House of Representatives
17 March 1949

18th Parliament · 2nd Session



Mr. Deputy Speaker (Mr. J. J. Clark) took the chair at 10.30 a.m., and read prayers.

page 1632

QUESTION

ROYAL PRINCE ALFRED HOSPITAL, SYDNEY

Industrial Dispute

Mr FULLER:
HUME, NEW SOUTH WALES

– I ask the Prime Minister, in the absence of the Minister for Labour and National Service,whether it is a fact that there is industrial trouble at the Royal Prince Alfred Hospital, Sydney, on the subject of improved living and eating conditions, and that the hospital authorities have threatened some of the nurses with dismissal. Is it also true that, amongst the leaders of the militant section of the nurses who are threatening to strike for better conditions, there are two young women named Harrison? Is it true that the father of these girls is the honorable member for Wentworth in this Parliament? As one of the girls is the president of the strike committee, and as hersister is also a member of that body, has the Prime Minister any reason to believe that these young women have Communist sympathies? If so, does that make their father a “fellow traveller”?

Mr.CHIFLEY. - I understand that, some industrial trouble has occurred at the Royal Prince Alfred Hospital, Sydney. I am not familiar with the names of the ladies who have taken a leading part in the agitation for improved conditions. It is not unusual for industrial trouble to be threatened by people who have no association with the Communist party. I should be very sorry to hear that some members of the family of the honorable member for Wentworth might be regarded as having Communist sympathies. I hope that that is not so. If they have Communist sympathies, I can only express my regret.

page 1633

QUESTION

CIVIL AVIATION

Rose Bay Flying Boat Base - Accident

At BilingaAerodrome- Provision of Aerodromes.

Mr HARRISON:
WENTWORTH, NEW SOUTH WALES

– I preface my question to the Minister for Civil Aviation by saying that at a conference of representatives of the Woollahra Municipal Council and the senior hirings officer of the Department of the Interior an agreement was reached that land now occupied by the Department of Civil Aviation and used for theRose Bay flying boat base should be returned to the council when the base is transferred to Botany Bay at the end of five years. I understand that the agreement is subject to confirmation by both the council and the Commonwealth. Is the Minister for Civil Aviation able to give me an assurance that it is the definite intention of the Commonwealth to transfer the flying boat base fromRose Bay to Botany Bay, and that such transfer will be carried out within a period of five years ?

Mr DRAKEFORD:
Minister for Air · MARIBYRNONG, VICTORIA · ALP

– I know nothing about a conference having taken place between representatives of the Department of the Interior, which is charged with responsibility for Commonwealth properties, and the Woollahra Municipal Council. I shall seek information on the matter. On several occasions I have intimated that it is the intention cf the Government to move the flying boat base fromRose Bay to Botany Bay when the scheme for the development of Mascot airport has been completed, or as soon thereafter as possible. Whether it will he possible to effect the transfer within the period suggested by the honorable member I cannot be certain at this juncture. I understand that some difficulties have to be overcome in connexion with tidal conditions in Botany Bay, which will render the transfer more troublesome than was originally anticipated. I can assure the honorable member that it is the desire of the Government to transfer the flying boat base to Botany Bay as soon as it is practicable to do so without interfering with the service being rendered to the public.

Mr CONELAN:
GRIFFITH, QUEENSLAND

– Is the Minister for Civil Aviation in a position to give the House any additional information about the crash of the passenger aircraft at Bilinga, in Queensland, last week? Has he yet received a report on the accident from the Air Accidents Investigation Committee ?

Mr DRAKEFORD:

– A committee of investigation, which was sent to Bilinga, obtained some additional information about the crash. After having made thorough inquiries at Bilinga, the committee returned to Brisbane in order to collate the evidence, but it has not yet prepared its report. There are certain indications arising from the information that the committee has already gathered, but until I receive the report and have an opportunity to examine it in conjunction with any advice that may be tendered to me on the matter, I am not able to supply any additional information.

Mr Anthony:

– Will the report of the committee be laid on the table?

Mr DRAKEFORD:

-No; it is a departmental report that will be made to me, and, on that document, I shall have to be guided on any future action that may be taken.

Mr ADERMANN:
MARANOA, QUEENSLAND

– I address a question to the Minister for Civil Aviation. The present policy of the Government under which allocations of funds are not made to local governing authorities for the construction of aerodromes until air services are established imposes an unduly heavy strain on the finances of the authorities concerned. Will the Government review its policy so that grants may be made to local authorities for the construction in whole or in part of aerodromes prior to the institution of such air services?

Mr DRAKEFORD:

– The decision of the Government in regard to this matter was arrived at only after considerable discussion and full consideration of all factors. The policy of the Government is regarded by it as the soundest policy it can adopt. Even if it were considered desirable that additional aerodromes should be constructed at specified places where the air traffic is not great, considerable difficulty would be experienced by the Department of Works and Housing in carrying out the work. All requests for the provision of aerodromes are considered on their merits. It is not wise, however, to encourage the hope that aerodromes can be provided at centres close to existing aerodromes. I realize that pressure is often exerted on honorable members by their constituents to have aerodromes constructed in particular localities. The policy of the department is to construct aerodromes on a community basis in places where they will serve a reasonably large population, rather than as specific locations close to each other. The representations made by the honorable member will be examined.

page 1634

QUESTION

ECONOMIC COMMISSION FOR ASIA AND THE FAR EAST

Accommodation at Lapstone Hotel.

Mr ANTHONY:

– Last December I directed to the Prime Minister a question about the expenditure on the Lapstone Hotel, where the Economic Commission for Asia and the Far East held a conference. I asked the right honorable gentleman to inform me whether a sum of approximately £8,000 had been expended on providing temporary accommodation at that hotel. The Prime Minister, in a written reply to me a little later, stated that approximately £8,000 had been expended on the construction of additional accommodation, offices for the secretariat, alterations to the conference room, and a number of other items. He also informed me that he expected that a large part of that money would be recovered after the conference had ended. As the Lapstone Hotel is being advertised for sale by public auction at an early date, will the right honorable gentleman state whether any of that money has been recovered by the Commonwealth?

Mr CHIFLEY:
Prime Minister · MACQUARIE, NEW SOUTH WALES · ALP

– It was the intention, after the conference at the Lapstone Hotel had concluded, to remove a considerable part of the temporary accommodation that had been provided there. The Minister for the Interior, who makes arrangements in regard to Commonwealth property, received an intimation that the company which controls the Lapstone Hotel would be prepared to buy a part, if not all of the additional accommodation that had been provided. Discussions took place in order to ascertain whether an arrangement could be made. At the moment, I am not able to inform the honorable member of the precise result of the negotiations, but I shall endeavour to obtain that information from the Minister to-day, and supply the details to the honorable member as soon as possible.

page 1634

QUESTION

THE PARLIAMENT

Sittings in Canberrra.

Mr SHEEHY:
BOOTHBY, SOUTH AUSTRALIA

– I desire to direct a question to you, Mr. Deputy Speaker.I should like you to inform me on how many days of each completed year the House of Representatives has sat since the transfer of the Seat of Government from Melbourne to Canberra, and the total number of days on which the House sat during the lifetime of each administration during the same period.

Mr DEPUTY SPEAKER:

– Obviously, I am not able to supply offhand the information that the honorable member seeks, but I shall have inquiries made and furnish the details to him.

page 1634

QUESTION

STEVEDORING INDUSTRY COMMISSION

Mr FALKINDER:
FRANKLIN, TASMANIA

– I address the question to the Prime Minister in the absence of the Minister for Labour and National Service. Is it a fact that applications were invited for appointment to the position of chairmen to the Stevedoring Industry Commission in the respective States? Did those applications close last year, and were the applicants assured of an early decision in the matter of appointments? Is it a fact that the vacancy in Hobart has not yet been filled and that a decision has not yet been reached on the applications ? Can the Prime Minister indicate the reason for this apparently unnecessary delay? In view of the disquiet expressed recently by many ex-servicemen in Hobart over the appointment of nonreturned soldiers to similar positions, will the Prime Minister give an assurance that in filling the position of chairman of the Stevedoring Industry Commission in Hobart preference will be given to an ex-service applicant ?

Mr CHIFLEY:
ALP

– The honorable gentleman has referred to the matter of appointment of chairmen to the Stevedoring Industry Commission. Applications were not invited for the position of chairman of the Commission, because the act under which the commission was established makes provision for the chairman to be a judge of the Arbitration Court. Judge Kirby was appointed to that position at the same time as he was appointed a judge of the Arbitration Court, He exercises jurisdiction in two spheres - as a judge of the Arbitration Court, where he has been sitting aa a member of Full Court on various matters, and also as chairman of the Stevedoring Industry Commission. I think that the honorable member must have in mind the State bodies that are responsible for certain stevedoring work in the States.

Mr Falkinder:

– ‘That is what I meant,

Mr CHIFLEY:

– Those bodies are waterside employment committees, and are known as “ port committees “. They are similar to the Stevedoring Industry Commission, but on a lower plane than that body. In most of the States the matter of vacancies on these committees has been adjusted, but some difficulty has arisen in connexion with the position in Hobart. T shall have that matter dealt with as quickly as possible. I think the conditions under which returned soldiers have preference of appointment have been made perfectly clear, and I am sure that due consideration will be given to that aspect when the appointment referred to by the honorable member is made.

page 1635

QUESTION

PRIVATE CORRESPONDENCE

AUSTRALIA and FOREIGN COUNTRIES -

Allegation against Department OF Trade and Customs.

Mr SHEEHAN:
COOK, NEW SOUTH WALES

– I address a question to the Minister representing the Postmaster-General and preface it by stating that I have received information from a natural-born Australian of Dutch descent who states that letters passing between him and his relations in Holland are being opened in transit. Are letters forwarded to and from Australia opened in transit by government officials ? Would the Minister advise the ‘House of the rule in reference to this interference with letters passing between Australia and residents of foreign countries?

Mr CALWELL:
Minister for Immigration · MELBOURNE, VICTORIA · ALP

– I shall refer th* honorable member’s question to the PostmasterGeneral and ask him to supply an answer at the earliest possible moment. If the House is sitting next week thehonorable gentleman will receive the reply here, but if not, he will receive it by post.

Mr HOLT:
FAWKNER, VICTORIA

– I desire to direct a ques-tion to the Minister representing the Minister for Trade and Customs. Does the Department of Trade and Customs keep a record of the number or contents of letters that the Postmaster-General’s Department opens on its behalf? What was the number of letters that were opened during 1948 ? If no such record is kept, what is the estimated number of letters opened monthly? Has the Department of Trade and Customs placed some of its officers in the Postmaster-General’s Department for investigation purposes, or does it rely on an indiscriminate test check of incoming correspondence?

Mr POLLARD:
Minister for Commerce and Agriculture · BALLAARAT, VICTORIA · ALP

– I shall be glad to refer the honorable member’s question to the Minister for Trade and Customs, and ascertain whether the information that he seeks can be made available.

page 1635

QUESTION

INTERNATIONAL AFFAIRS

Berlin Crisis

Mr ABBOTT:
NEW ENGLAND, NEW SOUTH WALES

– I direct the attention of the Prime Minister to a statement reported to have been made by the SecretaryGeneral of the United Nations, Mr. Trygve Lye, on Tuesday, “that the present east-west conflict was too dangerous to last”. In view of this statement, and the visit of Lord Listowel to Australia, can the Prime Minister say whether there has been a grave deterioration in the hope ‘of peace among the nations of the world? Will he say whether Lord Listowel and other emissaries from Great Britain to the other dominions were sent for the purposes of discussing imperial defence and of speeding up measures to make such defence projects effective? Does he not consider that the Parliament, in secret session or otherwise, is entitled to information on matters of such vital importance ?

Mr CHIFLEY:
ALP

– I should say- and, although this is only an expression of my own opinion, it is supported by the* opinion of otters more competent than I to express a view on such matters - that the possibilities of war have decreased during the last twelve months. The position in Berlin,, which the honorable member has mentioned by implication, is as 1 think that most honorable members know, regarded as intolerable. There have been certain discussions on the question of currency which concern what currency should be used, how it should be ‘ used, and from what bank of emission and under whose control it should be issued. It will be remembered that although the western allies were prepared to have the currency issued from a bank in the Soviet zone, they wanted it to be controlled by the four military governors. There is no doubt that a situation such as that which exists in Berlin must be dangerous. Any incident might cause a flare up. To the great surprise of their opponents, the western allies have gone a long way towards supplying the needs of Berlin, but the supplies which can be carried by air are not enough to keep the city’s industries in full production. This applies particularly to coal. Negotiations are going on, and the western powers have submitted certain proposals regarding currency, but I do not feel at liberty to discuss them. Lord Listowel has made it clear that he does not propose, while in Australia, to discuss particular subjects. He has come here as the envoy of the Government of the United Kingdom to see me and, later, the Prime Minister of New Zealand. Many of the newspaper stories about the reasons for Lord Listowel’s visit are complete conjecture, but I can tell the honorable member for New England that his lordship did not come here to discuss the Berlin situation. I do not propose, any more than Lord Listowel does, -to discuss the reasons for his visit. Any statement on that subject will be made by Mr. Attlee on behalf of the British Commonwealth of Nations.

Mr BEAZLEY:
FREMANTLE, WESTERN AUSTRALIA

– Will the Prime Minister, who is acting as Minister for External Affairs, say whether Australian airmen are still participating in the Berlin airlift? Does the Commonwealth bear any of the expenses of fuelling and maintaining the aircraft? Has it borne such expenses at any time? Have Australian aircraft as well as aircrews taken part in the airlift?

Mr CHIFLEY:

– No Australian aircraft have participated in the Berlin airlift. The Australian Government offered to provide ten DC3 aircraft to assist the western powers to transport supplies to Berlin, but the United Kingdom Government intimated that it would prefer Australia to send aircrews, because sufficient aircraft of larger and more suitable types than DC3 aircraft were available for the operation. The Minister for Air sent approximately 4-0 members of the Royal Australian Air Force to Europe, and those members have taken part in the airlift. Arrangements have been made to send other personnel to Europe shortly so that the members of the Royal Australian Air Force who are there now may return to Australia on leave. The aircraft that are being used in the airlift are owned by the Governments of the United Kingdom and the United States of America and the Australian Government has not been involved in any expense in regard to fueling and maintaining them. The expenses associated with the provision of Australian aircrews are being paid by the Commonwealth.

page 1636

QUESTION

PRIMARY PRODUCTION

Mr RUSSELL:
GREY, SOUTH AUSTRALIA

– I ask the Minister for Commerce and Agriculture whether his attention has been drawn to a statement made by Mr. 0. L. Isaachsen, general manager of the Bank of Adelaide, chairman of the Associated Banks in South Australia, and immediate past president of the South Australian Chamber of Commerce, wherein he is reported to have said-

In Australia, primary producers are in a better position than possibly for the past 50 yea rs.

Mr POLLARD:
ALP

– I have not seen the statement referred to, but I am quite sure that the bank manager spoke with a full knowledge of the facts, and I accept his statement as true.

page 1637

QUESTION

WHEAT

Mr RYAN:
FLINDERS, VICTORIA

– Can the Minister for Commerce and Agriculture say whether retail grain distributors are shortly to be required once more to handle bulk wheat? Is the Minister aware that country produce merchants and storekeepers have neither the labour nor the facilities to enable them to handle bulk wheat expeditiously and economically, and that the re-introduction of the bulk system would increase the price of wheat to purchasers by 3d. or 4d. a bushel? Will he ensure that the present system is retained in order to avoid waste of labour, and an increase of prices to poultry-farmers in particular ?

Mr POLLARD:
ALP

– The Australian Wheat Board controls the distribution of wheat to poultry-farmers and retail grain merchants, with the reservation that I, as Minister, have authority to direct the board to do certain things. If the situation is as the honorable member has suggested, and if it is possible to vary theproposed method of distributing wheat, I hope that the honorable member and the members of the Australian Country party, who voted against ministerial control when the Wheat Stabilization Bill was before the Parliament, will back me in issuing a direction to the Australian Wheat Board should that become necessary. I hope that it will not be necessary. The honorable gentleman may rest assured that I shall get in touch with the Australian Wheat Board and endeavour to ensure the distribution of wheat by the most efficient and effective method, taking into consideration the board’s difficulties, and in such a way as will help the poultry trade.

Mr TURNBULL:
WIMMERA, VICTORIA

– It is reported that the much publicized New Zealand wheat deal has already cost the Australian taxpayer approximately £6,000,000. Will the Minister for Commerce and Agriculture inform me whether that sum includes all administrative costs, or is it only the difference between the sale price of the wheat to New Zealand and world parity?

Mr POLLARD:

– The Australian wheat-growers who supplied the wheat to New Zealand have been paid full export parity for it. I do not know whether the figure which the honorable member has mentioned includes administrative costs, but I shall be delighted to obtain the information for him.

page 1637

QUESTION

COMMONWEALTH OFFICES

Mrs BLACKBURN:
BOURKE, VICTORIA

– I ask the Prime Minister, in the absence of the Minister for Labour and National Service, whether there are any Commonwealth acts or regulations similar to the State factories acts which require amenities and the necessary conveniences to be provided for the staffs of government departments and offices in both the States and Commonwealth territories? If there are, can he indicate the scope of the amenities provided? If there are not, will be take steps to have some improvements made of the conditions under which the various staffs are working?

Mr CHIFLEY:
ALP

– The Commonwealth has complete power to provide amenities in its own buildings. Alteration of leased premises has to he arranged with the lessors. We have no power at all over private employers. That was proved during the war when the Commonwealth introduced regulations in an endeavour to provide for better lighting in factories. The regulations were challenged in the High Court, which declared them invalid, and made it perfectly clear that the court regarded any action by the Commonwealth to improve working conditions in factories not owned by it as beyond its constitutional powers. If the honorable member will provide me with details, I shall be prepared to examine any office owned or controlled by the Commonwealth in which it is believed the amenities provided are insufficient.

page 1637

NORTHERN TERRITORY

Cotton Growing

Mr BLAIN:
NORTHERN TERRITORY

– I have heard rumours that at long last my efforts to have the cotton industry established in the Northern Territory have been taken seriously. In 1936, the then Minister for Trade and Customs agreed to alter the law to enable cotton seed grown in the Kimberleys, in Western Australia, and in the Northern Territory to be treated in Queensland, provided the seed was not used for seeding purposes. I conferred with Mr. Young, the manager of the Queensland Cotton Board at Whinstanes, Brisbane, on a proposal for the supply of a cotton ginnery at Katherine for £250. The proposal was turned down by the then Minister for the Northern Territory, Mr. C. L. A. Abbott. In a recent issue of the Darwin newspaper there appeared the following report: -

The Director of Lands for the Northern Territory, Mr. Barclay, will conduct a meeting in the Civic Hall on Saturday next to discuss the establishment of a cotton ginnery in this district.

If that report is true, will the Minister for the Interior give the Director of Lands the opportunity to visit Brisbane and to confer with Mr. Young and other cotton experts in Queensland in the hope that the establishment of the cotton industry at Katherine, in association with the Council for Scientific and Industrial Research, which has an experimental station at Katherine, will be taken seriously?

Mr JOHNSON:
Minister for the Interior · KALGOORLIE, WESTERN AUSTRALIA · ALP

– The Director of Lands for the Northern Territory, Mr. Barclay, is free to engage in any consultations or investigations concerning the development of industries in the Northern Territory in which he desires to participate. He would not require my consent to attend conferences in Queensland. The only consent that it would be necessary to obtain is that of the Administrator of the Northern Territory; but I am sure that the Administrator would facilitate the attendance of the Director of Lands at any conference the results of which might be beneficial to the Northern Territory.

page 1638

QUESTION

HOUSING

Hutsfor Migrants

Mr GULLETT:
HENTY, VICTORIA

– Has the Minister for Immigration seen a report in this morning’s press that the secretary of the Building Trades Federation in Victoria, Mr. Donald Thompson, has declared black the erection of huts for migrants on a site adjacent to some of the wharfs in the Port of Melbourne, the reason given being that the migrants who will he housed in thehuts could be used for the purpose of strike-breaking? Is there any foundation for Mr. Thompson’s allegation? Is Mr. Thompson a Communist? What action does the Minister propose to take in regard to this matter, because the erection of houses for migrants is being delayed ?

Mr CALWELL:
ALP

– I have seen the report to which the honorable gentleman has referred. I do not know the circumstances surrounding the ban. The report is the first intimation that I have received that the Melbourne Harbour Trust intends to build huts on its own property adjoining the wharfs. Trade unions throughout Australia have viewed with disfavour the erection of huts for Baltic migrants on the property of the migrants’ employers. In previous instances, I have arranged that the huts should be erected some distance from the employers’ property. The feeling of the trade unions has been that in the event of industrial trouble men who are resident in huts erected on their employer’s property will have to decide not only whether they shall strike but also whether they shall give up their accommodation, and possibly their messing arrangements. I do not like the idea of accommodation being provided on an employer’s property, but I believe that it should be situated as near as possible to the place of employment. The Commonwealth has acquired land at Sunshine on which huts will be erected. The people living in them will work for H. V. McKay, Massey Harris Proprietary Limited. There will be no trouble there. I shall discuss the matter with the chairman of the Melbourne Harbour Trust and with representatives of the Building Trades Federation early next week with a view to straightening out the difficulties. Mr. Thompson is a Communist. There are a number of Communists among the officials of the Building Trades Federation; but men who are Communists and men who are non-Communists all hold the same view about the erection of huts on the property of an employer.

page 1638

QUESTION

COMMONWEALTH GRANTS IN AID

Earth Tremors in New South Wales - Cyclone Damage in Queensland.

Mr FRASER:
EDEN-MONARO, NEW SOUTH WALES

– In the Gunning and Dalton districts there has been a series of earth tremours of varying severity, the repetitive effect of which has caused serious damage to foundations and superstructures of buildings in that area. I understand that, following representations made by the honorable member for Herbert, the Government agreed to subsidize, on a £1-for-£1 basis, assistance provided by the Queensland Government to sufferers from the recent cyclone in that State. As the earth tremors in New South Wales also come within the category of an act of God, will the Government consider subsidizing, on a £1-for-£1 basis, financial assistance provided by the New South Wales Government to those who have sustained losses as the result of the earth tremors in the Gunning and Dalton districts?

Mr CHIFLEY:
ALP

– In regard to building, representations were made in the first place by the honorable member for Herbert that the Government should assist the Queensland Government in granting relief to sufferers from the cyclone at Cooktown. Representations on that subject were also made by the honorable member for Capricornia, the honorable member for Maranoa, and others. I intimated to those honorable gentlemen that the Australian Government would consider granting such assistance only if a request were made by the State Premier, and then only if the disaster had been widespread. The provision of relief in respect of disasters of limited magnitude that occur in any State is the concern solely of the State government involved. Favorable consideration is always given by the Australian Government to requests made by State Premiers for assistance to aid sufferers fromsome national disaster which has affected people over a widespread area. Such assistance, however, is limited to necessitous cases where serious hardship has been caused.

page 1639

QUESTION

PHOSPHATIC ROCK

Mr DUTHIE:
WILMOT, TASMANIA

– Will the Prime Minister state whether the negotiations between the New Zealand Government and the Australian Government relating to the lease and the phosphate deposits on Christmas Island have been completed? Is he able to say when importation of urgently needed phosphatic rock from that locality will begin? Will the governments concerned conjointly control the working of the deposits? Will all States share in the importations of phosphatic rock from Christmas Island? I ask the last question because primary producers in Tas mania are suffering very gravely as a result of the acute shortage of fertilizers.

Mr CHIFLEY:
ALP

– An agreement covering the lease of the phosphatic rock deposits at Christmas Island was reached between the New Zealand Government and the Australian Government some considerable time ago. Mr. Gaze, the general manager of the British Phosphate Commission, was entrusted with the negotiations between the two governments. An agreement was reached, subject to certain conditions relating to expenditure on capital equipment after the1stJuly, 1948, under which the two Governments will pay £2,750,000 for the right to work the deposits. Although certain technical difficulties delayed the settlement of the final details of the agreement, there is no reason to believe that the work will not be proceeded with. Technical difficulties involving Hong Kong were also experienced in connexion with the taxation of the capital sum paid to the parties which held the rights to the deposits. It would take me too long to deal with these difficulties fully. Machinery and equipment have been installed at Nauru and Ocean Island and it is hoped that large quantities of phosphatic rock will be available from those sources. The deposits at Nauru, Ocean Island and Christmas Island will be worked concurrently. Distribution of the phosphatic rock obtained from Christmas Island will be carried out by the British Phosphate Commission. Some time will elapse before the final details of the working of the deposits and the distribution of the phosphatic rock can be determined. Plant and equipment has still to be installed at Christmas Island. With regard to the last portion of the honorable member’s question, phosphatic rock is forwarded to manufacturers in Australia for processing. The honorable member may rest assured that each State will be given a fair allocation of fertilizers. As additional equipment becomes available ample supplies will, I hope, be provided for all users.

page 1639

QUESTION

FINANCE

Savings Campaign - London Funds - 1914-18 War Debt

Mr ARCHIE CAMERON:
Postmaster-General · BARKER, SOUTH AUSTRALIA · ALP

– Is the Prime Minister able to give to the House some information relating to the progress of the savings campaign which he initiated about two months ago? Is he also able to furnish up-to-date information relative to London funds which, according to the press, now amount to £360,000,000? Will the right honorable gentleman link up his reply on that subject with the statement in the AuditorGeneral’s report that Australia still owes the United Kingdom Government £79,000,000 in respect of the 1914-18 war debt on which we do not pay interest, and which we are apparently making no effort to repay?

Mr CHIFLEY:
ALP

– The arrangement in respect of the World War I. debt to which the honorable member has referred, was made between the United Kingdom Government and the Australian Government about the time of the financial and economic depression in 1928-29. That arrangement has remained in operation ever since. So far as I am aware, no government in the interim-

Mr McBride:

– The Labour Government has forgotten about the debt.

Mr CHIFLEY:

– The honorable mem her for Wakefield was a member of certain governments in the interim that did not attempt to repay the debt. I understood that the debt was to remain in abeyance. I have made at least a dozen statements about the position of our London funds. I have pointed out that a sum of £150,000,000, which has since been somewhat reduced by repatriation payments, was to be left in London under a gentleman’s agreement and was not to be utilized for the purchase of capital goods, except in an emergency. I have explained the Government’s reasons for believing that Australia should hold abroad substantial sterling balances in order that, should our external earnings decline, we shall be in a position to import the capital equipment that will be urgently required for developmental purposes. There is little that I can add to the previous statements which I have made on the subject. I cannot understand the relation that the honorable member for Barker sees between our London funds and the savings campaign.

Mr Archie Cameron:

– How is the savings campaign progressing?

Mr CHIFLEY:

– Very well.

Mr Archie Cameron:

– What progress has been made in terms of pounds, shillings and pence?

Mr CHIFLEY:

– The overall effect is that deposits in the savings banks are steadily increasing.

Mr Archie Cameron:

– I understood that they were decreasing.

Mr CHIFLEY:

– Although the honorable member reads the sensational item? in newspapers from day to day, he probably does not read the financial statements that are supplied by the Commonwealth Bank or the Treasury about the position of savings bank deposits in Australia. If he will study them, he will learn that his impression that those deposits are decreasing is entirely wrong.

page 1640

QUESTION

RE-ESTABLISHMENT

Reconstruction Training Scheme

Mr SHEEHAN:

– Will the Minister for Post-war Reconstruction inform me whether trainee carpenters under the Commonwealth reconstruction training scheme are compelled to work as trainees under employers who, they consider, cannot give them satisfactory or adequatefacilities to enable them to obtain a satisfactory knowledge of their trade? Has the Department of Post-war Reconstruction established an appeals section to assist trainees in this matter? If not. why has it not done so?

Mr DEDMAN:
Minister for Defence · CORIO, VICTORIA · ALP

– It is not a fact thai, under the Commonwealth reconstruction training scheme, persons are compelled to work for employers who will not give them proper training. As honorable members know, trainees receive their initial training up to 40 per cent, efficiency in technical colleges or institutions conducted in conjunction with State governments. After they reach 40 per cent, efficiency, they are sent out to complete their training on the job. They are sent not to any employer, but to approved employers. In every industry there is an industrial committee on which employers, employees and the Department of Postwar Reconstruction are represented, and a list of approved employers is compiled. The trainees are not allowed to go to any employer whom they may desire to select.

They are permitted to go only to an approved employer. In addition to that, steps are taken to ensure that, on inspections on the job from time to time, evidence is obtained whether the men are receiving proper training. The honorable member for Cook may rest assured that the position is carefully watched, not only because we have an obligation to ex-servicemen to ensure that they receive proper training, but also, because on attaining 100 per cent, efficiency the employer must pay them the full wage. If the men are not properly trained, the Commonwealth is committed to greater expenditure on their training. We desire to see the men proceed from 40 per cent, efficiency to 50 per cent., 60 per cent., and, eventually to 100 per cent, efficiency. At all stages between 40 per cent, and 100 per cent, efficiency, the Commonwealth has to pay the difference to ensure “that the trainees receive the wage payable in respect of 100 per cent, efficiency. Therefore, from a financial stand-point, the Government has strong justification for ensuring that the men receive proper training with their employers.

page 1641

QUESTION

LABOUR PARTY PROPAGANDA

Mr RYAN:

– I have in my hand a press notice to the effect that the Dandenong branch of the Australian Labour party had arranged for the visit to that town on the 13 th March last of a “ brains trust “, comprising Mr. Colin Badger, M.A., Director of Adult Education, Judge Foster, of the Commonwealth Court of Conciliation and Arbitration, and Mr. John Bennett, “ The Spectator “ of station 3KZ. Will the Prime Minister inform me whether that visit is a part of a general propaganda campaign which the Labour party has organized and into which public servants are being thrown ? Does he consider that it is proper for a judge of the Arbitration Court to appear on what is obviously a party political platform?

Mr CHIFLEY:
ALP

– I have no knowledge of the particular .matter that the honorable member has mentioned, but I made my attitude plain yesterday, when replying to a question about remarks that had been attributed to Mr. Justice

Owen Dixon, a justice of the High Court, that judges, public servants and others are entitled, outside their ordinary hours of duty, to the rights any other citizen in the community possesses. I shall not be a party to any form of intolerance which will deny to the average citizen the right to express his opinions in his personal and private capacity, whether he be a judge of the Arbitration Court or a justice of the High Court.

Mr Harrison:

– Or a Cabinet Minister.

Mr CHIFLEY:

– Cabinet Ministers are always on duty.

Mr Menzies:

– I thought that not all Cabinet Ministers were on duty.

Mr CHIFLEY:

– I have no knowledge of the particular matter to which the honorable member has referred but I shall make inquiries and inform him of the result.

page 1641

QUESTION

CHEMICAL INDUSTRY

Mr FALKINDER:

– In view of the assurance given by the Prime Minister to this House last week that the Australian textile industry would not suffer by the importation of Japanese textiles, will the right honorable gentleman give, an equal assurance that Australian chemical manufacturers will also be protected against importations from the German chemical industry, which is now developing to a great extent?

Mr CHIFLEY:
ALP

– The honorable member has raised a very important, question which is being considered not only by this Government, but also by other governments, including the Government of the United Kingdom. I have had some very interesting experiences in connexion with representations by various firms during the last month. Those firms, twelve months ago, were not too keen about giving the community supplies of particular commodities that it required. There were, in fact, some cases in which I took up the matter very strongly with Mr. Wilson, the President of the British Board of Trade. I’ now find that those particular companies are so afraid of the increased production in continental countries, particularly western Germany, that they are very anxious to see that adequate protection is given to the Australian industry. Any government of any political faith in office in this country would always be anxious to give proper protection to assist Australian industry, provided that such protection was a matter of reasonable economy and that the goods involved were essential to the community. I agree that there are certain difficulties regarding such agreements as the Ottawa Agreement, under which there are certain fixed principles and certain rates of duties that cannot readily be altered, but I can assure the honorable member that the point that he has raised is one that, as I have said, is causing some thought, not only to the Australian Government, but also to the governments of the United Kingdom and of other countries. Those governments are concerned with the increased production and export of goods from countries such as Japan, Germany, Italy and France, that are now tending to undercut British goods. The honorable member can rest assured that the whole position is being examined.

page 1642

QUESTION

PRICES CONTROL

Mr RUSSELL:

– Has the attention of the Minister representing the Minister for Trade and Customs been drawn to a statement reported to have been made by the honorable member for Balaclava, in which he said that many prices would drop when the States took over control of prices from the Commonwealth?

Mr POLLARD:
ALP

– My attention has not been drawn to the reported statement of the honorable member for Balaclava, but i f he did make such a statement it would appear that it has not been borne out by the facts.

page 1642

QUESTION

EMPLOYMENT

Mr DEDMAN:
Minister for Defence, Minister for Post-war Reconstruction and Minister in charge of the Council for Scientific and Industrial Research · Corio · ALP

by leave - I lay on the table the following paper: -

United Nations - Questionnaire on Full - Employment and Economic Stability - Reply by Commonwealth of Australia.

I table this document because I think that it describes usefully, and in succinct form, the progress that we in Australia have made towards achieving greater stability in our economy and in improving our economic and administrative techniques for maintaining employment at a high level.

The questionnaire was prepared last year by the Secretariat of the United Nations at the wish of the Economic and Social Council. However, its history goes back some time before that, and as the matter is one in which Australia took a leading role, I think I should briefly describe what happened, in addition to commenting upon the document itself. At its first session in February, 1946, the Economic and Social Council decided to call an international conference on trade and employment, and set up a preparatory committee to draw up a draftagenda for the conference. That committee met in London towards the end of 1946, and in its report it stated, amongst other things, that there should, in its view, be some international body under whose sponsorship governments and inter-governmental bodies could consult with a view to concerted action to maintain employment, and that the appropriate body for this purpose would seem to bc the Economic and Social Council. The United Nations Conference on Trade and Employment met at Havana in November, 1947. Largely as a result of Australia’s forceful presentation of the case at the London and Geneva meetings of the preparatory committee, the draft charter considered at the Havana conference contained ia chapter entitled “Employment and Economic Activity”. The conference honored me, as leader qf the Australian delegation, by electing me chairman of the main committee dealing with this matter. In its final form the charter for an international trade organization imposes an obligation on all members to take action designed to achieve and maintain full and productive employment in their respective countries.

However, again largely as a result of Australian initiative, the Havana conference also adopted a strongly worded resolution on employment addressed to the Economic and Social Council which was shortly due to meet at Lake Success. Honorable members will recollect that it was at the end of 1947 that Australia was first elected a member of the council and on leaving Havana, I was privileged to represent Australia on the council for a short period at its February-March session. At this series of meetings, as a result of consideration given to the Havana resolution, the council decided that, in addition to the investigations that had been carried out, the Secretary-General of the United Nations should arrange for the collection of relevant information from member governments and also from nonmember governments participating in the work of the United Nations regional economic commission. It was in implementation of this request that the Secretary-General circulated, in July, 1948, a memorandum containing the fourteen questions set out in the document that I have tabled. I understand that by the end of 1948 some 22 countries had replied, and that their replies are now being examined by the secretariat.

Honorable members will see that the questions are very comprehensive. They include requests for information about government commitments to maintain furl employment, the allocation of responsibility among government agencies, the kind of programmes and provisions which are available to offset a decline in effective demand, and the methods operative for anticipating the time of any downturn. In tabling the Australian Government’s reply, I have omitted the documents referred to as these are mostly printed reports freely available to honorable members, and are very bulky. The reply itself is a fairly comprehensive document which runs into some 23 pages. It emphasizes strongly the kind of commitments that we have made to keep up employment, and the positive steps taken to give effect to these undertakings, particularly in the fields of national works planning, banking policy and social services. At the same time, the reply points to the problems involved in planning and carrying out policy in conditions of federalism and arising from the fact that the techniques for maintaining full employment have not yet been fully developed or tested .by experience. It. described the various main forms of inter-governmental machinery which have been established to assist in achieving co-operation, such as the Premiers Conference, the Australian Loan Council, and the National Works Council.

