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Tuesday, 23 September 1958

Mr JOSKE (Balaclava) .- This is a bill to amend the National Health Act. It is not being opposed by the Opposition, but it was clear during the debate this afternoon that, while the Opposition could find no fault with the bill, it still did not like the policy of the Government with regard to national health, and that Opposition members still believe in their policy that national health services should be entirely socialized. The concluding remarks of the honorable member for Port Adelaide (Mr. Thompson) showed that he considers that the bill is a sound bill. In that respect he did not differ from the views expressed this afternoon by his colleagues.

As I have said, the Opposition clearly believes in socialized health and socialized medicine, whereas the Government believes that the spirit of free enterprise should exist in the sphere of health and medicine, as in every other sphere. The Opposition has always taken the view that socialism must come before everything else. The main objection by the Opposition to the Government's national health plan - apart from their theoretical ideas based upon socialist doctrines - is that the Government's health scheme has worked, whereas the Opposition's health proposals were gross failures and it was never possible to carry them out.

Mr Duthie - Because the British Medical Association sabotaged them.

Mr JOSKE - The proposals were so outrageous that the Labour party, when in government, was unable to carry them out. They were of such a nature as to be amongst the main causes of the defeat of the Labour Government in 1949. I suppose there is no one who remembers that more bitterly than does the honorable member for Wilmot (Mr. Duthie), who, in his inveterate style, interjects, and interjects, and interjects, and adds to the empty air. The Government has succeeded in what it has done, as can be seen when one looks at its policy with regard to immunization, tuberculosis allowances, treatment of tuberculosis sufferers, free medical service for pensioners, free life-saving drugs, free milk for children, or anything else.

A great tribute should be paid to the right honorable member for Cowper (Sir Earle Page), who introduced the current national health legislation. At the time that that act was, as a bill, before the House, I had the privilege of being able to praise the work that had been done by the right honorable member for Cowper. I regret to say that the gentleman from the Opposition who followed me was inclined to doubt that the praise was due, but he has met with his deserts. He is no longer a member of this House, and I warn such people as the honorable member for Wilmot, and the honorable member for Yarra (Mr Cairns), who is also constantly interjecting, that they too may meet with their deserts before very long.

Our hospital and medical benefits scheme, which is operated through the nonprofit health insurance organizations in this country, has been extremely successful. It is approved, not only by the organizations concerned and by the medical profession, but also by the public at large. It has greatly reduced the cost to the individual citizen of medical and hospital services, and it has ensured that the best hospital and medical services are easily obtained. It has not meant a great increase in taxation, as would have been the result if we had had the socialized medical and hospital services which the Opposition wished to bring into existence. It has not meant tremendous additions to the Public Service, which would have resulted if we had had nationalized medicine.

We have had the experience of organizations working with the Government for the benefit of the people as a whole. This has been one of the most successful instances in which, in line with modern theory, private enterprise has been able to carry on with the assistance of governments. Governmental action has been taken to the extent that private enterprise needs to be supported by that action. This bill is another instance in which the Government has come into the field which private enterprise is not able wholly to fill, but in which private enterprise is playing a very great part indeed. If we contrast the Government's policy with Labour's policy of socialization, with all the waste and inefficiency that goes with socialization, what do we see? Labour was unable to put its policy into effect because it could not get the medical profession to co-operate. Why was that so? According to statements made in this debate, the medical profession went on strike and, according to members of the Opposition who used that phrase, that was an appalling thing to do. But I have heard the honorable member for East Sydney (Mr. Ward) and many of his colleagues uphold the right to strike. They claim that a person is entitled to strike in a just cause. I should have thought that the term " strike " was wrongly applied to members of the medical profession, that they were not striking but evercising the fundamental right to carry on their occupation freely as they thought fit, believing that they should not be bullied or pushed about by any government or any set of individuals.

