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Thursday, 30 August 1973
Page: 628

Mr CHIPP (HOTHAM, VICTORIA) - I ask a question of the Minister for Social Security concerning the Australian Labor Party's proposed health scheme. Can the Minister give the House an unequivocal assurance that, under that scheme, medical practitioners will be paid on a fee for service basis as is in fact recommended by the Deeble-Scotton report? Can he also give similar assurance that in no circumstances will they be paid on any form of capitation basis as is done in the United Kingdom health scheme?

Mr HAYDEN - I think that the correct way in which to answer this question is to say-

Mr Chipp - Just say yes or no.

Mr HAYDEN - No, that is too simple. This scheme will expand choice in the community. It will expand freedom of choice for consumers who are patients. It will expand the choice available to medical practitioners. The present system of health insurance tends to discriminate against medical practitioners who may wish to take up another form of remuneration apart from that of fee for service. For instance, many of the private health insurance funds will pay no benefit at all where a service is provided by a medical practitioner on contract, on salary or on a per capita basis of remuneration such as is found in the American concept of health maintenance organisations.

Our scheme in fact is based on freedom of choice by the patient of his or her doctor. That is guaranteed. It is based essentially on the system of private practice as it currently operates. It is based on the system of fee for service remuneration of those private practi tioners. In those situations where medical practitioners indicate that they wish to use some other form of remuneration or they wish to develop some other form of practice, we will give them the opportunity to do so. We will allow them to make that choice. This is an opportunity that very clearly does not exist today because health insurance has been designed in a way that discriminates against medical practitioners who wish to do that. I repeat: Under our scheme there will be a much greater expansion of the opportunity for choice being exercised by both the public and the medical practitioner.

Mr Chipp - Mr Speaker, I rise to order. I rarely rise on a point of order, but I am impelled to do so now. This question time, like all other question times, has been abused by Ministers in two ways - the length of answers and the fact that questions that are asked are not answered 'by Ministers. Mr Speaker, if you intend not to allow this question time to be turned into a farce you will appreciate that members on this side of the House have rights as well.

Mr SPEAKER -I should remind the honourable mem'ber for Hotham that this has been the general practice of my predecessors ever since I became a member of this Parliament, and I intend to follow that practice.

Mr Malcolm Fraser - Mr Speaker, I raise a point of order. With respect, it was not the general practice of your predecessor to allow Ministers an uninhibited right of reply. There were innumerable occasions when your predecessor questioned the length of replies by Ministers and warned Ministers to shorten their replies or asked them to do so. I submit with respect, Mr Speaker, that you are breaking that tradition and breaking it quite deliberately.

Mr SPEAKER -Order! I suggest to the honourable member for Wannon that he was the worst offender in the House in the last Parliament.

Mr MALCOLM FRASER (WANNON, VICTORIA) - Mr Speaker, again I raise a point of order. Yesterday I admitted that I was one of those who were chided and checked by the previous Speaker and I accepted his rulings as being impartial and fair. All we want is the same treatment for this side of the House now that you, Mr Speaker, are in the chair. We are not receiving that treatment. This is a partisan approach.

Mr SPEAKER -Order! I should like to mention also that on the last day of the previous session the honourable gentleman took a point of order about the Prime Minister answering a question after question time as he did not have the information available during question time. I had some notes compiled, which I sent to the honourable mem'ber, showing that on numerous occasions when he was a Minister he had answered questions after question time. Yet, the honourable member took a point of order on the Prime Minister for answering in the same way. The honourable member is the most inconsistent member of this house. He has to be able to take it too.

Mr Malcolm Fraser - Utterly partisan; a disgrace.

Mr MacKellar - It is a disgrace.

Mr SPEAKER -Order! The honourable member for Warringah will withdraw that.

Mr MacKellar - What?

Mr SPEAKER -Order! The honourable member for Warringah will withdraw the remark 'It is a disgrace'.

Mr MacKellar - Mr Speaker, if you consider that my remark was a reflection on the Chair, I withdraw it.

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