can distribute to the community the benefits of prosperity which its members are entitled to share. Whatever may be the provisions in social legislation of this kind, Parliament should seek to ensure that every member of the Australian community receives benefits on the basis of equity and fair dealing according to the ability of the Government to provide them. I feel that this bill, unfortunately, fails to give expression to that ideal.

I wish to correct an erroneous idea which has been held concerning the British national health scheme. A statement was made here this afternoon that a person must accept the medical practitioner who is allotted to the area in which he lives, whether that practitioner is acceptable to him or not. That is not correct. Any person can make his own choice of medical practitioner, and if at any stage he wishes to change to another practitioner, he is at liberty to do so. I hope that those who may seek to discourage the idea of a national health scheme will keep a little nearer to the truth when they attempt to justify their hostility to it in principle.

This legislation moves a little nearer to the ideas that the Labour Opposition has been putting forward from the very beginning of the consideration of these subjects. We feel that, inevitably, the Government will find itself compelled to accept instalments of that policy which we have expressed from time to time. The right honorable member for Cowper sought to chide members of the Labour Opposition for, as he said, not introducing legislation such as this while Labour was in office. But he failed to mention the fact that the scheme of medical aid that was given to the Australian community by a Labour government provided for everybody. As it covered every man, woman and child in the community, there was no need to specify people in certain classes.

Therefore, I say that the right honorable gentleman possibly desires to place certain people in an invidious position by drawing attention to special circumstances of need or age. There was no need to certify as to need or age under the scheme that the Labour government sought to establish, because every man, woman and child was covered. That being so, I say that the right honorable gentleman did less than justice to the principles that were laid down by the Labour government in those earlier years.

This Government, in the light of the ever-increasing claims for medical care and treatment that age brings, has found that on the basis upon which the medical fund was originally established, the benefit asso ciations cannot afford to provide persons of 65 years and over with an adequate cover. Therefore, the Government itself has had to accept the responsibility for these people. Now, the bill before the House provides for the establishment of a special account into which contributions will be paid in respect of people of 65 years of age and over and people with preexisting or chronic illnesses, and this account will be guaranteed by the Government. In other words, there is an acceptance, in principle, of the idea that the Government should effect, in part, a form of nationalized effort in that direction. The Government has at last been compelled to meet the position of people in these special circumstances. Members of the Labour party feel satisfaction that, inevitably and progressively, Government policy has had to veer towards the policy that we have advocated. We make no apologies for having stated that it is the obligation of the nation to provide proper services for thehealth and well-being of all.

Therefore, I feel that this legislation, while certainly belated, at least does provide for a very essential service to chronic sufferers and to the aged who, generally speaking, require greater consideration and care than those of lesser years. Many people are not in a financial position to meet the charges involved in treating the infirmities and chronic illnesses of the aged, and have been denied, in many instances, the facilities that are essential to their care.

With other honorable members, I offer a very strong objection to the lack of consideration for people who are not members of a voluntary medical scheme. Surely there should be no differentiation merely because of this circumstance. It may be that conditions will prevent some people from making a contribution to a medical scheme. That fact should not deny to them the full advantage of whatever can be made possible by the Government. I feel that we should consider this matter on the broadest basis possible and afford the greatest help that we can.

I was interested to note that the right honorable member for Cowper was impressed by the economies that had been effected in the general administration of insurance funds. The honorable member for Werriwa (Mr. Whitlam) was good enough to place in my hand a copy of a statement by the Minister for Health (Dr. Donald Cameron) who, in answer to questions on notice, indicated that in 1957 an amount of £8,919,018 was paid in contributions to such funds. The benefits that were paid amounted to £7,012,055; the amount spent in management expenses and other administrative costs was £1,011,045, leaving a balance of £895,918. Those are most interesting figures, and I feel that we should analyse them.

There is, however, one other feature of the Minister's reply to which I should direct attention. It appears that patients still have to pay 37.5 per cent, of the cost of treatment for which claims are accepted by the medical benefits societies. It is obvious that the Australian people have nothing approaching a free medical service. The present scheme still requires members of the public to make heavy payments for medical treatment, in some instances far greater than their circumstances reasonably allow them to make. One honorable member said during this debate that many persons are enabled to make the necessary payments for medical treatment because of the social service benefits that they enjoy. The value of social service payments to-day does not compare with their value in the days of the Chifley Labour Government. It is of no use for honorable members opposite to suggest that because the rate of payment for a particular social service is greater than it was at an earlier time, the recipient gets an added benefit from it. This is not so. In fact, the amounts received by recipients of social service benefits are by no means adequate. In regard to the social service legislation that they have implemented, Government supporters will have to answer for neglects that could have very serious and far-reaching consequences in the future.

Let me say a word to those who are concerned with the administration of our medical services. Never forget that the nation is extremely generous towards those engaged in the medical profession. It grants subsidies to universities, and it provides substantial amounts of money for medical research of all kinds. The community is constantly making contributions towards the advancement of the science of medicine, and it rightly requires that the members of the medical profession should give in return the widest and best possible service. I hope that at some time in the near future, this

Parliament will provide a free and comprehensive medical service for the people of Australia. I believe that we have a responsibility to do so.

Let me say in conclusion that the division of control over health matters between the States and the Commonwealth does not help to promote the degree of efficiency that we have a right to expect. We need a greater degree of co-ordination between State and Commonwealth authorities. The provision of hospitals and medical services generally is becoming such a heavy financial responsibility that the Commonwealth will be compelled to accept an obligation to provide increasingly greater funds to the States for these purposes.

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