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Monday, 17 September 1973
Page: 1038

Mr KEATING - I direct a question to the Minister for Social Security and I refer to the 2 per cent drop in the number of general practitioners adhering to the most common fee. Does this 2 per cent lack of adherence genuinely reflect the overall problem of non-adherence within the medical profession and, on the basis of fee for service, does the Minister have any comments on the lack of service given by general practitioners after hours?

Mr SPEAKER - I call the Minister for Social Security.

Mr McLeay - Another scurrilous attack.

Mr HAYDEN (OXLEY, QUEENSLAND) (Minister for Social Security) - It will not be a bought defence. Many complaints have been made to me from time to time about the absence of personal doctor-patient relationship - for instance, an after hours service and the fact that radio controlled locums are used for this purpose. I must say, expressing a personal view, that I think this is probably a desirable trend anyway because I think it unreasonable to expect each individual doctor to be available for 24 hours a day, 7 days a week. What this does point up is the fact that there is a serious defect in the argument that the conventional concept of the family doctor being available for such impossible hours will not stand up and weakens, of course, some of the case that some people are trying to make on behalf of the medical profession in this respect.

What is more important is the way in which the common fee concept is being abused. In the 1969 election the previous Government sold hard to the Australian public that a situation was about to be introduced of a common fee whereby patients were led to believe that for the most expensive services they would be charged no more than $5. What the public did not hear, said in low key by government spokesmen at that time, was that that would happen only where the common fee was charged. To the extent that the common fee is not being charged or is not being recognised - in two out of three home visitations, for instance, there is overcharging in terms of the common fee concept - that has become a complete unreality. The previous Government had no answer to this problem and never attempted to solve it. The latest pronouncements are that the Opposition will introduce a system whereby those doctors who want to adhere to the common fee con cept can contract into the scheme it would operate. Those who do not want to adhere to the common fee would not have to contract at all, which means nothing. What it means is that doctors can do as they wish. Certain proposals have been outlined in the report of the planning committee on the universal health insurance program to be introduced next year. Those proposals include some suggestions as to how a greater degree of adherence to the concept of a fee schedule or a variation in the common fee could be achieved.

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