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Tuesday, 23 September 1958

Dr DONALD CAMERON (OXLEY, QUEENSLAND) . - in reply - When the honorable member for EdenMonaro (Mr. Allan Fraser) was speaking this afternoon, I said that I would refer to one point that he made. That was the question of the payment of hospital benefits for the inmates of benevolent institutions. As I pointed out in my second-reading speech, the bill provides for hospital benefits and is not intended to apply to institutions which are not regarded as hospitals. There are a great many pensioners who live in convalescent homes and receive their pension of £4 7s. 6d. a week. A great many of those convalescent homes are approved by the Commonwealth Department of Health as private hospitals and where the patients are enrolled as members of a hospital insurance organization, they receive hospital benefits as well. It is not proposed to interfere with those institutions or the inmates of them, but it is not proposed to go further and extend hospital benefits to homes which are not hospitals. I am sure that the House agrees that that is a reasonable provision.

The amendments which are being moved under this bill are to provide hospital and medical benefits and, as the honorable member for Eden-Monaro has remarked, there are, in addition to the type of institutions I have cited, other institutions part of which are approved as hospitals. Now, where part of the institution is approved as a hospital, hospital benefits are payable; but this is a bill for the provision of hospital benefits and it is not intended to provide hospital benefits in respect of homes for aged people which, in fact, are liberally assisted by this Government under another act.

I want to deal with another matter which was referred to by the honorable member for Eden-Monaro in opening the debate for the Opposition this afternoon. Although these are not the actual words he used, I think I can claim that they convey fairly the sense of what he said and if they do not, he can correct me. He said the Australian Labour party believes in voluntary insurance organizations and in the encouragement of private societies, but objects to the necessity for individuals to have to join them to obtain the payment of Commonwealth benefits. I think that is a fair summary of his statements.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - It is not exactly what I said, but it is a fair summary.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - The honorable member for Eden-Monaro went on to say that if the Labour party came to power, is would put an end to this system. If those are not his exact words, I think that my statement is a fair representation of what he said was the attitude of the Labour party towards this system, of obtaining public benefits through societies in this way.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - Making it necessary to belong to a private society to extract the Commonwealth benefit.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - I must say that, personally, I cannot see why there is something wrong with the assistance of a type of social service which is, in effect, a self-help social service with public funds. That is, of course, the whole basis on which funds are supplied to the national health scheme. If honorable gentlemen opposite object to this use of public funds, they have every right to object to the Aged Persons Homes Act, although I have never heard them do so because, in fact, until somebody raises some money and spends it, no public funds are available to them under that act. When they do raise money and spend it, those institutions can receive assistance from public funds. The cases are strictly analogous.

The second thing I want to say about the statement which the honorable gentleman from Eden-Monaro agrees I have correctly presented is that I hope that every one realizes what he has actually said and what is the implication of it because he has, in fact, foreshadowed the end of the voluntary organizations so far as national health insurance is concerned.


Dr DONALD CAMERON (OXLEY, QUEENSLAND) - The friendly societies can end what they are doing because some other method of providing funds is to be introduced by the Labour party in government. The Blue Cross organization can shut up shop and go out of existence. I hope that the hundreds of thousands of contributors to that organization can appreciate that fact. The great voluntary societies which come under this national health scheme can wind up because the Australian Labour party will no longer continue a health scheme through which those societies handle public funds. There are hundreds of thousands of people in the community who are insured in those organizations. Friendly societies have operated them for years, but the Australian Labour party is now serving notice on them that those activities can come to an end under whatever health scheme the Australian Labour party produces.

I hope that is appreciated by the friendly societies and other organizations and the enormous numbers of persons who are insured with them, because what other interpretation can be put on the honorable member's statement? Either the Labour government - if we are unfortunate enough to have one - will set up some other method of making these payments or it will introduce some compulsory system under which people will join the organizations the Labour party thinks they should join. What has happened - and I repeat it - is that the Australian Labour party has served notice on the friendly societies and benefit organizations that, if the Labour party is elected to power, their day is ended.

I want to say one or two things about the Pensioner Medical Service because honorable gentlemen have spoken about it to-day and have been rather critical about it. I want to remind the House that those who enjoy the full benefits of the Pensioner Medical Service under the present National Health Act number in this community almost 700,000 people. I would think that that means that there are 700,000 people upon whom this Government has conferred great benefits and who previously received no benefits of this sort at all.