In describing those elements in present government policy which aim at preventing a decline in economic activity in the future, the statement distinguishes three main aspects of policy which are the control of the upward surge of inflationary pressures now, so as to moderate the extent of any decline later; the introduction, where practicable, of “ automatic stabilizers “ into the economic system ; and the intensification of preparations to meet a possible decline in demand. In connexion with counter-inflationary policy, the reply points out that the- Commonwealth lias sought, during the post-war period, to eliminate the gap between revenue and expenditure that of necessity existed during the war. While its remaining direct controls are very limited, the Government is attempting to moderate current inflationary pressures by endeavouring to avoid undue increases in public expenditure on goods and services in order to limit the pressure on resources, and by the control of capital issues and of bank advances on a selective basis. A number of “ automatic stabilizers “ have been introduced into the existing governmental economic machinery, and the Government has attached great importance to the development of these. “ Automatic stabilizers” are factors which operate, largely independently of any new governmental or private action in the direction of maintaining stability. As set out in the second part of the reply to question 5, the principal ones operative in Australia are social service payments, the accumulation of a large reserve of public works, housing rental subsidies under the Commonwealth-State Housing Agreement, and the stabilization of farm incomes The latter are of great importance, and a special annexure outlines the existing arrangements affecting farm incomes. The reply in other places emphasizes the desirability from Australia’s viewpoint of supplementing our domestic arrangements by international agreements. The third aspect is the question of preparations to meet a recession. It is hoped that our resources will always be fully used, both by public and private investment programmes, and that employment will be maintained by having available for use plans for development both of a long and short term nature, which can be progressively moved forward as resources become available. However, should a falling off in private activity develop, then special governmental action to offset this will be necessary. As indicated in. the reply to question 7, the main plans at present conceived, apart from the operation of the “ automatic stabilizers “ previously mentioned, are an increase in government expenditure, both Commonwealth and State, on public works projects and the provision of credit through banking policy.

The reply chiefly describes the reserve of works, which is brought together in the National Works Council. The reply brings out the emphasis being placed in discussions at the council upon increasing the proportions and diversity of those works which are planned to the “ ready to commence “ stage, and which are of a shortterm character and dispersed over a wide area. The reply mentions the role that the Commonwealth Bank could play. It refers particularly to the provision of credit, to marginal injections of finance through the bank’s special departments, and to the policy of keeping interest rates low and stable.

There are other important sections in the reply, including that on statistics. However, I think I need say no more about the document. Some people have deprecated the policy of maintaining full employment. They point to the difficulties which have arisen currently in our economy, and which are likely to arise in the future. It would be idle to assert that our techniques, either for administering a full employment economy or for maintaining employment in that economy at a high level over a long period, are perfect. But, as the document I have tabled shows, we are steadily improving these techniques. We are much better able than we were a few years ago to handle these practical economic problems. The Government in the last few years has. made considerable progress in improving the stability of our economy. It has placed most emphasis upon the development of the functions of the Commonwealth Bank, the planning of the reserve of works, the stabilization of farm incomes and the development of social services. I think that the story in our reply to the United Nations questionnaire is a reasonably satisfactory one, showing substantial progress by the Australian economy in the last few years.

page 1644

QUESTION

LEAVE TO MAKE STATEMENT NOT GRANTED

Mr DEPUTY SPEAKER:

– Is leave granted ?

Mr Lang:

– No.

Leave not granted.

page 1644

AIRPORT FOR TASMANIA

Report of Public Works Committee

Mr LEMMON:
Minister for Works and Housing · Forrest · ALP

– I move -

That, in accordance with the provisions of the Commonwealth Public Works Committee Act 1913-1947. it is expedient to carry out the following proposed work which was referred to the Parliamentary Standing Committee on Public Works and on which the committee has duly reported to this House the results of its investigations, namely: - The construction of an aerodrome at Llanherne, Tasmania.

The first stage in the construction of the aerodrome will consist of a bituminous-surfaced gravel runway 5,800 feet long and 200 feet wide, with concrete ends, together with associated taxiways and aprons, hangars and passenger buildings, with water supply, sewerage, &c. The preliminary estimated cost is£760,000, including land acquisition and compensation to landholders. The final stage will provide extensive freight storage and handling facilities, together with other buildings likely to be required, and the construction of a second 123-degree magnetic runway parallel to the original one, if it becomes necessary to establish duplicate landing facilities as a result of unforeseen development of passenger and freight traffic.

The Public Works Committee, in subparagraph 7 of its summary of conclusions, stated inter alia that the 60-degree runway at Cambridge, the existing aerodrome, should be well maintained for emergency use, but the Department of Civil Aviation states that, for safety reasons, it would be preferable to maintain the 96-degree runway at Cambridge in lieu of the 60-degree runway. The aspect raised by the Department of Civil Aviation was considered by the committee, which has replied that its recommendation regarding maintenance of the 60- degree runway was made in the light of the evidence given by expert witnesses; but that, as safety is involved, the department itself should resolve the matter. The Department of Civil Aviation has reiterated its opinion that the 96-degree runway at Cambridge should, for safety reasons, be maintained instead of the 60-degree runway.

In accordance with paragraphs 55 and 71 of the committee’s report, any extensive building works will be referred to the committee for investigation. It is, there fore, submitted that the Parliament should approve of the construction of an aerodrome at Llanherne, Tasmania, in accordance with the report of the Public Works Committee, but subject to the maintenance, for emergency use, of the 96-degree runway at Cambridge aerodrome in lieu of the 60-degree runway as recommended in the committee’s report.

Question resolved in the affirmative.

page 1645

SHIPPING BILL 1949

Message received from the Senate intimating that it had agreed to the amendment made by the House of Representatives in this bill.

page 1645

PHARMACEUTICAL BENEFITS BILL 1949

Second Reading

Debate resumed from the 16th March (vide page 1582), on motion by Mr. Dedman -

That the bill be now read a second time.

Mr MENZIES:
Leader of the Opposition · Kooyong

– This is a comparatively short bill, but it deals with a very important matter. It is true that it deals with a small aspect of that matter; but, inevitably, consideration of the bill will give rise to consideration of matters which are outside the bill, but definitely related to it. The most important provision is contained in clause 6, which stipulates that no doctor shall prescribe anything which is in the Government formulary unless his prescription is written out and signed on a government prescription form. The form is to be prepared in duplicate, and sent to the chemist who is to dispense the prescription. Presumably, he is to keep one copy and forward the other to the authorities administering the act, together with his claim for payment. We have been told that there has been a great deal of discussion about this matter. The Minister for Post-war Reconstruction (Mr. Dedman) who introduced the bill in this House said that, on the side of the Minister for Health (Senator McKenna), there has been infinite patience, whilst on the side of the British Medical Association there has been nothing but obstruction. One has learnt rather to distrust that kind of sweeping generalization, and, therefore, one looks at this provision to ascertain its point. After all, the main thing to do is to understand exactly what the bill is aiming to bring about. It is aiming to bring about compulsion. It is true that some people have an objection tocompulsion as a general principle. The real question is, however, “ What are you proposing to compel somebody to do ? “ The real test is the nature of the act the performance of which is to be compelled. Therefore, we must look to see what it is that the doctor is to be compelled to do, and, when we look at that, we find a few facts that are worth recording. The Government has prepared a formulary. As a formulary, there is some reason to think that it is good. I am not prepared or competent to discuss it; but, being a formulary, it necessarily contains a limited specification, because it could not go on for ever. If doctors were able to prescribe any drugs in the world, a formulary would not be needed. The object of the formulary is to confine the identity of the drugs and the proportions of the drugs and other ingredients that may be prescribed by a doctor who has examined his patient. Then, as the legislation is now proposed to be amended, the Government says to the doctor, “If in prescribing for your patient, after having examined him and exercised your skill, experience and judgment, you prescribe something that is entirely within the formulary, you must write out your prescription on the government form and send it along to the chemist. But, if in the exercise of your judgment, you prescribe drugs in a proportion that is not within the formulary, or prescribe some ingredient that is not within the formulary - and that may happen very frequently - you must not use the government form, and your patient will not get his medicine free.” Therefore, time after time, the choice that will be presented to a medical man, in the presence of his patient, will be this: “If I exercise my judgment, as I normally would, and write the prescription that I would normally write for this individual suffering from this complaint, it will not be within the formulary and he will have to pay for his own medicine; but, if I make an alteration, if I set about bringing it within this very elaborate document, I shall have to do it on the government form, and he will obtain his medicine free.” Surely, it is an intolerable position to put any medical man in to say to him, “If you exercise your judgment fully and without reservation, you may involve your patient in paying for his own medicine, but, if you care to abandon your own judgment to an extent that will enable you to prescribe within the formulary, your patient’s financial position will be protected ; for he will get his medicine for nothing”. So, the constant choice presented to men dealing with this most delicate of all matters is whether they will prefer, on the one side, the immediate financial interests of their patients, or, on the other side, the obligation to exercise their judgment without regard for any other circumstances than the health of their patients. The medical practitioners say, “ To put us into a compulsory system in which we must be constantly confronted with that choice is not only unjust to us but also infamously unjust to the people who consult doctors to receive attention and, frequently, the prescription of medicine “. That is the. first immediate comment that I make on the bill. Although it is talking in terms of compulsion, it is talking compulsion in relation to the essence of public health. The doctor’s judgment of what he should prescribe and the treatment that he should give should be completely unfettered. His only consideration should be the best interest of his patients.

But the measure goes far beyond that. It would be curious to say that we must look at it just by itself and that the only question before us is whether the clause to which I have directed my speech is to go into operation or not. The truth of the matter is, as all honorable gentlemen know, that this legislation and the provisions of the medical health legislation, which was put through the House last year, are both a part of the total national health programme of the Government. This is one step, and we cannot judge it unless we decide in which direction the step is taken. I want to say a few words about that, because it is of vast importance to the people of Australia that they should be said and should be considered. In the course of his second-reading speech, the Minister, having referred to the fact that there were about 6,000 doctors in the British Medical Association in Australia, said that 117 of them had been using the formulary. In the Senate it was suggested that the opposition to this legislation was of a political kind. The two statements cannot be reconciled. Am I to understand that there are only 117 out of 6,000 medical practitioners in Australia who, in the normal course, support a Labour government? Of course not! We know from experience that medical men are as divided in their normal political allegiance as are any other groups of people in the community. The fact that 95 or 96 per cent, of the people who practise medicine in Australia have rejected this proposal means * that the proposal ought to be looked at, because the people who have rejected it are more closely associated with public health and more closely associated with doing something for the well-being of the people in a physical sense than are any other people in the community. So I look to see what is behind ail this. I want to make two comments, which, I venture to believe, are comments of great moment. The first is that this proposal is a part of the total scheme to abolish the private practice of medicine and to create a salaried medical service, which will mean, of course, once it has been established, the complete abolition of the present choice and the present doctorandpatient relationship.

Mr Beazley:

– How does that square with the provision in the Constitution against civil conscription?

Mr MENZIES:

– I shall ask the honorable member for Fremantle (Mr. Beazley) how one or two other things square with each other. The honorable member for Wilmot (Mr. Duthie) shakes his head in an even more disconsolate manner than usual. Unfortunately for the Government, the objective of the Government has been completely exposed by the Government itself, because the Minister for Health had conferences on this matter, not before the alteration of the Constitution, but after it. After the phrase concerning civil conscription had been written into the Constitution, the Minister for Health conferred with the British Medical Association. He did so on Monday, the 21st July, 1947. In ‘ the course of his discussions with representatives of the British Medical Association, the honorable gentleman said -

We cannot go ahead with the physical things that are required to develop a national medical service at any great speed to-day, and it may well be that, with all the goodwill in the world, gome ten years may elapse before the national medical service develops a momentum that will enable it to exercise a preponderating influence in the community. Whilst I am quite frank in telling you that my belief is that the national scheme is best for the people and is the ultimate objective of the Government. I qualify that by the statement I made to Sir Henry-

That is Sir Henry Newland - in the beginning and by my belief that there can be no meteoric approach to the position.

Dr. Colville then said ;

I am quite clear on that, but could we confine ourselves to discussion of the ultimate end of this scheme? You keep emphasizing that the development would be gradual and that there would be people who would prefer private practice to the government service, but the ultimate object is admittedly that private practice will be eliminated T

The Minister replied -

That is so. There is no dispute as ‘to that.

There we have the nigger in the woodpile. He has been dragged out. I am afraid that his appearance is untimely for the Government, but there he is. The ultimate objective of the Government is the abolition of private practice. This bill is just one step towards the achievement of that objective. When the Minister in charge of the bill made his secondreading speech, which I observe is identical with the one that was made by the Minister for Health in the Senate, he said -

The Government proposes in this measure to ensure that the benefits which it has sought to provide and which the people themselves hare approved, will be available to the people.

When the honorable gentleman said, “ and what the people themselves have approved”, I ventured to interject and ask whether he meant the referendum. The Minister said, “ Yes That did not surprise me. It was completely in line with what the Minister for Health had said time after time in the course of his discussions with the British Medical Association, that is, “We are merely interpreting the will of the people. We have a mandate to do this because of the referendum”. Therefore, it becomes necessary to examine the argument that the people have authorized this scheme, which, by the solemn admission of the Government, is designed ultimately, not by meteoric process, to eliminate the private practice of medicine. Honorable members will recall that proposals were put to the people for an alteration of the Constitution in relation to social services, organized marketing and the terms and conditions of employment in industry. There were three proposals, all of which were voted upon by the people at the time of the 1946 general election at a special referendum. The proposal in relation to social services was a mixture of existing legislation and some that existed merely on paper. I shall read it once more to the House. It was as follows : -

The provision of maternity allowances, widows’ pensions, child endowment, unemployment, pharmaceutical, sickness and hospital benefits, medical and dental services (but noi so as to authorize any form of civil conscription) benefits to students and family allowances.

Honorable gentlemen who were members of the last Parliament will recollect that that proposal was fully discussed. The members of the Opposition were not only staunch supporters of a number of those items but were themselves the creators of some of them. We drew attention to the fact that the Government was mixing matters that were beyond question with matters that were quite speculative. In the committee debate on the bill the honorable member for Indi (Mr. McEwen) moved an amendment to divide the social services proposals into two parts, but the amendment was rejected. L remind the Prime Minister (Mr. Chifley) and the House that, after the rejection of the amendment, the Opposition, with the exception of the honorable member for Barker (Mr. Archie Cameron), voted for the bill.

Mr Beazley:

– After an amendment moved by the Leader of the Opposition (Mr. Menzies) had been accepted.

Mr MENZIES:

– That is so. I am not likely to forget it. It is the only time that an amendment of mine has been accepted by the Government, except in another place.

Mr Chifley:

– An amendment to the Banking Bill moved by the right honorable gentleman was accepted.

Mr MENZIES:

-That _ will be accounted to the Prime Minister for virtue. The essence of what I am saying is that we supported the bill to amend the Constitution, not because we were in favour of everything in it, but because we were not prepared to oppose the grant to the Commonwealth of power to deal with social services and, in particular, with certain social services that were deeply established and generally accepted in Australia.

Mr Chifley:

– The right honorable gentleman will doubtless agree that the validity of the Government’s powers in relation to them had been placed in doubt by a decision of the High Court.

Mr MENZIES:

– I agree. For those reasons, we supported the social services amendment. We did not do so because we were in favour of the freebottleofmedicine bill. We supported it because wc were in favour of certain great services, the validity of which had been put in doubt by a decision of the High Court. For what it is worth, I myself, as Leader of the Opposition, said on every platform that I advocated a “ Yes “ vote on the social services proposal and a “ No “ vote on the others. I have recited these facts, because honorable members need to recall that in respect of the two proposals that we opposed the referendum was defeated and that in respect of theproposal that we supported it was carried. Even then, the majorities were not what might be described as obese. A total of 2,297,000 “Yes” votes to a total of 1,927,000 “No” votes is not an enormous majority. One has only to look at those figures to realize that if the Opposition had said on that occasion, “We recommend you to vote ‘ No ‘ on the social services proposal “ the referendum would have been defeated completely. Therefore, the existence of this power in the Constitution is attributable entirely to the attitude that was taken up by honorable members on this side of the House. For the Government now to claim that the referendum vote was a vote authorizing it to establish this pharmaceutical benefits scheme or to introduce a compulsory system in relation to doctors is the greatest piece of impudence of which I have ever heard. Were those things advocated by us? If the proposal for an amendment of the Constitution in relation to social services had been divided into two parts, one dealing with child endowment, widows’ pensions, and so on, and the other requesting that the Commonwealth be given power to abolish the private practice of medicine and to establish a compulsory system that would exercise an influence on the medical judgment of a medical practitioner, and if the Opposition had said that it was opposed to the second proposal, does the Government think for one moment that the people would have given it the power for which it asked? Of course it does not. When the bill for amendment of the Constitution was before the House, the honorable member for Indi moved the amendment to which I have referred. The Attorney-General (Dr. Evatt) said -

The honorable member for Indi argued that controversy might be aroused regarding sickness and hospital benefits and medical and dental services, and that, therefore, they might be dealt with in a separate manner. The manner of dealing with them will be a matter for this Parliament to determine.

The Attorney-General emphasized that constitutional amendments relate to power and not to the way in which the power will be exercised. He said, in effect, “ No matter what the words may be, what the Parliament will do in pursuance of them is a matter for the Parliament to determine”. That, of course, was quite right. Then he turned to my colleague, the honorable member for Gippsland (Mr. Bowden), and said -

Why should it be unpopular to ask the people to give to their Parliament the power to make provision on their behalf for medical and dental services? I appreciate the honorable member’s desire and intention to assist. I ask him, and others who have spoken in a similar strain to support the bill in its present form. If they prefer a system of national insurance in connexion with some of these benefits, they will be at perfect liberty to make such provision should these proposals be accepted by the people.

It is hardly necessary to qnote these words because everybody who understands this matter - and we all do in this place at any rate - knows that when we ask for a constitutional power we are not asking for a legislative programme. Having obtained that power with the support of people who are utterly opposed to the abolition of private practice in medicine, the Government now has the nerve to go to conferences and to come into this House and say, “ We are merely interpreting the wishes of the people, because at the referendum they expressed their approval of what we are now doing”. I say to the Prime Minister, and I assert very confidently to the House and to the people, that the Government will never submit to the people the proposal as I have disclosed it this morning because the Government knows perfectly well that it would be rejected out of hand by the people once they understood it. What appears at first sight to be an unimportant bill dealing with a rather tiddlywinking matter turns out to he a material step in a journey the ultimate objective of which is now completely exposed on the categorical admission of the Government of this country.

Mr CHIFLEY:
Prime Minister and Treasurer · Macquarie · ALP

– The Leader of the Opposition (Mr. Menzies) has used a lot of words to disguise the true position. It is realized by all democratic countries to-day that one of the first duties of governments is to protect the health of the people under their control. Conflicts between governments and the British Medical Association are not new. Such a conflict occurred when the Lyons Government introduced the national health and pensions insurance legislation, which was the forerunner of the social services legislation that was later introduced by the Labour Government. The national health and pensions insurance legislation was torpedoed by the Australian Country party, and principally by the right honorable member for Cowper (Sir Earle Page) who was the agent in this Parliament of the British Medical Association. Exactly the same sort of conflict has been going on in Great Britain for years. Such a fight was waged during the regime of the Lloyd George Government and it is still being continued. Recently, President Truman announced his intention to introduce into the United States Congress a national insurance scheme for the purpose of protecting the needy section of the people and already the American equivalent of the British Medical Association has announced its opposition to the scheme. Since the first announcement by this Government of its intention to bring in a pharmaceutical benefits scheme the British Medical Association has adopted an unreasonable attitude. During the Lyons Government’s administration the association adopted the same implacable attitude towards that government’s national insurance scheme. The fight has been intensified as the years have gone on. I do not reflect in any way on the quality of the services rendered to the people by the members of the medical profession. They have improved and their scope has vastly increased as the years have gone on. At one time a member of a friendly society was able to obtain medical attention and most medicines free of cost. All that has now changed.A great many of the medicines prescribed by doctors for members of friendly societies must now be paid for. Any person who has at heart the interests ofthe masses of the people desires that some relief should be afforded in respect of medical and pharmaceutical expenses. Specialization has increased very widely and specialists’ fees have risen by leaps and bounds. I have mentioned previously in this House the case of a man who having contracted a disease in his foot had to consult three specialists, each of whom charged a fee of £3 3s. In addition, the man had to pay £4 4s. for X-ray examinations, before his complaint could be diagnosed. I do not contend that he was not given excellent treatment. Indeed, he was given the best treatment that medical science could provide. The point I make is that he was involved in an intolerably heavy financial burden as the result of his disability. In the interests of the average wage-earner the cost of such treatments to the patient concerned should be minimized. I shall not deal with medical benefits at this stage.

Mr Holt:

– Does the Prime Minister mean by that statement that he proposes to deal with medical benefits in other legislation ?

Mr CHIFLEY:

– I shall not traverse fresh ground at this stage. I shall deal with medical benefits later.

Mr Holt:

– The right honorable gentleman does not mean that he will do so in this bill?

Mr CHIFLEY:

– No, not during the present sittings of the Parliament.

Mr Anthony:

– “ One step enough for me”!

Mr CHIFLEY:

– The Leader of the Opposition referred to salaried service as though salaried services to the community could not mean efficient service. Such a suggestion was made at a meeting which I attended between representatives of the Government and of the British Medical Association that was held about four years ago.

Mr Gullett:

– Hear, hear! If the right honorable gentleman had been a patient in a repatriation hospital he would know that that is so.

Mr Barnard:

– That statement is unworthy of the honorable member for Henty (Mr. Gullett).

Mr CHIFLEY:

– I am glad that at least one honorable member opposite has risen to that bait. The conference to which I have referred took place during the war. I asked the representatives of the association whether General Eisenhower, who was the Allied leader responsible for the conduct of the war in Europe, and General MacArthur, who was responsible for the conduct of the war in the Pacific, were not salaried men. There is only one answer to stupid statements of that kind. The war was conducted and won by men who had been in receipt of salaries all their lives. The great war-time Prime Minister of Great Britain, Mr. Winston Churchill, was a salaried man. President Roosevelt was also a salaried man.

Mr Anthony:

– Stalin was also a salaried man.

Mr CHIFLEY:

– I do not believe I have ever heard such utter rubbish as the statement that we cannot expect efficient service from salaried men. History proves that the most distinguished service has been rendered by men in receipt of salaries and it gives the lie to the claim of the Opposition.

Innumerable conferences have been held with representatives of the British Medical Association with the object of securing the co-operation of that organization with the Government in its medical and health schemes. The honorable member for Wentworth (Mr. Harrison) will probably ask why the Government does not do something about the wharf-labourers or coal-miners who strike. I anticipate his question by saying that the coal-miners and the wharflabourers have not been on strike for four years, as have the doctors.

Mr Menzies:

– On strike for four years! They have not been attending to their patients? The death roll must be terrific.

Mr CHIFLEY:

– Since 1946, not only contrary to the law but also in opposition to the expressed will of the people, the doctors have opposed the Government’s pharmaceutical benefits scheme. They have been repeatedly asked to appoint representatives to draw up a formulary, but they have constantly refused to do so. The Government has reiterated its request to the doctors to co-operate with it, but to no avail. We shall not desist from our purpose. The United States of

America tas tackled this problem as has also the United Kingdom. In the House of Commons recently when it was shown that the existing health legislation in Great Britain involved an annual expenditure of £200,000,000 more than had been anticipated, Mr. Churchill indicated that he was going to play the very devil about the scheme, but when he was challenged by Mr. Bevin to move a vote of censure on the Government by moving to reduce the proposed vote, he funked it and ran away because he knew he could not go to the people and say that he had sought to deny them the health benefits to which they were entitled. Even comparatively small countries like Lebanon are now becoming interested in providing services of this kind for their peoples. Doctors in this country have repeatedly refused to discuss with representatives of the Government the kind of formulary that should be drawn up. Does that indicate that the doctors and their organization are willing to co-operate with the Government? Let me take a simple case to give point to the effect on the people of their attitude. During the last few decades great discoveries have been made in medical science. The discovery of insulin for the treatment of diabetes is one of them. Doctors have nothing to do with the manufacture of insulin. Insulin preparations are manufactured by commercial manufacturers. All that a doctor has to do is to determine whether or not his patient is suffering from diabetes, and, if so, what dosage of insulin should be administered. There are no fewer than 15,000 sufferers from diabetes in Australia, many of whom are working men and women, young men and old-age pensioners. They have been told by their medical advisers that insulin is absolutely necessary for the treatment of their complaint. Insulin treatment may cost them up to 6s. 9d. a week. That is a very heavy expense for people in poor financial circumstances. All that the doctor is asked to do by the Government is to prescribe on an appropriate form the correct dosage of insulin for his patient. On the form he is permitted to state his name, his telephone number and his hours of consultation. The request made of him is a very simple one and he is well aware that if he co-operates with the Government he will greatly assist sufferers from diabetes who are in straitened circumstances, but he refuses to do so.

Mr Anthony:

– What is to prevent the Government from paying the chemist?

Mr CHIFLEY:

– I do not propose to discuss all the details-

Mr Anthony:

– Of course not.

Mr CHIFLEY:

– I can deal with the details quite adequately. The honorable member need not worry about that. I have in my hand a blank prescription form. The doctor, if he so desires, may have his name, consulting hours and telephone number printed on the slip. He is asked to write on the relevant line the name of the patient whom he is treating. Earlier, I referred to patients who required insulin, and I shall continue that analogy. The doctor has nothing to do with the preparation of insulin, but a life-long sufferer from diabetes, who is, perhaps, an age pensioner, will be able to obtain supplies of the drug free of charge if the doctor will use the official prescription form. The doctor who declines to co-operate in that matter is almost inhuman.

Mr Menzies:

– Unless the doctor uses the official form, the Government refuses to pay the cost of the drug that the patient requires.

Mr CHIFLEY:

– That is correct. The system of forms has been introduced for excellent reasons. Before I deal with those reasons, I desire to make it perfectly clear that I am not disparaging the work that medical practitioners perform. They work long hours, and encounter many difficulties. Doctors, particularly those in country areas, extend many courtesies to the public. I do not desire to detract from their work in any way. However, there are in every profession, including politics and the medical profession, a small percentage of persons who do things that are not right. The system of giving doctors the right to issue prescriptions without using a government form has been proved, in the countries that have tried it, to be a racket. When the fee-for-service system operated in Hew Zealand, doctors themselves admitted. that 3 per cent., 4 per cent., or 5 per cent, of the medical practitioners abused the privilege that had been given to them. Finally, the system fell into complete disrepute. Experts in the United Kingdom and New Zealand who have had experience of that system have strongly advised the Australian Government to have nothing to do with it. They advocate the use of a proper form that can be checked. They are utterly opposed to the fee-for-service system. Even since the new health scheme has been introduced in New Zealand, some doubtful prescriptions have been noticed. For example, some doctors have prescribed a bottle of whisky as a medicine. Whisky may be an excellent tonic sometimes, but apparently prescriptions of that kind have annoyed the present Minister for Health (Senator McKenna). One doctor considered that the morale of a woman patient would be improved if he prescribed cosmetics for her. Such prescriptions have been written by doctors who are not prepared to do the fair thing. During the last few months instructions have been issued to prevent the continuance of such practices.

Insulin, to which I have already referred, is only one of the drugs that are included in the formulary. I admit that disagreements may arise about unusual or even intricate items in the formulary, but the doctors have not been helpful in resolving such difficulties. The Federal Council of the British Medical Association has been asked to send representatives to discuss the formulary with the Government. As late as the 10th March last, the Federal Council refused even to discuss the matter. The right honorable member for Cowper (Sir Earle Page) will agree that remedies and drugs that are now prescribed are much more expensive than they used to be. At one time, a patient paid 2s. 6d. to have a bottle of medicine dispensed in accordance with the prescription that had been given to him by his doctor. The cost rose to 3s. 6d. and then to 4s. 6d. I want honorable members to understand quite clearly that, in making these statements, I am not quarrelling with the judgment of a doctor in prescribing for his patients; but, under present conditions, doctors often tell their patients to purchase a proprietary line of medicine from a chemist. Such proprietary lines may beexpensive. I heard a few days ago that a man had paid 15s. for a number of tablets. Years ago, the cost would havebeen substantially less. The great developments in the medical world in respect of formularies, tablets, specifics and drum are most beneficial to the health of the patient but involve him in considerableexpense.

I now propose to examine the attitude of the rank and file of medical practitioners. When the executive of the Waterside Workers Federation or the miners’” federation recommends a stoppage, honorable members opposite condemn it loudly and claim that the rank and file should’ be given an opportunity to express their dews.

Mr MCBRIDE:

– The waterside worker* or the coal-miners are not condemned by the Government when they go on strike.

Mr CHIFLEY:

– I have always condemned the practice. However, honorablemembers opposite cannot deny that they have loudly condemned the executives of unions who order a stoppage and: they have insisted that the men should have the right to express their views at a secret ballot. Thedoctors in the United Kingdom, voting in a secret ballot, rejected theGovernment’s health scheme, but subsequently some one had sufficient senseto see where that attitude would lead,, and the doctors decided to adopt thescheme that the Minister for Health, Mr. Bevan, had organized. No democraticGovernment in the world, which has resolved to introduce a pharmaceutical benefits scheme, will allow a state of affairs to continue whereby the people are denied the advantages of it. I am, not saying that patients do not get value for their money, and that doctors do> not render a most valuable service to thecommunity. However, in performing that service, the doctors are only being humane. The Government’s healthscheme is not a political matter. The Lyons Government proposed introducinga national health and pensions insurancescheme, but eventually the medical profession and the Australian Country party torpedoed it. I supported that scheme, not because it was complete, -but because it would have provided a foundation for the establishment of a scheme such as this Government now proposes to introduce. I would not have hesitated to support that scheme on any platform in the country. Indeed, I wrote to Professor Brigden, who was to have been the chairman of the commission to control that scheme, and offered him my services in a voluntary capacity to address trade unions and advocate the adoption of the plan. At that time, many members of the Labour party in this House opposed the national health and pensions insurance scheme, but I supported it because I believed that with the passing of time it could have been improved. The Leader of the Opposition agreed that a national health and pensions insurance scheme should be introduced. The Government is now endeavouring to introduce a national health scheme, as has been done in other countries, and any person who ha9 any consideration for the masses of the people will not dispute the view that sufferers should have the advantage of free pharmaceutical benefits, and a reduction of the burden of the cost of medical services.

I shall now analyse the attitude that the Federal Council of the British Medical Association has adopted. Endless discussions have taken place between the Government and that body. Whenever the Minister has made some concessions in an endeavour to meet objections, because the Government has always been anxious to have the co-operation of the doctors, the Federal Council has changed its ground. The stage was even reached when the Federal Council objected to the establishment of health centres. Years ago, it supported the idea, but it is now opposed to the establishment of a health centre in a particular town.

Mr Anthony:

– By “ health centres “ does the right honorable gentleman mean hospitals ?

Mr CHIFLEY:

– No. A health centre is an institution where doctors are stationed to treat patients.

Mr Anthony:

– The right honorable gentleman means salaried doctors.

Mr CHIFLEY:

– No one will deny that the Mayo Clinic, at Rochester in the United States of America, is a wonderful institution.

Mr Conelan:

– Health centres have already been established in Queensland.

Mr CHIFLEY:

– That is so. Some of the hospitals in New South Wales arc health centres. Indigent patients are treated at those institutions by the resident medical officer. Let us show what a broad-minded, tolerant body the Federal Council of the British Medical Association is ! The Government sent to each doctor throughout the Commonwealth a copy of the formulary, together .with various details about it. The Federal Council of the British Medical Association despatched a direction to each of its members, instructing them not to read that information, and to return it to the Department of Health without opening the envelope. Yet honorable members opposite have urged that members of other organizations, such as those of the waterside workers and the coal-miners, should be given an opportunity to understand a situation before their executives make a decision. As I have stated, the Federal Council of the British Medical Association directed its members not to read the information relating to the health scheme that the Government had posted to them. I am not complaining about that. Other organizations have acted in a similar manner. I merely point out that the Federal “Council, without consulting its members, advised more than 3,000 doctors to return the formulary and other data unopened to the Department of Health.

Mr Gullett:

– Hear, hear ! Why should the doctors co-operate in their own destruction ?

Mr CHIFLEY:

– Does the honorable member for Henty (Mr. Gullett) regard that as an example of cooperation? Suppose the Government had sent information to members of a certain union and the executive of the organization had directed them to return it unopened to the sender. Honorable members opposite would claim that that executive had prevented the members of the organization from obtaining information about the position. However, members of the Opposition cannot escape from the simple facts of the matter. This Government, which is a most democratic government, has made up its mind that the great mass of the people should receive pharmaceutical and medical benefits free, or at a reasonable charge. Our scheme is vital to the health of the people, and will assist to safeguard their financial position. The Federal Council of the British Medical Association is opposed to the Government’s plan. The Leader of the Opposition has referred to the constitutional position and has dealt with the subject in an academic manner. We must take a practical view. We are dealing with matters that are not academic but which affect the health of the man in the street. Much of the talk about the right of the doctor in respect of preventive treatment is sheer bunkum. No other governments in Australian history have done half as much to preserve the health of the people and to foster preventive medicine as Labour governments have done. The opposition to the Government’s health scheme is merely a smokescreen to hide conservatism and downright pigheadedness. In making those statements, I refer, not to the general practitioner, who has rendered a most valuable service to the public, but to the Federal Council of the British Medical Association. That body is determined that it shall judge whether the pharmaceutical benefits scheme shall be introduced. Honorable members opposite, who have criticized the national health plan on constitutional grounds, have not condemned the attitude of the Federal Council of the British Medical Association in regard to the matter. The Leader of the Opposition referred to the referendum on social services a few years ago, and to those who supported it and those who did not support it. One fact is perfectly clear. The majority of the people were prepared to grant to the Parliament of the Commonwealth complete constitutional authority to deal with social services. Arguments about who supported that referendum and who did not support it do not matter. The majority of the people have given their’ verdict. But the Federal Council of the British Medical Association says, in effect, “ It does not matter what the people have said or what the Parliament says. We shall decide what the people will get in respect of pharmaceutical benefits “. No government can tolerate such a position. It does not matter how long the fight goes on, there will be only one finish to it, make no mistake about that. When Mr. Churchill and his henchmen brought before the British House of Commons the question of the additional £200,000,000 over and above the Estimates, by way of supplementary Estimates or an appropriation of some kind, they were challenged by the Minister to do something, but they were not game to do anything because they were aware of what the people desired. They also knew that the scheme had already been given a trial in England, and that the people were not prepared to go backward, but wanted to go forward.

