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Thursday, 6 December 1973
Page: 4444

Dr FORBES (Barker) - The only thing I would say in relation to the contribution made by the honourable member for Lilley (Mr Doyle) tonight is that I will leave him to go back and explain to his constituents and to Queenslanders generally why the Government which he supports is introducing a proposal to require Queenslanders to pay 1.35 per cent of their taxable income for services which will be no better or no greater than those they receive as of right at present for precisely nothing and, indeed, services which will be worse, because those services, despite the extra money - -some extra money may flow to them - that will be made available, as has been explained on this side of the House, will have to be shared by a much larger number of people. But that is his problem, not mine. Before saying something on this Bill, I extend my congratulations to the honourable member for Hotham (Mr Chipp), who led for the Opposition in this debate this afternoon in a speech whose constructiveness, clarity and forcefulness I have seldom heard equalled in this House. I believe that in the quality of that speech he has made a great contribution to the cause of something which many Australians hold dear.

People all around Australia are saying today and have been saying for many weeks now: Why, why, why?' Why is the Government trying to throw out a health scheme which the overwhelming majority of them have found perfectly satisfactory, which has given them good quality health care at reasonable cost, with freedom of choice of doctor, hospital and health insurance fund, and with speed and compassion, and in which they have genuine confidence? However much the Government may protest to the contrary, however much it may twist and distort figures and however much it may emphasise individual cases and incidents and attempt to make people believe that black is white and white is black, this has been the experience of the overwhelming majority of- Australians. This is why the Government is worried; this is why it has been backtracking and backing down; this is why the scheme contained in this Bill is a tattered, disreputable remnant of the scheme it started out with. The Government has begun to realise that the Australian people, most of whom have found the existing scheme completely satisfactory, have risen up in anger as they have come to understand more clearly the implications of the Government's intentions.

The Ministry for Social Security (Mr Hayden) has said that these attitudes have been based on a campaign of misrepresentation. I throw that back in the Minister's teeth. If we are to talk about misrepresentation, which is a polite word for lying, let me say that this Minister and the Prime Minister (Mr Whitlam) have, in relation to health, engaged in a campaign of misrepresentation which, in intensity and duration, equals any similar exercise in Australian political history.

Mr SPEAKER -Order! I ask the honourable gentleman not to reflect upon the personality of another honourable member, irrespective of whether he be the Minister or any other member of the House.

Dr FORBES - For 5 years the Government has lied and lied and lied.

Mr SPEAKER - Order! I think the honourable gentleman would be aware that it is most unparliamentary to use such language across the chamber. There are always other ways of expressing an opinion.

Dr FORBES - I will have more to say about that in a moment. It is because the Government has become conscious of the fact that the Australian people have seen through its barrage of propaganda that it has been frightened into throwing the public a bone in the form of the so-called White Paper. The Minister has represented the White Paper as proof of his readiness to listen to public opinion, to be flexible and to compromise - a triumph for open government. The theme of the White Paper is that people can get all the advantages of the present scheme and more besides - or rather, that is the impression it is designed to convey. I have no hesitation in saying that it is a dishonest document. It is deliberately designed to mislead. To the extent that it gives specific undertakings that have been translated into this legislation - for example, the apparent climb-down on bulk billing - it undermines the very objectives which we were told so often it was essential to achieve if Australia was to have an efficient health scheme.

Has the Minister forgotten how often he has railed against the administrative costs of the present health funds and used these administrative costs as the justification for wiping out the funds and establishing one great big monolithic, bureaucratic, government run fund? Has he forgotten that he has given bulk billing as the major means of saving administrative costs? Of course, he was right - although I might mention in passing that exactly the same savings in administrative costs could be achieved by introducing bulk billing in the context of the existing health funds. My point here is not to debate the merits or otherwise of bulk billing - my colleagues have done that admirably - but to emphasise that administrative savings were to be one of the great achievements of the Labor scheme; that bulk billing was to be the principal means of achieving it. Yet virtually all the measures designed to make bulk billing a widespread practice have temporarily, anyway, been abandoned. The Government has backed down on one of the elements which it told us made its scheme incomparably better than the present one; this basic principle has evaporated. No wonder the electorate distrusts the Government.

There are other climb-downs in the same category in the White Paper. That is, the Government does something specific, translates it into the legislation to allay criticism, and at the same time abandons basic principles which were supposed to be of such fundamental importance that they justified the introduction of an entirely new and radical scheme. With these we know where we are. But there is another category of statements in the White Paper which is far more dangerous because the statements do not appear in the legislation. They cannot appear in it because they are only vague expressions of intention or belief that particular things which have worried people will work out in the way those worried people would like them to work out.

I will explain what I mean, Sir, in this way: Despite the soothing words in the White Paper, there is no guarantee either in it or in the legislation that there will be sufficient standard ward beds for the people who want them when they want them; there is absolutely no guarantee that their doctor will be able to follow them into hospital even if they happen to be attached to the visiting staff; there is absolutely no guarantee that private hospitals will remain in existence still less the subsidised community hospitals in my own State; there is absolutely no guarantee that large numbers of able specialists will not be forced out of private practice into salaried public service by economic deprivation; and there is absolutely no assurance that in the absence of Government support for the special account in particular and other forms of Commonwealth assistance in general, insurance cover for private hospital treatment will not be prohibitively expensive as to be out of the range of all but a very wealthy few.