During the debate this afternoon, honorable gentlemen opposite said that a means test was imposed on pensioners before they could get pensioner medical service benefits. That is true, but it is nothing to the means test that was imposed by a Labour government before pensioners could get a pension at all. In fact, although there is a means test, it applies only to those people over and above this number of approximately 700,000, who have means which are estimated to enable them to pay contributions to benefit societies.

What are the rates that it is necessary for people to pay in order to belong to a benefit society? A single person can insure himself for hospital benefits for 3d. a week. To-day we have heard from the other side of the House a great story about how people are too poor to afford the rates of contribution. I put it as a matter of common sense to the House that if a person is so poor that he cannot afford 3d. a week, surely he will be in the pensioner medical scheme anyway, or be provided for by the repatriation scheme, or some other scheme of that sort. The lowest rate for which a single person can insure himself for medical benefits is 9d. a week. So, this story about deprivation of benefits because they are so expensive really falls a little flat.

Having said this about the pensioner medical scheme, I should like to point out that although there are some exclusions, they apply only to those who have income in excess of their pension out of which some small contribution might reasonably be expected to be made. There are, in fact, only about 50,000 persons who are pensioners and who are unable to participate in the scheme, and about 700,000 who are pensioners and who are able to participate in the scheme. Fourteen out of every fifteen are able to participate, and for those remaining the rates of contribution to a benefit organization are extremely low.

I say finally two things about the pensioner medical scheme. The first is that in spite of the criticism that honorable gentlemen opposite have offered about it, they, when in government, never thought of any pensioner medical scheme at all. They never thought of providing medical services for pensioners. So, for whatever criticisms they have to offer now, it is a little late in the day. The second and final thing I want to say about the pensioner medical scheme is this: Through your indulgence, Mr. Speaker, which we have all appreciated, we have been able to debate the scheme during this afternoon and to-night, but the plain fact, if I may take the liberty of saying so, is that this bill has nothing at all to do with the pensioner medical scheme; it is about an entirely different matter.

So I pass from the pensioner medical scheme and say a few words about what my friend the honorable member for Port Adelaide (Mr. Thompson) said this afternoon. If I may say so, he made the only constructive speech that came from the opposite side of the House during the whole course of the debate.

Mr Ward - Are you trying to destroy him?

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - It is apparently easy for people in the party opposite to be destroyed, without anybody outside the party trying to do it. They are continually destroying each other. One instance of that occurred this afternoon. If I may refer to it again. The honorable member for Eden-Monaro approved of the principle of people not being able to make a profit, as we call it, out of hospital insurance, but the honorable member for East Sydney condemned any action which would prevent it. I leave it to honorable members opposite to fight it out amongst themselves.

I want to refer to some- things that the honorable member for Port Adelaide said. The first relates to the provision of proprietary medicines for pensioners. It is a fact that there are some proprietary medicines which are not available as pharmaceutical benefits to pensioners, but pensioners have available to them the entire range of general pharmaceutical benefits which are available to the whole population, a special formulary which comprises a very extensive list of special pharmaceutical benefits for pensioners, and any drug which is the subject of a monograph in the British pharmacopoeia, and which a doctor may prescribe without reference to the special formulary, if he wishes to do so. This covers almost the entire range of medicine. The only drugs not included are certain proprietary preparations, and the practice is that these should not be made pharmaceutical benefits without the advice of the specially appointed committee.

It is true to say that some doctors may not agree with the committee, but surely the Government, if it is to use public funds to pay for pharmaceutical benefits, must be guided by the advice of the specially skilled people appointed to guide it. This committee consists of most expert people, actively engaged in practice, and I may tell the honorable gentleman that they do not rely only on their own judgment. They frequently take the advice of such eminent bodies as the Royal College of Physicians and the Royal College of Surgeons. So nobody can say that adequate .provision is not made. As I said by interjection to the honorable gentleman this afternoon, I believe it is true to say that where a drug is not included on the list, there is almost invariably on the list and available as a pharmaceutical benefit a completely adequate alternative.