In conclusion, I want to say that the prescribed form is a very simple document. It is perfectly true that there could be argument about the formulary. The Federal Council of the British Medical Association is entitled to express its views, and without any special knowledge of the matter I can understand that there could be differences of opinion about what drugs should be in the formulary and what ought not to be in it. But 1 should have thought that the interests which intended to argue about that aspect would have been prepared to appoint representatives to discuss the matter. Yet that is exactly what the Federal Council of the British Medical Association has refused to do. It says, in effect, “We shall be the sole judges of what pharmaceutical and medical benefits the people will receive, of what is to be paid for them, and of what, medical charges are to be made “. There is no particular provision in this bill that would effect the judgment of a doctor in prescribing a medicine, as the Leader of the Opposition has alleged. The doctor may form his own opinion about a patient’s ailment and about what should be prescribed for it from the formulary. Having formed his own opinions, he is subject to no coercion of any kind. Drugs like insulin, penicillin and certain liver extracts, for instance, are included in the formulary. The patient has only to take his doctor’s prescription, if it has been made out on the prescribed form, to the chemist and he can obtain the drugs free. All that a doctor is asked to do is to write the prescription on a government form upon which he must put his name and the consultation time in each instance. He may even have his own name overprinted if he desires. Is it unfair to ask for cooperation to that degree from people who talk about their consideration for humanity? I do not think it is unreasonable. Nor do I think that it was unreasonable to expect the British Medical Association to send representatives to join in discussions about what the formulary should contain. The Minister for Health made an offer to place a majority of medical men on the board, which means that there would have been no question of any Labour party member having the final decision. In the experience of this country, and of other countries, the cost of most modern specifics and compounds has risen very greatly and in many cases it is now beyond the financial capacity of the patient to pay. As a result, governments now take the attitude that they will either pay portion, or all the cost that would be incurred otherwise by the patient, because such a provision is desirable in the interests of the public and of the patient. But the doctors have said, “ No, we shall be the judges in this matter”. I repeat, all we are asking the doctor to do is to write a prescription on a form, on which he may put his own name, or have it over-printed if he likes, so that a patient may obtain the prescribed medicine free. The medical profession has refused to co-operate in this, and I consider that all the talk by doctors about co-operation is mere humbug. The right honorable gentleman said something about political aspects. I think it will be found that, no matter what political party is in power in what country, the Federal Council of the British Medical Association, or its equivalent in other countries, will say emphatically that it intends to have the final say in all matters regarding health benefits. The British Medical Association torpedoed the National Health and Pensions Insurance Act in this country, and the British section of it tried to torpedo a similar bill in England during the term of office of a conservative government.

Mr Beale:

– The right honorable gentleman’s party torpedoed it here.

Mr CHIFLEY:

– The doctors tried to torpedo the bill relating to health and medical benefits in the United Kingdom. As soon as President Truman, of the United States of America, made an announcement about the American Government’s intentions in that connexion, the doctors in America set out to torpedo that proposal too. Those actions are the result of a purely conservative outlook, and all I can say concerning the officers who control the Federal Council of the British Medical Association is that they have museum minds that refuse to move with the times. If their attitude continues to be as it is, they will be replaced by people who are prepared to give a proper service to the community.

Sir EARLE PAGE:
Cowper

– I think that it will take much more than the crocodile tears of the Prime Minister (Mr. Chifley), who has been weeping for humanity, to alter the basic fact of this dispute which is, that the British Medical Association and the doctors who form it are at loggerheads with the Government because the doctors wish to be left to prescribe every and any drug that can save life and prevent misery while the Government is so mean and contemptible that it wishes to limit the amount of help that can be given. That is the essential point at issue and I shall challenge the Government on it now, so as to test its sincerity. There is no real difference between the doctors and the Government regarding this matter. The doctors are not connected with the implementation of this scheme of free medicine. That is a matter entirely between the chemist, the patient, and the Government. The doctor has no standing whatever in the transaction, which concerns only the Government, the patient, and the chemist. He receives no fee or reward from the Government. Without this heavy-handed- legislation, the Government could by-pass the doctors entirely and immediately implement the scheme in a very simple way. The Leader of the Opposition (Mr. Menzies) has shown that this legislation must conceal all sorts of fell designs. The chemist is the only agent to be paid by the Government in this transaction. He dispenses the patient’s prescription. I make a simple suggestion to the Government so as to test its sincerity. Let the chemist put a stamp on each prescription whether it falls within the formulary or not, and send the stamped prescription to the Government for payment or otherwise. If this method were adopted the Government’s scheme could he implemented to-morrow without the necessity of this legislation being passed. I am sure that, if that suggestion were adopted, it would be found that a similar simple scheme could be operated in connexion with the partial payment on behalf of patients of medical fees. Surely such a simple method as that should have been tested before an attempt is persisted in to make all doctors break the law.

Mr Daly:

– Strikers!

Sir EARLE PAGE:

– The doctors will be strikers against this scheme. It is strange to hear such an interjection from the honorable member for Martin (Mr. Daly), who is apparently opposed to a strike to maintain certain people’s rights and their freedom to do what is right for sick people, while Communists are roaming around the country fomenting strikes in essential industries. I do not desire to deal with the Prime Minister’s aspersions on myself, because if my record is examined in connexion with what I have done for the health of this country it will be found that I brought into being the Medical Research Endowment Act, that I established the radium bank and that I also established the pre-school kindergartens that were model establishments that have been taken as a model everywhere. Mr. Lyons and 1 brought into being the fund that enabled the establishment of that excellent institution, the King George V. Maternity Hospital in .Sydney. The Prime Minister said that I was responsible for the defeat of national insurance. The fact is that I introduced the first national insurance bill into this Parliament, but I was away during the debate on it in 193S, arid I found on my return that because the terrific opposition whipped up by the Labour party had so inflamed the public opinion, the legislation could not be carried into effect. A national health policy is designed to benefit the health of the people. There are two bodies in Australia that know most about such a matter - the doctors and the friendly societies. The doctors treat practically every one who is sick and the friendly societies provide medical benefits for patients. It is the Government’s mulishness and stubbornness against accepting advice from anybody who is an authority on particular matters that has landed us in the mess we are in to-day with legislation that has been on the statute-books for as long as six years and yet cannot be implemented. The honorable member for Cook (Mr. Sheehan) made a suggestion to-day that should have been worked out long ago. The Minister for Health, speaking in the Senate, admitted that although a third of the sick people in Australia were associated with friendly societies, the Government had never consulted the friendly societies about this scheme. We must find a test for the value of a national health scheme. What will do the best and the most for sick people - a scheme operated with the full, voluntary co-operation of doctors, or one that applies compulsion to doctors? Surely that question has only to be stated in order to answer itself. How is it possible to compel skill and judgment, which is what doctors have at their disposal? How can doctors be forced ? Will doctors not co-operate better if they go into the scheme wholeheartedly? Practically the only obstacle to the implementation of this scheme at the present time arises from the fact that the Government jumped into the scheme without seeking any advice beforehand from the sections of the community from which it should have sought advice, and now it stubbornly and mulishly refuses to retreat from its position. Later I shall give a categorical denial, and give day and date and actual words, that will refute every statement that the Prime Minister has made regarding the failure of the British Medical Association to co-operate in this scheme. To show that some honorable members who support the Government are hypocrites in this matter I need only mention that there are honorable members opposite who say in caucus that they oppose the

Government’s attitude, but when the bill is being debated sit like a lot of dumb folk.

Mr Menzies:

– They are not so dumb as they might be, however.

Sir EARLE PAGE:

– The scheme involves the Government, the chemist and the patient only. The doctor has no place in it, and yet in this measure we find no suggestion of force being applied to any one except the doctor who, I repeat, is outside the agreement altogether. The Government, in fact, has suddenly dragged the bright star of compulsion from the sky and has put it on the doctor’s head because the doctor happened to be walking past at the time. The doctor does not receive anything at all from the scheme, yet he is the only one who is to be subjected to compulsion.

Sitting suspended from12.45 to 2.15 p.m.

Sir EARLE PAGE:

– It is the irony of fate that free medical treatment and free medicine should be associated with a measure the purpose of which is to exert compulsion upon doctors. As a matter of fact, all the free medical treatment chat the public has received up to date has been given by doctors who have made their services available voluntarily to the old, the sick and the poor in hospitals and in their homes. There is no doctor with any considerable practice in Australia who does not give from 30 per cent. to 40 per cent. of his time gratuitously to the service of patients.

It is strange, therefore, that the Prime Minister should this morning have dared to attack the doctors, and charge them with inhumanity in that they were standing between the people and free medicine. It is the Government that is standing between the people and free medicine. By providing that a chemist may stamp a prescription in accordance with the formulary which is written on any paper, the free medicine scheme could be put into operation at once. The present deadlock is due to the mulishness and obstinacy of the Government. I listened carefully to what the Prime Minister said, and not by one word did he deny the statement of the Minister for Health (Senator McKenna) that the ultimate purpose of the Government was to nationalize the medical profession, and to conscript doctors. Therefore, I can only conclude that that is the policy of the Government. The Prime Minister has publicly, on the floor of the House, said what terrible persons the doctors are. Evidently, the Prime Minister wants the doctors to put the knife into his hand so that he may cut their throats. Even the hard-hearted surgeon usually has a nurse to hand him the knife ; he does not require the patient to perform that service. 1 am concerned about the improvement of the health of the people. The success of medical treatment depends essentially upon the skill and judgment of the doctor. There is a personal relationship between the doctor and the patient, but no such relationship can exist if the doctor is a salaried man who merely works his eighthour shift, and then hands over to another doctor. From my own experience, I can say with confidence that there are thousands of well people walking about to-day who would have been dead long ago if they had had to rely for treatment upon shift doctors, particularly if they had been working a 40-hour week. The Australian medical profession does not need to apologize to any one for its standing. I have operated beside surgeons in other countries, and I have seen our surgeons operating here. I know that the standard of their work is as high as that in any other part of the world. I resent the statement made in this House the other day that the medical profession, except for a few eminent men, consists of mediocrities. It is only necessary to look at the records of the Royal College of Physicians and theRoyal College of Surgeons in order to see that some of its most eminent members are Australians. Indeed, the Government is now bringing back an eminent Australian in the person of Sir Howard Florey to assist in the work of the Australian National University. Yet honorable members opposite, in order to achieve a mean political end, have reflected upon the skill of members of the medical profession in Australia.

This is a senseless and contemptible bill. It would appear that the Government was too lazy, or too mean, or too clumsy to prepare a better one. The Minister for Health said that the main objection to the full formulary which the doctors desire so that they may prescribe exactly what is necessary is that it would cost £1,000,000 more. What is £1,000,000 compared with the health of the people and the provision of a complete medical service? If the Government refuses to spend the extra money necessary to make the scheme really effective, what it does spend will be wasted. The Minister objected, to the suggestion that the Government should do the administrative work associated with the free medicine scheme because, he said, it would increase administrative costs to 11 per cent., whereas if the doctors undertook the work, administrative costs would be only 1 per cent, of expenditure. Evidently, he expects the doctors to pay out of their own pockets the cost of administration as well as to devote much of their valuable time to the work. For the sake of the comparatively small amount involved, the Government is prepared to keep the quarrel going. So that the Government may put its pet scheme into operation, .it is prepared to interfere with the personal freedom of the doctor, and with the doctor-patient relationship which has produced such excellent results, and saved so many lives.

This bill ought really to be entitled: “ A bill to prevent people having lifesaving drugs prescribed for them by their doctors “. For some extraordinary reason, the Government is saying to the public that if the people will not have free government medicine, on the Government’s terms, they cannot have any medicine at all - free or otherwise. One hundred years ago, de Tocqueville pointed out that a similar state of affairs would develop in the United States of America if there were excessive centralization. In his book, Democracy in America, he wrote -

Centralization succeeds more easily, indeed, in subjecting the external actions of men to a certain uniformity . . . and perpetuates a drowsy precision in the conduct of affairs, which is hailed by the heads of the administration as a sign of perfect order … in short, it excels more in prevention than in action. Its force deserts it when society is to be disturbed or accelerated in its course; and if once the co-operation of private citizens is necessary to the furtherance of its measures, the secret of its impotence is disclosed. Even while it invokes their assistance, it is on tincondition that they shall act exactly as much as the government chooses, and exactly in the manner it appoints . . . These, however, arc not conditions on which the alliance of the human will is to be obtained; its carriage must be free, and its actions responsible, or such is the constitution of man the citizen had rather remain a passive spectator than a dependent actor in schemes with which he is unacquainted.

The principal operative provision of the bill is in clause 6, which says, in effect that a medical practitioner shall not write otherwise than on a prescription form supplied by the Commonwealth a prescription for an uncompounded medicine or a medicinal compound, the formula of which is contained, or is deemed to be included in, the Government’s formulary. The Government claims that this formulary includes practically every drug that matters in the healing art. It thus seeks to prevent the sick getting any of those drugs, unless the doctor’s prescription is written on the official form. Thus, the Chifley Labour Government, and not the doctor or the patient, will, in the last analysis, determine whether the patient shall receive the medicine.

One of the effects of the bill, if it becomes law, will be to make medical “ scabs “ or “ blacklegs “ out of members of one of the oldest learned professions in the world. It will force doctors to break their Hippocratic oath, and to reveal details of their professional knowledge to a third party - the Government. For the information of Ministers, I quote the relevant part of the Hippocratic oath. It is as follows : -

Whatsoever things I see or hear concerning the life of men, in my attendance on the sick or even apart therefrom, which ought not to be noised abroad, I will keep silence thereon, counting such things to be as sacred secrets.

Only last week, in order to extricate himself from a political difficulty, the Minister for the Army published confidential details of the private life of an unfortunate soldier. That was his reward for going to the war. Had he been a civilian those details could not have been published, but, because he was merely a number in the Army, the Minister revealed information about him which should never have been made public. If the Government keeps on as it is going, it will not be long before we are all regarded merely as numbers. The Government has already proved that it cannot keep secret even the most confidential information. Matters have been revealed which ought to have been known r,o only one or two Cabinet Ministers. Therefore, what hope is there that secret and confidential information relating to the medical history of patients will not bp divulged ?

Mr Anthony:

– Such information could possibly be used for purposes of blackmail.

Sir EARLE PAGE:

– Even that is possible. That point of view was placed before the Government by the doctors at one of the many famous - or infamous* - conferences that have been held. The Government then said to the doctors that it would not allow confidential information to get into the hands of laymen and that only medical men would see the records. How many medical men would have time to type the records? Lay secretarial staff would have to prepare the records in the first place. Then, as the honorable member for Richmond (Mr. Anthony) has said, the way would be open for blackmail. Once these personal matters are on record, they are available for every one to see. The only safe position for the citizen is for the Government not to have such records at all. If the Government must have details for any purpose, let it get them directly from the patient concerned, not the doctors who are bound by the Hippocratic oath to preserve secrecy in their dealings with their patients.

The bungling of the Government in this matter of dealing with national health is shown by the fact that there have been six amendments to the Pharmaceutical Benefits Act. The original measure was rushed through Parliament in the middle of the night more than six years ago because of its urgency. When we asked for more time in which to consider the bill, the Government claimed that it wanted the scheme to operate immediately. But it has not yet operated. Then the Government said that the measure was badly drawn and was proved to be invalid by the High Court. The Government thereupon sought additional constitutional power from the people, which it obtained some three years ago. But, even with this additional constitutional power and the course quite open, the medical scheme seems to be going backward instead of forward. In commending the referendum to the people, the Prime Minister said that approval of the social services proposal would ensure a free, complete and technically efficient scheme and full cooperation of the medical profession. Now that the Government has -full constitutional power it admits that it is not necessary or possible for the scheme to be complete or free. Last October, when the Minister for Health again discussed the scheme with the British Medical Association, he said, in effect, “ Yes, we now have all the power that we lacked two or three years ago, but now we find that it is not necessary for the scheme to be complete and free “. So what we are presented with is a scheme that is incomplete and only half free. This is all a part, as the Leader of the Opposition said, of a longrange plan to nationalize the medical profession, if not to-day or to-morrow, then as soon as it can be nationalized. We are presented with the first step. The doctors say, “ We are going to defend our freedom “. I hope and believe that every freedom-loving man and woman in the country will stand behind the doctors and see that they get a fair deal. The free medicine scheme, co-operation in which this bill proposes to force on the medical profession, provides for a list of medicines which does not at all cover needs. The reason why the Government cannot succeed in its attack on this problem is its clumsy, dictatorial and bungling approach. The Government is concealing the truth of its bungling from the Parliament and the people and is attempting to blame the doctors for non co-operation, when what is really at fault is its own stupidity and obstinacy. Years before the Government thought of health matters at all the British Medical Association had worked out a general scheme which dealt with human life from before the cradle right to the grave. Its policy was to improve the health of mothers, to prevent disease, to prolong life and to secure the most rapid healing of the sick by the most efficient equipment and the most wholehearted service. As individuals, doctors have shown tremendous patriotism and public spirit. They have worked out the causes of epidemic disease, and the causes of disasters in surgery which they have also sought to eliminate. When approached by the Government in regard to a campaign for improved national health, the doctors offered their fullest advice and cooperation. For instance, in the Parliament in 1947 - two years ago - a definite offer was made by the British Medical Association to the Minister for Health. Briefly, this offer was to come immediately to agreement on the prescription of pharmaceutical benefits of single remedies which have been found to be necessary for the treatment of diseases which threaten life. Single substances the doctors suggested were as follows : -

  1. Chemotherapy. - Sulpha-drugs, penicillin, anti-malarial drugs, anti-syphilitic drugs, emetine.
  2. Preventive Therapy. - Vaccines, sera, antitoxins.
  3. Substitution Therapy. - Thyroid extract, adrenal cortex, liver extract, insulin.
  4. Therapy in Emergencies. - Adrenalin, mersalyl, digitalis, and its preparations, coramine, oxygen, pentnucleotide, soluvas preparations.

These are just examples. The list is not all-embracing, but the headings represent what should be included. The Prime Minister referred to insulin to-day. It is entirely his fault that diabetics have not had free insulin for two years. Many of these remedies are manufactured by the Government. They could be supplied free to the chemists by the Government, and their use by the chemists could be checked easily by the Government on the prescriptions on which they were ordered. No abuse would be possible, and there would be no black marketing possibilities if these drugs were free. All talk about black marketing possibilities in dealing with free products which were passed to the chemists from the Government’s own laboratories can be swept aside as utter nonsense. One Minister in a brainwave, said that doctors might conduct private hospitals and lay in stocks of, for instance, insulin. But, in New South Wales and, I think, in the other Australian States, it is unethical for doctors to own private hospitals. The only black marketing that I know of is in trading in goods that are scarce and expensive. Black marketing in drugs that were amply supplied and that cost nothing would not be possible. The abuse of narcotic drugs is already dealt with by State legislation. The issue of narcotic drugs is regularly checked by the State health departments from registers kept by all hospitals, doctors and dispensers. A balance sheet has to be presented to the police on demand. Action along the lines suggested by the doctors would put Australian medical treatment in the forefront of the world, and would help to destroy the “ bottle of medicine “complex that has grown up over so many years. But nothing was done by the Government. Let the Government do as I have suggested. Subsequently, it can agree on ways and means to go farther - on a friendly basis and not at pistol point with the doctors - both on the issue of the balance of prescriptions and on the actual medical care of patients. Two years ago the doctors further offered the Government its well-considered plan of thirteen logical steps, as follows: -

  1. Safeguarding and improvement of nutritional, housing, educational and other sociological standards.
  2. Adequate provision for research and statistical investigation.
  3. Sufficient properly staffed diagnostic laboratories located where required.
  4. Organization of consultant service to make it readily available to all members of the community.
  5. Group practice initiated by members of the profession themselves.
  6. Extension of the Flying Doctor Service.
  7. Increased subsidized practitioner ser vice to outback centres.
  8. Extension of industrial, venereal, immunological and other preventive medical services.
  9. Extension of the present maternity services, with the establishment of hostels for waiting mothers.
  10. Extension of hospital construction and equipment with special reference to the treatment and care of sufferers from tuberculosis and mental diseases, and the crippled, bedridden and the aged; and the provision of private and intermediate wards to all public hospitals and elsewhere as required.
  11. The organization of regular postgraduate training.
  12. Increased infant and child welfare ser vices.
  13. Some means of bridging the financial gap between a complete medical service and its availability to all.

Most of the present difficulties of the Government are due to the fact that instead of taking these logical steps in their proper order, it has tried to take the last step first. It has tried to implement the scheme without proper foundations.

The first step of the medical profession is to safeguard and improve nutritional and housing standards, such as by providing free milk to children and nursing mothers, and by modern housing. It is more important that food and complete medical service should be available at all points than that they should be free. Freedom means nothing if there is no service. The regulations which the Government threatens to introduce in order to implement its rigid ideas are quite impracticable and in opposition to the wishes and principles of the doctors’ life work. The lawyer, the politician, and the bureaucrat are trying to teach the doctor how to do his job, and are threatening to impose all sorts of penalties on the doctor, even though it is impossible to carry out the regulations and preserve the health of the patient. The Government, however, has been adamant with regard to making a doctor a government servant. Doctors insist that they can do their best work by being free and independent. They insist that they should use their own prescription forms, which contain their names, addresses, consulting hours, &c, and which are more readily identifiable than government forms, but they have agreed to alter them to suit the Government’s purposes, or to make a duplicate for government official files so long as the prescription forms remain the doctors’ forms. The only answer by the Minister to this suggestion was that it could not be done because the Government’s forms were numbered. In the next breath he said that all sorts of penalties and drastic regulations would be imposed regarding the use of government forms because they were practically open cheques. The doctors’ reply was that if there were no government forms there would be no open cheques lying about.

In addition, the doctors have made many constructive proposals. Even the existing formulary is very much better and more comprehensive than the original ene proposed, because of the Government’s partial acceptance of certain suggestions by the doctors. In fact, the original formulary of the Government had practically no provision for dealing with chronic eases. The doctors have also offered to accept representation on the Government’s formulary committee and revise the formulary from time to time. The doctors have further offered the use of their own committees to check any abuses, quite free of cost to the Government. However, the doctors have strenuously objected to divulging any of their professional relationships, or to acting as the detective, clerk or administrator of the Government’s scheme. Their attitude is summed up in the statement that what is needed is not so much free bottles of medicine as the raising of the general health standards of the nation. Then the need for medicine would be considerably less. Moreover, there would be less absenteeism and unemployment, because of illness.

The Government has offered to pay the patient half of the doctor’s fee. There is nothing to prevent it paying that to the patient straight away, as such a payment has nothing to do with the doctor; it is purely between the Government and the patient. The doctors have no beneficial interest in the plan. The doctors are quite willing to help to make the plan work so long as they are not to be regarded as salaried public servants or to be compelled to make available to the Government records that they rightly regard as secrets between them and their patients. The first principle that is regarded by doctors as being essential if the Government is to secure the whole-hearted co-operation of the medical profession in Australia is that the profession, in the public interest, shall not be subjected to any form of service which will lead directly or indirectly to its members as a whole becoming full-time salaried servants of the State or local authorities. The second principle is that the medical profession shall remain free to exercise the art and science of medicine according to its traditions, standards and knowledge, and that the individual doctor shall retain full responsibility for the care of the patient and have freedom of judgment, action, speech and publication in his professional work. The third principle is that the citizen shall be free to choose or change his family doctor; to choose, in consultation with his family doctor, the hospital at which he shall be treated ; and to decide whether he will avail himself of the public service or obtain the medical service that he needs independently. It will be seen that by laying down those principles the members of the medical profession are attempting to safeguard the interests of their patients. The fourth principle is that there shall be adequate representation of the medical profession on all administrative bodies associated with a national medical service in order that doctors may make their contribution to the efficiency of the service. The fifth principle is that the controlling body of any national medical service shall be given authority to administer the service under its own enabling act and be free from political interference. That, surely, is reasonable. The sixth principle is that funds available to the service shall be fixed by statute, a non-alienable portion of the social security contribution being earmarked for the purpose, and that all central and local bodies shall have power to put unexpended funds into reserve accounts. The seventh principle is that the correct method of payment for general practitioners in a national medical scheme shall be on a fee-for-service basis. The eighth principle is that specialist and consultant practice shall be carried out by private practitioners on the same basis of payment. To sum up, the profession desires, first, a form of administration free from political control; secondly, the present form of service on a fee-for-service basis ; and thirdly, a form of hospital administration such as in the main exists at the present time. The members of the medical profession contend that they should be enabled to carry out their work in such a way as to ensure the maintenance of the present doctor-patient relationship.

Mr BARNARD:
Minister for Repatriation · Bass · ALP

, - The Opposition’s case against this bill has been presented by the Leader of the Opposition (Mr. Menzies) and the right honorable member for Cowper (Sir Earle Page). The medical skill and knowledge of the right honorable member for Cowper cannot be questioned. Nobody disputes his right to express his view regarding the medical services with which he is familiar. No body wishes to disparage the services thai the right honorable gentleman has rendered to medicine in this country and his efforts in this Parliament to secure an extension of medical services to the people. No honorable member on this side of the House desires to speak in a derogatory fashion of Australian medical men. The standing of the Australian medical profession is equal, if not superior, to that of the medical profession in other countries. 1 approach this bill as a layman who has served for a number of years on the Social Security Committee of this Parliament which inquired into the medical services of Australia. The right honorable member for Cowper is a member of the old conservative school. He wishes to preserve the freedom of the medical profession to provide medical services for the people and to assess its fees, not according to the needs of patients but according to their ability to pay. It will not be denied that doctors throughout the country give their services free of charge to a considerable degree. I have not the slightest doubt that during the years when the right honorable member for Cowper was an active member of the profession he rendered much service for which he was not paid. I do not wish to decry the medical profession of this country or to detract from the wonderful humanitarian work that doctors are doing now and have done for many years. The committee of which I was a member took evidence from and sat in conference with, the peers of the medical profession. They desire to preserve the status quo. They refuse to recognize the fact that medical science has progressed so much that specialization is necessary now to a much greater degree than it was previously. In the days when the right honorable member for Cowper commenced to practice medicine, a family doctor treated all of the members of the family. He attended the mother when a child was born, treated the baby for measles and prescribed for the father when he had a touch of influenza. That was a feature of medicine in days gone by, but to-day the position has changed considerably and the practice of medicine has become specialized. Now, when a family doctor has examined a patient, he will probably say that an X-ray must be taken or a certain specialist consulted. En consequence, medical treatment has become more expensive. It is true to say that the majority of persons in the middle income group cannot afford to pay the fees that are now demanded of them for medical treatment. Very poor people get the best medical treatment, because they go to the public hospitals and are treated by our finest surgeons and physicians. The rich get the finest medical treatment, because they can afford to pay for it. Between the extremes of rich and poor there is a group of people which cannot afford to pay for medical treatment. Bearing that in mind, in 1938, the Government, of which the right honorable member for Cowper was a member, brought down a bill to provide for insurance against certain contingencies affecting employees, the wives, children, widows and orphans of employees, and for other purposes. I cannot recollect any other measure that was discussed at such length or subjected to greater criticism in this House, and my experience of the Parliament extends over a considerable time. The bill was finally passed by this House. The honorable gentleman who was in charge of the bill, Mr. B. G. Casey, the Treasurer of the day, had so much trouble with the medical profession that he appointed a royal commission to examine the aspect of medical services that the House is now considering. The medical profession stalled in those days, too. There was a tragic ending to that royal commission. An aircraft in which a number of the members of the commission were travelling crashed, and they were killed. The government of the day was so satisfied that the measure to which I have referred was a good one that it “guillotined” it through this House and through the Senate. The time-table that was laid down for the passage of the bill through the Senate ensured that the debate would be completed by midnight on the 30th June of that year, when certain members of the Senate finished their terms of office in. the Parliament. Honorable gentlemen opposite who supported that Government were satisfied that the measure would provide, among other things, better medical services for the Australian people. They were satisfied that the old order, about which the right honorable member for Cowper has spoken, had passed. They were convinced that the majority of the people of Australia could not afford to pay for the medical services that were offered to them. The right honorable gentleman has come into this chamber to-day armed with a brief for the medical profession. I do not quarrel with him over that, because occasionally I have had a brief for an organization. The Leader of the Opposition has had briefs for all kinds of people.

Mr Menzies:

– I wish that the honorable gentleman would not make my mouth water !

Mr BARNARD:

– Under certain circumstances, I should not mind the Leader of the Opposition having a brief for me.

Mr Menzies:

– I remember the time when I did a lot of work for trade unions:

Mr BARNARD:

– The right honorable gentleman rendered some good service to the trade unions in the past. His skill and ability in courts of law is recognized, even by trade unions. The point that I am attempting to make is that the attitude that is now adopted by the right honorable member for Cowper is in contradiction of the terms of the bill that he was a party to passing through this Parliament in 1938. By its introduction of that bill a decade ago, the Lyons Government admitted, in effect, that the medical services that were then being provided for the people were not satisfactory, and that that defects should be rectified. The right honorable member for Cowper was a prominent member of that Government, but to-day he has said that we must preserve the status quo in relation to the medical profession. He has argued that there should be no interference with the profession and that the doctors should be allowed to continue to act as they are now doing. The Social Security Committee, to which I have already referred, of which I was Chairman, was appointed by a government of which the present Leader of the Opposition was a prominent member. The committee met frequently over a number of years and among other things dealt with the knotty problem of the institution of an improved medical service. Hour after hour and day after day the committee tried to fashion a scheme acceptable to the medical profession.

Mr DEPUTY SPEAKER (Mr Clark:
DARLING, NEW SOUTH WALES

– Order! I remind the Minister and all other honorable members that I do not wish them to confuse medical services with pharmaceutical benefits. The Chair allowed the right honorable member for Cowper (Sir Earle Page) very wide scope. The Minister has given a sufficient reply to what was said by the right honorable member for Cowper in regard to medical services.

Mr BARNARD:

– I wondered how far the Chair would allow me to proceed on that aspect of the matter. I have no desire to transgress your ruling, Mr. Deputy Speaker, and I shall confine my remarks to pharmaceutical benefits which is the aspect of a medical service with which we are now dealing. The institution of a pharmaceutical benefits scheme was discussed during the period when the portfolios of Health and Social Services were held by Senator Eraser, and negotiations with representatives of the British Medical Association have been continued ever since that time. As the Prime Minister said this morning, on every occasion when it appeared that some form of agreement was likely to be reached, the representatives of the British Medical Association shifted their ground. The Government made most strenuous attempts to secure the cooperation of the medical profession in the institution of a pharmaceutical benefits scheme under which the people would be entitled to obtain without cost not only low-priced medicines but also expensive drugs. The preparation of the formulary was not the work of public servants. The co-operation and advice of medical men was sought when it was drafted. It is nonsense for honorable members opposite to say that the Government has not been patient in this matter. It has been most patient in its efforts to reach agreement with the Federal Council of the British Medical Association under which a satisfactory pharmaceutical benefits scheme could be instituted. Dr. Hunter, the secretary of the British Medical Association, has not remained silent on this matter. I know him very well. As far as I am aware, he is a very good secretary; but on occasions he lets his head go. The following interesting article appeared in the Melbourne Age on 15th March: -

The British Medical Association will establish a “ fighting fund “ to challenge, if necessary, the validity of the amended Pharmaceutical Benefits Act. Individual members of the association will be invited to contribute to the fund . . . The general secretary of the Federal Council of the British Medical Association (Dr. J. G. Hunter) said to-night: “ Once more the British Medical Association offers a solemn warning to the people “. If this amending bill becomes law it will bp impossible for thu individual doctor, if he wishes to remain free of Government control, to prescribe any life-saving drug for hispatients unless in so doing he is prepared to break the law.

Mr FULLER:

– Break the law?

Mr BARNARD:

– Yes, break the law : The article continues -

The doctor will have to choose one of three alternatives, namely, pass under Government’ direction, break the law or jeopardize his patient’s life.

When a spokesman for the British Medical Association makes statements of that kind the only alternative left to the Government is to bring down legislation to compel doctors to obey the law. Doctors have been law breakers for four years. Honorable members opposite always have much to say about disciplining wharf labourers and coal-miners who strike foi better conditions ; but they do not suggest that members of the medical profession who have been on strike for years, should be disciplined. The British Medical Association has said to its members, “ Do not read the formulary which is being posted to you by the Government. Send it back unopened “. And no fewer than 3,000 doctors obeyed that direction to the letter ! With childlike faith they accepted the direction of the British Medical Association not to read the formulary. It was reported in the press that one. doctor was so determined to obey the direction of his association that, mistaking a parcel containing penicillin for the package containing the formulary, he sent the penicillin to the department. It is useless for honorable members opposite to adopt such an uncompromising attitude on this matter. Many diabetics in the community cannot afford to pay for insulin treatment. The Government desires that all diabetics should be able to obtain their requirements of insulin free of cost, but the doctors say, “ No ; unless it is provided on a prescription the terms of which we shall decide the patient must pay for it”. The Government has been compelled to take disciplinary action against the doctors. I agree wholeheartedly with the action taken by the Government to compel them to obey the law. Every avenue of approach has been explored, but the British Medical Association has taken a recalcitrant attitude. Spokesmen for the British Medical Association have made statements that are so palpably untrue that they would not deceive a high school girl who knew nothing about the practice of medicine. Dr. Hunter is reported to have said -

The doctor is being forced into this position by a government which professes concern for the people and their health, a government whose Minister for Health, on introducing the original act, said: “Under this bill there will be no compulsion of medical practitioners or pharmaceutical chemists to take part in the scheme.” The provisions of this bill are at once so coercive and so strongly antagonistic to the people’s interests as patients that it may be doubted whether it will ever come into force even if passed by Parliament.

One would think that a medical man who probably ranks among the elite of his profession would present a factual statement of the case, but instead he said -

The doctor will have to choose one of three alternatives, namely, pass under government direction, break the law, or jeopardize his patient’s life.

I can understand why the right honorable member for Cowper has waxed eloquent in his defence of the British Medical Association. He knows that he has a bad case and that he must defend at all costs the statements made by the secretary of the organization of which he is a member. The Government has been forced to exercise compulsion in this matter. It has introduced a bill which provides that if a doctor prescribes penicillin or a proprietary medicine for a patient he must write the prescription on the prescribed form so that the patient may obtain the serum or medicine free of cost. That is the sole purpose of this measure. In opposing the Government’s proposal doctors are actuated by two motives. First, the average doctor is mentally lazy. He does not want to have to take the trouble to look up the formulary or to commit some or all of it to memory. All doctors more or less work on a common formulary. If honorable members will examine the average doctor’s prescription they will see that it consists merely of a few lines indicating the size of the bottle, the volume of the dosage, and the particular proprietary medicine which the doctor has prescribed as suitable for the treatment of his patient. The second motive behind the objection of medical men to the Government’s proposal is that they d:aire to retain absolute freedom to charge whatever they like for their services to persons who they know can afford to pay. It came to my knowledge recently that a patient who consulted a doctor was given a prescription the dispensing of which cost him pounds, notwithstanding that he suffered from a simple complaint which could normally be cured by an inexpensive mixture of drugs. The people are being fleeced by medical practitioners of that type. In 1944, I attended a conference at Philadelphia, United States of America, at which the subject of free medical services, including pharmaceutical benefits, were discussed. The conference, which was attended by representatives of 50 nations, passed a resolution by an overwhelming majority favouring the introduction of medical and pharmaceutical benefit schemes under which the whole or part of the costs of medical advice and treatment would be met by the respective governments. It was agreed by all representatives present that the cost of medicines and drugs had so greatly increased that they were beyond the means of the average wage-earner. I do not propose to labour this matter. I support wholeheartedly the views expressed by the Prime Minister in relation to this bill. I trust that it will not be necessary to put the provisions of this bill into operation. Even at this late hour I hope that the members of the medical profession will realize that the Government is serious in its intention to provide medical services and medicine for the people in accordance with their need and irrespective of their ability to pay. I am sure that the Minister for Health (Senator McKenna) is still prepared to confer with representatives of the British Medical Association in an effort to reach an agreement which, would benefit the people and that he is still anxious to avoid having to resort to compulsion in order to ensure that members of the medical profession obey the law. As Minister for Repatriation, I control a department that has prescribed for exservicemen for many years. That work is undertaken by salaried officers and <others who receive a fee for a certain period. The system has worked most satisfactorily. It is nonsense to say that doctors do not work so hard when they are paid a salary as they do when they arc in private practice. Most of the specialists to whom the right honorable member for Cowper has referred work for a salary, and -often a poor salary. Members of the medical profession, I believe, become absorbed in the humanitarian service that they render to mankind and if they are left alone, they will co-operate with the Government in this scheme because they know that it will be a godsend to most patients.