I fail to understand how the Opposition can by referring to the action of the doctors as a strike, command any support in its favour. Honorable members opposite say that they believe in the right to strike, but when people exercise what they are pleased to describe as the right to strike, they object Their reasoning does not make sense. It shows how thoroughly biased and one-eyed members of the Opposition are. It indicates clearly that the Labour party is a class party.

Mr. Speaker,it is important to stress that the Labour legislation was of such a character that it was declared illegal by the High Court on the basis that it involved a form of civil conscription. Honorable members opposite claim to belong to a party that is a lover of freedom. Their Leader, the right honorable member for Barton (Dr. Evatt) would have us regard him as the apostle of freedom. I have repeatedly said in this House that far from being the apostle of freedom, he has shown himself in fact to be a person who would grind with his heel anybody who was a freedom lover. The legislation that Labour forced through this House, and through another place, involved nothing less than civil conscription. That is the type of health legislation which the Labour party would bring into being. Labour would like to see on the statute-book legislation under which doctors had to do as they were told, and not act according to the dictates of their knowledge and skill gained after long years of study and much experience. If Labour had its way the doctors would be told by the bureaucrats that they had to prescribe a particular type of medicine, and that they had to do certain things. They would be told which patients they had to attend to, and they would not be allowed to take patients just because the patients chose them. The important relationship between doctor and patient would be gone for ever. Honorable members opposite have indicated in this debate, by implication only, how they would like to have in force in the community a socialized system of medicine and hospitalization whereby one did as one was told, swallowed what one was told to swallow, and submitted to surgical operations according to the wishes of the authorities. That is what would happen under a system of civil health conscription. What would be our condition in those circumstances? Let me refer to what some honorable members opposite have said in this debate.

The honorable member for Eden-Monaro (Mr. Allan Fraser) made a speech this afternoon wherein he showed himself to be living in a realm of fantasy. I assume that he believed what he said, and his remarks can be justified only on the basis that he is lost in his own imaginings, because what he said was far from concrete fact. He objected to the bill because a person goes to his insurance company or his benefit society and makes his own private arrangement. He described making private arrangements as immoral, and he was aided and abetted in his description by the honorable member for Wilmot, who said that making private arrangements was scandalous. So private arrangements, which people may wish to enter into, are described by members of the Labour party as immoral and scandalous. Such a view can be sustained only on the basis that they believe that all medicine and all hospitalization should be socialized. While the honorable member for Fawkner (Mr. Howson) was making an excellent speech this afternoon the honorable member for Eden-Monaro interjected, " We are not socialists. Wait until you see our policy for the next election and hear what we say on this point ". Apparently the electors are to get a sugarcoated pill.

The honorable member for Bonython (Mr. Makin) is interjecting. I do not know what he is saying, but I am not worried because I know there is nothing in his remarks. When the honorable member was objecting this afternoon to our disparaging of a nationalized health scheme, one could sense his nostalgia for that kind of scheme. Of course, honorable members opposite want nationalization of health. Are they not socialists at heart? Just take the two honorable members sitting on the Opposition side of the table - the honorable member for East Sydney and the honorable member for Hindmarsh (Mr. Clyde Cameron). What greater socialists are there in Australia than those two honorable members? The honorable member for East Sydney, as the House will remember, declared himself recently on that subject in a television interview in Sydney. We all heard the honorable member for Hindmarsh " come clean ", if I may use that expression, with regard to his views on socialization. Of course they are socialists, and they want to socialize medicine and hospitalization if they can do so. The honorable member for Grayndler (Mr. Daly) - again a socialist - spoke this afternoon. What did he say? He made a piteous cry about the way the pensioners are being treated under the national health scheme. One does not forget that the honorable member for Grayndler and the honorable member for Bonython were in this House in 1949 when the pensioners were crying aloud to be given extra benefits.

Mr Makin - I was not here.