I want to refer briefly to what the honorable member for Bradfield (Mr. Turner) said about the institution of a higher table. This matter has received some thought by my department and by the Government, but it is outside the scope of these amendments. I believe that in insurance it is a good maxim to proceed step by step. The present amendment will provide a great deal more benefit to a great many more people. It is not correct to say, as the honorable member for Wilmot (Mr. Duthie) said to-night, that a great many people were excluded from the operation of the scheme and were unable to benefit by it at all. Commonwealth benefit has always been available to persons suffering chronic and pre-existing ailments. The Government has never excluded them. What the Government is doing now is to make them eligible not only for Commonwealth benefit but also for fund benefit.

Mr Duthie - The funds rejected them before.

Dr DONALD CAMERON (OXLEY, QUEENSLAND) - That is so. The funds rejected them, because the funds had to act on insurance and actuarial principles. Nobody condemns them for doing that. The Government is now making it possible for the funds to extend their benefits.

I do not think that on this second reading it is necessary for me to say very much more, but I want to make one reference to the National Welfare Fund. It has been said in the course of this debate that although the National Welfare Fund pays out now far greater sums than it did under the previous administration, it is no more effective. I thought that that was a most extraordinary statement. Not only is the fund a much larger fund, but also it provides for a much larger range of social services. It provides, in fact, for the entire national health scheme. It provides, for instance, for all the Salk vaccine used throughout Australia. It did not provide for any of these things under a Labour administration. I really cannot understand why any one should now say it is less effective. The plain fact is that the Labour party, which is now grudgingly accepting these amendments to the national health scheme was, during its own term of office, completely unable to produce a national health scheme which was acceptable to the people of Australia. In fact, one of the greatest reasons for its dismissal from office in 1949 was the fact that it attempted to introduce a health scheme which was quite unacceptable not only to the professional classes, not only to the doctors, but also to the great majority of the electors. Any criticism that honorable members opposite have to offer of this scheme falls rather flat. Those people who have not been able to introduce a health scheme of their own have little right to criticize any alleged deficiencies in a health scheme introduced by others.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - I wish to make a personal explanation.

Mr SPEAKER - Does the honorable member claim to have been misrepresented?

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - Yes, I have been misrepresented by the Minister for Health (Dr. Donald Cameron) in relation to two matters. In the first place the Minister stated that I had foreshadowed the end of voluntary benefit organizations and had stated a policy for the destruction of friendly societies and Blue Cross organizations. That statement is entirely untrue and is in direct contradiction with the statement that I made in the House earlier to-day. In the second place, the Minister declared that I had agreed that a contributor should not be allowed to make a profit out of his membership of a benefit society. That statement is also entirely incorrect and completely misrepresents what I said. On the first point, I told the House this afternoon that the Labour party, while believing in voluntary insurance and encouraging citizens to belong-

Mr Wheeler - I rise to order. Is this a personal explanation?

Mr SPEAKER -The honorable member is making a personal explanation. I ask him not to enter into debate. He should confine himself to the matters in respect of which he claims to have been misrepresented.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - The Minister misrepresented me when he stated that I had foreshadowed the end of voluntary benefit organizations and had stated a policy for their destruction. What I said was that the Labour party, whilst believing in voluntary insurance and encouraging citizens to belong to private societies, was utterly opposed to the indirect compulsion in the present scheme which withholds the Commonwealth benefit, which the citizen has paid for by his taxes, unless he first joins a private organization. I added that the Labour party had maintained its objection to that system ever since the legislation was introduced eight years ago, and would eliminate that obnoxious provision. In other words, the Labour party will maintain the voluntary societies which the Minister says it will destroy, and in the second place-

Mr Joske - I rise to order. The honorable member is complaining about misrepresentation and he is quoting what he said, which shows that the Minister was correct.

Mr SPEAKER - I ask the honorable member for Eden-Monaro not to enter into a debate.

Mr ALLAN FRASER (EDEN-MONARO, NEW SOUTH WALES) - The second point made by the Minister was that I had agreed that a contributor should not be allowed to make a profit out of his membership of a benefit society. I never said anything of the kind. I fully believe that a man who pays his fees to a benefit organization should be allowed to receive the full benefit from that organization. What I did say was that in the special cases now to be provided for by this legislation, where a man has exhaused all his benefit rights from a society and where the Commonwealth now comes in to make up his requirements in that respect, the benefit payable to him should be limited to the actual additional cost of his treatment.

Question resolved in the affirmative.

Bill read a second time.

In committee:

The bill.

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