Dame ENID LYONS:
Darwin

– -I. congratulate the Government on having at last introduced, in the daylight, a measure dealing with pharmaceutical benefits. Hitherto, this kind of legislation has been introduced in the early hours of the morning, when honorable members have not had a real opportunity to debate it fully. Although this bil! is being debated in the closing hours of a sessional period, I am delighted that we have an opportunity to discuss the various statements that have been made in the press and elsewhere about this legislation ever since the Government announced its intention of introducing it. The Minister for Repatriation (Mr. Barnard) spoke of the ease with, which doctors would bc able to deal with the formulary. He blamed the doctors for the delays that have occurred in the introduction of the pharmaceutical benefits scheme, and said that all the doctors have to do is to commit a few things to memory and examine the formulary. I do not know whether the Minister has seen the formulary, but the 6,000 doctors of whom he has spoken cannot have done so.

Mr Barnard:

– They returned it to the department unread. . ..

Dame ENID LYONS:

– The formulary consists of 88 pages.

Mr Barnard:

– I carry a copy of it in my pocket.

Dame ENID LYONS:

– Every honorable member should acquaint himself with the provisions of the formulary, so that he will know that it is not a trivial thing that the doctors are asked to do in addition to their ‘ ordinary work. Il really will require a good deal of extra effort on their part. However, that point is outside the main issue. I 3hall make every effort to keep within the Standing Orders in my speech on thic bill, but it is quite impossible to discuss it in any way other than in the light of the points that the Leader of the Opposition (Mr. Menzies) has made. He has said that this legislation can only be regarded as a part of a complete plan that has many other features, with which we are gradually becoming familial-. The Leader of the Opposition made a statement this morning that the Prime Minister (Mr. Chifley) did not attempt to refute. I refer to the admission by the Minister for Health (.Senator McKenna), as revealed in a document from which the Leader of the Opposition quoted, that the ultimate abjective of the Government is to abolish private practice.

Mr Menzies:

– That is a government document, an official report.

Dame ENID LYONS:

– No government spokesman has yet made an effort to deny the correctness of that statement. If the abolition of private practice is the ultimate objective of the Government, the doctors, believing as they do that they arc the guardians of certain fundamental rights in this community, are not only ;u stifled but absolutely compelled to resist every effort that the Government makes in order to achieve that objective. “We believe that this bill is only the first step in the attainment of that programme and the Government has not denied it. The right honorable member for Cowper (Sir Earle Page) was, taken to task by the Prime Minister on his record in government and in relation to medical schemes. However, the right honorable member for Cowper has made certain points that cannot be disregarded. He has said that if the Government is genuinely desirous of merely providing free medicine for the people, it has only to ensure that the chemists are paid for the prescriptions that they dispense. It is obvious that, in relation to this contract, the doctors, as such, may be completely disregarded. If the Government were genuine in its claims, it could have given free medicine to the people long ago. I speak on this matter with some feeling, because for a long time I have been receiving letters from sufferers from diabetes, who need insulin. Their means are very small, and the cost of insulin is considerable. Why does not the Government proceed with this section of its plan by assisting such sufferers?

Mr Scully:

– The honorable member should put that question to the doctors.

Dame ENID LYONS:

– At this moment the Government could be giving to every man and woman who needs insulin the relief that it says they should have. I believe that such relief is necessary for them. Any measure of this kind, particularly one that introduces the element of compulsion, must be judged on certain points in it. If we are to compel citizens to do certain things that they would otherwise avoid doing, we should have good reason for acting in that way. Coercive legislation can be justified only as the result of a real public need, and a real public demand for it. Has there been any public demand for free medicine? Can this Government say that, at any stage, the public have demanded the provision of the pharmaceutical benefits scheme? Of all the bills that have been introduced in this Parliament during the last few years, the pharmaceutical benefits legislation, as far as I have been able to determine, has had the least impact upon the public mind. It has certainly been the subject of considerable controversy between the medical profession and the Government, but how many people have asked their doctors to co-operate with the Government in the scheme?

Mr Duthie:

– How many people have had the courage to ask their doctors to co-operate with the Government in the scheme?

Dame ENID LYONS:

– Without reflecting personally on the honorable member for Wilmot (Mr. Duthie), may I say that most men are not particularly courageous in matters medical, and I have no doubt that possibly the honorable member feels a little intimidated when he visits his doctor. But any suggestion that the public at large are afraid to ask their doctors, “Why are you not using the formulary that the Government has offered you in order that I may have this medicine free ? “ is sheer nonsense. The number that have asked their doctors that question is infinitesimal. Although there has been no public demand! for the introduction of the pharmaceutical benefits scheme, honorable members opposite cite the result of the referendum on social services as evidence of such a demand. I am becoming a little tired of the manner in which honorable members opposite interpret the results of referendums. Do they seriously contend that the affirmative vote in the referendum on social services constitutes a demand for this legislation?

Mr Daly:

– It was support for the introduction of this legislation.

Dame ENID LYONS:

– The honorable member for Martin (Mr. Daly) knows perfectly well that, speaking broadly, this matter was barely mentioned at the time of the referendum. The principal issues were child endowment, and age and invalid pensions. As a representative of the Liberal party, I told the people whom I addressed, “ On this measure I do. not personally advise you one way or the other”.

Mr Fuller:

– So the honorable member sat on the fence?

Dame ENID LYONS:

– No; I told the people that l proposed to vote for the proposal. I said, in effect, “ I would not presume to advise you on how to vote on this proposal, because I do not think that it matters very much, but it will serve to clear away any possible doubt about the constitutionality of the social services legislation. In my view, the legislation that has been passed will never be challenged, but I shall vote for the proposal “. If honorable members opposite suggest that the affirmative vote on that occasion constitutes a demand for the legislation that they had in the back of their minds as being possible after such u result, honorable members on this side of the House are equally entitled to represent the affirmative vote as a demand by the people of Australia that endowment be paid in respect of the first child. That was a part of the policy that the Liberal party advocated, and it would have been a part of legislation which we hoped to introduce, had we become the Government later. The result of the referendum on social services confirmed the power to do so.

There is no demand by the public at large for the introduction of the pharmaceutical benefits scheme. However, I do not desire to approach the matter from a purely negative stand-point. As I proceed I shall express another view which, f hope, will be seen to be founded on reason. I do not desire to protect any vested interests anywhere, except in the sense that I may be considered as one who holds a brief for the mothers, the children and the young people of this community. Recently, the honorable member for Indi (Mr. McEwen) made a statement to the effect that we were rapidly approaching the point where individual rights would disappear, and a Minister replied, “Everybody’s rights except the rights of the people”. In making that statement, the Minister revealed the false attitude of mind that has developed among some people who believe themselves to be progressive, when, in fact, they are’ moving backwards frequently, moving sideways sometimes and not by any means always moving forward. That Minister, and others who share his opinion, always fail to see that the people h.re individuals, and only insofar as we ure treated as a collection of individuals can we be rightly and properly treated as a mass. That statement applies particularly to anything relating to the medical practitioner. The Government can treat people, in a mass, fairly easily in some things, such as public health, but in the treatment of disease our individuality is the most inescapable phase of the whole matter. What place does this scheme occupy in our whole social services structure? It is the general aim of the Government party - and in this it is supported by the Liberal and Australian Country parties - that social services in this country shall gradually be freed from the operation of the means test. That is a proposition that I think ie accepted by the people at large as being the general policy of all political parties. It stands to reason, therefore, that every social service that is in operation at present must, in the light of that under taking, if I may so term it, expand in the next few years apart altogether from the existence-

Mr ACTING DEPUTY SPEAKER:
Mr. Lazzarini

– I remind the honorable member that this is not a general debate on social services. The means test ha* no connexion with this measure.

Dame ENID LYONS:

– The means fest is specifically touched upon by this measure, as I hope to show in the course of a sentence or two. That being the case social legislation of this nature must be undertaken with proper regard to its feasibility in relation to the whole of our social services. We must ask ourselves whether we shall be able to finance every social service measure that may be brought forward, including the present measure. At the present time Australia is enjoying bounding revenues. It is not likely that that condition will continue for ever. Honorable members opposite will agree with that statement. I think that they will agree also that it was demonstrated during the war years that there is a point beyond which it is impossible for taxation to go. Heavy taxation brings about the very conditions that will make it impossible to raise the standard of living and increase social services. Therefore it behoves us to see that every item of social service legislation introduced into this Parliament is regarded in the light of its feasibility. Here we have something that is regarded by members of the Government as being essential to the well-being of the health of the community. I ask the Government to re-examine it upon the basis of this question : Is health really dependent upon medicine? The answer is, of course, that it is not.

Mr Conelan:

– Doctors think that it is.

Dame ENID LYONS:

– The healthy person is not the person who is constantly taking medicine. There are certain drugs, upon which, we all know, life itself may depend. There are others which make life possible, and still others which save life in times of crisis. Every one of those drugs was the subject in 1947 of an offer to this Government of immediate agreement by the British Medical Association to assist the scheme and to make such drugs available free to the people. Speaking for the members of my party, because it is part of my party’s official policy, I say that all such drugs should be provided free to all who require them. There is another aspect that I commend to the consideration of the Government, and which I know has the support of the British Medical Association. It is that there should be free provision of medicine for all age and invalid pensioners. Drugs should be made available free to those people, who are coming to the end of their lives.

Mr Fuller:

– This Government will look after them.

Mr Bowden:

– It will not be there long enough to do so.

Dame ENID LYONS:

– If aged and invalid people knew that they could obtain free the medicine that they required and that they cannot reasonably be expected to provide for themselves out of their present pensions they would be relieved of considerable mental stress. I have put it to the House on another occasion that the British Medical Association would be very happy to enter into some arrangement with the Government on a contract basis, if the Government wished, to make medical services for all people free. But to say that it is a wise thing to provide every person who has a headache with a headache powder, particularly at the expense of the Government, is to speak the most utter nonsense. The right honorable member for Cowper has been criticized for what he did and for what he failed to do while he was in office. What do honorable members consider are the merits of the establishment of pre-school survey kitchens, and of the schools known as the Lady Gowrie centres which deal with the nourishment, feeding and care of children under school age? What do they think of a scheme to provide hospitalization for a mother who has been reduced to ill health by having too much to do? The real source of health is not to be found in medicines and palliatives or anything that provides a mere escape from symptoms. The real source of good health is in laying, during childhood, the foundations of proper health. I should not like honorable members to think for a single moment that I make.it my business to watch what people in this House, or in any other place, eat, but I am a naturally observant person and I cannot help noticing that in some places where I sit to eat in public, many men ask for corned beef and potatoes and fail to eat the cabbage and carrot that are also provided. They also ask for cold meat and pickles when they could just as easily ask for cold meat and green vegetables. Correct diet is the real source of health, and it is in connexion with such matters that the right honorable member for Cowper, who has been subjected to so much criticism to-day, has made an effort to assist the community. He has also attempted to provide instruction for mothers in the care of children. I know that honorable members opposite are always rather sensitive to criticismof their measures by any member of their own party. It so happens that in Australia there are very few Ministers for Health who are also doctors, but there is one Minister for Health who is a doctor and is also a Labour party supporter. 1 refer to the Minister for Health of Tasmania, who has condemned the free medicine scheme. He said that a free milt service would be much better.

Mr Sheehy:

– The provision of free milk would be a State responsibility.

Dame ENID LYONS:

– He even went further and said recently that this Government, by its withdrawal of the subsidies on whole milk, had made it impossible for a basic wage earner to maintain his children in real health.

Mr Dedman:

– Those are two completely irrelevant statements.

Honorable members interjecting,

Mr ACTING DEPUTY SPEAKER:

– There is too much interruption. The honorable member for Darwin has the floor.

Mr Dedman:

– What she is saying has nothing to do with the bill.

Dame ENID LYONS:

– I was aware i hat I was making a particularly provocative statement, but what I was saying has a great deal to do with the bill. What I am contesting is the need for this legislation, even in its original state, apart altogether from any additional coercive measures. I am contesting the real need for such a measure. On previous occasions I have referred to i he present age as the age of aspirin, when people run away from even the slightest ache or pain. For the first time in the history of this country the aspirin age has the blessing of the’ government of the day. Half of the preparations listed in the formulary are headache powders and the like, and they are to be provided at the expense of the community at large. [ put it to the Government that free benefits of this kind should be afforded to age pensioners and those whose live? depend upon drugs. But I do not believe that palliatives should be provided by the Government for people who develop all sorts of minor illnesses and aches as a result of their wrong habits. Those who think that this measure will not have the effect of leading to a greater consumption of drugs by the community will be very interested to know that Mr. Jewkes. the Director of Pharmaceutical Services, who is an appointee of the present Government, -I understand, delivered an address in April, 1948, on the Pharmaceutical Benefits Act to members of the Pharmaceutical Society of Victoria. The following statement was ;imong his final remarks: -

In conclusion, let me say to those who would like my advice that if I were in business ;rt the present time and knew as much about i lip scheme as T know now, I should be exceedingly busy preparing my shop and reorganizing my staff in order to adequately und efficiently handle the new business that would he coming: my way.

That Ls the belief of the Director of Pharmaceutical Services, who ha.3 been appointed by the Government for the very purpose, I take it, of administering that act. Mr. .Jewkes was a pharmacist before lie Government appointed him to this position. There is then very little likeli-1’ood that, in. the future, we shall find a reasonable level of cost operating in respect to this measure. I have not asked what the cost of this scheme has been so far. It would be very difficult, I imagine, to assess it at the present time since we have the Prime Minister’s word for it this morning, that there are only 117 doctors throughout the whole of Australia who are taking part in the scheme. As the Leader of the Opposition has pointed out, nobody could suppose thai every one of the doctors who condemn the scheme is a supporter of the Liberal party. One at least is a supporter of the Labour party. Nearly half of those 117 doctors, who are the only doctors out of a total of 6,000 who have agreed to co-operate in the scheme, are government doctors, and a great proportion of the remainder of those 117 are refugee doctors who, in effect, have felt bound to comply with the Government’s orders. So that, to pretend that the opposition to this measure from this side of the House is purely political, is completely false. Opposition to the measure arises from a purely professional attitude and is based, I believe, on sound ethical and moral grounds. I believe that the medical services of this community, and of any other community, represent the last barrier between the traditional and fundamental freedoms that the people should enjoy, and the monstrous totalitarian operation of the police state. Honorable members opposite smile at that. Every measure that the Government has introduced recently expresses to a nicety the view expressed by the Minister for Post-war Reconstruction (Mr. Dedman), that I have already quoted, that the rights of the individual can be ignored because he says that the Government protects the rights of the people. The people are but the individuals who make up the community, and if their rights, as expressed by the age-old practice of medicine, go by the board then I believe that very little will be left to them of freedom. Whatever comes from the State must always be controlled and interfered with by the State, and thai must always mean the loss to the individual of certain of his inherent. God-given rights. Health is not a matter of medicine only, although government* ran contribute towards the good health of the people by maintaining publichygiene on a large scale. However, if the Government believes that it is rendering a notable service by making palliative remedies available to the public, it had better take another look at this proposal. Let the Government make sure that it. has the support of the people before it persists with this coercive measure, which is of a kind that the Government is not able or willing to apply to other sections of the community. We have heard it said that the doctors are on strike. If the coal miners on strike would continue to produce coal as the doctors are continuing to give medical service to the community I should not very much object to coal strikes.

Mr DALY:
Martin

.- As usual, the honorable member for Darwin (Dame Enid Lyons) has made a fine speech, but honorable members on this side of the House will not overlook the fact that, despite her oratory, she did not make it clear that the principles incorporated in this amending bill and in the principal act were endorsed by the people at a referendum. The same principle was embodied in the National Health and Pensions Insurance Act, which was passed through the Parliament when the Lyons Government was in office. The principle of free medicine has been accepted by the Pharmaceutical Service Guild, and even by the doctors themselves. The people want free medicine, but the scheme is being sabotaged by the British Medical Association. During the last four years, we have witnessed the spectacle of one of the most honoured of the professions, the members of which owe much to governments for the provision of public hospitals, and for other facilities which have aided them in the practice of medicine, waging war ou the sick, the infirm, the poor, the aged and the members of the middle class, as well as those in receipt of low incomes. Only this morning, a stipendiary magistrate in Brisbane said that the sooner the free medicine scheme was in operation the better. A married woman who came before him had said that her father’s invalid pension of £4 5s. a fortnight was not enough to provide for his upkeep after medicines were paid for. The honorable member for Darwin said that there was no public demand for free medicine. If there has been no public demand, the reason is that there is such a scarcity of doctors that sick persons, whether they like it or not, have to accept medical :: I tension on the terms laid down by the doctors.

  1. have been appalled to note the support given by the Opposition to the British Medical Association which, in the language of industrialists, has been staging an unjustified strike. The Opposition is always demanding that the Government should take action against strikers for holding up industry. It demands that the Government should order the miners back to work; yet, when the Government takes action against the doctors, who are on 3trike against legislation endorsed by the people, the honorable member for Gippsland (Mr. Bowden), one of the diehard, shell-backed tories in this House, supports the strikers.
Mr Bowden:

– The doctors are not on strike, and the honorable member knows it.

Mr DALY:

– It is the best example of a strike that I know of. When [ was in Sydney recently, I saw on the Sydney Morning Herald bill-boards a heading, “Doctors Prepare to Fight Chifley”. What an outcry there would have been if it was the coal-miners who were preparing to fight the Government ! In the leading articles of newspapers the doctors’ strike is condoned, as it is condoned by the honorable member for Gippsland, the honorable member for Darwin and others. Discussing the attitude of the British Medical Association in New Zealand, Dr. Smith, medical superintendent of the Hokianga Hospital, said -

The doctors’ trade union, a political, not a scientific or cultural association . . . the British Medical Association is conservative in all things. Their ideas have become as nails driven into their coffins, and so punched in, that the very heads are deeply buried and can’t be withdrawn. In effect they have lost their heads … A true association of medical mcn can only be consummated when they associate in their work (and not only in politics, which consists of protecting their status and demanding the best of terms) and practise co-operative medicine for the good of humanity, instead of practising as lone brigands for the good of themselves, as now.

That describes very well the attitude of the British Medical Association in Australia, and in other countries where progressive governments have tried to bring free medical and social services to the people. Members of the Opposition have charged the Government with attempting to interfere with the patient’s choice of a doctor. The Prime Minister, in a very fine speech this morning, pointed out that conference after conference had been held with the British Medical Association over a number of years without producing any worthwhile results. As a member of the Social Security Committee, I have sat in conference with representatives of the British Medical Association, and I found that as soon as any proposal was put forward which might interfere with the earnings of the leading members of the profession their hostility was aroused. In reply to the claim that this scheme would interfere with the free choice of a doctor, L ask what freedom of choice has a person who lives in a small town where there is only one doctor? What freedom of choice have the people in the outback who live a hundred miles away from the nearest doctor? Honorable members know, too, that before the war doctors made the selling of their medical practices a stepping stone to what might well be called riches. They would develop fine practices in towns and then sell out, sometimes to absolute novices, at high prices. The people in those towns had no choice but to patronize the new doctors, unpractised as they so often were. The doctors object to the extra work that this scheme entails. I doubt whether any section of the community receives so great a return from its efforts with so little outlay in wages as does the medical profession. If one goes to a doctor’s surgery, one generally finds that his staff consists only of a girl whose job is to show patients in. What if the doctors do have to fill in extra forms? Let them expand their staffs to do the extra work, if they do not find it convenient to do it themselves and thereby save another £300 or £400 a year. The doctors say that the formulary does not suit. How did we get on during the war, when thousands and thousands of members of the forces were treated by salaried doctors from a formulary not so extensive as that now proposed ? The doctors co-operate in the repatriation service, than which there is no nearer an approach to a nationalized medical service. If the doctors do not object to repatriation work, in which thenis an established formulary, comparable with that proposed for the general public, on what grounds can they base their objection to the formulary under the Pharmaceutical Benefits Act? 1 should say that at least half of the doctors do not know the constituents of the patent medicines that they prescribe for their patients. Two-thirds of the drugs prescribed, it is claimed, consist of aspirin, or aspirin-based preparations. All thi objections of the doctors to the formulary on the ground of extra clerical work g<> by the board. All their other objectionscould be overcome by a little co-operation from them. No matter how good or bad the scheme may appear to them to be. they have an obligation to co-operate with the Government in an endeavour to make it work. If, after nine months or a year, they still have objections and can substantiate them, let them then tell thi* Government where the scheme needs improvement. Without doubt, the scheme would be improved where it was shown to need improvement. Instead of adopting that co-operative spirit, the doctor? have condemned the scheme out of hand. It is an unforgivable sin for them deliberately to sabotage the scheme at itsinception.

Honorable members opposite who have criticized the scheme say that the people do not want free medicine. Mr. B. G. Casey, who is now, I understand, federal president of the Liberal party of Australia, was Treasurer in the Lyons Government, when he piloted through this House the National Health and Pensions Insurance Act, in support of which he said, “We will give to the people of the country free medicine “. To-day the Opposition’s attack on the bill was led by the right honorable member for Kooyong (Mr. Menzies), who resigned from the Lyons Ministry because it would not proclaim that act in order that the people might have the benefits that it proposed to confer on them. So there can be little sincerity in the opposition to the scheme on the. part of members on the other side of the chamber. The doctors have attacked the Government’s policy of free medicine on the ground that its application would lower the standards of their profession.

Have not the chemists equally high professional standards to maintain? Why should co-operation in the scheme lower the prestige of the doctors and not that of the chemists? But the chemists are co-operating wholeheartedly. The Federal Council of the Federated Pharmaceutical Service Guild of Australia reported its attitude to the pharmaceutical benefits scheme as follows: -

The pharmaceutical chemists of Australia have wholeheartedly supported the pharmaceutical benefits scheme on an undertaking that their position as pharmacists and traders would not be worsened by doing so.

That is a reasonable approach that the doctors could well have emulated with more credit than they have earned from their unjustifiable strike. It is useless to say that the people do not want free medicine. They do. Friendly societies all over Australia have for many years provided free medicine to thousands of Australian homes. There is a great demand for free medicine among breadwinners whose wages of £6 or £8 a week do not enable them to buy the high-priced drugs that their families need in sickness. The people want to know what justification members of the British Medical Association have to go on strike and refuse to carry out the law of the land. That question has never been answered by them to the satisfaction of the people.Highsounding talk about lowering the standards of the medical profession will not go down. All that the people know is that they are being robbed of their rights by men who have done very well out of their medical practices. I remind the doctors arid honorable members opposite that medical training is not gained entirely as the result of the students’ own skill and knowledge. As a keen student of social matters, I have visited many hospitals all over Australia. The training and experience that medical students gain in public hospitals is to their great benefit. The service that they supply to the same hospitals after graduation is well-merited reciprocity. Honorable members opposite have also said that . the doctors fear a salary scale. The honorable member for Richmond (Mr. Anthony) is a conscientious member of Parliament who serves his constituents reasonably well.

Mr Archie Cameron:

– That commendation will bring about the defeat of the honorable member for Richmond.

Mr DALY:

– He, at any rate, seem* to serve them well, for they seem satisfied with him. At all events, taking a pride in his work, the honorable member for Richmond would not care whether he was paid £1,000 or £10,000 a year for that service. Throughout the years, publicspirited men in politics and industry have served the people as salaried servants. I echo what the Prime Minister said earlier about the great deeds done by men like Churchill and Roosevelt as the salaried leaders of their nations. I also invite the attention of honorable gentlemen opposite and the medical profession to the fact that a great many medical men work on salaries for the Australian Government and the State governments. So there is no reason why medical men generally should not willingly fall into line. The objections to a salaried service, at any rate, are red herrings drawn across the trail to mislead the people about th<facts of the Government’s health scheme. What the Government has in mind is s new conception in medicine. It would take away from the British Medical Association the right to exploit the sickness of the people. The Government proposes that the best medical attention that oan be provided shall he provided to all, regardless of income. The least we can expect from the British Medical Association is that it will instruct its members to co-operate with the Government to ensure the operation of th,scheme in the best interests of the people. It is useless for the British Medical Association to say that the scheme is to be put off. The British Medical Association has fought governments in other British countries. The Government knows that it has a fight on its hands. It willingly faces that fight. I propose to quote, in support of the Government’s plan, an excellent article published in the Melbourne Herald of the 17th June, 1948. entitled “ The Battle of the Bottle “. 1 commend this article to honorable members opposite. It is a fair presentation of both sides of the case.

Mr Gullett:

– Who wrote it?

Mr DALY:

– One of those mysterious people who usually write for the press - a “ special correspondent “. The article presents “ The case for the doctors “, “ The case against the doctors “, and “ The findings “. The findings, I may say, are completely impartial - particularly as they favour the Government! The article treats the subject soundly, and the newspaper in which it is written, is, of course, renowned as a politically biased journal! Summarizing the case against the doctors the writer quotes a doctor as having stated -

I know many of these people simply cannot afford to pay for their medicine. They trust me and they’ve been coming to me for years. Am I to shut the door in their faces and deny them what the law says is their right? Many conscientious doctors are troubled by this conflict of loyalties. They feel that pressure on doctors, particularly on those in industrial suburbs, must increase and that gradually more and more doctors will make use of the formulary to give their patients financial relief. One said: “I can’t tell an old-age pensioner she’s got to pay 10s. or15s. for sulfa drugs when the Government says she’s entitled to them for nothing “.

The doctor referred to is obviously a man of principle. Unfortunately, with the exception of about 120 medical men to whom I pay tribute for supporting the Government’s scheme, the doctors of this country are waging a war against people of the kind mentioned in that quotation. I commend this legislation. Although it may not achieve the full purpose for which it is designed, it is evidence that we on this side of the House are prepared to do something on a national scale, for the people of this country who cannot help themselves. Measures such as this will enable those people to enjoy not only the necessaries of life but also some of its amenities.

Mr ANTHONY:
Richmond

.- The honorable member for Martin (Mr. Daly) has given an eloquent address on the need for a free medicine scheme in this country. His remarks underline the statement by the Prime Minister (Mr. Chifley), that this big, strong Government will not stand any nonsense from anybody, particularly from 6,000 doctors. I hope that this attitude is a prelude to a new phase of this Government’s administration, and that the big strong man act will encompass Communists and other members of the community who defy the law repeatedly without fear of prosecution. But let us see what justification there is for this strong man atti tude towards doctors. Both the Prime Minister and the Minister for Health (Senator McKenna) have claimed that the medical profession has consistently refused to co-operate with the Government. We are led to believe that although the Minister has pleaded with the British Medical Association time after time for that co-operation, it has not been forthcoming because this intransigent body has decided that it will run its own course. I have before me records which show that statement to be a complete lie. I have a report of a conference held between the Minister for Health, and the Federal Council of the British Medical Association in Melbourne on the 21st March. 1947. Any one who reads what was said at that conference by both the British Medical Association representatives and by the Minister can have little doubt about who is telling the truth. The record shows clearly that there is no truth in the suggestion that the British Medical Association has never at any time shown willingness to co-operate with the Government. One of the British Medical Association representatives, Dr. Collins, stressing the need for freedom on the part of the medical profession to prescribe the most modern drugs that have been accepted as the proper treatment for certain serious ailments, said -

We are teaching our students at the universities to restrict their treatment to essentials and abandon any form of treatment which has not a strict scientific sanction. That is the modern tendency in treatment, and it is upon our conception of the treatment that we have suggested that pharmaceutical benefits should be restricted particularly to lifesaving drugs.

I emphasize that in respect of what are termed “ life-saving “ drugs, the British Medical Association has offered the Government its full co-operation. The quotation continues -

The single substances that I have in mind, for the sake of example, are drugs like the sulphonamides and penicillin, quinine, &c, and the particular diseases which are remedied in that way that I have in mind are diseases like septicaemia, pneumonia, meningitis, heart failure and other medical emergencies.

The Minister then gave his reason for the Government’s refusal to accept the British Medical Association’s suggestions. He said -

There is a practical danger there. . . . Suppose there was a doctor who would prescribe unnecessarily or for imaginary patients or even for named patients who were somewhat in collusion with him.

The answer given by the doctors to that statement was most effective. Any person who has had penicillin treatment as I have had will agree that no patient will 3eek 48 doses for an ailment which can be cleared up with 36. Penicillin is injected into the veins by a hypodermic needle several inches long and doses are repeated every three or four hours. It is absolute nonsense, therefore, to say that there would be collusion between patient and doctor to extend penicillin treatment unnecessarily merely for the doctor’s benefit. The British Medical Association representative said to the Minister -

Take for example a drug like penicillin which <is administered by injection. Patients will not submit to any more injections once they are cured.

The honorable member for Martin and the Prime Minister shed bitter tears for the man on ?5, ?6 or ?7 a week who had to meet chemists’ bills. It was unfair, they claimed, that anybody on such a low salary should have such commitments. I remind them that any family man. to-day can, through a friendly society, receive a complete pharmaceutical benefit for himself and his dependants up to the age of sixteen years for 3d. a week. The Government, however, is taking a social services contribution of ls. 6d. in the ?1 from taxpayers. Admittedly that contribution entitles taxpayers and their dependants to benefits other than the pharmaceutical benefit, but the fact remains that a man on ?S a week has to pay 12s. a week. for which his only return may be a pharmaceutical benefit obtainable through a friendly society for 3d. a week. That is the crux of the argument. A contribution of 3d. a week to a lodge can secure for the contributor and his dependants all that he can obtain under this bill, with which the Government seeks to destroy the medical profession.

Mr Thompson:

– Friendly societies do noi provide special drugs.

Mr ANTHONY:

– I thank the honorable member for Hindmarsh (Mr. Thompson) for his interjection. He has said that the patients would not get the special drugs from friendly societies.

Mr Thompson:

– Not for 3d. a week.

Mr ANTHONY:

– At the conference to which I have referred, the representatives of the British Medical Association suggested that the doctors should prescribe certain drugs and that the prescriptions should be honoured by a chemist and paid for by the Government. The British Medical Association’ representatives presented a list of drugs that they considered should be included in the formulary because they were lifesaving drugs and not merely substances to cure colds or bouts of influenza. The list included sulpha drugs, penicillin, anti-malarial drugs, antisyphilitic drugs, emetine, vaccine, sera, anti-toxins, thyroid extract, adrenal cortex, liver extract, insulin, adrenalin and a number of other drugs the name? of which I do not propose to read. At a conference which took place as far back as the 21st April.. 1947, the British Medical Association agreed to co-operate with the Government and to prescribe these drugs if the Government would pay for them.

Mr Thompson:

– It agreed to prescribe them on the doctor’s own prescription forms.

Mr ANTHONY:

– The doctors agreed to co-operate with the Government and to prescribe those drugs on any form that the Government desired to provide. The only matters in relation to which they would not submit to dictation were compound medicines, mostly used for the treatment of minor ailments such as coughs and colds. In relation to coughs fi.nd colds, Dr. Colville said -

These small ailments are legion. Many ar? imaginary. Most doctors who get a cold in the head do not take anything themselves. I think Dr. Metcalfe would agree on that point.

Dr. Metcalfe, the. DirectorGeneral of Health, who was present at the conference, replied, “ I think so “. He agreed with Dr. Colville that, generally speaking, minor ailments must run their course and that bottles of medicine do not make any difference, even though a patient might feel that they were doing him some good.

Mr Haylen:

– The honorable member desires the doctors to compel patients not to take medicine.

Mr ANTHONY:

– The Government is going to compel the doctors to take a dose of medicine, and the community will suffer for it. I hold no brief for the British Medical Association in this matter. My concern is for those people who are now patients or are likely to be patients of the medical profession. I want doctors to be unrestricted in their judgment and methods of treatment. When [ was in the Army, the Army doctors, irrespective of the ailment from which a soldier was suffering, prescribed one remedy only. Honorable members probably know its name. That will be the kind of medical service that we shall have if the medical profession is nationalized. When the proposal was made by the Minister for Health (Senator McKenna) that the doctors should prescribe all drugs for the treatment of serious and life-endangering ailments, the honorable gentleman said -

So far as the doctor is concerned, there is not the faintest restriction upon him to prescribe anything he considers desirable for the patient.

The doctors wanted to prescribe penicillin, insulin and other drugs. The Minister said that he did not think that any Government would seek to impinge upon the prerogative of the doctor. That was a perfectly proper statement. But the honorable gentleman has changed his opinion since then. He went on to say -

When it becomes a matter of determining what benefits patients are entitled to, surely that is a decision at a political level.

According to the Minister, patients were to be entitled to receive free of charge only inconsequential drugs. At that time it was intended to exclude from the formulary all of the drugs that are now so important in scientific medical treatment.

The Government has embarked upon a deplorable campaign to slander and malign the medical profession. In order to bolster its chances at the next general election it has raised the false issue of medical men versus the poorer members of the community. I do not think that the campaign will have the results for which the Government hopes. Recently I was speaking to a doctor who has a very large practice in an industrial suburb of Sydney. I said to him that probably he was being worried almost to death by people who wanted him to write prescriptions entitling them to free medicine. He told me that, although his patients are drawn from the poorest people in .Sydney, he has not had half a dozen such requests made to him since this issue was raised. The people are not fools. They realize that, if a doctor is compelled to prescribe from a formulary, they may suffer by reason of that compulsion. They know that a doctor may, in those circumstances, prescribe something which is in the formulary although, in his judgment, it is not in the best interests of the patient to do so. Much has been said by honorable members opposite about a strike by the British Medical Association. I live in a country town in the far north of New South Wales. Recently I wanted to get in touch with a doctor there. 1 telephoned him first at S a.m., because I thought that at that time he would noi have left home to go on his rounds. However, he had already left. I telephoned him again at lunch time, but he was still out. I rang again at 9 p.m., but hfwas still on his rounds. That doctor is doing that for seven days a week. H<has one Sunday off in a month, when he is relieved by another doctor. He i.working round the clock. That is the kind of man whom supporters of the Government accuse of being on strike. The case of that doctor is typical of the case of hundreds of doctors throughout New South Wales. He does not get a penny for a great proportion of the work that he does. He attends people when he knows they cannot pay his fees. Often he performs for a nominal fee an operation for which he would normally charge a large sum of money, and sometimes he does it for nothing. Is that the kind of activity that can be stigmatized as a strike merely because medical practitioners will not bow to a government that obviously aims at destroying the medical profession? There is no doubt about the Government’s ultimate objective in regard to the medical profession. At a conference between the Minister for Health and representatives of the British Medical Association, held on the 21st July, 1947, Dr. Colville said-

I am quite clear on that, but could we confine ourselves to a discussion of the ultimate eni of this scheme? What is the ultimate end? You keep emphasizing that the development would be gradual-

He was referring to the development of governmental medical practice - and that there would be people who would prefer private practice to the Government service, but the ultimate object is admittedly that private practice will be eliminated.

