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Tuesday, 19 August 1980
Page: 384

Mr ROGER JOHNSTON (Hotham) - Firstly, I congratulate the Government for its responsible Budget, with all its help to those in real need. The details of the National Health Amendment Bill and the Nursing Homes Assistance Amendment Bill were well described by the Minister for Health (Mr MacKellar) in his second reading speeches. These Bills are being introduced for the benefit of all Australians. They are aimed at ensuring that taxes paid by Australians are not misused - a responsibility undertaken by this Liberal-National Country Party Government with an effect which has been seen in many ways.

Two points are covered by this legislation and they are straightforward. It is a pity that the Opposition has seen fit to make a lengthy speech complaining about everything. It is surprising that it sees fit to oppose the measures when all we are doing is knocking some crooks, saving the taxpayers money and helping pensioners. Honourable members on this side of the House care about pensioners. It is unfortunate that so much of this Parliament's time is taken up in combating the actions of a fraudulent few. We see it time and again. But this Government is determined to ensure that the taxpayers and, in the case of these Bills, the patients and registered health funds are protected against the cheats, the crooks and, let us face it, the real criminals.

I will give some examples of the false information supplied in support of applications for nursing home fee increases. Details about the employment of a handyman at $141 a week and two clerks at $172 a week were included in an application for a fee increase. Later inspection showed that these people had not been employed and that the overpayments involved some $25,000. In another example the expenditure incurred showed leasing cost of $ 1 ,944 in respect of kitchen and laundry equipment owned by the proprietor. The actual charge was to cover the leasing costs of the motor vehicle of the proprietor's wife. On another occasion a cheque for $1,522 was drawn and then cancelled but not adjusted in the books, therefore overstating expenditure by this amount.

In a third example a proprietor claimed for a clerk who was not employed and also padded wage costs to the extent of $48,000 per annum. In a fourth example a registered nurse and a nursing assistant were claimed on the standard staff roster when no such nurse was registered with the relevant board and the assistant was not known at the given address. A further example is the case of the proprietor who admitted to padding staff rosters and having falsified a complete wages book and a set of cheque butts. The falsification would have resulted in a fee increase of $ 1 .80 a patient a day of undetected expenditure. The last example is that of the inclusion in the expenditure for a year of $31,000 on an item which was not related to the nursing home. Wages claimed in another year included dummy staff and staff not related to the nursing home, thus increasing wage costs by $61,000. The benefits overpaid amounted to $54,000.

Basically, these Bills are about the supply of false or misleading information which will return the proprietors of nursing homes money to which they are not entitled. Whilst the words of the original Bills may not have been perfect, the aim was there. Nevertheless we have seen a few unscrupulous proprietors taking unfair advantage of the system to the disadvantage of patients and health funds and thus the public and taxpayers in general. Many people suggest to me that we put too many Bills through Parliament. At first thought I would tend to agree. However, each one has a definite purpose. I would welcome any suggestions about other ways to overcome the few crooks who rip off the system. These Bills are important and necessary.

Premises can be approved as non-government nursing homes subject to a number of conditions. The meeting of these conditions allows payment of Commonwealth nursing home benefits. One of the conditions is that the Government controls the fees. In practice, the Health Department approves a fee increase when the nursing home shows that its operating costs have increased. Commonwealth and registered health insurance nursing home benefits are reviewed annually. They are set to cover the fees being charged for 70 per cent of the beds in non-government nursing homes. This, of course, makes allowance for the minimum statutory patient contribution and the variation among States, but excludes the deficitfinanced homes. Whilst deficit-financed nursing homes have been required to submit audited accounts, proprietors of private non-government nursing homes have not. I believe that that is a very serious deficiency of the original Act. Honourable members can easily see how this could lead unscrupulous proprietors to furnish false information. On top of this, there are no penalties for submitting such false information. The patients, generally pensioners, would pay too much out of their own pockets, the Government and the registered funds would pay out more in benefits and thus all taxpayers would pay more. The patients are usually unable to protect themselves against such fraud, because generally they are of limited means, elderly or in frail health. The Government is, however, able to protect them and taxpayers by amending the Act. That is the reason for these Bills.

In a similar field, this Government has been firm and fair in dealing with the provision of medical services. It provides tough penalties for people who act fraudulently in this area. These Bills provide penalties of the same magnitude for fraud in the nursing home fee situation. The penalties for offences under the National Health Act for the frauds discussed range to a fine of $10,000 or imprisonment for five years - quite a deterrent, I suggest. Also provided in the Bill is a change of penalty for the non-furnishing of records by a nursing home. The previous provision allowed the permanent head of the Department to revoke the nursing home approval. This is a tough step and is especially hard on the patients. The change now calls for a suspension or a revocation. This might not seem much of a change but under the Bill benefits will not be paid during suspension, the fees charged will be reduced by the amount of this benefit and the home must be run normally. Thus for the patient nothing will change, whilst the proprietor will be penalised according to the benefit payable to each patient. This will ensure the furnishing of records very quickly, I am sure.

Of course, there is an appeal provision, in this case via the Minister. The Minister has indicated the support of industry in general. I am sure that he would have had no need to seek approval of the health insurance organisations, the patients or the taxpayers. After all, these Bills are directed only against the few crooks amongst the nursing home proprietors and are for the benefit of the patients and the taxpayers. I commend the Bills to the House.

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