I could go on with this list, but the items on it all have one thing in common - 'the White Paper makes reassuring noises about all of them which do not mean a damn thing. Given the record of this Minister and this Government over the last 12 months, the Australian people would be extremely unwise to listen to or to heed reassuring noises of any description. Still less is this so if we consider the record of the present Prime Minister, the present Minister for Social Security and honourable members opposite in general over the last 5 years. I said a moment ago that they have misrepresented and misrepresented and misrepresented the situation in order to establish their scheme as a significant initiative in the public mind. Their tactics were clear: In order to clear the way for acceptance of their scheme they would denigrate the existing scheme and everybody associated with it, including myself as Minister for part of the lime - that was probably the only part of the denigration that was justified; the health funds and the people associated with them; the doctors; the private hosiptall; the profit making nursing homes; the State governments - you name them. If they were associated with our scheme, the present scheme, they came under the most vicious attack. Truth, objectivity and the personal reputations of large numbers of people were the casualties.

I have constantly asked myself why all this was necessary if Labor's own scheme was as good as honourable members opposite said it was. Looking back I think I understand. The original scheme was not the Whitlam-Hayden scheme - it was conceived by 2 young economists, Deeble and Scotton. Not unnaturally, being economists, the financial aspects dominated their thinking. It was only by constructing a scheme that was virtually entirely tax financed that, as they saw it, you could control health costs that were burgeoning everywhere in the world. That is how the United Kingdom has been able to keep expenditure on health below 5 per cent of the gross national product. This was undoubtedly their model, although it was of course adapted to Australian conditions and Labor Party political prejudices. Everything else followed, particularly the large degree of uniformity, government control and dragging everybody and everything down to the lowest level which the Australian people have found so objectionable. In other words it was nationalisation in fact, if not in name.

Deeble and Scotton sold this scheme to the ALP lock, stock and barrel. It emerged as ALP policy without a change of a dot on an T or a cross on a 't'. Deeble and Scotton did not have to work very hard to sell it. It appealed to the Labor Party's opportunist instincts. The voluntary health scheme was going through a bad patch. There was some public dissatisfaction with the benefits it provided while the Government was waiting for the Nimmo Committee to complete its work and the next great step forward could be taken. What better environment could there be into which to launch this deceptively simple, superficially appealing and apparently cheaper scheme? It appealed not only to their opportunist instincts but also to their socialist instincts. We must remember that it was essentially the British scheme. It was entirely or almost entirely, tax financed, but it was wrapped in tinsel to disguise its socialist origins. It made some headway in the public mind, not on its merits, because the realities were hidden from the public gaze, but on the constant reiteration by the present Prime Minister that the then current difficulties of the voluntary health scheme were inherent in the scheme itself.

I do not have to remind the House how the 1970 reforms, following on the acceptance by the then Government of most of the Nimmo Committee recommendations, gave the complete lie to that assertion. We were able to produce the present arrangements which so many Australians have found so sensitively attuned to their health care needs without abandoning the basic principles of voluntary health insurance. Almost overnight the main arguments on which the Labor Party based its proposition for a substitute scheme disappeared. Faced with this position - with the ground cut from under their feet - the present Prime Minister and the present Minister for Social Security decided to bluff it out - to misrepresent and misrepresent and misrepresent everything about the defects of the present scheme and the elements of their own scheme.

Let me give the House one example of each type of misrepresentation. Firstly, there are the health funds. I defy the Minister to deny that he and the Prime Minister quite deliberately set out to denigrate the health funds and that he set out to create in the public mind that the funds were profit making institutions operating for their own benefit, that the large number of closed and friendly society funds were a source of extravagance and inefficiency and that they squandered money on excessive promotion and selfindulgence. I defy them to deny that at the time they said these things they knew them to be untrue. Let me take another example, this time from their own scheme. They have asserted constantly that it does not mean the nationalisation of medicine. Yet they know - indeed they have boasted - that under their scheme many more patients will enter the public wards of public hospitals. There will be 900 more beds in Victoria alone.

They have told us that the occupants of these beds will be treated by salaried or sessionally paid doctors, not on a fee for service basis. They know that most specialists in private practice depend on the fees they are paid for services rendered to patients in intermediate or private wards and in private hospitals for the major part of their income.

They know that the more people cease to be private and become public patients, the more specialists will be forced by economic necessity to become salaried doctors. If this is not nationalisation, I do not know what it is. They have said again and again that their scheme does not mean nationalisation. They know that to be untrue.

I want to conclude by quoting what I said in a speech that I made a few years ago. I said:

We want a health insurance scheme in which the citizen is always treated as an individual human being and not just as a cog in a medical care machine. We want a scheme in which his feelings, his convenience, even his idiosyncracies, are respected, in which he always remains a person and not just an illness or a cipher on a computer card. We also want a system which encourages a degree of self reliance and which does not encourage the individual to rely entirely on the machinery of some monolithic government agency for care and sympathy - qualities which any bureaucracy, however well motivated its personnel, is ill equipped to provide.

It is because the present scheme provides that and this one provides the very opposite that I oppose it with every force in my power.

Mr SPEAKER -Order! The honourable member's time has expired.

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