The Minister replied, “That is so; there is no dispute about that”. Equally, it can not be disputed that the intention of the present Government is to make every doctor a salaried servant of the State, to take away the right of private practice, and to destroy the initiative of the profession. Can any one blame the medical profession for resisting the Government In the interests, not merely of its members, but also of the patients themselves ? A lot has been said this afternoon about what people will do for salaries compared with what they will do as private individuals working on their own behalf. The Prime Minister went to great lengths to stress that General MacArthur and General Eisenhower worked for salaries. The honorable member for Martin was also good enough to bestow some little praise on me by pointing out that, in return for the performance of my parliamentary duties, I receive only a fixed allowance. Incidentally, members of the Parliament do not perform a whole series of grinding duties merely for the sake of receiving their allowances, and I believe that many members of the Parliament on both sides of the House would willingly give their services free in order to serve the community. However, the payment of a fixed allowance to members of the Parliament for the performance of their parliamentary duties has very little to do with the controversy whether or not ordinary individuals work harder for the community when they are in receipt of a fixed salary than they do when they are actuated by private incentive. I believe that the present measure represents the thin end of the wedge of the effort to dragoon the medical profession, and that the effect of the Government’s interference with members of that profession will be to the detriment of the community which the profession serves. I refer, of course, to the doctors’ patients; and whilst I have no brief at all for doctors as doctors, 1 certainly have a brief for the people whom they treat.

Mr Calwell:

– Why has not the honorable member any time for “ doctors as doctors “ ?

Mr ANTHONY:

– I said that I have no brief for doctors as doctors. They are completely capable of looking after themselves, as the Minister for Information (Mr. Calwell) and his colleagues have discovered. However, I am concerned that the people whom the doctors serve should be denied penicillin, sulpha drugs, insulin and other important and costly preparations, not because of any lack of co-operation on the part of the doctors, but because of the miserable attitude adopted by the Government, which refused to include the more expensive drugs in its formulary-

Mr Calwell:

– But the Government has not excluded those drugs from the formulary !

Mr ANTHONY:

– Up to a certain stage of the negotiations, it excluded them; and even now the Government would not have agreed to their inclusion but for the insistence of the doctors, who, for the last two years, have contended that these drugs should, and must, be included. The doctors have been consistent in advocating that such drugs should be provided free.

I do not think that it is necessary to traverse the arguments advanced by members of the Opposition who have already taken part in the debate, except to emphasize that the “ splendid service “ for which the Government is taking 10s. or 12s. from the average worker’s pay by way of social services contributions, can be provided by any friendly society for any worker and his family for 3d. a week. The present deadlock in the negotiations between the Government and the British Medical Association concerning the free medicine scheme, which the Government alleges is due to that body having adopted an unconscionable attitude, is concerned with the provision of a service which the friendly societies of this country can render at a cost that is only a fraction of the price of a packet of cigarettes.

The Prime Minister waxed quite emotional at the mention of medical treatment and pharmaceutical benefits for 3d. a week, but the fact remains that those who subscribe that amount retain their independence because they can choose any doctor who is on the lodge panel to treat them. In reply to the suggestion of the doctors that penicillin and other costly life-saving drugs should be included in the formulary, the Minister for Health, who tried to lay the blame on the doctors for preventing the community from receiving the benefit of those drugs, said -

When it is a matter of determining what benefits patients are entitled to, surely that is a decision on the political level.

La the course of his later remarks, he said that, as an administrator, he would be open to severe criticism if he provided any services in excess of those authorized by the Treasurer, to whom he was responsible. In the course of his discussions with the Federal Council of the British Medical Association, the Minister said -

Having regard to the possibility, rare as that might be, of fraud- [ emphasize that that is one of the excuses that he gave for not including expensive drugs in the formulary and for not permitting doctors to prescribe what they thought fit for their patients-

Mr Calwell:

– That is not an excuse, but a reason.

Mr ANTHONY:

– It is not a reason at all, as the Minister for Information will realize when I proceed with the Minister’s statement, which continued - - . in which a doctor might participate. I 01 ii give one instance - the question of a doctor and a chemist acting in collusion and sharing the profits of their collusion.

That was one of the reasons advanced to explain why the Government could not agree to the inclusion of essentia] drugs in the formulary! The Minister then said to the representatives of the British Medical Association, “ What would you do about that, Mr. B.M.A.?”, and Dr. Colville very properly said, “ That is a criminal action and must always be provided against “. Then the Minister, backing down, said, “I suppose one could put iL in that category, that is, of obtaining benefit by false pretences “. He had, therefore, to make a complete retreat from the suggestion that he had advanced.

We are dealing now with the position which confronts us in 1949. All along the line the British Medical Association has insisted on the right of doctors to prescribe for their patients the drugs and medicines which they believe may benefit them and cure their illnesses. By contrast all along the line the Government hasinsisted that the doctors shall prescribe only those drugs and medicine? which are included in its own formulary. The British Medical Association has consistently resisted the Government, in th* interests of not only its members but alsothe people whom its members are called upon to treat. It follows,, therefore, that any challenge which the Government issues in this matter is directed, not so much to < 6,000 doctors of this country, &a to 6,000,000 Australians, who will ultimately decide thematter.

Mr. HAYLEN (Parkes) [4.34J.- J think that the Opposition is getting into deep water in its criticism of the Government’s present proposals. I cannot understand why so much heat has been imported into the debate so early, unless the explanation is to be found in the evasiveness which has been evident in all the speeches delivered by honorable members opposite from the Leader of the Opposition (Mr. Menzies) to the honorable member for Richmond (Mr. Anthony), who has just spoken. It is obvious that the collective purpose of members of the Opposition is to distract public attention from the salient consideration which has actuated the Government in introducing the measure, namely, the need to provide medicine and a comprehensive scheme of medical treatment for the sick poor. “ Doctors “ on the Opposition benches, with their new “ degrees “ shining upon them, have referred to everything except, the reason for the introduction of the bill. After all,, is it not fair, humanitarian and reasonable to provide fretmedicine for sick people in order to assist them in their distress? Honorable members opposite have roamed all over the place. There is talk of this bill being the thin end of the wedge of nationalization. of what happened at various conferences with the British Medical Association, of what this doctor or that doctor has said, and of what the Minister has said in rebuttal. When they appear to be coming to the point of stating whether or not they stand for free medicine for the sick poor of this country, they are off again at a tangent. The Government has made a simple request that has been ignored for too long. In his second-reading speech the Minister made it clear that negotiations with the British Medical Association had gone on for so long that it was obvious to the most patient of men - and the Minister for Health (Senator McKenna) is a very patient man - that the doctors had no intention of moving away from their decided stand on this matter. The doctors said to themselves, one gathers from the correspondence on the. subject, that their stand was a stand against nationalized medicine, so that, therefore, any other extraneous matters that may be imported into the dispute, such as free medicine for the people, must be resisted. Honorable members opposite talk of compulsion. As Rousseau said many years ago there is a social contract under which people do certain things for the benefit of the community. For instance, the honorable member for Richmond must be well-mannered in this House because our social conventions provide for the presence in the House of Mr. Speaker, one of whose duties is to compel the honorable member to be wellmannered while he is in the House. Many of our freedoms and liberties are whittled away by one means or another for one magnificent purpose, namely, the greater good of the community. So that the cry of the British Medical Association that the livelihood of its members, and particularly their freedom, is being curtailed, is just so much nonsense. If we measure the request against the benefit and put the proposition in its simplest terms it will be seen that the Government has said to the doctors, “ We have no intention whatever of determining what kind of prescription you may write for your patient - that is your business - but if in your judgment as a doctor of repute, with the experience of years behind you, you decide to issue a prescription which falls within the formulary of the free medicine scheme we request, and we now demand, for the sake of your patient, the taxpayer, that that prescription shall be free “. That is a fair proposition. I was for some years a member of the Social Security Committee which was destroyed by the refusal of the Opposition to be represented on it. I saw all this tortuous build-up of the opposition to free medicine and a free medical service. On one occasion we had an agenda covering discussions with the medical profession on 31 points. After the discussion had extended over three days, 30 of the points were agreed to. The 3lst point, which was not agreed to, related to free medicine. The representatives of the medical profession were adamant in their opposition to it. The necessity for compulsion, a subject that has been canvassed very greatly during this debate, was forced upon the Government. It had no alternative. There are 15,000 diabetics in this country. There are 20,000 arthritics and 18,000 sufferers from various kinds of rheumatoid diseases, including spondylitis. All of them are chronic cases. Not one hospital in New South Wales would accept them. They are not accepted even in rest homes, because they are difficult patients to look after. Those suffering from arthritic diseases can be moved only with great difficulty. Their tragedy is lived out in the streets of almost every city and town in this country. They are not sick enough to be hospitalized. If there were sufficient hospitals to accommodate them, beds would probably be found for them. In the main, they stay with relatives and undergo occasional hospital treatment. They are forever going to doctors to obtain prescriptions. Otherwise, we should not have the staggering figure of 20,000,000 bottles of medicine a year being prescribed by doctors. As I have said, these people are chronic sufferers from various diseases. The Government surveyed the scene of free medicine so that those people who are involved in expenditure ranging from 6s. to 8s. a week, may receive the benefit of free medicine. Some of these unfortunate sufferers belong to lodges or other organizations that provide them with free medicine.

Some go to our public hospitals for treatment. But the great majority of middleclass people in that unfortunate condition live out their lives quietly and unostentatiously in the back streets of our cities and towns. In some instances, we have found it difficult to induce them to accept the benefits to which they are entitled. We all know the delightful story of the old lady who, though she had lived for 90 years, said that she was not entitled to a pension unless she did something to earn it. In general, sick people believe that they should continue to pay for their medicine. Honorable members opposite contend that nobody wants free medicine, the inference being that so much money has been circulated by this Government that nobody needs a free medicine scheme. Let us examine the position in relation to a sickness benefit. The majority of sick people need medicine. For the year ended the 30th June, 1948, the figures relating to the number of persons participating in the sickness benefit was very high. In the whole of Australia 53,047 males accepted the sickness benefit, and, presumably, the medicine that went with it, for complaints ranging from infective and parasitic diseases to cancer, rheumatism, diseases of the circulatory and respiratory system and so on, down the whole dreadful calendar of serious illnesses. In the whole of Australia 15,539 women accepted the sickness benefit. It is astonishing to find that there were so many more sick men than sick women in the community. There may, of course, be other reasons for the disparity between the figures. In any case, a grand total of 69,486 people were sick enough to ask the Government for the sickness benefit, and they would have been entitled to free medicine had the scheme been in operation. The story that there is no demand for free medicine is palpably untrue. I concede that at this time no terrific pressure 13 being put on members, as is generally the case in organized drives, but I contend that there is a big demand among the people for this benefit and that the demand would become greater if the way were cleared for them to obtain it. The battle has been raging for some time. Opposition to the free medicine scheme has become a political issue and, for the time being, the people are sitting, on the sidelines waiting to see what is going to happen. Imagine going to a local doctor and finding on his surgery door, or on the wall of his little waiting room, a notice that he does not participate in the free medicine scheme. In the doctorpatient relationship there is a tendency for the doctor to become the paramount force. When a person is sick he is somewhat amenable to advice. A sick man does not go to his doctor in a fighting mood. It will be found that in the final analysis there will be a very strong demand, and should the position in this country deteriorate, so far as employment is concerned, this will be a big section of out social services provisions. The principle of freedom of judgment and action is well sustained in this bill. The doctors may make their own decisions about prescriptions, but if they select a prescription within the formulary they are merely asked to fill in a government form. The fight is between the Government and the Federal Council of the British Medical Association. Compliments have .been paid to the doctors in this House to-day, and it goes without saying that they are a section of the community to which we owe a great deal. In the overwhelming majority of instances it is found that the conduct of the doctors is irreproachable. It it surprising that a young soldier, the honorable member for Henty (Mr. Gullett) should refer in sneering terms to the repatriation doctors. He implied thai because they are salaried, they are incompetent, but if they were in private practice they would be all right. Because they had elected to do some further community service and get a salary for it, he implied that they are incompetent. That charge could be answered by thousands of returned soldiers who have found their health again because of the devotion of the doctors in the repatriation hospitals. The slur upon a doctor would not be lessened whether he was a salaried officer or not. The interjection of the honorable member for Henty may have been unfortunately phrased. He may not have wanted it to convey the implication that it did; In any case it was in very bad taste indeed. It is not usual to find the Opposition trying to defeat its own case.

The honorable member for Richmond referred to some correspondence he had received from doctors, and waxed eloquent about a very restricted formulary which was confined to life-saving drugs for the treatment of dangerous diseases. If the doctors were prepared to accept that formulary for free medicine without any difficulty at all, and we are giving a formulary somewhat similar, but expanded, where is the difficulty? There is no difficulty so far as the clerical work is concerned. Except in very remote surgeries, the clerical work is being done for the doctors by some young men and women and the nurses attached to the surgery. That may not be so at an outpost, but if it is too much of an outpost there is usually no doctor there at all. I dismiss entirely the theory that what is sauce for the goose is not sauce for the sender; that the doctor is too busy, absorbed and overworked to fill in the prescriptions on the Government forms. lt is said that it should be all right for the chemist, who is a trader and has an extensive business, to fill in these forms, because it takes the responsibility off the doctor. But the chemist is more than a trader and he ha9 his problems too. The desire of the Government to provide the sick poor of the community with some relief from their ailments by giving them free medicine, is being frustrated not because the Federal Council of the British Medical Association thinks that the scheme is dangerous, but because it fears that it is the forerunner of something else. There are several prescriptions for nightmares and the Federal Council should do something about treating itself. The speech made this afternoon by the honorable member for Darwin (Dame Enid Lyons) was a very fair statement of the position. She is a humanist, of course, and understands the sickness of families. For many years her work has been amongst the people of the community and therefore her words were worth listening to. She became very earnest when she referred to the matter of relief for sick people who are unable to get assistance. She then sheered off, as every other honorable member opposite has done, and blamed the Government for creating this present impasse. She did not come back to the simple principles of the bill, which are that there is to be no compulsion in this matter, but that we demand that the sick poor shall have the prescriptions that are within the formulary.

Another honorable member made great play about the quantity of medicine that will be used. This bill does not provide that a doctor must give a person who is ill a prescription. That is a matter for decision by the doctor. If the people drink millions of gallons of sludge it is their own fault. Although medical witnesses from time to time scoff at the idea of medicine they say that the patients want it. One of the greatest fears about free medicine is that there will be an orgy of medicine drinking, as the honorable member for Martin (Mr. Daly) said in his remarks about that very fine article in the press, “ The Battle of the Bottle”. Although that has been the history of medical schemes in the past, this Government has benefited by the experiments associated with this sort of legislation in New Zealand, and has followed the organizational establishment of the scheme in the United Kingdom. What can happen from human fallability lack of organization, and inability to foresee the future was, as far as possible, adjusted in the measures previously before this House relating to the social benefits and free medicine schemes. The reason why this proposal is before us again is that the Government has a duty to discharge, and I urge that it be discharged. Irrespective of whoever may be standing in the way, especially on account of professional prestige, if there is a duty that should be performed for the sick poor of the community, let us get on with it. Charity is exhibited in the whole life of the medical men, and they really must discharge from their minds the thought that there is any compulsion. There are so many sick people in the community that the doctors do not know how to cope with them. Most doctors would like to be able to help them all, and they must have 20 per cent, of their patients on the free-list. Here is a chance to make themselves solvent, and save the time that is occupied by the Government providing social benefits. It is ridiculous to say that this scheme should not be proceeded with because it is going to give the doctors more work. Nothing of the sort !

The whole medical scheme, which seems to worry the medical profession so much, will be endangered unless practical steps are taken forthwith to see that we provide these social benefits. I am in the habit - and I crave the indulgence of the House for mentioning this aspect - of going to my electorate once a week and interviewing my constituents. During the last twelve months, I have been making a note of the case histories of a number of sick persons. One elderly lady, who is an age pensioner and lives in a room in a suburb of Sydney, suffers from asthma. She spends approximately 4s. 6d. a week on medicine, in an endeavour to obtain relief from her distressing complaint. Her health may improve for a fortnight, but the attacks of asthma then recur. The cost of the medicine is whittling away her pension. If the pharmaceutical benefits scheme were in operation, she would be able to get the medicine free of charge. Half a dozen other people have spoken to rae about the pharmaceutical benefits scheme. One woman expressed her views as follows: “ You cannot blame the doctors. They do not like this scheme. I have nothing but admiration for the doctors who have attended me. Regardless of the lateness of the hour, they have come. Sometimes [ have not been able to pay them as much as I should have. However, I should like to feel independent, although I know that medical treatment is available to me as a part of the social services to which I am entitled, and as my reward, as an ageing citizen, who is resting after my years of toil in the community. I do not want to receive charity from the doctors or the Government, but I do consider that there are thousands of people who should have the advantage of the free medicine scheme “. The most vulnerable section of the community, the very, very poor in the highly industrialized areas, can at least go to public hospitals, and wait in a queue until the doctor can attend to them. They can get a considerable quantity of bulk medicine to take away with them if their complaints are relatively common. The middle class, who, in the words of economists, are caught between the upper and nether millstones, need the pharmaceutical benefits scheme just as much as the poor of the community doi”We should ameliorate their lot, becausetheir position represents a tragedy in thecountry to-day. However, an, ethical principle is given as a reason why a> medical practitioner, after having decided, that a patient requires a certain prescription to restore him to health, should1 not use the formulary. He decides that he is being compelled to write a prescription from the left-hand side of Instable -when he prefers to write it from the right-hand side. He also favours his own prescription form rather than, that provided by the Government. He is reluctant to supply on, the official form the prescription and otherdetails that will be required for an examination of the prescriptions that hesends to the chemist. The Government s not asking too much of doctors when it seeks their co-operation in the pharmaceutical benefits scheme. I deplore thebattleground that has been made of this issue, the recriminations concerning doctors and the unreasonable fear that the conditions of medical practice will becomeimpossible when the Government entersthe field. In the not distant future, because of rising costs, the majority of thepeople will not be in a financial positionto meet the costs that they incur through; sickness in their family. Therefore, theGovernment decided to introduce its pharmaceutical benefits scheme, andopponents immediately described it as an attempt to nationalize the medical profession. Immediately the Government decided that the sick poor of thecommunity should have free medicine., somebody yelled, “ This is nationalization “. Despite the honest statement by the Minister for Health about the Government’s limited constitutional powersin this matter, a battle rages around the question whether the authority which the Commonwealth obtained at the referendum on social services will plam the validity of this legislation beyond doubt. A statement by another Minister on the subject was torn from its context, and made a sombre and darkening resolution on thepart of the Government to nationalizeeverything in the country. The people can safely dismiss those grim forebodings. There is only one issue in this- simple bill. Bo honorable members opposite still contend that it contains ‘an element of compulsion? After having analysed the bill, we find that it makes only a request to doctors on behalf of the people who deserve our care and who should receive the pharmaceutical benefits. They have been made a stalking horse for a row between the Federal Council of the British Medical Association and the Government, which desires to extend its social services programme. However, people who have considered and judged the position are asking this question : “ If the act authorizes the provision of pharmaceutical benefits for us, why are they not being made available to us? Is there any reason other than that we are the victims of a larger fight that is looming? We are being mulct in an amount of 6s. or 8s. a week because we are sick people “. That is the whole «tory. Anything else is extraneous. Members of the Opposition have made expansive speeches upon every other aspect but the one that is vital to the bill. The purpose of this legislation is to give to the people something that they demand and need, namely, the free medicine within the formulary as is provided by the Pharmaceutical Benefits Act. Mr. LANG (Reid) [5.0] .-The Government has stated that this bill is aimed at the British Medical Association, but when it becomes law, every doctor, and not the British Medical Association, will become a potential law-breaker. The bill has nothing to do with the British Medical Association, but it nas everything to do with doctors. The ‘Government will be fighting the suburban physician and the country doctor in every part of the Commonwealth, irrespective of how great their services may be, and, of course, they cannot be discounted. Doctors will be required, in effect, to say why they are prescribing for their patients. They must fight against that. In this matter, a principle is involved, and the doctor must fight for it, or die. Every doctor who does not use the official form when writing his prescriptions will be a lawbreaker. The people of Australia have a right to know that doctors object, on principle, to being compelled to fill in the official forms. Every qualified medical practitioner throughout the Commonwealth who does not use the official form will be a criminal. If doctors refuse to break the law and use the official form, they will be abandoning their principle? and placing in jeopardy the lives of their patients. The onus will then be on the Government to take legal action against them throughout the length and breadth of the Commonwealth. I emphasize that that would not be action against thBritish Medical Association, but persecution of the medical practitioner in small country towns. The suburban family doctor as well as the specialist.in Collins-street, Melbourne, and Macquariestreet, Sydney, will suffer under this measure. The bill declares war upon the general practitioner as well as the specialist. The measure is not, a> the Government claims, against the British Medical Association but against every doctor. If doctors, who practise outside the metropolitan areas, wish to continue to pursue their profession and remain within the law they must abandon what they regard as a principle. [Quorum formed.] They will be able to practise only if they agree to write their prescription on the Government form. The McKenna-Chifley prescription code will become a condition of their terms of employment. Il they do not observe it, they can starve. They will not have the right to full employment. They will be permitted to prescribe only those drugs that are not included in the Commonwealth pharmaceutical formulary. Thus, their patients will be denied the benefits of all the medicines contained in the formulary, including penicillin.

The measure creates a precedent which is very dangerous from the point of view of the Labour movement. It introduce.a new kind of civil conscription. It confers upon the Government power to stipulate any term with respect to an individual’s employment that it desires to impose. Before a doctor will be allowed to practise his profession he will have to agree to write his prescription on a Government form. That is the start. Whither then ? If the Government can make doctors conform to this law then any other class of worker can be brought within the scope of a similar law. Thus this measure enables the Government to get around the guarantee which it gave to the people that it would not introduce civil conscription in this country. The next stage will probably be the establishment of a civil employment register in which every employee must be registered by means of a form to be provided by the Government. The engineer, the bricklayer-

Mr DEPUTY SPEAKER:

– Order ! The honorable member must confine his remarks to the bill. [Quorum formed.]

Mr LANG:

– I was pointing out that this measure imposes civil conscription upon medical practitioners.

Mr DEPUTY SPEAKER:

– Order ! The honorable member is not entitled to enlarge upon that argument. He must confine his remarks to the bill.

Mr LANG:

– I am entitled to say what I believe, sir.

Mr DEPUTY SPEAKER:

-Order! The honorable member knows that under the rules of the House he must confine his remarks to the question before the Chair. He is entitled to refer to the amendment of the Constitution which he has in mind and to relate it to medical practitioners; but he is not entitled, to discuss that point generally.

Mr LANG:

– This measure will impose civil conscription upon the medical profession.

Mr DEPUTY SPEAKER:

– Order ! The honorable member is entitled to express that point of view; but he will not be in order in enlarging upon it.

Mr LANG:

– I hope that I shall be allowed to show that similar treatment of other professions and classes of workers would be objectionable.

Mr DEPUTY SPEAKER:

– No, the honorable member would be out of order should he attempt to do so.

Mr LANG:

– I say deliberately that this measure imposes civil conscription upon the medical profession, and that it would be very simple for the Government to apply- the same principle to professions and callings in addition to the medical profession.

Mr DEPUTY SPEAKER:

– The honorable member has made that point sufficiently. I suggest that he proceedwith his next argument.

Mr LANG:

– The medical profession is not one that can be controlled by the Government. But if a doctor may only practise on the condition that he fills in a particular kind of form it is easy to see that he will become, in effect, a government employee. Once the medical profession is under the control of the Government and doctors are told, even a doctor like John Hunter, that they may practise their profession only if they fill in forms, a card system will have been introduced.

Mr Edmonds:

– That is not correct.

Mr LANG:

– It is correct. It is in this bill, and I say that it is the wrong thing to do. Once we come to that position we shall have come - and I say this coldly, calmly and deliberately - to the point where we shall have a police state in Australia. This bill is typical of the Government’s attitude on humanrights. Embodied in the measure is the Government’s idea of freedom. The Government refuses to recognize the right of the individual to the basic freedoms to which it pays lip service at the United Nations. This bill is a complete negation of the Declaration of Human Right. The Government would do well to study that document and to realize that the bill is a repudiation of the commitments that it has accepted under the Charter of Human Rights. In particular, I suggest that -it consider the bill in- relation to the preamble to the Charter as well as Articles 1 to 23 of the Charter. Whenever the Government finds itself *in trouble it immediately thinks of coercive measures. It wants to card-index everybody. Many of the greatest battles of the Labour party have been against attempt? to rob the individual of his privacy and! his right to choose his employment..

Mr Lazzarini:

– The honorable member must admit that he sent his pimps into the people’s homes at 6 o’clock in th, morning.

Mr LANG:

– The honorable member for Werriwa (Mr. Lazzarini) knows* what job I gave him when he sought my assistance on one occasion. One of the most bitter strikes in the history of New South Wales occurred over the introduction of what is known in that State as the “ Taylor card system “.

Mr DEPUTY SPEAKER:

– Order ! I think the honorable member is getting on to industrial matters that have no relation to the bill.

Mr LANG:

– With all due respect to you, Mr. Deputy Speaker, I consider that the introduction of the Taylor card system has some connexion with the bill because of the very great industrial trouble that it caused in New South Wales. According to the Prime Minister that system was responsible for the right honorable gentleman having the position that he occupies to-day. The Labour movement objected to the introduction of that card system just as it will object to this measure.

Mr George Lawson:

– I rise to order. Is the honorable member for Reid in order in reading his speech?

Mr DEPUTY SPEAKER:

– The Chair does not know that the honorable member for Reid is reading his speech. [ believe that he is quoting from copious notes.

Mr Gullett:

– I rise to order. I have no brief for the honorable member for Reid, but I suggest to you, sir, that during the course of his speech he has been subjected to systematic attempts to prevent him from making it, and I ask you to accord to him the same protection that you would accord to a Government supporter.

Mr DEPUTY SPEAKER:

– Order ! The honorable member for Henty (Mr. Gullett) will resume his seat. The Chair is in charge of the House, and the remark that he has just made constitutes a reflection on the Chair. I call upon him to apologize for having made it.

Mr Gullett:

– I certainly apologize to the Chair for any reflection that 1 may have cast on it.

Mr DEPUTY SPEAKER:

– The honorable member will resume his seat without further discussion.

Mr LANG:

– Embodied in this measure is provision for a card system that is to be applied to the medical profession of Australia.

I am endeavouring to show that when the card system known as the Taylor card system was introduced in New South Wales it caused a strike. Every Labour party supporter in New South Wales stood solidly against it. 1 am only pursuing that line of argument in order to show that the Labour movement objects to being card-indexed. If I am not allowed to do that in the Parliament, my position is so much the worse.

Mr Edmonds:

Mr. Edmonds interjecting,

Mr DEPUTY SPEAKER:

– Order ‘ The honorable member for Herbert (Mr. Edmonds) must observe silence or leave the chamber.

Mr LANG:

– I am trying to point out and I consider that I am doing it very effectively, that the workers considered that the introduction of the Taylor card system was the first step in civil conscription, and they objected to it because they regarded its introduction as an invasion of their private privileges. Despite what any one else in this Parliament may say, I am entitled to express the belief that the same principles ar.at stake in this measure. Many railway workers in New South Wales sacrificed their careers in the fight that followed the introduction of the Taylor care! system in order to uphold what they regarded as a most important principle. Are the doctors, then, not also entitled to fight for the same principle’; I submit that to the Parliament. If those days engine-drivers - the men on the footplate who held the throttle - were. after that great fight, reduced to the status of firemen. I ask, then, a rrdoctors to become wardsmen if they anunable to practise their profession because of the provisions of this measure? I put it now to the Labour movement of this country that if the status of an enginedriver on the footplate could be reduced by an act of Parliament after he had given years of service, the same thing could happen to a doctor. The Prime Minister would not be here had it no: been for what I did for him.

Mr Drakeford:

Mr. Drakeford interjecting,

Mr LANG:

– The Minister for Air (Mr. Drakeford) also worked on the footplate. Everybody knows that the Prime Minister has said that, but for i lie Taylor card-index system, he would not be in this Parliament to-day. The right honorable gentleman should have a proper appreciation of what happens to men who fight for a principle. He fought for a principle, and he has done well for himself. He should know that the workers resent the imposition of a cardindex system under which every man is numbered and noted. But that is what this bill provides for the doctors. The situation of the railwaymen in 1916-17, under the Taylor card-index system, is identical with that of the doctors to-day. The doctors have very much in common with the engine-drivers who were involved in that struggle one-third of a century ago, hut this time the Prime Minister is on the other side of the fence. He is making exactly the same mistake as an anti-Labour premier made in New South Wales in the railwaymen’s case. He thinks that because he now wields a big stick he need not fight for a principle. But the Labour movement says that the principle is more important than the individual. In this case, the Prime Minister, thinks that he can let the principle go because it does not affect him personally. That is a very dangerous trend of thought. The greatest fights in politics have been those in which men have taken risks in order to fight against what they have regarded as unjust and repressive legislation, and dictatorship. The Government has not the slightest justification for placing the doctors in the position that is proposed in this bill, and if the doctors decide to fight, it will find itself in an untenable position. It should realize that many supporters of the Labour party, even amongst the working class, the poor and the suffering, would prefer to pay for any medical treatment that they receive and retain the privacy that exists between doctor and patient rather than accept the free medicine scheme. However, it appears that under this bill, even though a patient may desire to consult his doctor privately and pay full charges, the doctor will be required to use a government form if he prescribes drugs included in the -Government’s formulary. If he uses his own form instead of the government form, he will be a law breaker. Is that not an assault upon the rights of the patient as well as upon the rights of the doctor? Many people are concerned about this point and would welcome an explanation of it from the Government.

The present situation between the Government and the medical profession has been created by stupid blundering. The Government apparently has an obsession that it must stage a big fight against the British Medical Association. Therefore, it has deliberately set out to look for a fight. It should not be surprised if it finds itself with a fight on its hands. The Minister for Health (Senator McKenna) seems to be hard to handle when dealing with simple working arrangements. He thinks in terms of forms and regulations instead of approaching the subject as a- simple proposition not very different from other arrangements that have been in operation for many years. The Government blames the doctors for the present situation. That is an easy defence of ministerial incompetence. The doctors have every reason to resist a plan that they consider to be not in the best interests of their patients. They have co-operated for many years with the friendly societies in providing medicine for members of the societies. Relations between the medical profession and the societies have always been most amicable. The reason for that is that the friendly societies have always had a worthwhile scheme based on sound common sense and a minimum of red tape. Similar good relations would have been engendered had the Government’s scheme been established on a similar basis. A report by the secretary of the Manchester Unity Independent Order of Oddfellows recently distributed to members of that organization is the best commentary upon the Government’s attitude towards the doctors that has yet been published. It points out that the organization opened its first branch in Sydney in 1804. The friendly societies and the medical profession, working in conjunction, have provided ever since those days the only real, complete home medical service that Australia has known. To-day the friendly societies in Australia have over 6,000 branches with a total membership of 750,000, representing about 2,000,000 people who are receiving all the medical attention that they desire from the doctors in cooperation with the societies.

A Labour government in New South Wales recognized the work of the friendly societies in the Subventions Act, which provided that the State would pay all members’ dues when they reached the age of 65 for males, and 60 for females. The societies took out a contract with doctors and chemists to cover both medical and medicine benefits. The average contract provides for a payment of 35s. a- year for medical benefits, and 12s. a year for medicine. The services are provided without fuss, without argument, and without red tape. There are no involved forms to be filled in by the doctor making a claim on a society. There is no elaborate centralized machinery. The lodges do all the work through honorary officials. If the Government wants to solve this problem, it can do no better than call in representatives of the friendly societies, and benefit by their long experience with the medical profession, and the pharmacists. An extension of the friendly society principle, which is based on co-operation and social service, should cover all requirements. Above all, the friendly societies have never had to resort to threats in their dealings with the doctors.

There is more than a suspicion that the Government’s anxiety to stampede the doctors into accepting some kind of scheme is due to the mounting surplus in the National Welfare Fund. On the 30th June last, the fund had a balance of £69,800,000 invested in treasury-bills. That is a huge reserve fund, established out of the social services contributions, which are a tax levied on wages. The Government should face the fact that the public has shown very little interest in free medicine. But there would be real interest in a scheme based on the friendly society principle. The alternative would he to abolish social services contributions, and let the individual make his own a rrangements.

The Government should realize that the average doctor is a reasonable man or woman, with a social conscience no less sensitive than is that of other people. This Government persists in attempting to segregate the doctors as a class. The doctor is just as reasonable as any other worker, when it comes to matters affecting his calling. He will put up a fight for what he regards as his rights. So will the members of every other trade union.

The Government has had to face the unpalatable truth that only 40 doctor? out of a total of 6,500, are signing its free medicine form. Of the 40, quite a large percentage are Communists, or “fellow travellers”. In Broken Hill, two doctors have lined up with the Minister for Health. One is Dr. McMeekin, who was the Communist candidate at the Cobar by-election. He was howled down by the workers at Broken Hill, and run out of town at Bourke. The other doctor is Dr. Alan Finger, recently returned to Adelaide. Dr. Finger was named as one of the top-ranking Communists in Australia by the American Congressional Committee in its survey of world communism. Others who have supported the Minister are Dr. Darke, of Katoomba, Dr. Gardiner, of Hellensburgh. Dr. Mickel, of Brisbane, and Dr. Jolly, of Midlands, Perth, all of whom belong to the parlour-pink, if not the drawingroom red, brigade. The Government would be well-advised to withdraw this bill, and start again from scratch in a spirit of conciliation and common sense. If 2,000,000 people can be served satisfactorily by doctors and chemists on behalf of the friendly societies, there should be no difficulty in expanding the service to include every one wanting the benefit? offered by the Government.

Mr George Lawson:

– On whose side is the honorable member ?

Mr LANG:

– On the side of Australia, not on the side of humbug, as is the honorable member for Brisbane (Mr. George Lawson). This measure will only result in further conflict and confusion. A small committee of experienced doctors and friendly society executives could evolve a satisfactory scheme without any penal clauses and without any strikes.

Mr DEPUTY SPEAKER:

– Order! The honorable member’s time has expired.

Sitting suspended from 5.45 to 8 p.m.

Mr HUTCHINSON:
Deakin

.- The bill seems to have two main purposes. The first is the action shot to end the long cold war against the doctors by coercing them into assisting the Government to initiate a medical benefits scheme that is acceptable to the Government, but not to the medical profession. The second is the continuance of the propaganda campaign against the doctors on sentimental lines to influence the electors in favour of the Labour party when the general election is held. Far from being in the role of the accused, the doctors are in the role of the accusers. From the outset of this debate, it has been plain that the doctors will not stand against a free medicine scheme if one is desired by the Government. What they object to is the kind of scheme that the Government has propounded and intends, if possible, to foist upon them. I think that their objections can be summarized under, three headings. The first is that it is not a good scheme and will not benefit the people whom it is supposedly designed to benefit because it is circumscribed. The second is that it will impose more work on the doctors who already have more work than they can cope with. There is a lamentable lack of doctors in both country and city districts. The third is that it is a part of the plan of the Government to nationalize medicine in Australia. That that is so has been made plain by the Minister for Health (Senator McKenna). He has told doctors candidly that the Pharmaceutical Benefits Act is the beginning of a scheme for the socialization of the medical profession that will end the existing relationship between doctors and their patients. I repeat that the doctors do not set their face against a free medical scheme if one is wanted. I think a free medicine scheme would be the most colossal waste of public money that could be indulged in and I do not think the way to lift the health standard of the Australian community is to provide free medicine. But the doctors had an able spokesman in the House to-day in the right honorable member for Cowper (Sir Earle Page), himself an eminent medical practitioner, who said, in effect, “If the Government wants a free medicine scheme, let it have one, but let it be untrammelled. Let there not be a limited formulary. Let us prescribe for our patients as we think they should be prescribed for. Let us be free to prescribe as our skill and knowledge say that we should. Let us prescribe on our own prescription forms. Let the prescriptions be taken to the pharmacists for dispensing. Let the chemists send the bills to the Government for payment. Let the basis of the scheme be the British Pharmacopoeia, which gives a much wider scope than is given by the proposed formulary. As new drugs come into being, they are quickly taken into the British Pharmacopoeia. As the drugs become available the doctors will then be able to prescribe them without delay “. That, in general terms, is the challenge of the British Medical Association to the Government. Every supporter of the Government must either reject or accept it.