Mr JOSKE - I will leave out the honorable member for Bonython; I understand that he was not here. But the honorable member for Grayndler was here and he was crying out about how the pensioners were so badly treated. In 1949, when the pensioners were crying to the Labour government of the day for better treatment, the honorable member for Grayndler sat tight and never said a word to help them. That has been the form of the honorable member for Grayndler and his colleagues. When their government was in office in 1949, many of them who could have helped the pensioner did not do so.

This afternoon the honorable member for Bonython said that the position of the pensioner was worse under this Government than it was in 1949. That, of course, is quite contrary to the fact. The way in which the honorable member for EdenMonaro (Mr. Allan Fraser) tries to get over that position, as he has done more than once, is to ring the changes and say, " I will forget about 1949 and go back to 1948", and produces 1948 figures.

Now I turn to the provisions of this bill with regard to the aged, and pre-existing illness group and the chronic illness group.

All these people have been knocking at the door for some years, trying to get medical and hospital benefits under the national health scheme. The problem of providing for them has not been an easy one to solve. When the right honorable member for Cowper first introduced this legislation he drew attention to their position and said that he was working hard with a view to bringing them within the scheme. Now, the present Minister for Health (Dr. Donald Cameron) has been able to devise a plan by which they may be brought within the national health plan.

They are being brought within that plan without any extra cost to themselves other than is paid by a contributor to the plan. They get exactly the same benefits as any other contributor to the plan and they are not paying any more for it than is any other contributor to the plan. They do not have to do anything to obtain these extra benefits. The machinery is worked out between the associations, the organizations and the Government. If it turns out that the organizations have not sufficient in the new special funds which are being created to pay them, the Government comes to the aid of the organizations and provides the money.

There is no question, under those circumstances, of the Government seeking repayment from the organizations. The money is paid over to them and goes to them once and for all. This is a very excellent step forward. It is a feather in the cap of the present Minister and he is to be greatly congratulated for a very wise plan indeed. It has taken a lot of thought to evolve but it is generally accepted and approved.

My attention has been drawn to certain provisions in the bill on which the Minister might care to give some information either in his reply or at the ' committee stage. Clause 6 amends section 39 of the principal act and deals with cases where -

The Government of a State or an institution conducted by a State commences to pay contributions to the hospital benefits fund.

The question of the meaning of the word " commences " has been raised with me. Does it mean that existing inmates of benevolent homes will continue to receive special fund benefits or will they, from now onwards, receive special fund benefits in addition to the ordinary Commonwealth benefits that they would receive under the act?

Another point relates to clause 15 which adds a new division entitled " Special Accounts " to the principal act. In proposed new section 82e (i), as set forth in that clause, mention is made of persons who are in a benevolent institution - other than a benevolent home, convalescent home, home for aged persons, rest home and so on. lt has been suggested that there is some difficulty in Victoria owing to the fact that under Victorian law many of these institutions are treated as hospitals. Personally, I should have thought that that difficulty is overcome by sub-paragraph (ii) of proposed new section 82e, which provides that the institution .must be recognized by the Director-General as a hospital for the purpose of this paragraph.

Those who have commented on this matter to me have suggested that the emphasis should be placed not so much on the hospitals or homes as on the type of treatment given. Perhaps the Minister could deal with that matter.

Proposed new section 82j deals with records relating to special account contributors and sets out that organizations must maintain records which show the name and date of birth of each person covered by the contributions.

It has been suggested that this will place an undue burden on them for although they can give the name and date of birth of their contributors, in the case of large families and growing families they seldom get the name and date of birth of new-born children until a claim is made. An amendment might be framed to cover that particular position.

The only other matter I wish to mention, in the brief time left to me, is with regard to an Australian social welfare conference. Health can be regarded only as a branch of social welfare. In the United States of America national social welfare conferences have been held during the past 80 years, in Canada for 30 years and in other countries for quite a period. Australia has an annual immigration convention but that covers only one portion of social welfare. The question of national social welfare is a wide one and it might be a very good thing if the Government considered the holding of a national social welfare conference at which matters of health, amongst others, could be dealt with. Such a conference might be an annual or a biennial affair.

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