Mr Beazley:

– It has not been thrown out.

Mr HUTCHINSON:

– It has been.

Mr Beazley:

– That is denied by the Western Australian branch of the British Medical Association.

Mr HUTCHINSON:

– I have been given to understand that the challenge has been thrown out to the Government by the British Medical Association. The trouble is that the Government wants a free medicine scheme on its own terms, which entail the ultimate destruction of the medical profession as we know it to-day. Under the terms of the Pharmaceutical Benefits Act, as it is proposed to be amended by this bill, doctors will have to write prescriptions on forms supplied by the Government if the prescriptions come within the formulary prepared by the Department of Health. Speaking as a layman, I think a man would have to be lawyer as well as a doctor to cope with the intricacies of the proposed formulary and the accompanying regulations, which embrace 88 pages of closely set type. It has been said by doctors that it would be impossible speedily to write a prescription based on that gigantic document. After having examined the patient, the doctor would have to refer to the formulary to see whether the prescription that his diagnosis of his patient’s condition informed him was needed for the patient was covered by it. That additional work would involve more than time or, as the honorable member for Parkes (Mr. Haylen) suggested, clerical aid. A qualified medical practitioner or pharmacist would be required to do that work. Honorable members will appreciate, therefore, the vast amount of extra work that this scheme will impose upon doctors who, in most instances, are already overworked. I can imagine the busy scene in the surgery of a country practitioner between 2 o’clock and 4 o’clock in the afternoon when large numbers of people visit their nearest town ship for business purposes, and perhaps to see their doctors. Imagine the waste of time that will occur if the doctor has to follow, the lengthy procedure that will be necessitated under this scheme ! Anybody who has studied the formulary will realizethat the task of a doctor will be far from easy, and that the consequent waste of time will be to the detriment, not only of the medical man, but also of patients who, after all, should be the first consideration. Doctors will hot be able to charge additional fees for the extra work that is to he imposed upon them.Obviously, it will take a practitioner longer to deal with each patient, and that of course must mean longer periods of waiting for other patients. On the other hand, the scheme will result in a saving of time to the chemist. He will not have anything to write out, and whereas the doctor will still have to go to the trouble of collecting his own fee, the chemist will be paid by the Government. The chemist will have by far the best of the deal.

We all realize of course that this scheme is in accordance with the Government’s policy; but where is all this going to end? We have in office a Government that has adopted a policy of complete and utter socialization. The medical profession is the first in line for treatment. That has been made quite clear by the Minister for Health. Where will this policy of socialization end? Will it be of any benefit to the community? Will the socialization of the medical profession mean that doctors will work round the clock as they do now, rendering faithful service to the community? Will they be just as keen to advance their position in life? Will we continue to see the unclosed door at any hour of the day or night, particularly in country districts; or will the medical profession bo turned into a closed service which eventually will be brought within the strict limits of a government department, staffed by men who, in the main, will not practise medicine, and who, in turn, will be controlled by politicians ? I can see no public benefit resulting from such a service or from any socialized service. Doctors will become merely paid government servants. They will be required to work certain specified hours, and I have no doubt that they will demand that they be not required to work any more than those hours. Will the public gain by that? Obviously it will not. Will the medical profession be more efficient just because a group of officials sends out forms to them and insists that medicines be prescribed in accordancewith the governmentformulary and that the specified quantities of ingredientsbe not exceeded? I understand that that too is involved in the scheme. Medical men are to be required to prescribe within the formulary, and in the quantities specified. That will mean of course that a doctor will not be able to treat individual clients exactly as he believes they shouldbetreated.

It is claimed that this willbe a free medicine scheme, but obviously nothing that is given to the people is free if it is paid for by the Government. Nothing that comes from this Government or from any other government is free, because after all government funds must be provided by the people. The money for this scheme will be derived from the social services contribution, and from high taxes, which have an unhappy habit of involving all the people through higher prices for goods and services. The people of this country are also paying high indirect taxation to-day.

Mr DEPUTY SPEAKER (Mr Clark:

– Order! I ask the honorable member to direct his remarks to the bill.

Mr HUTCHINSON:

-Although certain individuals may gain some advantage under this scheme, its cost will be borne by the taxpayers. Therefore, we must consider how this scheme may grow, and the sum of money that may ultimately be. involved. I believe, thatthisis not the right way to tackle the health problems of the nation, and that it will result eventually in a colossal waste of public money.

We have been told that the doctors are on strike. That has been said by nearly every Government supporter who has spoken in this debate. But have the doctors in fact laid down their instruments and refused to practise? I do not know of any who have done so. Has it been necessary for the Government to compel doctors to treat patients? If such compulsion has been necessary I should like to hear of it. Like most people, I know some doctors. I come from a country district, and I know that the surgeries of country doctors are open at almost any hour of the day or night. If the doctors are on strike, they have a queer mad way of striking, and it might be a good thing for the country in general if some of that type of madness spread to certain other sections of the community, because the result would he what we are all so earnestly seeking, increased production and lower prices.

Mr CALWELL:
Minister for Information and Minister for Immigration · Melbourne · ALP

– Honorable members opposite in their contribution to this debate have spoken rather expansively of the good services that the medical profession has rendered to the people of Australia over the years. One might have imagined that that matter was in question. The contribution that the medical profession throughout Australia has made since the foundation of our civilization on these shores has been considerable and meritorious. Medical practitioners in all States have, by their industry and devotion to their profession, reached a high standard of efficiency. The standard is so high that it has won the admiration of the world. The medical profession in Australia stands so high that we are now represented abroad by some of the greatest doctors of which Europe knows. When, we read recently of the illness of His Majesty the King, we noticed that Sir Thomas Dunhill, an Australian of great distinction, was one of the doctors in . attendance. There is no need to elaborate greatly upon the con tributions that Australian doctors, both inside and outside of Australia, have made to curative and preventive medicine. The question of the standing of the doctors may be dismissed from this discussion. Nobody pays greater tribute to their work than do the members of the Labour party. Honorable members opposite, by raising the question of the services that have been rendered to suffering humanity for decades by the doctors of Australia, are trying to make it appear that in this legislation there is an implied slur upon those doctors. Times change The great days of the private practice of medicine are over here and in every other country in the .world. In modern society the only people who get proper medical attention are the very rich and the very poor. The great mass of the people between those extremes do not have the medical attention that any progressive government ought to ensure that ite citizens shall enjoy. It is not the fault of the medical profession that people are not able to pay large hospital fees. It is not the fault of the medical profession that uptodate equipment for the diagnosis and treatment of disease is- very costly, that the great majority of the doctors have not the necessary money to purchase such equipment, and that most people in the community are not able to pay for proper medical treatment. In the United States of America, that land of free enterprise, private clinics, the most famous of which is the Mayo Clinic, have been established in order that there shall be more efficient treatment of each person’s case and an economical use of the available equipment, which is, as I have said, beyond the capacity of most doctors to purchase. In those clinics doctors specialize in the treatment of certain diseases and every effort is made to reduce the cost of treatment. We are living in an age when throughout the world there is a desire to provide for every man, woman and child an equal opportunity for the diagnosis and treatment of disease, and to encourage research into the causes of disease. President Truman is at this very moment engaged in introhealth insurance. Honorable members ducing a very much improved system of opposite would have the Parliament and the hundreds of thousands of listeners to this broadcast of our proceedings believe that a scheme such as we have propounded has never been thought of before anywhere. As a matter of fact, a national health insurance act has been on the statute-book of the United Kingdom since 1936. The Attlee Government piloted through the House of Commons and the House of Lords an act, entitled the National Insurance Act 1946, which considerably improves the Act of 1936.

Mr ARCHIE CAMERON:
BARKER, SOUTH AUSTRALIA · CP; LP from 1944; LCL from 1951; LP from 1954

– What has insurance to do with this bill, which relates to pharmaceutical benefits ?

Mr CALWELL:

– Honorable members opposite have talked a lot about what the medical profession has done and is doing. I am pointing out that provisions similar to those that are contained in the legislation we are now considering are included in legislation that was recently enacted in Great Britain. The title of the British legislation is the National Insurance Act, because in that country there is a direct contributory system which is called an insurance system. Our system could also be called an insurance system, because everybody in the community, with the exception of the lower-paid workers, contributes, by way of the social services contribution, to an insurance scheme which provides for medical benefits and many other advantages. The honorable member for Richmond (Mr. Anthony) has said that all those benefits can be purchased from friendly societies for a payment of 3d. a week. That is sheer nonsense. The honorable gentleman has said that the benefits that will be provided under this legislation are, in effect, the only benefits that will be received by the average wage-earner in return for a social services contribution of 12s. 6d. a week. The benefits under this legislation will form only part of the benefits that can be enjoyed by the Australian community. We are now spending money at the rate of £74,000,000 a year upon social service benefits, and it may be that we shall be spending at the rate of £100,000,000 a year before the end of this financial year. Pharmaceutical benefits, free medicine and hospitalization are only a portion of the total benefits. If we had not had this trouble with the doctors, our social security expenditure this year would have been over £100,000,000. I have been a member of a friendly society for 36 years. I am a member of the Australian Natives Association and, what is equally important, I have always been a financial member of it. I am still a contributor to the funds of that association. I know how much members of friendly societies can receive under the various State acts under which the societies operate. I also know that only the very healthy can become members of friendly societies. Those who are not sufficiently medically fit to become members are left to their own resources or to the charity of their friends. This legislation will coyer all people. It is ridiculous to say that all persons can receive the benefits of this legislation from friendly societies. Only a section of the community can be admitted to friendly societies, and to obtain any substantial benefit from such membership it is necessary to join at a rather early age.

I havesaid that the great days of private medicine are over. That is not only my opinion. I heard it for the first time in Melbourne during World War II. when I was leaving a meeting of the Central Medical Co-ordination Committee, of which I was a member. The opinion was expressed by a famous Melbourne surgeon. Of the sixteen members of the committee, only two were laymen. The other members were great doctors. I suppose that, politically, all of them were opposed to the Labour party. One member with more prescience than the others, said that we were entering into a stage when society had to provide more medical benefits than it had done previously and that it was necessary for governments to intervene in order to ensure that the great section of the community between the very rich and the very poor received the medical treatment to which it was entitled. In the Senate the Minister for Health (Senator McKenna) explained the difficulties with which he had had to contend when dealing with theBritish Medical Association. The British Medical Association in this country has changed, its ground many times in conferences and correspondence wi th the Minister. In that respect it is no different from the British British Medical Association in ihe years between 1936 and 1946. A spirit of obstruction and rigidity, and a refusal to co-operate or to compromise, that is exactly similar to that which characterizes the British Medical Association in this country, was apparent in the attitude of the parent body in Great Britain during the debate which preceded the nationalization of medical services in Great Britain in 1946. However, ultimately the British Medical Association in the United Kingdom decided to co-operate with the present Minister for Health, Mr. Aneurin Bevan. In July last year the British national medical scheme, which is almost identical in every respect with the scheme which the Australian Government is now seeking- to introduce, was inaugurated with the blessing of the British Medical Association and to the. satisfaction of the British Minister concerned. A recent’ issue of the British Medical Journal, the organ of the British Medical Association, which set out the names of the .famous British medical personalities who are co-operating in the scheme, dilates at some length on the achievements of British medicine, and writes enthusiastically of the services to medicine of. British doctors. It actually made available to the British Minister for Health its front page to enable him to express his pleasure at the co-operation he had received, from the British medical profession.

Mr Beazley:

– A distinguished British medical personality, who recently arrived in thi? country and was tendered a reception in Perth, praised the British medical scheme-

Opposition members interjecting,

Mr CALWELL:

– I am grateful to the honorable member for Fremantle (Mr. Beazley) for the observation that he has just made. Unlike many honorable members opposite, the honorable member is interesting at all times, and I value the contribution which he has just made to my speech. I was about to point out that after a great deal of wrangling, and many attempts on the part of the British medical profession to frustrate the scheme, it at last decided to co-operate with the Government. We hope that the Australian doctors will co-operate similarly, because, much as we deplore the present attitude of the medical profession, we realize the importance of their services to the community and we wish to work in harmony with them. Indeed, . if a proper medical scheme is to be. provided for the community it is essential that there shall be complete co-operation between the medical practitioners and the elected representatives of the people.

Undoubtedly it is impossible, to-day for many people to obtain proper. medical attention because they cannot afford if. Even friendly societies cannot provide all the services desired by their members. It is necessary, therefore, to make an entirely new approach in order to ascertain whether we can ultimately persuade the members of the British Medical Association in this country that their attitude of hostility to the constitutionally elected Government is anti-social. They’ appear to believe’ that the Government has no right to introduce such a scheme, and that, whether or not the Government possesses such a right, they should not co-operate with it. No one can say that the present Government has not been most patient, not only with the doctors . but also with the chemists. In 1943, .when Senator Fraser was Minister for Health, he invited the Federal Council of the British Medical Association to nominate persons to discuss, fashion and. perfect a formulary. The British Medical Association refused that offer. Later that year there was a general election at which the people, by a very substantial majority, approved of our general approach to the problems of that time, which included the establishment of a national medical service. The Government, which returned to office stronger than it had been before, attempted to implement its medical scheme, but the High Court declared the measure to be invalid, and the Government had to make another approach to the matter. We continued to negotiate with the doctors, and ultimately we had to submit a referendum to the people to authorize the legislature to amend the Constitution to provide a national medical service. The people, by a majority in every State, approved of the proposal, and the Constitution has been amended accordingly. The present legislation has been drafted under that additional constitutional power, because we think that the people desire, and we believe that they need, a national medical service. However, the British Medical Association has expressed a three-fold objection to our proposals. The association has said, in effect : “ In the first place, we do not like the proposed form of control ; secondly, we do not like the regulationmaking powers contained in the act ; and, thirdly, we do not like the proposal to establish experimental health centres “. Taking the last objection first, I point out that at one time the association favoured the establishment of experimental health centres. Their present objection to the establishment of such facilities is based on the fact that government doctors and not private doctors, will be employed in those centres; and on that flimsy pretext the association resists the establishment of experimental health centres. The association also stated that it does not like the form of control proposed. It believes that the Government ought to permit a commission to administer the scheme, and that the commission should be composed entirely of doctors. The present act provides that the Minister shall administer the scheme through a Commonwealth department. If we were to concede the right of doctors to administer the national health policy, and to be responsible only to themselves for anything done or not done, we should be reverting to the stage in which we were when the banking policy of the country was determined by a bank board which was not responsible to the government of the country.

Mr DEPUTY SPEAKER:

– Order ! The Minister for Information (Mr. Calwell) must return to the discussion of the measure before the Chair.

Mr CALWELL:

– If the Chair will bear with me for a moment-

Mr DEPUTY SPEAKER:

– Order ! I do not intend to enter into any discussion of the matter with the Minister. I ask him to return to the discussion of the bill.

Mr CALWELL:

– I was making the analogy that if it is unsound to permit a board of bankers to direct the banking policy of the nation, it is equally unsound to permit a board of doctors to administer the health policy of the nation. There must be complete responsibility to the Parliament for all administrative acts. If the Parliament were right to concede to doctors the power and authority to administer the laws concerning the practice of medicine it would be equally right for it to delegate authority for fiscal policy, banking, or any other matter to representatives of the particular interests concerned. I do not think that the Parliament would ever concede such a right; and, in any event, I do not think that the medical profession is capable of providing first-class administrators. The medical profession produces eminent surgeons and physicians, and great scientists and research workers. But scientific knowledge is something altogether distinct from administrative ability. Even if doctors were good administrators, they would not necessarily be sound policy makers. I do not think that the present Government would ever concede the claim made by the British Medical Association that it should be permitted to administer our laws in respect of medicine. The British Government, of course, does not concede to the British Medical Association in the United Kingdom any such right. The powers conferred upon the Minister by the British Act of 1946 are very great and cover almost everything. In fact, they are even greater than the powers conferred on the Minister for Health in this country, and in these days of responsible government, that is as it ought to be. The British Medical Association also objects to the regulation-making powers contained in the act, and contends that they ought not to be so included. The power to make regulations, however, is included in almost every act. When I occupied a back bench on the other side of the chamber, and the right honorable member for North Sydney (Mr. Hughes) was a Minister, I asked him how many acts of the Commonwealth Parliament conferred power on the Executive to make regulations. By way of reply, the right honorable gentleman invited me to count them for myself, and I rejoined that one day he would be replaced by a Minister who would give me the information that [ sought. However, I did take the trouble to examine the legislation of the Commonwealth Parliament in order to ascertain that information, and I found that 72 acts confer power on the Executive to make regulations. In any case a government could not administer a law unless it had power to make regulations. If it did not have a regulation-making power it would have to go back to the Parliament every time it wanted to do anything.

Mr Menzies:

– Were there only 72? £ am sure this Government has since improved on that.

Mr CALWELL:

– If it has done so, it has merely followed the example of the right honorable ‘ member for North Sydney, when he was a member of the Menzies Government and when he himself was Prime Minister of Australia. Even if the Government gave way to the British Medical Association on these three points would have no guarantee that other objections would not be raised. As a matter of fact, in its present uncooperative mood, the British Medical Association will continue to raise objections, no matter how we may deal with every proposal it submits. I remind honorable members that the Government accepted the proposal by the British Medical Association based on the New Zealand practice for part-payment of fees by the patient to “the doctor and part-payment by the Government to the doctor.

Mr ARCHIE Cameron:

– When does the Minister propose to deal with this bill ? The bill deals with pharmaceutical benefits and not a free medical service.

Mr CALWELL:

– It also deals with fees. Now that the British Medical Association’s proposal has become the law the association objects to it. It now says that the patient should find all the money in the first place and go to the Government afterwards and get back the portion which the Government owes him.

Mr DEPUTY SPEAKER:

– Order ! The Minister must deal with the bill now before the House.

Mr CALWELL:

– I have read the transcript of the speech delivered in the Senate by the Minister for Health in reply to the second-reading debate last night. He canvassed the very same matters that I am canvassing now.

Mr DEPUTY SPEAKER:

– Order ! The Chair is not concerned with what happened in the Senate. The bill before the House deals with pharmaceutical benefits. The Minister is not in order in discussing medical services. He may make a passing reference to tha’ subject, but he may not indulge in a £ ral discussion of it.

Mr CALWELL:

– I am riling with the bill dealt with by the .. minister for Health in the Senate last right and 1 am dealing with it as he did.

Mr DEPUTY SPEAKER:

– Order ! The Minister must obey the ruling of the Chair.

Mr CALWELL:

– There seems to be a difference of opinion between us about what is relevant to the bill now before the House.

Mr DEPUTY SPEAKER:

– If the Minister does not accept the ruling of the Chair I shall have to deal with him.

Mr CALWELL:

– I am trying to state the case for the Government on this issue and to answer certain arguments that were advanced by the right honorable member for Cowper, who canvassed extensively the whole question of fees and services. The right honorable gentleman also said that this bill represents a form of conscription. The honorable member for Deakin (Mr. Hutchinson) used that expression again only a few minutes ago. As a matter of fact the honorable member said that the Government had adopted a policy - and these are his exact words - “ of complete and utter socialization “.

Mr DEPUTY SPEAKER:

-Order! I do not know whether the Minister is discussing the ruling of the Chair or the bill before the House. He must confine his remarks to the bill.

Mr CALWELL:

– I am replying to statements that were made by the right honorable member for Cowper and the honorable member for Deakin. This bill contains no provision for the imposition of conscription and there is nothing in it which deals with socialization. As a matter of fact, the Government has guaranteed that the traditional doctor-patient relationship will be maintained. We have given to every person in the community the right to choose his own doctor, and we have given to every doctor the right to carry on his private practice. When introducing the bill last night the Minister for Post-war Reconstruction (Mr. Dedman) pointed out that when the Minister representing the Minister for Health in this House initiated the secondreading debate on the Pharmaceutical Benefits Bill in June, 1947, he said -

Under this bill there will bc no compulsion on medical practitioners or pharmaceutical chemists to take part in the scheme.

Those are unequivocal words.

Mr Menzies:

– All that is now abandoned.

Mr CALWELL:

– Not at all. The Minister continued -

By reason of the fact that the scheme is designed to lessen the economic barrier between the patient and efficient treatment for his illness or incapacity, the Government believes that the members of both professions will co-operate fully in giving effect to its intentions. lt was obvious, as the Minister had pointed out, that the whole design of the bill was to lessen the barrier between the patient and the efficient treatment of his illness or incapacity. In June last, when dealing with the pharmaceutical benefits scheme in the Senate, the Minister for Health stressed that there was to be no regimentation of doctors, and that, when co-operating in the scheme, the doctor would have complete freedom of action. He went on to say -

A doctor is completely free either to come into the scheme or to stay outside it.

Does that sound like conscription or regimentation?

Mr Archie Cameron:

– If so, how can honorable members opposite claim that the doctors are on strike?

Mr CALWELL:

– I shall deal with that aspect later. The Minister continued -

A doctor who comes into it is not bound by the formulary if his conscience and medical judgment dictate the prescription of something that is outside it.

His words did not indicate that there was to be any compulsion or regimentation. The doctors, however, said that they would not co-operate with the Government. Their action is an attitude of passive resistance to the Government’s scheme which could be construed as an attitude of striking against the scheme. There is no evidence of conscription in the legislation, nor is there any evidence of any of th.; evils about which honorable members opposite have spoken. Let me refer to a leading article which was published in the Melbourne Age on this subject on 24th February last. It reads -

In November, when Senator McKenna outlined the Commonwealth Government’s plan for establishing medical, hospital and dental services, it was welcomed as a reasonable, progressive provision according with modern thought and trends. Australia was making no drastic innovation by fostering a national health service. The example had been set by Britain and other enlightened countries.

That is a complete answer to all the arguments that have been advanced by honorable members opposite to-day. 3 am paying them a great tribute bv describing their contributions to the debate as arguments. They have consisted in reality of gross distortions of fact. They represent the highest form of misrepresentation of elemental truths. Honorable members opposite will, however, continue to make the same kind of statements. The Age is under no delusion about the matter, and that journal is not a supporter of this Government. The article continues -

In the deplorable argument which has since arisen between the controlling body of the British Medical Association and the Government, no evidence has emerged to impugn the validity of the assurances then given that the Government was not seeking to nationalize the medical and dental services of Australia.

That is a definite and unequivocal statement. The article continues -

It was not proposed to disturb traditional, cherished doctor-patient relationship. The plan as propounded was for the purpose of establishing new services and incidentally relieving the patient of some of the financial burden of illness by paying half the doctor’s fee, part of the hospital cost, and (under earlier legislation) the cost of medicines.

The writer then decries at some length the attitude of the doctors, and the responsibility of the Government to try to make a reasonable agreement with them. The article continues -

On the part of the ruling body of the British Medical Association there has been considerable suspicion and not a little hostility … If there are scientific and ethical objections, they seem to have been obscured by professional considerations which, on analysis, might prove to be tinctured with politics.

Honorable members opposite are making this a political issue. The whole health plan of the Government and the Parliament, which will finally enact it, is, as it should be, above controversy. Honorable members opposite want to make propaganda out of it. In that respect the article states -

National health is too vital a consideration to be made a target for propaganda and recrimination.

With relation to the desire of the British Medical Association to control this Government, the writer stated -

The British Medical Association no doubt realizes that in civilized communities care of the national health is not the exclusive prerogative of the medical profession; it is properly a concern of governments also. In Australia, as elsewhere, a large and increasing part of the public revenue is devoted to health and social services. To these the people have an undeniable claim.

  1. do not accept the view that the leaders of the British Medical Association express the mind of the great majority of the doctors. It is all very well for them and their friends in this Parliament to say that they support a scheme for free medicine. It is easy for them to say that they support a principle, and when it comes to the application of that principle to say that the proposed method of application is no good. The truth of the matter is that the British Medical Association is not sufficiently advanced in its thinking to realize the need for the scheme which the Government has introduced. If we want to ensure that the health of the community will be properly protected we must have a scheme such as this. We have a responsibility not only to this generation but also to posterity, to see that in our time we evolve and devise a scheme that will give the maximum benefit to the people who mo9t need medical attention. I am hopeful that the British Medical Association will ultimately see the unreasonableness of its attitude, and will let us persuade it to co-operate as it should do. The disciplinary powers that we take in this measure are essential at least to demonstrate to the medical profession that when the Parliament passes legislation it means it to be enforced. Legislation is passed by the Parliament, not to be put upon the statute-book to be a dead letter the moment that it is enacted, or to be frustrated because an organized body of very estimable citizens decides that it does not like either the colour of the Government, or this or any other legislation which it might bring forward. Honorable members opposite who tell us that we intend this legislation to discipline doctors have never offered any objection when a government that they supported was in office attempted to discipline other people in the community whose views were different from those of the Government. I cite the action of anti-Labour governments in making wharf labourer.take out licences, and in depriving them of their living if they did not do what the Government demanded. I conclude by making some quotations from the New Statesman and Nation of the 1st January, this year. This is an excellent British publication of very high standing and large circulation.
Mr Menzies:

– I am glad that the Minister does not describe it as a conservative journal.

Mr CALWELL:

– It is a journal that has a progressive thought running through it. That is why it is popular and influential. In an article dealing with the cost of the British health service this passage appears -

The cost of the National Health Service will be much in excess of the estimates.

We have heard the aspect of cost raised to-day. Some honorable members opposite have asked how much money the Government will have to expend, and have suggested that another £1,000,000 may be required. The article continues -

By the end of the financial year (niue months’ working of the Service) the cost, instead of being £180,000,000, will be over £225,000,000 - an excess of over £1,000,000 a week. We doubt whether the Minister of Health will be much embarrassed by these figures; they are, in fact, both a measure of the success of the National Service and a revelation of the urgent need for it. The irony is that the very violence of the British Medical Association’s opposition so well advertised the Service and increased its popularity (and its consequent expense) that by “vesting day” (July 5th), nine out of ten people had registered.

To-day, over 97 per cent, of the 21,000 general practitioners and over 87 per cent, of the 10,000 dentists in England and Wales, and, in Scotland, 2,339 out of 2,380 G.P.’s and 1,000 out of 1,200 dentists, have joined the Service. The hospitals which were taken over have co-operated so energetically that their activities will account for at least 60 per cent, of the rise in costs.

The public, including the middle-class and well-to-do, are taking full advantage of the scheme, while the doctors, though individuals grumble over details, are, as a profession, cooperating magnificently.

The “vesting day” mentioned in that extract was the 5th July, 1948. In considering the figures that I have given it should be remembered that Britain has gone much further than we propose to go. I commend to honorable members opposite the observations that I have read. I hope the day will not be far distant when the doctors in Australia will he co-operating magnificently. The co-operation that is being given in Great Britain is shown in the following paragraph from the same article : -

Instead of the budgeted 2,700,000 prescriptions a week, they are averaging 3,000,000. This increase is substantial but by no means alarmingly high in proportion to the total cost of the scheme . . . The results are just beginning to show. They entail a heavier salary budget than was estimated. The scheme is in its infancy; the sickness services of this country have revealed deficiencies too long concealed ; the costs are heavy, but the ultimate dividend is incalculably high.

The ultimate dividend from our scheme will be incalculably high, because this is a good, sound scheme. It only needs the co-operation and the intelligent assistance of the medical profession, the dental profession, the chemists and druggists of Australia to make it a worthwhile scheme, and I think that I express the wishes of the great majority of the people in Australia when I say that I hope that such co-operation will soon be readily forthcoming.

Mr BERNARD CORSER:
Wide Bay

– Despite the display of politics by the Minister for Information (Mr. Calwell) I oppose this measure on principle. I contend that it is not based on any principle of democracy. The majority of the people of Australia have opposed this scheme, not only through their parliamentary representatives, but also at the referendum. I am strengthened in my opposition to the bill after hearing the opinions of the right honorable member for Cowper (Sir Earle Page), who is an eminent surgeon. I feel sure that every one who knows of his record as a medical practitioner and of his desire at all times to improve medical services must have been impressed by the very sincere and spirited opposition that he has offered to this measure. I consider that he is better qualified than any other honorable member in this House to speak on this measure, and that we could be guided, without prejudice, by many of his statements, and by the facts that he quoted. No one can deny that the medical profession, and professional men generally, have given their services generously to their profession. They have devoted much time first to their studies and subsequently to their practice. The Government has found it necessary to introduce this bill because of the opposition of the medical profession to the Pharmaceutical Benefits Act 1947. This determined resistance on the part of the doctors to dictation by the Government warrants our support. The doctors are fighting for a principle for which democracy stands to-day. In opposing this bill, I am encouraged by the knowledge that the doctors have always stood together to resist the tyranny of this Government. Their determination is in striking contrast to the abjectness of some sections of the community, which, regardless of their political beliefs, go cap in hand to the Government to square off, in the hope that they will receive easier treatment at the hand of the master o* this Parliament. It is worth while fighting on behalf of such a body of men as the doctors who also are fighting to preserve their own interests and the principles that they have affirmed. The Government’s claim that the people approved this legislation at the referendum on social services is not correct. The provisions of this bill were not included in the Pharmaceutical Benefits Act 1947, which honorable members opposite claim is in accordance with the decision that the people gave at the referendum.

This is a bill to steal the liberty of one section of the people. The Government, indeed, is on the way to its goal, which is the general liquidation of all the liberties of the people. In pursuing that policy the Government is following doctrines that have emanated from foreign countries. The commercial life-blood of a storekeeper is his goods, and if the Government were to deprive him of them, it would be a thief.

Mr Calwell:

– I rise to order. I should like to know whether the remarks of the honorable member for Wide Bay (Mr. Corser) are relevant to the bill now under consideration.

Mr DEPUTY SPEAKER:

– I think that the honorable member is crossing it at right angles, but he may get back to the bill.

Mr BERNARD CORSER:

– I expect to keep on the track to a greater degree than the Minister for Information has done in his speech.

Mr DEPUTY SPEAKER:

– I ask the honorable member to relate his remarks to the bill.

Mr BERNARD CORSER:

– If the Government were to commandeer the commercial life-blood of a storekeeper, as it proposes to commandeer the special qualifications of medical practitioners, it would be guilty of a serious breach of our laws. By this legislation, the Government is endeavouring to deprive the doctor of his freedom to prescribe, and insists that he shall use an official piece of paper when writing his prescriptions. The Minister for Health (Senator McKenna), when speaking on this bill in the Senate said, “ all that means is a piece of paper”. “ Scraps of paper “ have played a prominent part in history and have even led to war in other countries. Under the provisions of this bill, the Government seeks to deprive the medical practitioner of his freedom to prescribe. This legislation, obviously, is contrary to the best interests of the medical profession, and has been introduced to satisfy the greed of a socialist government. It is an attack upon members of a profession who do not enjoy the advantages of a 40- hour week. Many honorable members would not be occupying their seats in this chamber to-night if doctors had insisted on working a 40-hour week. The Government must realize that it cannot organize every profession by using ruleofthumb, or spirit level methods.

The purpose of the bill is to socialize the medical profession. Why should that profession be socialized any more than the activities of members of parliament in their electorates, or of other professions such as architects and surveyors. It would appear that the medical profession must be assailed in order that the Government may be able to claim that it is doing something for the people. For a number of years, the Government has been collecting millions of pounds from taxpayers to finance its social services programme. The cost of the social services structure has become so great that taxpayers, particularly the younger generation, are discovering that taxes cannot be reduced to the degree that the Government had led them to believe. Honorable members opposite have expressed indignation because they claim that the doctors are on strike. That is nonsense. Instead of threatening to deal with the doctors, the Government should show a greater determination to tackle workers in certain industries who are almost continually on strike. Why is the Government devoting this special attention to the doctors when they are not on strike? The doctors have succeeded in restricting the operation of the Pharmaceutical Benefits Act of 1947, and the Government has now introduced amending legislation to force them to come into Hine with its policy. However, the doctors have not broken any law or done any injustice to the people. No citizen has died as the result of the attitude of doctors towards the pharmaceutical benefits scheme. But the community has suffered serious inconvenience, people have become unemployed and the country has lost millions of pounds worth of production as the result of the action of strikers in industry.

Mr DEPUTY SPEAKER:

– Order ! The honorable member’s remarks are not relevant to the bill.

Mr BERNARD CORSER:

– I am keeping to the bill as closely as I can. Doctors have given faithful and generous service to the public and the importance of their honorary work cannot be measured in ordinary terms. Doctors have not imposed restrictions on the community, lt is the Government, through this legislation, that is seeking to impose restrictions on the medical profession. The Government is attacking the doctors in the hope that it will gain some political support. It claims that its policy will be to the advantage of the people, but its principal concern is to assail private enterprise. This bill is an assault upon the freedom of the people. Under it the Government is taking another step towards the nationalization of everything in this country. That is its avowed policy, [n that respect there is nothing new in the measure, but on this occasion it is the medical profession that is being attacked. The Government seeks to socialize that profession, and it claims that it will thus help the people. The Minister for Health (Senator McKenna), in his second-reading speech on the bill in the Senate, claimed that all that the doctors will be obliged to do will be to write their prescriptions upon a particular piece of paper. The bill has the support of all socialists and Communists in the community who are lined up with the Government in its determination to deprive the medical profession of its freedom. It will destroy the family doctor tradition by centralizing medical services in particular buildings where persons seeking attention can be attended to from day to day and can fill their hip pockets with medicine to be drunk, as it were, around the corner. As has been the experience in New Zealand, this scheme will involve wasteful expenditure of millions of pounds of public funds. The only purpose it will serve will be to provide free of cost medicines to poor unfortunates who are addicted to sipping the stuff. It is a step towards the regimentation of the citizens of Australia in line with the policy that is being pursued in Soviet Russia.

The Government should realize that this scheme will tend to destroy the initiative of medical practitioners generally in their efforts to win an honorable and eminent place in their profession and to serve the community to the best of their ability.

Mr DEPUTY SPEAKER:

– Order ! The honorable member must confine his remarks to the bill.

Mr BERNARD CORSER:

– This scheme will tend to deprive medical practitioners of initiative in their efforts to evolve more effective medicaments.

Mr DEPUTY SPEAKER:

– Order ! The honorable member will not be in order in proceeding with that line of argument. He can deal with practitioners only to the degree to which they are affected by the bill.

Mr BERNARD CORSER:

– The Minister for Health, when introducing the measure in the Senate, said -

This amendment neither proposes nor initiates any interference with the practice of medicine. It involves the doctor only in a piece of paper - that on which he writes his direction to the chemist for the supply of the medicine, compound or appliance in the classes named in the clause. The doctor will still diagnose and assess his patient’s needs in the light of his medical knowledge and experience mid in accordance with his own unfettered judgment.

The point I am making is that if subjected to compulsion of this kind medical practitioners will lose their initiative and desire to extend their knowledge of the preparation of prescriptions. To that degree the Government is doing an injury to the community. Under existing conditions, every young doctor aspires to attain pre-eminence in his profession. He is actuated solely by a desire to serve the sick and suffering and the nation generally by safeguarding the health of the community. The motives which actuate the medical profession have won for it the highest esteem. However, this measure merely seeks to subdue the doctor. It compels him to do certain things in order that the Government may be enabled to provide what it calls “free” medicine to the people. Medicine which will be provided under this scheme will not be provided free, because the Government does not provide free anything which must be paid for from the taxes collected from the people, and, to-day, every person whose income exceeds £150 annually will assist to finance this scheme through his social services contribution.

The firmness displayed by the Government in submitting’ medical practitioners to this compulsion, is lacking in its dealings with other sections of the community. The Minister for Information (Mr. Calwell) said that the will of the Government and of the Parliament shall be supreme, but he and his colleagues do not insist so strongly upon the application of that principle when it is a matter of disciplining strikers on the waterfront and in the coal-mining industry. In those instances, the will of the Parliament is not supreme, because the Government kow-tows to strikers. It now proposes to place the doctors under compulsion in the issuance of their prescriptions. It forgets that the prescriptions which it is so anxious to make available to the people under this scheme have been evolved as the result of the initiative of the medical profession over the years. Whilst the Government does not hesitate to place under compulsion the medical men whose sole aim is to relieve suffering and restore health, it does not think of using compulsion in its dealings with those who hold up industry and thus cause untold misery, loss and despair in the community. Inherent in this scheme is the condition that a doctor must fill in a certain form before he can provide relief to the sick and suffering. That is a clumsy provision, which I regard as the conception of a degenerate mind. One is appalled by the action of any government in legislating along those lines. Surely, no one believes that patients will benefit under a system which has the effect of restricting and discouraging medical practitioners in their efforts to do their best in the treatment of sickness and disease. However, it will be impossible for doctors to practise their profession unless they observe this provision. Would any one suggest that a member of Parliament, or a Domain orator, should be obliged to fill in a government form before he could be permitted to make a speech ? I repeat that the bill represents another step in the implementation of the Government’s policy of nationalization. Therefore, the medical profession is worthy of the greatest possible support that can be given to it in its fight against this measure. I commend the right honorable member for Cowper for the splendid contribution which he made in his speech to-night to the cause of the medical profession, which is worthy of the support of all sane and freedomloving Australians.

Mr BEAZLEY:
Fremantle

.- If any members of the Federal Council of the British Medical Association have been listening to this debate, particularly since it was resumed at 8 o’clock, they must be very disappointed at the way the cause which they have advanced in defence of themselves has been mangled in the mouths of honorable members who profess to espouse it. If the case for the British Medical Association were as weak as the meanderings that have emanated from the honorable member for Deakin (Mr. Hutchinson) and the honorable member for Wide Bay (Mr. Corser) to-night have indicated, it would be very weak indeed. But, of course, it is not so weak as the case advanced by either of those honorable gentlemen, and therefore it must be regarded with more respect than their arguments would warrant. To go into one of the more barren fields of this debate - the question of whether or not the Government has a mandate to introduce pharmaceutical benefits - I remind honorable gentlemen opposite that prior to the general election of 1946 the Parliament passed a Pharmaceutical Benefits Bill which was invalidated by the High Court of Australia. It was quite well known to the Australian public that the Australian Government was attempting to legislate for pharmaceutical benefits and the public, knowing that, returned the Government to office at the general elections of 1946. Coincidental with the general election the electors accepted a referendum proposal that conferred upon this Parliament the power to make laws in relation to pharmaceutical benefits and medical and dental services, but with the proviso “but not so as to authorize any form of civil conscription “. So that while it is impossible for any honorable member of this House to say with certainty what the people want on any specific matter and particularly on this matter, as far as a general election and a referendum could indicate there is public support for this measure. The Government that was prevented from implementing legislation for pharmaceutical benefits because of the High

Court decision in 1946 was re-elected. In the course of the election campaign that Government was both submitting a referendum proposal to remedy the weakness that the High Court decision hadshown, and promising to attempt to re-enact pharmaceutical benefits. I do not think that the British Medical Association disputes that fact. Those of the council of the British Medical Association in Western Australia with whom I have had conversations have never attempted to dispute that fact. Nor is it true that, if the Government were to make the British Pharmacopoeia the recognized formulary, the British Medical Association would support the scheme. The honorable member for Deakin said that the British Medical Association had asked for the British Pharmacopoeia to be the formulary. The British Medical Association has done no such thing. The members of the British Medical Association council in Western Australia with whom I have discussed this matter have said to me that the British Pharmacopoeia would be inadequate as a formulary. What the doctors want is really the absence of a formulary, because they believe that there are many new proprietary lines coming forward which are not met by any formulary or by the British Pharmacopoeia. We ought to discuss this issue on the basis of the argument that the British Medical Association has advanced, not the argument that the honorable member for Deakin advanced on behalf of the British Medical Association - an argument which that organization has never advanced on behalf of itself - namely, that that organization was willing to cooperate with the Government if it would authorize the use of the British Pharmacopoeia as the formulary. Having told us how inadequate the formulary was, the honorable member for Deakin proceeded to tell us that it was too large, with its 84 printed pages, and too cumbersome for a doctor to handle. He cannot advance both arguments at once. It was symptomatic of the paucity of his argument that he had to use that statement.

The Leader of the Opposition (Mr. Menzies) dealt at great length with his cwn proposition that this measure was the first step in a scheme to nationalize medi cine. The right honorable gentleman was sitting in the front row of the Opposition benches when the referendum proposals of 1946 were before the House, and he moved the amendment that added the words “ but not so as to authorize any form of civil conscription “ to the proposal. The Attorney-General (Dr. Evatt) on behalf of the Government, accepted that amendment. The High Court of Australia, in many instances in which there has not been an express prohibition on the exercise of the Commonwealth power, has been very quick to infer an implied prohibition. It is quite certain that the Leader of the Opposition in saying that this measure was the first step in the nationalization of medicine, was unsound, because the High Court would not tolerate such an attempt in view of the express prohibition contained in the proviso “but not so as to authorize any form of civil conscription “.

As for the argument that this bill abolishes private practice in medicine, in my opinion we have never heard that argument really sensibly advanced by any honorable member opposite. The doctor in private practice is the man who will administer this scheme or, as the case may be, refuse to administer it. The fact that a doctor writes his prescription on a form that, when presented to a chemist, entitles a person to a free dispensation of medicine, does not abolish his private practice. But the Leader of the Opposition did advance an argument that is very worthy of respect and that is, in fact, advanced by the British Medical Association, when he said that there was a moral coercion on the doctor. The right honorable gentleman explained moral coercion in this way: If a doctor were consulted by a patient whose economic circumstances he knew to be bad, there might be a tendency for him not to prescribe according to an unfettered conscience the medicines that he thought would be the very best for the patient’s ailment, but to take into consideration the economic circumstances of the patient and write another prescription that would fall within the formulary. The Leader of the Opposition said that that implied a moral coercion on the doctor, and I think that that is a perfectly valid view.

But that does not only apply to the Government formulary. Every public hospital in Australia has a formulary, and when a doctor prescribes for a patient he knows that, if he prescribes beyond the limits of the public hospital formulary, the hospital will not provide the medicine free to the patient. Why has the medical profession not objected to that moral coercion that has existed for many years? Nor is it only in connexion with public hospitals that that system operates. Many doctors are attached to benefit lodges. The lodges have a rigid formulary, and if a doctor prescribes outside it the patient will not receive the medicine free from the lodge. So I cannot see that the argument of the Leader of the Opposition is worthy of respect. It applies no more forcibly to the Commonwealth formulary than it does to the public hospital or friendly society formulary or, for that matter, to. the formulary that was used during the last war by the Army. There was not a limitless right for a medical officer in the Army to prescribe any drug. His prescriptions were confined to the Army formulary. It is not true to say that the law compels a doctor to prescribe medicine that is listed in the formulary. The Leader of the Opposition confined himself to the moderate statement that there was moral pressure on the doctor because of the poverty of certain patients. He did not attempt to state that this measure orders the doctor to prescribe only medicine within the formulary. It does not do so, although some honorable gentlemen opposite, including the honorable member for Wide Bay have been guilty of that complete distortion of the intentions of this measure.

Mr Bernard Corser:

– I read them.

Mr BEAZLEY:

– The honorable gentleman may have read them but he certainly did not state them in the House.

Mr Bernard Corser:

– I read them in the House.

Mr BEAZLEY:

– The real crux of the matter is that the Government is now endeavouring to tighten up the 1947 law concerning pharmaceutical benefits and to impose penalties to operate in cases in which a doctor prescribes medicine that is within the. formulary but does not write the prescription on the prescribed form to enable the patient to present it to the chemist for the free dispensation of the medicine. That is the intention of the amending bill.

The doctors have defied the law since 1946. But I do not complain of that. I believe that any section of the community has the right to set its conscience against the State, and I am very glad to see honorable members opposite converted to that point of view. They did not accept that argument when wharf labourers set their conscience against the State and would not load metals to be used against the Chinese by the Japanese, but they accept it now on behalf of the doctors. I repeat that I do not deny the right of any group to set its conscience against the State, as the doctors have done in this case. However, I wish that honorable members opposite would not try topretend that there has been no defiance of the law but would concentrate their efforts instead upon demonstrating that the law is a bad one. We are always hearing that one cannot get health out of a bottle and that free bottles of medicine will not make a health scheme. Even the statement that one cannot get health out of a bottle is not entirely true. Certain classes of people get life itself from a bottle. If insulin from a bottle is not injected into a person with diabetes, he will die. Therefore, the diabetic patient does get life from a bottle, if the bottle contains insulin that is injected periodically into his veins. If honorable members opposite are going to deride this scheme as a means of offering health to the community, they should at least have the intellectual honesty to recognize that there are categories of persons who do get health from a bottle and who would obtain great economic relief from the provision of expensive drugs, such as insulin, free of charge. I do not think that any doctor would say that it took him too much time to write an order for insulin on a form for a diabetes patient. I have never heard that the British Medical Association has advanced that argument. Even if we accept its general argument that a waste of time is involved in research into 84 printed pages of the Commonwealth formulary to ascertain whether the ingredients for complicated mixtures are included in it, no sound argument can be advanced on the score that trouble would be involved in finding insulin in the formulary. Thousands of diabetic patients would benefit greatly if, at least in the narrow field of prescribing insulin, the doctors would write their prescriptions on a form that would enable it to be provided free. Insulin is not the only drug in that category. There are all sorts of vaccines, and serums, liver extracts, sulpha drugs and penicillin, all of which are widely prescribed. Even if the rest of the formulary were valueless and the scheme, apart from those things, was useless, no member of the British Medical Association would pretend that the free dispensing of vaccines, serums, liver extracts, sulpha drugs and penicillin would not be of great benefit to the many people who need those special drugs. The law which this bill will amend lays down that, if doctors will not prescribe medicines included in the formulary in the manner that it directs, certain penalties, including fines of £50, may be imposed on them.

There is not the least doubt that this legislation will be challenged in the High Court after it has been enacted. It is a moot question whether the court will rule that the legislation represents civil conscription. I should not venture to guess what the court will decide, but I should not be in the least surprised if this matter does not ultimately find its way to the Privy Council. When the referendum proposals of 1946 were accepted by the people, the doctors of Australia were given a categorical guarantee against nationalization, a guarantee that they would not be compelled to enter any Commonwealth pharmaceutical service. 1 have not the least doubt that, although they are complaining that this scheme represents nationalization, they will take their stand, when they appeal to the High Court, on that very guarantee. It will be one of the main points advanced by the doctors who now profess to fear that the bill is the thin edge of the wedge of nationalization. This is a proposal to use the doctor in private practice. The fact that he is asked to prescribe on a government form does not entail the abolition of private practice and his removal from his home to an institution) as the honorable member for Wide Bay claimed. If a doctor puts pen and ink to his own prescription form, the physical act is the same as if he put pen and ink to the government prescription form. Whether the doctors accept the general formulary or not, I consider that their attitude would be far more impressive if they would prescribe on government forms certain life-giving drugs, such as insulin, vaccines, serums, liver extracts, sulpha drugs and penicillin. I come now to a point raised by the honorable member for Darwin (Dame Enid Lyons), who declared this afternoon that it would be far more important if the Commonwealth Government were to prescribe free milk instead of free medicine. That was another argument in favour of the expenditure of money on protective foods instead of on what are derisively called by honorable members opposite “ free bottles of medicine “. Certain doctors have entered into this campaign of derision concerning free bottles of medicine. I am surprised to learn that medical practitioners who have been prescribing medicines for years and years are now suggesting that medicine is unimportant. They have involved a great many people in large bills for their prescriptions. If they deride free prescriptions, I presume that they also deride the prescriptions for which they have charged the people in the past. The honorable member for Darwin failed to recognize that the pharmaceutical benefits scheme will be financed out of taxation revenue. That means that the highest income groups will bear the greatest charge for free medicines when they are prescribed. The lowest charge will be borne by the low-income groups. Insofar as members of the low-income groups are not required to pay for medicines out of their incomes - and I know a man who recently paid £11 for a prescription - they will have more of their incomes available for the purchase of protective foods.

Mr ARCHIE CAMERON:
Barker · ALP

– It is a strange thing that we have before us once again another bill dealing with social services, this time in the form of pharmaceutical benefits. On the last occasion, an. important bill was introduced into this House in the very early hours of the morning, when honorable members were not in any condition to give proper attention to its points. That was less than two years ago. Now we are considering another measure that will vitally amend the legislation of 1947. This bill has been placed before us on the day before the Parliament is to adjourn for two months, and when the Government knows that many honorable members have either already left, or are about to leave, for their homes. If the Government believes that its social service schemes are of such outstanding value to the people, it should have the courtesy to introduce legislation concerning them at a time when honorable members would have an opportunity to consider it properly. This bill was received from the Senate only last night, and we are expected to dispose of it within 24 hours.

Mr Sheehan:

– It is only an amending bill-

Mr ARCHIE CAMERON:

– Yes, but it is a vitally important amending bill The present act repealed two previous acts, so that this is the fourth stab thu Government has had at putting into effect a pharmaceutical benefits scheme. The importance which the Government attaches to the measure may be gauged from the number of Ministers who have taken part in the debate. They include the Minister for Defence (Mr. Dedman), the Minister for Repatriation (Mr. Barnard), whose department includes a large medical component, and the Minister for Information (Mr. Calwell), who gave us a great deal of information abou i what is happening in the United Kingdom and New Zealand, but remained strangely silent about the implications of the bill itself. This afternoon we also listened to a speech from the representative of another section of the Labour party - the honorable member for Reid (Mr. Lang). It did not seem to me to be one of the best speeches that the honorable member has made, but never before have I seen members of the Labour party so restless as when the honorable member for Reid was speaking. They could not remain still. Indeed, they betrayed such a state of agitation as I have previously witnessed only when, as a boy, I used to poke a stick into a bull ants’ nest.

The first thing we have to consider is the allegation that the people of Australia authorized the Government’s pharmaceutical benefits scheme at the last election. The next point to be considered is the allegation that members of the medical profession are on strike. Finally, we must consider whether this legislation involves civil conscription of the medical profession. I well remember what took place at the last election. What happened in my own electorate is interesting, because I was the only member of the Parliament who voted against the proposal to submit social service proposals to a referendum of the people. At the election which took place at the same time as the referendum, I was returned by an absolute majority of just over 5,000, but the electors of my constituency turned down the referendum proposal by a majority of more than 10,000. Unfortunately, their example was not followed generally throughout Australia, with the result that the Parliament has been invested with wide powers to legislate in respect of social services. However, I emphasize the point that in the referendum the people merely invested the Parliament with power to legislate. They did not specifically approve of this bill. The particular power which was added to section 51 of the Constitution is set out as follows: -

The provision of maternity allowances, widows’’ pensions;, child endowment, unemployment, pharmaceutical, sickness and hospital benefits, and medical and dental services (but not so as to authorize any form of civil conscription), benefits to students and family allowances.

As a confessed conservative, I believe that it was unwise to add that power to the Constitution.

Mr. ACTING DEPUTY SPEAKER (Mr. Lazzarini). - Order! The honorable member may not discuss the Constitution.

Mr ARCHIE CAMERON:

– Every Minister who has spoken has put forward the argument that this bill was specifically approved by a vote of the people at the last election. I maintain that this measure was never before the people, nor was the act which it proposes to amend. The Pharmaceutical Benefits Act 1947 repealed two previous acts, one of which had been declared by the High Court to be in part invalid. The next question to be considered is whether the doctors are on strike. I have no knowledge of any doctor having refused to provide medical attention to any person who applied for it. I take it that a striker is a person who refuses to carry on in his ordinary occupation or avocation until something which he wishes to be done has been done. According to that definition, the doctors are not on strike. No doctor has downed tools or walked out on the job, but the doctors have, in the interests of their patients, refused to work under the provisions of the Pharmaceutical Benefits Act 1947. They have decided to raise funds, openly and publicly, to fight in the High Court any attempt to penalize a doctor for refusing to work under the act.

The third point to be considered is whether this proposed legislation involves civil conscription, and in order to decide that it is necessary to define conscription, In the constitutional amendment to which I have referred, the term is used to distinguish between civil conscription and military conscription. The Commonwealth has power to conscript doctors or dentists or chemists or anybody else for military purposes, but it has no power to conscript them for civil purposes. Obviously, this bill has to do with civil matters which are in no way connected with the defence power under the Constitution. That power is not mentioned in t he principal act, or in this amending bill. I define conscription as an attempt by a Government to compel a person to do something which that person would not do if left to his own devices. I have not looked up the dictionary meaning of the word, but that seems to me to be a common sense definition, and that is exactly what the Government is trying to do to the doctors. What the Government is doing is not in the interests of patients or of the medical profession or of the hospitals; its purpose is to further a policy to which the Labour party is pledged. It has no other objective. The objective of the Labour party was stated on the 21st July last year at a conference in Melbourne between representatives of the medical profession and the Commonwealth Minister for Health, Senator the Honorable Nicholas McKenna. I propose to quote from the authorized report of the conference. The shorthand notes having been taken by the Reporting Branch of the Attorney-General’s Department, I should say that there can be no question as to the authenticity of the report. The relevant passage is as follows : -

Senator McKENNA. We cannot go ahead with the physical things that are required to develop a national medical service at any great speed to-day, and it may well be that, with all the goodwill in the world, some ten years may elapse before the national medical service develops a momentum that will enable it to exercise a prepondering influence in the community. Whilst I am quite frank in telling you that my belief is that the national scheme is best for the people and is the ultimate objective of the Government, I qualify that by the statement I made to Sir Henry in the beginning and by my belief that there can be no meteoric approach to the position.

Dr. COLVILLE. ; I am quite clear on that, but could we confine ourselves to the discussion of the ultimate end of this scheme? You keep emphasizing that the development would be gradual and that there would be people who would prefer private practice to the Government service, but the ultimate objective if. admittedly that private practice will be eliminated?

Senator McKENNA. That is so. There is no dispute as to that.

Consequently, that having been admitted, less than a year ago, at a properlyconstituted conference between the Minister for Health and the medical profession, we have clearly before us the fact that the intention of the Government is the complete elimination of private medical practice in Australia. In other words, socialization of the medical profession and medical practice is the objective of the Government, and that objective will be arrived at so soon as time and circumstances will permit. I have said many times, especially in my own electorate, in South Australia, where people ask me what the real meaning of the policy of the present Prime Minister is, that the real Prime Minister is a socialist, that he believes in socialism as a doctrine and dogma, as the early apostles believed in the Resurrection, that he will carry out that policy, inch by inch or mile by mile, every time he gets the chance, and that, as soon as a political state of affairs arises in this Parliament that does not permit him to carry it out, he will try to get a prominent place on the Opposition benches to make things uncomfortable for the incoming government, whatever its political colour may he. I have no illusions and people should have no illusions as to the real core and kernel of everything that is done politically by the right honorable member for Macquarie as the Prime Minister of Australia. He will socialize the chemists, the doctors, the hospitals, the banks, shipping or anything else as soon as he gets the opportunity and as quickly as the processes of the law will permit him.

Mr ACTING DEPUTY SPEAKER:

– Order ! I ask the honorable member to return to the bill.

Mr ARCHIE CAMERON:

– The bill contains another important matter. We have noticed that the practice of the Government contains a streak of vindictiveness. So soon as the Government’s policy is challenged successfully it strikes. As soon as the High Court gave its decision adversely to the Government in the matter of banking we got nationalization of the banks.

Mr ACTING DEPUTY SPEAKER:

-Order! That has nothing to do with the matter before the Chair.

Mr ARCHIE CAMERON:

– I use it purely as an illustration. As soon as members of the medical profession proved themselves at conferences and in the face of adverse publicity to be unamenable to the policy and objectives of the Government, we had this bill put before us. The Government intends to proceed with the penal clause of the bill and, by one means or another, to force the medical profession of Australia to do something that, in its opinion, is not only against the interests of the patients of Australia, but is also against the conscience of the overwhelming majority of the medical practitioners. There has been nothing at all to prevent every member of the medical profession from joining the scheme if he wanted to. We have been told by one Minister that it is a voluntary arrangement. Out of more than 6,000 doctors in Australia, only 117 have joined the scheme and many of those who have joined have been roundly dealt with by the honorable member for Reid, whose intelligence service is amaz ing. It is a great pity that the British Army did not get hold of him years ago.

Mr Lang:

– It is always accurate

Mr ARCHIE CAMERON:

– One of the requirements of an intelligence service is that it be accurate. Sometimes, with unhappy results, intelligence services have not been accurate. There used to be slips on Olympus arid even Jupiter’s wife was under a cloud for a long time. But 117 out of more than 6,000 doctors is not a high proportion. A lot of the Government’s supporters will have to do better than that at the polls or they will not only not be returned but will also lose their deposits.

Mr Pollard:

– That is an old saying of the honorable member.

Mr ARCHIE CAMERON:

– Yes, I have always expected the departure from this House of the Minister for Commerce and Agriculture (Mr. Pollard), but he has managed to retain his seat, though why I do not know. He has been so afraid in the past, however, that he has decided to seek a safer seat at the next general election.

Mr ACTING DEPUTY SPEAKER:

– Order! The honorable member must deal with the bill.

Mr ARCHIE CAMERON:

– The formulary is what I propose to deal with.

Mr Sheehy:

– Is that free medicine that the honorable member has just sipped from his glass?

Mr ARCHIE CAMERON:

– Water is the only medicine I take. The honorable member for Fremantle (Mr. Beazley) said that some people get life out of a bottle. Others get their amusement out of a bottle.

Mr Pollard:

– And become as vocal as the honorable member is.

Mr ARCHIE CAMERON:

– Yes, they are very vocal when they get it. Some of us do not need the contents of a bottle as a stimulus to vocality or in order to prime us up. The formulary rather intrigues me. Some one in the employ of the Government, perhaps a Minister, who soon will be honoured for his discovery, produced the formulary. It was to be like the laws of the Medes and the Persians. Like the Scriptures, nothing could be added to it and nothing taken away. No one could cure the ills of mankind unless he complied with it. This lovely S8-pages document, which I carry with me as a souvenir, contains a fearful lot of Latin and Greek and probably Arabic and thi Lord knows what. The medical profession throughout history has been building up things of this description. Yet the Commonwealth believes that its formulary is the be-all and end-all, the alpha and the omega, and everything from Dan to Beersheba, and that the cures of all the ills of mankind are contained in it. The answer of the medical profession is that that is a lie. The Government must admit that it is, because, in this bill, there are provisions for adding to the formulary. Apparently some one close to the Minister for Health has whispered in his ear that the formulary may not include some of the drugs that the honorable member for Fremantle alluded to a little while ago. Consideration of the formulary, with which is bound up the form of prescription, leads me to the belief that the Government is much more concerned with compelling medical men to write their prescriptions on a certain form, than with ensuring the proper treatment of patients. To the Government patients do not matter. The medical man does not matter. All that matters is that medical practitioners should be compelled to write their prescriptions on a certain form. One would think that all that a doctor had to do to ensure a cure was to write a prescription on a government form and say “ abracadabra “. What strikes me is the manner in which the Government seems to assume that there is something absolutely sacrosanct about a formulary. It is the hall-mark of bureaucracy. It is the hallmark of those who would reduce all the people in Australia to one common level, and make everybody amenable to government discipline and government policy. I wonder why the Government does not go a step further and compel every patient or every elector, to carry at all times a copy of the formulary together with a few blank prescription forms. Another way in which the Government could still further inconvenience the general public, would be to compel every person who wanted free medicine to sign an application for it. Why somebody has nol thought of that I do not know, but 1 have no doubt that it will be thought of sooner or later. I am quite sure that we are not yet anywhere near the end of the Government’s capacity to insist upon the use of forms in relation to social services.

I come now to prescriptions. I say to honorable members opposite that a prescription is the property of the patient. The patient goes to a doctor, he is examined, and the doctor writes out a prescription for medicine. That prescription is the property of the patient. This bill completely alters the existing law however, and henceforth prescriptions will be the property of the Government.

Mr Sheehy:

– What happens to prescriptions that are written by doctors now?

Mr ARCHIE CAMERON:

– The patient takes his prescription to the chemist, or if he so desires he tears it up.

Mr Sheehy:

– Whose property is it?

Mr ARCHIE CAMERON:

– It i,-. the patient’s property. I have some prescription forms in my pocket now. The fundamental objective of this law is to alter the whole basis of relationship between doctor, patient, and chemist. Dealing with the writing of prescriptions the vital wording of proposed new section 7a is -

Except as prescribed, a medical practitioner “hull not write a prescription for the supply to a person entitled to receive pharmaceutical benefits . . . otherwise than on a prescription form supplied by the Commonwealth fr,i the purposes of this Act.

I am sure that if somebody came down from the moon, Mars, or from a space platform of which we hear some talk today, and had a look at this world for the first time, he would think that unless a prescription were written on the form supplied by the Government it would not be effective.

I shall deal now with certain matters relating to friendly societies. I am a member of a friendly society, and I believe that the Government would have been well advised to follow the friendly society principle in any medical benefit or pharmaceutical benefit scheme that it endeavoured to introduce. Of course, the reason why the Government has not done that is that honorable members opposite are, in principle, convicted by their own statements on socialism. Friendly societies are voluntary organizations. They are co-operative organizations. They are private enterprise at its best. They are formed by the banding together of small men in the community for mutual advantage and protection. The Government does not want anything like that. The principle underlying this bill is that underlying all the Government’s social services schemes, namely, that everybody must be taught to be entirely dependent on the Government for his welfare and well-being. I object to that theory in Australian politics. It is far better that we should have a self-reliant, independent community than a dependent community which looks to the Government for everything. Honorable members opposite talk of free medicine, but it will be free only to some people, and I say that the basic principle of all social services, if they are to become universally acceptable and effective, is that everybody who is to benefit from them should contribute to their cost. The Minister for Information (Mr. Calwell) said at first that the Government’s social services scheme was costing the country £70,000,000 ia year, but later he said that, with the addition of the pharmaceutical benefits scheme, the cost this year might even be £100,000,000. The Minister who i.=. supposed to be responsible for information, apparently cannot say within £30,000,000 what the Government’s social services scheme is costing. It is only while the prices of wool, wheat, metals and other primary products are as high as they are to-day that the Government can be «o prodigal with its funds. As the Minister for Commerce and Agriculture pointed out recently, the time is approaching - how soon it will come we do not know - when we shall be faced with an entirely different standard of price levels. When that time comes, there will be a substantial shrinkage of government revenue, and the Ministry will have to curb its ideas on expenditure, and one of the first things that will have to recede will be the expensive social services programme upon which this Government has embarked. The honorable member for Fremantle spoke of moral coercion. He was referring to a remark made by the Leader of the Opposition (Mr.

Menzies) this morning about the moral coercion that could be imposed on the medical profession under this law. 1 say that the bill goes a bit further than that. Undoubtedly, moral coercion is implied in clause 6, but an attempt has been made to put illegal coercion into that provision also. The Government is saying, in effect, to the doctor, “ You shall not prescribe anything that we may have happened to incorporate in our statutory rules covering formularies, unless you do so on a government form. If you do not use a government form, you will be fined £50 “. Yet, Ministers and Government supporters have the effrontery to tell us that this is not a form of civil conscription! Formularies are well known in friendly societies, but a member of a friendly society pays a stipulated and limited weekly contribution for certain benefits that are known to nim. What the Commonwealth Government said to the people of Australia at the last referendum was, “ Amend the Constitution and, as far as social services are concerned, the world is yours. There will be no limit”. The pharmaceutical benefits scheme is completely unlimited, and therefore it cannot be compared with friendly society schemes or what is done in the Army or anywhere else. It is something entirely apart, and, above all, it has been deliberately devised to place the Australian community in a strait-jacket so far as medical services are concerned. My logic will not allow me to associate two matters that are sometimes associated by government speakers. Sometimes, when dealing with general questions, honorable members opposite argue that so long as the Chifley Government remains in office we shall have full employment with the highest wages that the country has ever known, and in almost the same breath they tell us that at the same time we must have the greatest and most expensive social services system that the world has ever seen. J. cannot reconcile those two proposition.?., but I am not capable of the intellectual gymnastics in which some honorable gentlemen opposite indulge.

I leave this bill, as members of the Opposition have had to leave many other hills during the life of. this Parliament, knowing that it will be passed. We know lb at as soon as it becomes law it will be studied by the legal profession and that it will be challenged in the High Court of Australia. I hope and trust that the High Court will have a better appreciation of the meaning of the last amendment of the Constitution in regard to pharmaceutical benefits than has the Australian Government, which desires to make every man, woman and child in the community dependent upon its policy and every medical practitioner subservient to its will.

Mr THOMPSON:
Hindmarsh

– The honorable member for Barker (Mr. Archie Cameron), in dramatic tones, spoke of the formulary as being, in the opinion of the Government, the alpha and the omega in relation of free medicine, to which nothing could be added. He seemed to be wondering how the Government had got hold of it. During the whole of my experience of friendly societies, which now extends over many years, a formulary has been used by them in connexion with the supply of medicine to their members free of charge. The formulary that is used under the agreement between the societies, doctors and chemists for that purpose is the British Pharmacopoeia. If, under this legislation, a doctor prescribes a drug that is not in the formulary, the patient will be required to pay for it. That applies also to friendly societies. If the doctor who is treating a member of n friendly society prescribes a drug that is not contained in the British Pharmacopoeia, the patient is required to pay for it. So far as the friendly societies are concerned the British Pharmacopoeia is the alpha and the omega. It is accepted by doctors as being sufficient to. meet the needs of the societies. Thirty or 40 years ago many doctors did not send prescriptions to chemists to be made up. The position then was that the ordinary single member of a society paid to his doctor a fee of 10s. a year. In return he obtained free medical attention and was supplied free of charge with any substances contained in the British Pharmacopoeia that were prescribed -by the doctor. In those days doctors usually prescribed drugs that were listed in the Pharmacopoeia because many of the proprietary prepara tions that can be obtained now were not available then. Doctors who did not have dispensaries entered into contracts with private chemists for the making up of their prescriptions. Some doctors who had contracts with friendly societies paid chemists only 3d. or 4a. for each prescription that was made up for a lodge member. The chemists were able to undertake the work at that price because, in addition to sending lodge patients to them, the doctors also sent private patients, who were charged at the normal rates. In that way the chemists were able to operate profitably. The friendly societies discovered that the most suitable drugs for their members were not always prescribed. The friendlysocieties dispensary movement was then inaugurated and as a result doctors could prescribe the most suitable drugs for lodge members without extra cost to themselves. Later, the societies decided to pay doctors a certain sum for the medical attention that they gave to lodge members and to make arrangements with chemists for the making up of prescriptions. That scheme worked satisfactorily for quite a long time. In recent years, however, medical science has been revolutionized. Instead of prescribing the compounded mixtures that they prescribed years ago, doctors have gradually come to use proprietary specifics.

Honorable members will recollect that the honorable member for Richmond (Mr. Anthony) said that for 3d. a week the members of friendly societies could obtain all the medicine that they required, whereas the average working man is now paying 10s. or 12s. a week in social services contributions to obtain that benefit and, as he admitted, others as well. The figure of 3d. a week is approximately correct and I do not propose to argue with the honorable gentleman about it. but I dispute the statement that a member of a friendly society can obtain all the medicine that he requires for that weeklypayment. For many years I was secretary of a friendly society. Members continually inquired why chemists charged them 3s. or 4s. for practically every prescription that they required to be made up for them. I explained that, under the rules of the society, they could be supplied free of charge only with drugs which were listed in the British Pharmacopoeia and that they were required to pay for those that were not listed. Doctors often give friendly society members prescriptions for, say, eighteen tablets, but the members are told by the chemist that, although they have lodge prescriptions, they must pay 3s. 6d. for the tablets.

Mr Sheehy:

– Seventeen shillings.

Mr THOMPSON:

– The amounts vary. The honorable member for Richmond said the average family now paid 10s. or 12s. a week social services contribution. The average family man in Australia has two children. If he is in receipt of the average salary of £350 a year, his social services contribution in the current year will be £3 15s., or ls. 6d. a week. He does not pay an amount of 1. OS. or 12s. as suggested by the honorable member, and during the ensuing financial year he will be called upon to pay lOd. a week. Of course, the honorable member did not mention the other benefits which a married man with a wife and two children to support who earns £350 a year receives in the way of social benefits. Instead of paying 10s. or 12s. a week as suggested by the honorable member, a man in such circumstances will be required to pay only 3s. 6d. a week, and f rom the 1st July next he will be required to pay only 2s. a week for all the social services benefits which he receives, including child endowment. Statements such as that made by the honorable member to the effect that the Government charges 10s. or 12s. a week for services which a member of a friendly society lodge can receive for 3d. a week are wilfully misleading. When the honorable member made that assertion I .pointed out that the payment of 3d. a week to a friendly society did not entitle a member to the supply of all the drugs to which he is entitled under the pharmaceutical benefits scheme. However, my correction did not prevent the honorable member from persisting in his attempt to mislead the people by belittling the merits of the bill.’ Whilst such arguments may appeal to those who do not know the facts, they are certainly not an honest method of debating an important measure.

The. honorable member for Barker (Mr. Archie Cameron) asserted that any in dividual who obtains a prescription from a doctor is entitled to retain that prescription. Whilst members of friendly societies in South Australia who have their prescriptions dispensed at lodge dispensaries are permitted to retain their prescriptions, members of lodges which contract with outside pharmacists to dispense their members’ prescriptions do not retain them. A special charge i? made by such pharmacists to lodge members for dispensing. Originally the charge was ls. per script, but later thai was increased to ls. 3d. I do not know what the present charge i3 because 1 have not been in such intimate association with the friendly society movement during the last two years as I was formerly. However, I know that the pharmacists are paid from a pool. At ihe end of the quarter they send aggregate accounts to the friendly societies con-, corned, and the members who had handed in their prescriptions for dispensing never see them again. The Government has undoubtedly availed itself of theexperience gained by the friendly societies over many years in formulating its scheme.

Let us consider for a moment the justification for the Government introducing such a measure. Prior to the last general election the Government had introducer! to the Parliament a bill to provide free medicine, and that measure was passed by the Parliament. The ordinary man in the street does not understand the term “formulary”; all that concerns him is whether he will obtain his medicine free. The ordinary medical prescription is incomprehensible to the patient unless he happens to bc able to read, Greek, Latin and French, and I repeat that all that concerns the average person is whether he will be required to pay for his medicine. At the time the Government assured the people that they would be able to obtain penicillin, sulpha drugs and other proprietary lines as part of the free medicine scheme, and the people were quite pleased. However, the validity of that legislation was successfully challenged in the High Court, and the legislation became ineffectual. At a subsequent referendum the electors were required to indicate whether they favoured the transfer to the Commonwealth Parliament of power to legislate to provide social services, and the electors voted in the affirmative. The power to legislate in respect of social services which was thus conferred on the Commonwealth Parliament included power to provide widows’ pensions and various other benefits, including free medicine. That referendum was conducted simultaneously with a general election, as the result of which the Government was returned to office. The Government considered that it was desirable to introduce fresh legislation to give effect to its national health scheme, and that legislation was enacted over two years ago. During the debate on that measure, the principal objection advanced by opponents of the Government, including the Leader of the Opposition (Mr. Menzies), was that the Government’s policy would ruin private pharmacists, at whose expertise, it was alleged, the free medicine was to be dispensed. Notwithstanding that objection, the measure was enacted, although it was generally realized that it did not contain any power to compel doctors to prescribe free medicine or to use the formulary of over 80 pages, to which the honorable member for Barker has referred. “When the National Health Service Bill was debated in the House last year, I was not anxious that it should be enacted until the pharmaceutical benefits scheme could be implemented. I had no complaint against the merits of that bill, but it seemed to me that it was necessary, first of all, that we should give effect to the pharmaceutical benefits scheme. In the meantime, the Government has made a number of approaches to the British Medical Association. Possibly the Government did not approach that body in the right manner, but I do not express any opinion on that. The point is that the pharmaceutical benefits scheme has not been implemented, although the scheme commands general support. Even the Adelaide News, which nc one could truthfully assert is a Labour organ, declared unequivocally that the controversy associated with the implementation of the pharmaceutical benefits scheme should be settled, and free medicine made available to the people. Now the opposition to that scheme is coming from the

British Medical Association, which has said, in effect, “Unless the Government allows us to carry out this scheme in our own way, and permits our members to write prescriptions in any way they like, we shall have nothing to do with the scheme “. Incidentally, my experience of doctors has taught me that whilst most of them are not averse to writing prescriptions, some of them are prone to make their prescriptions needlessly complicated. Indeed, I have been assured by dispensers of long experience with whom I am acquainted, that in prescribing for lodge patients some doctors needlessly include a number of ingredients, instead of prescribing drugs listed in the British Pharmacopoeia, in order to justify making an extra charge of 3s. 6d. If a doctor includes in a prescription for a lodge patient only drugs which are included in the British Pharmacopoeia he is not entitled to make any additional charge. Dispensers have pointed out to me that mixtures which are just as efficient as are the proprietary lines can be compounded from drugs listed in the British Pharmacopoeia, and, in some instances, a patient has been compelled to pay for tablets because they were prescribed when the same drugs were available in another form in the British Pharmacopoeia. That is by no means a stretch of the imagination. From my own experience as president of a friendly societies’ dispensary I know that such things have happened. In that capacity I was compelled to take part in the management of the dispensary. Honorable members opposite ask why the doctors should be compelled to do what the Government desires. Under the laws of every State in the Commonwealth only registered medical practitioners are permitted to diagnose complaints and to write prescriptions for the treatment of the sick. If any person other than n registered medical practitioner does so he may be prosecuted as a “ quack “ and be heavily fined. If a doctor says, “ 1 shall not write a prescription unless I am permitted to do so in my own way “ the pharmaceutical benefits scheme cannot be implemented. The fullest co-operation of the medical profession is absolutely necessary. The doctors have said, “ We are prepared to co-operate with the Government in the scheme but we insist on our right to write prescriptions in our own way. The Government can pay the chemists for the prescriptions dispensed by them “. Let honorable members opposite consider the labour involved in checking prescriptions dispensed by a chemist with a large dispensing business. If the system suggested by the doctors were put into operation the volume of checking that would be necessary would be enormous. Some time ago the chemists agreed with the friendly societies to dispense prescriptions at a flat rate simply because they decided that there was no other way in which prescriptions could be handled. If the chemists said to the friendly societies, “ We shall dispense prescriptions for a flat rate of 6d. and you can pay for the cost of the drugs used it would be necessary to maintain a constant check on the prices charged for the drugs. I am well aware of the tremendous task that is involved in carrying out a halfyearly stocktaking in an ordinary chemist’s shop. The volume or weight of drugs and specifics in each bottle or container has to be accurately measured and an estimate made of the value in each instance. The Government would have to appoint highly qualified chemists to check the prices of drugs charged by the chemists. Only a highly qualified chemist can assess accurately the value of drugs used in a prescription. If honorable members opposite had the experience I have had in that direction they would appreciate the fact that it would be almost impossible to institute such a scheme unless the Government employed an army of qualified chemists for checking purposes. It might be said that the chemists could themselves assess the value of drugs used in prescriptions which they dispensed. If they were permitted to do so honorable members opposite would probably say that some chemists would make large profits from the making up of prescriptions. Checks would have to be imposed to ensure that the correct charges were made. I am sure that honorable members opposite would be the first to complain if such a system were instituted. During the last two years, honorable members opposite have complained of the growth of the Public Service, yet, if their suggestion were adopted, the number of public servants would have to be increased tremendously. There is a tremendous shortage of qualified pharmaceutical chemists in Australia to-day. All city chemists have the greatest difficulty in obtaining additional staff or temporary relieving staff to enable their employees to take their holidays. There are no chemists available for the costing of prescriptions.

Mr Turnbull:

– Are not chemists employed on that work now ?

Mr THOMPSON:

– Yes; but if the proposals of honorable members opposite were adopted it would be necessary to appoint an army of chemists in the government service checking prescriptions to ensure that the prices charged were correct. If a government department paid out a total amount of, say, £3,000,000 without imposing any check on the charges made honorable members can imagine what the Auditor-General would have to say in his report. The Government has decided to provide free medicine for the people. Honorable members opposite generally agree with that decision. They agree with the Government that taxpayers who pay large amounts in social services contribution are entitled to some return by way of benefits and that the pharmaceutical benefits schemerepresents an opportunity to return to the taxpayers some of the money taken from them. The Government has decided that the pharmaceutical benefits scheme can be given effect in only one way, but the doctors will not co-operate with it. The Government does not want to interfere with the right of doctors to conduct their practices as they desire. It merely says to them, “If you prescribe a mixture contained in the formulary you must do so on the prescribed form. You are free to write out other prescriptions in any way you like “. Members of the medical profession have always opposed any form of control over their activities. They would be well advised to co-operate with the Government in this scheme. The honorable member for Barker has said that the validity of this legislation will be tested in the High Court. Apparently a decision on that matter has already been made, notwithstanding that the legislation is not yet on the statute-book, for the honorable member did not say that its validity may be, but that it would be, tested in the High Court. He was evidently relying on information that was given to him by the honorable member for Reid (Mr. Lang). If this measure becomes law, and is subsequently tested before the High Court the people will know whether the alteration of the Constitution approved by the people at the referendum empowered the Government to institute a free medicine scheme. The British Medical Association would have to accept the decision of the High Court, and we should all know where we stood. If the court were to decide that the legislation was unconstitutional the Government would have to go to the people again and seek a clear mandate. This bill does not take away from the doctors their freedom or rights. It merely provides that the people shall be able to obtain free any medicine which the doctors consider should be supplied to them.

Mr TURNBULL:
Wimmera

. -Some very fine speeches on this subject, which must have been very convincing, not only to the Government, but also to the people generally, have been delivered by members of the Opposition. The speech of the Leader of the Opposition (Mr. Menzies), although not lengthy, covered the whole subject very effectively, and was a gem. In the person of the right honorable member for Cowper (Sir Earle Page) we have in this House a man whom I believe possesses a grand combination of political and medical knowledge. In his very fine speech the right honorable gentleman dealt with the finer points of this subject in a way that no other member of the Parliament could. Unfortunately a medical member of the Government, the honorable member for Denison (Dr. Gaha) was unable to speak on this measure. Although I shall not go into the finer points of tfr; bill and detain the House for very long, certain opinions which have been expressed require that I should offer my comment. There has been a deal of confusion on the part of government speakers. All major bills that have been introduced in this House by the Government during the last few years have con tained a tinge of socialism ; they have all been stepping stones to socialism. This bill, of course, is no exception. I agree with some things that government members have said. I agree with the statement of the Minister for Information (Mr. Calwell) that the great days of private medicine are over. When the Government interferes by implementing this measure there will be no more great days in medicine. The Minister also said that the only sections of the community that are provided with adequate medical services are the very rich and the very poor.

Mr BARNARD:

– That is right.

Mr TURNBULL:

– That would suggest that the middle class is the only one that is not now provided for, and it is clear to every one that the additional amount that they would have to pay by way of social services contributions could never be recouped by them through the Government’s free medical scheme. I do not think that the Minister was quite right in his contention, which is evidence of the confused thinking to which I have referred. The Prime Minister (Mr. Chifley) has said that the poor people will be the sufferers if the British Medical Association holds up this measure for much longer. The right honorable gentleman mentioned that the’ man in the street, and men and women living in back rooms in cities need medicine urgently. Although that may be fairly true, it is indeed strange that he is so sympathetic and sheds crocodile tears whenever he refers to a proposed measure designed to give more power to the Government. On the 13th October, 194S, according to Hansard the Prime Minister said that he was only a cog in the machine. He was replying to my efforts to induce the Government to make increased payments to age pensioners retrospective to the 1st July, 1948. On that occasion, because the retrospective payment would not give the Government additional power, he claimed that he was “ only a cog in the machine “. However, in relation to free medicine he said that he would definitely see that this bill was passed, and that he would bring the British Medical Associtation into line. He also said that that was the desire of the people. He spoke as a man of authority, as the Prime Minister should be. The Government claims that it has a mandate for every bill introduced into this House merely because the people returned it at the last general elections* The honorable member for Fremantle (Mr. Beazley) said that although no one can say definitely what the people want, the Government thinks that they want the free medicine scheme.

Mr Pollard:

– The Government has been a very good judge to date.

Mr TURNBULL:

– That is more than the Minister for Commerce and Agriculture (Mr. Pollard) has been in his department. At least two Government members have not made up their minds about the real desire of the people in this matter. The Minister for Information said that the medical men are not far enough advanced in their thinking to realize the value of the scheme. I think that was a bit of impudence on his part. The only advance that the Minister for Information wants to see is an advance towards socialism. Of course the Opposition does not consider that that is an advance. As medical practitioners do not subscribe to this measure, he does not consider that they are sufficiently far-advanced. He said that they are not good policy makers. When we examine the political background and education, that is, the political education, of Ministers, we doubt whether they are good policy makers. We on this side of the House are of opinion that their policy is not in the best interests of Australia. The Prime Minister spoke of the doctors being on strike. As that charge has already been effectively refuted, I need not labour the point, but I desire to refer briefly to a statement by the honorable member for Fremantle. He said, in effect, “I am pleased that the Opposition has seen the light and now approves of strikes “. The position of the doctors in this matter is not analogous to that of workers in industry who engage in strikes. The doctors have protested against the Government’s scheme, hut they are continuing to work. On the news service this evening, I heard an announcement that th<? coal-miners at Cessnock have con tinued on strike and that Sydney will bewithout gas next week.

Mr DEPUTY SPEAKER (Mr Clark:

– Order! I ask the honorable member to relate his remarks to the bill.

Mr TURNBULL:

– Honorable members on this side of the chamber have always contended that if workers are not satisfied with their conditions, they should protest but should continue to work and have the matter decided by arbitration. The Prime Minister mentioned that Mr. Churchill and the late President Roosevelt were paid officers of the State, and said that that fact did not prevent them from rendering great service to their respective countries. I remind the right honorable gentleman that Mr. Churchill and the late President Roosevelt were free agents and were not subject to dictation from anybody. But the purpose of this bil] is to compel doctors to participate in the pharmaceutical benefits scheme. The Prime Minister also stated that the fact that members of the Australian Imperial Force were paid by the Government did not prevent them from serving their country faithfully and well. Of course, members of the Australian Imperial Force entered ,the Army, not for the monetary reward but to serve their country in war-time. The reasoning that the right honorable gentleman displayed 011 that matter was sadly astray. Despite the optimistic views of the honorable member for Hindmarsh (Mr. Thompson), an expensive organization will be necessary if the pharmaceutical benefits scheme comes into operation, and the taxpayers will have to foot the bill. The right honorable member for Cowper has explained clearly the manner in which the Government may operate thescheme without compelling the doctors to write prescriptions on the official form. This bill is a step towards nationalization. The doctors must be free of red tape and government interference. The confidence that exists between doctor and patient must not be destroyed. I shall read to honorable members an opinion that a great authority, Nicholas Murray Butler, has expressed about the importance of that confidence, because his words prove that the medical profession should never be regimented. It reads -

A physician is armed with tools, great powerful weapons. He is armed first and chiefest -with the instinct of humanity, human feeling,service sympathy. The physician, more than any man in a modern community, loses control of his own time. He may not agree with -certainty to be anywhere at a given hour, for hig professional instinct forbids him to refuse a call to relieve suffering. I hope the time -will never come when the test tube and the microscope with all their immense value will he permitted to displace the fundamental humane and human instincts which make the great physician.

Nothing must ever replace the physician. Tn France, there is a monument to Louis Pasteur, and upon it are inscribed the “following words: -

To cure sometimes, to relieve often, to coin”fort. always.

The Government must not attempt to bind the medical profession with red tape, or nationalize it. Previous speakers on this side of the House have made many of the points that I proposed to make on this bill, and I shall not indulge in tedious repetition, as some Government supporters have done. 1 oppose the bill.

Mr DEDMAN:
Minister for Defence, Minister for Post-war Reconstruction and Minister in charge of the Council for Scientific and Industrial Research · Corio · ALP

in reply - This is a bill to provide pharmaceutical benefits for the people of Australia. It does not relate to medical benefits, but doctors and the medical profession generally do come into both those matters. Honorable members opposite have stated that the proposals in this legislation represent the first step in the conscription of doctors. All I have to say, in reply, is that, as it is a bill to provide free pharmaceutical benefis for the people of this country and is, in itself, a good measure, it is a completely irrelevant argument to say that it is the first step in medical conscription. If the bill, in itself, is good, it should be accepted as such. This is not the first bill relating to pharmaceutical benefits that has been considered by the Parliament. Indeed, the Parliament passed a pharmaceutical benefits bill in 1944, and that legislation was amended in 1945. Another pharmaceutical benefits bill was introduced in 1947. All that the present bill does is to compel the medical’ profession so to act as to provide the free pharmaceutical benefits that the previous acts have provided for the people of Australia. They are being denied pharma ceutical benefits because the doctors will not co-operate with the Government in giving to them those benefits to which legislation already on the statute-book entitles them. The bill is designed to overcome the opposition, not perhaps of all members of the medical profession, but of a majority of them. A majority of doctors, but not all of them, have always been backward in co-operating with governments anywhere in the world to give to the people of various countries those medical and pharmaceutical benefits that they have needed. That history extends over a long period. One of my earliest political recollections is of the measures taken by Mr. Lloyd George in the United Kingdom in 1911. Those measures included pharmaceutical benefits. The medical profession of the United Kingdom “ ganged up “ against Mr. Lloyd George and refused to cooperate with the government of the day. Th order to refresh my memory of these matters, I have been reading some of the English newspapers of that time. I shall not quote at great length from any of the daily newspapers. Had I sufficient time, I should have liked to quote extracts from some of them. However, I shall confine my remarks to a statement by Sir James Barr, president-elect of the British Medical Association, as reported in the British Medical Journal of December, 1911. He said -

The provision of medical and surgical attendance, drugs and appliances is utterly inadequate for an efficient service and is calculated to undermine rather than improve the health of the nation. This act will perpetuate all the worst features of club practice without having any redeeming feature of its own.

If this Act be allowed to remain on the statute-book it will set back the hands of the medical clock for at least a quarter century. 1 quite agree with the Standard that it is nothing short of a national calamity that such a man (Lloyd George) should hold any office in any government.

That legislation, of course, was placed upon the statute-book in the United Kingdom, and it has remained there ever since. No government, either Liberal or Conservative, has ever attempted to remove it from the statute-book ; and every individual to-day recognizes that the passage of that legislation was a progressive step. But, in that instance, the medical profession displayed the same outlook as it has always dieplayed towards any progressive cause, and it is revealing the same outlook in Australia to-day. That legislation in the United Kingdom to which I have referred was passed, not by a Labour government, but by a Liberal government. It is true, of course, that the government of the day, which was led by David Lloyd George, was truly a liberal government. It was not a reactionary conservative government masquerading under the name of Liberalism. Just as that was the situation in the United Kingdom, so we find a similar position in the United States of America where President Truman with his progressive outlook has outlined certain measures which he desires to take, including the granting of pharmaceutical benefits. I propose to quote extracts from statements made on behalf of the Committee for National Health in the United States of America. That committee consists of a number of prominent individuals among whose names appears that of Eleanor Roosevelt; and, in passing, I say that I prefer to accept the opinion of Eleanor Roosevelt, who is a world-wide authority on welfare matters, rather than that expressed by the honorable member for Darwin (Dame Enid Lyons). The statement issued by the Committee for National Health in the United States of America with respect to the American Medical Association’s twelve-point health programme reads -

The committee asserted that it was “ designed to obscure the American Medical Association’s stubborn opposition to any programme which would bring medical care within the means of the average man “. “ The American Medical Association’s only proposal for meeting that national problem is the same as before - voluntary health insurance,” the committee statement said. “ It has not moved an inch on this basic issue, despite all the window dressing.” . . . “ The American Medical Association’s own statistics,” Dr. Frothingham said, “ show that SO per cent, of the population - all those with incomes under 5,000 dollars - are not able to meet the expenses of serious illness out of their own resources. . . .”

The American Medical Association has fought national health insurance, the cost of which would be borne by the beneficiaries and their employers, as too expensive,” he declared. “ It has ma.de no estimate of the cost of its own point nine, or its proposal to subsidize

American Medical Association-controlled voluntary insurance plans. We challenge theAmerican Medical Association to make such, estimates. They might disclose that organized medicine is more concerned over who controls the finances of medical care than how much, it costs the people.”

Those statements relating to events in the United Kingdom and the United. States of America show clearly that the British Medical Association and its counterpart in the United States of America, the American Medical Association, and, I presume, the majority of the members of the medical profession, though not all of them, are always against any progressive move designed to give to the people in any country the benefits that modern medicine has made available.

I pass now to certain statements made by the Leader of the Opposition (Mr. Menzies). I shall deal first with his claim that the Government has no mandate for this legislation. That claim was answered effectively by the honorable member for Fremantle (Mr. Beazley). His remarks are worth repeating, but in the limited time at my disposal I shall merely add a few observations of my own. The Leader of the Opposition said that any claim that the Government has a mandate for this legislation is completely false; and he went on to say that all that the Government had achieved through carrying this issue at the referendum was that it had obtained power to pass legislation with respect to matters of this kind. That is a very specious argument, because a government cannot ask the people to give it power to enact certain legislation, and, at the same time, separate that power from the purposes which the people desired to achieve in agreeing to its request. It is plain that the people had clearly in their minds what the Government could do if they gave it power to pass legislation of this kind, because the Government had already passed an act in relation to pharmaceutical benefits in 1944 which provided free pharmaceutical benefits, whilst at the general election in 1946 which was held simultaneously with the referendum the Prime Minister in his policy speech made it perfectly clear that the Government, intended to aro full steam ahead with its proposals to provide free pharmaceutical benefits if the people gave it power to pass legislation for that purpose. From time to time with respect to other legislation, honorable members opposite have claimed that the Government has had no mandate. They said that the Government had no mandate to pass the banking legislation and the shipping legislation. I have said frequently in this House that I do not accept that argument but, as I pointed out when speaking on the Shipping Bill, the’ government of the day did not have a mandate to sell the Australian Commonwealth Line of Steamers but that fact did not prevent it from doing so. The Government has a mandate for this legislation. In fact, if ever a government has had a mandate to do anything this Government certainly has a mandate to pass legislation to provide free pharmaceutical benefits.

The next matter which the Leader of the Opposition mentioned was in relation to a quotation which he made from the minutes of the proceedings of a meeting which was attended by the Minister for Health (Senator McKenna). Honorable members opposite including the right honorable gentleman himself have continually charged me, if not other members of the Government, with distortion and misrepresentation ; but I shall prove that his statement in this instance constitutes the grossest distortion and the gravest misrepresentation that has ever been perpetrated in this House. I shall do so by quoting passages from the minutes of the proceedings of the meeting to which he referred. The statement which he quoted was torn from its context, and he made no explanation whatever of the circumstances in which that statement was made. It was made at a conference between the Minister for Health and members of the Federal Council of the British Medical Association held on the 21st July, 1947. I shall deal first with the circumstances in which that conference took place. It was, I believe, the first conference to be held between the Minister and the representatives of the British Medical Association on the particular subject-matter. In making the statement which the Leader of the Opposition quoted, the Minister was simply explaining the situation as it existed at that time. The conference was held before the Minister had even discussed the Government’s proposals with the Cabinet, and the Minister made that perfectly clear in his concluding remarks which were duly noted on the last page of the minutes. The following transcript appears on page 108 of the minutes of the proceedings :–

The MINISTER: Yes, I would say it was the only course because I have not formulated specific proposals from the Government. I have asked for your advice which you have been good enough to give, but I have not asked you to consider firm Government proposals. I shall be in a much better position to formulate proposals now. You have probably glimpsed where my mind is tending on various matters. I think it might be desirable at a later stage if I met you perhaps on a firmer basis when the matter has had consideration by Cabinet.

I shall quote further extracts from earlier stages of the proceedings that will show clearly that the Minister was not suggesting specifically that the Government intended to nationalize the medical service of this country, but was, in fact, advancing an argument that a medical service, with salaried medical officers could, and would, work side by side with private practice. In fact, the burden of the Minister’s argument was that in the long run a salaried medical service would prove so much more efficient than a medical service operated by private practitioners, that eventually private practitioners would be forced out - not by any compulsion on the part of the Government, but by the fact that a more efficient service would be available to the public under the government scheme. The quotations that I am about to give will show that the Minister made that perfectly clear. On page 4 of the minutes of the proceedings appears this statement by the Minister -

With regard to the national medical scheme, apart from what I have already said no decisions have been made by my Government. I have made no recommendations to the Federal Cabinet at all, and apart from that announcement by the Prime Minister, which is unquestionably Government policy, there have been no decisions.

The pronouncement by the Prime Minister conveys three main points-1- the fact that there is bo be a Government-sponsored national scheme; that it is proposed that it should be complete; and that it is proposed that it should be free. And, in fact, before formulating any plans at all I am taking the precaution - I consider it to be a wise one- of consulting the people who know about things medical; and that is your profession and your Council as representing that profession.

The Minister said later in the proceedings -

With regard to the Government’s intentions, my thoughts are, on the conclusion of discussions with your body, with other bodies in the field who are interested, dentists and others, to formulate plans that I shall in due course submit to the Federal Cabinet. At this early stage it is realized that no very detailed plans will be formulated. They will be matters of broad principle.

Later there is a report of some remarks made by Dr. Colville. The report states -

Dr. COLVILLE: Could I be a little more specific? You mentioned in your earlier remarks that you envisaged that this new national service would run side by side with private practice, and I want to make it clear now that I am speaking about the general, ordinary medical practice of the community. You indicated that while that would be the condition at the start of this service, as it developed, you thought and hoped that there would be a gradual swing-over from private practice to the Government medical scheme.

We, I am sure, will agree with the statement that that is likely to occur, because, although there is no question of compulsion or conscription of the medical profession in your proposals, there will he an element of economic compulsion whereby eventually, I should say, the free service must win the day. I would like to be clear that both parties to this conference are in agreement that the ultimate result of the application of your plans would be the complete elimination of private practice. May I assume that?

The MINISTER: You may take it that the Government believes that a national medical scheme, in which doctors in some form or other are in its service - in the service of the scheme - is desirable. Having decided that it is desirable, the Government would welcome the position that all medical practitioners were to come into it to-morrow. That being the position, what you put to me is unquestionably accurate - that the Government’s belief is that the interests of the people of Australia will be best served by such a service. Accordingly, the speed with which that particular service develops is a question of the medical practitioners themselves deciding upon their degree of co-operation. I think you have put the position accurately, doctor.

Later, the Minister said -

The MINISTER: I intimated to Sir Henry at the opening, when he asked that question, that I thought there always would be a residue of persons who would demand a completely private ‘ practice and there would always probably be a residue of doctors who would insist upon functioning in that way. I think that is going to be true no matter how far ahead the Government goes. Inevitably there will be a residue of people amongst your profession and amongst the public who will have nothing to do with a national medical scheme.

At a later stage in the proceedings theMinister said -

Whilst I am quite frank in telling you that: my belief is that the national scheme is best for the people and is the ultimate objective of the Government, I qualify that by the statement I made to Sir Henry in the beginning’ and by my belief that there can be no meteoric approach to the position.

I consider that those extracts prove quiteclearly that in tearing away a particular statement entirely from its context andin failing to make clear what were thecircumstances in which the Minister made the statement, the Leader of the Opposition has been guilty of the most gross misrepresentation, amounting almost to perversion of the truth in his failure to put the whole case.

Mr Menzies:

– Not one of statementsthat the Minister has quoted qualifies the passage that I have quoted.

Mr DEDMAN:

– Every one of them, does.

Mr Menzies:

– I hope that everybodywill read the statement. I know the viewthat they will form if they do.

Mr DEDMAN:

– The honorable member for Darwin (Dame Enid Lyons) let the cat out of the bag entirely. I wrote down seven words that the honorable member uttered, and I quote them now.. She said, “I contest the need for this bill “. Honorable members on both side? of the House will, I hope, recollect thosewords that she uttered. They mean that the honorable member for Darwin contests the need for the whole free medicine scheme.

Mr McBride:

– Nothing of the kind.

Mr DEDMAN:

– She went on to makeit perfectly clear that that was what was in her mind, because she said later that it would be very much better for the money required to operate this schemeto be used to provide free milk. I point out to honorable members that the responsibility to provide free milk for the community is one entirely for State governments. I, and other members on the Government side are in f avour of such a proposal. The producers of whole milk in this country have never received a’ better price for their product than they have received since this Government has been in office. The honorable member for Darwin and the Opposition will not easily extricate themselves from- the- position that they are in. The honorable member made it clear that she contested the need for this bill, and the claim that the people of this country wanted free medicine. I took down some more of her words. She said, “ There is no demand for it “. According to her there is no need for free medicine, and the money being spent on this particular measure would be far better spent on the provision of free milk for children in the community. The provision of such a service has nothing to do with this Government, but is a responsibility of State governments. I point out also that the honorable member for Darwin said that this Government was at fault because of its withdrawal of the subsidy on whole milk. That, also, is a matter for State governments. The Tasmanian Government would probably introduce a scheme to provide free milk for children, and would probably subsidize the price of milk at the present time, if it were not for the fact that Tasmania has a reactionary Legislative Council that would not pass- such a measure if it were passed by the Lower House in that State.

Mr Archie Cameron:

– Tasmania has a Labour Government.

Mr DEDMAN:

– That is true, but it is not in complete power. It is in office only. I emphasize that the honorable member for Darwin said that she thought that the people did not need free medicine and did not want free medicine. She quoted something that had been said by Dr. Turnbull, a member of the Labour party in Tasmania. I do not know Dr. Turnbull and I do not know what he said, but it seems to me that he is following the very bad example set by some persons who once were members of the Labour party in Tasmania but deserted the cause of those who first raised them up into public life. The honorable member also spoke about what she termed “the traditional liberty and the age-old practice of the medical profession “. What she was talking about was licence, not liberty - licence on the part of the medical profession to prevent people from obtaining the free pharmaceutical benefits that the Parliament has decided to give them. The honorable member even introduced the deity into her arguments. She said, “This Government is going to take away the God-given right of the medical profession to act as they think fit “. One can draw a comparison in this matter. It is not many years since only the wealthy people in Australia and other countries could get free education. It could have been said then that it was a “ God-given right “ of governments to conduct the affairs of their countries so that people would he denied education. But eventually the day came when the governments said on behalf of the people, “All people must be educated “. People are compelled to be educated to-day, as doctors have to be compelled to fall into line with the desires of the people of this country who want the .free medical benefits that they are entitled to have.

The honorable member for Darwin used some expression relating to aspirin. Evidently she believes - and I think that there is some force in her argument in this connexion - that the people of Australia already take too much medicine, much of it “ quack “ medicine that is advertised in the newspapers. 1 remind the House that during the period of the war when we needed man-power for urgent war purposes and an attempt was made to limit the advertising of all those “ quack “ medicines that the honorable member spoke about, implying that they were ruining the health of the people, the Opposition parties ganged up against the Government and prevented it from eliminating that type of advertising from the newspapers. If I had sufficient time at my disposal, I could present a very good case for a medical service of salaried medical officers. That would not be germane to this bill, and I have mentioned the subject only because, in the United Kingdom and the United States of America, free medical benefits are combined with free pharmaceutical benefits. The purpose of the bill is quite plain. With the approval of the people, which it obtained at the 1946 referendum, the Government enacted legislation designed to provide free pharmaceutical benefits for the people. But they have been prevented from obtaining those benefits by the obstructive tactics of the British Medical Association and the great majority of the members of the medical profession. The controlling bodies of the medical profession in Australia, the United Kingdom and the United States of America apparently hold the belief that they can determine the policies of their respective governments. In 1911 a situation arose in the United Kingdom whichcaused that great and genuine Liberal, David Lloyd George, who was not a pseudo-liberal such as we have to-day, to say to the medical profession, “ The Government intends that its national insurance scheme shall be carried out, including the provision for free pharmaceutical benefits. If the doctors are not prepared to carry it out, we shall force them to carry it out “. That great Liberal - not a member of the Labour party - determined that the medical profession of the United Kingdom would not be allowed to decide the policy of the Government to which he belonged. This Government is also determined that the medical profession shall not control its policy. It intends that the people shall have free pharmaceutical benefits, and thisbill is designed simply to ensure that the profession will not obstruct its plans.

Question put -

That the bill be now read a second time.

The House divided. (Mr. Deputy . Speaker - Mr. J. J. Clark.)

AYES: 31

NOES: 15

Majority 16

AYES

NOES

Question so resolved in the affirmative.

Bill read a second time.

In committee:

The bill.

Mr MENZIES:
Leader of the Opposition · Kooyong

– Clause 3 contains an amendment to section 4 of the principal act in these terms: -

If the Minister so determines, the Minister of State of a State administering the laws of that State relating to public hospitals shall, for the purposes of this Act, be deemed to be the governing body of the public hospitals in that State.

I should be obliged if the Minister could throw a little light on that proposed new sub-section. I am at a loss to understand the purpose of the provision.

Mr DEDMAN:
Minister for Defence, Minister for Post-war Reconstruction and Minister in charge of the Council for Scientific and Industrial Research · Corio · ALP

– The proposed amendment is consequential upon clause 9, which amends section 13 of the principal act.

Mr Menzies:

– That makes it all quite clear.

Bill agreed to.

Bill reported without amendment; report adopted.

Bill - by leave - read a third time.

page 1720

BILLS RETURNED FROM THE SENATE

The following bills were returned from the Senate without amendment: -

Commonwealth Electoral Bill 1949.

Northern Territory Representation Bill 1949.

Australian Capital Territory Representation Bill 1949.

Science and Industry Research Bill 1949.

page 1721

SPECIAL ADJOURNMENT

Mr CHIFLEY:
Prime Minister and Treasurer · Macquarie · ALP

. -I move -

That the House, at its rising, adjourn to a date and hour to be fixed by Mr. Speaker, which time of meeting shall he notified by Mr. Speaker to each member by telegram or letter.

For the guidance of honorable members I can say that the probable date of the next meeting of the Parliament will be the 18th May.

Question resolved in the affirmative.

page 1721

LEAVE OF ABSENCE TO ALL MEMBERS

Motion (by Mr. Chifley) agreed to -

That leave of absence be given to every member of the House of Representatives from the determination of this sitting of the House to the date of its next sitting.

page 1721

PAPERS

The following papers were presented : -

Arbitration (Public Service) Act - Determinations by the Arbitrator, &c. - 1949 -

No. 22 - Commonwealth Public Service Clerical Association.

No. 23 - Australasian Society of Engineers.

No. 24 - Commonwealth Storemen and Packers’ Union.

Commonwealth Disposals Commission - Fourth Annual Report, for year ended 31st August, 1948.

Commonwealth Public Service Act - Appointment - Department of the Interior - R. J. Pauley.

Lands Acquisition Act - Land acquired for - Defence purposes -

Albury, New South Wales, and Bonegilla, Victoria.

Fort Largs, South Australia.

Postal purposes -

Coominya, Queensland.

Hamley Bridge, South Australia.

Walang, New South Wales.

Waterloo, South Australia.

Wollert, Victoria.

United Nations Food and Agriculture Organization - Fourth Session, held at Washington, D.C., November, 1948 - Report of Australian Delegation.

House adjourned at 11.35 p.m. to a date and hour to be fixed by Mr. Speaker.

page 1721

ANSWERS TO QUESTIONS

The following answers to questions were circulated: -

Canberra : Cafeteria Services ; Hostels

Mr Adermann:

n asked the Prime Minister, upon notice -

  1. Is it a fact that a sub-committee of Cabinet has approved the establishment of cafeteria services in Canberra for Commonwealth public ser vents?
  2. If so, can he furnish any information regarding the location of these services?
  3. Is it proposed that the services shall be government-controlled or will the public be invited to tender?
  4. When is it expected that the services will come into operation?
Mr Chifley:
ALP

– The answers to the honorable member’s questions are as follows : -

  1. Yes.
  2. The aim is to have cafeterias to service East and West Blocks, Barton offices, Interior and the old hospital areas and the Kingston industrial area. There is at present a small cafeteria in the Department of External Affairs, West Block.
  3. It is proposed that the cafeterias should be controlled by the Department of Labour and National Service, which controls other Commonwealth cafeterias.
  4. The first cafeteria is expected to open this year.
Mr Fadden:
DARLING DOWNS, QUEENSLAND

n asked the Minister for Works and Housing, upon notice -

  1. What are the works in the Australian Capital Territory which have been charged with the £34,744 loss on workmen’s hostels conducted by the Department of Works and Sousing?
  2. What was the amount of loss so charged to each respective work?
  3. Was this loss absorbed as part of the capital cost of the work?
  4. Did such loss increase the capital cost of each work accordingly?
  5. Is this regarded as a correct accounting procedure ?
  6. Were any of the works in question investigated by the Public Works Committee?
  7. If so, was such procedure disclosed to that committee?
  8. Is it proposed to continue such practice in the future?
Mr Lemmon:
ALP

– The answers to the right honorable member’s questions are as follows: -

  1. The losses are distributed over all works, including architectural and engineering projects, both of a capital and maintenance nature.
  2. The charge is made as on cost, added progressively to wages paid and separate totals of the amounts charged to each project are not maintained.
  3. Yes.
  4. Yes.
  5. Yes.
  6. Yes. The Administrative Building and Lawley House.
  7. No; the procedure was not in operation when the Public Works Committee examined these projects.
  8. Yes.

The Parliament: Sittings in Canberra.

Mr Deputy Speaker (Mr Clark:

rk). - Earlier to-day the honorable member for Boothby (Mr. Sheehy) asked me the following questions: -

  1. On how many days in each completed year has the House of Representatives sat since the transfer of the Seat of Government from Melbourne to Canberra?
  2. What was the total number on which the House met during the lifetime of each administration in the same period?

The answers to the honorable member’s questions are as follows : -

  1. The number of sittings of the House of Representatives since the transfer of the Seat of Government to Canberra, in 1927, are as under - 1927, 43 sittings (from 9th May); 1928, 62 sittings; 1929, 54 sittings; 1930,98 sittings; 1931, 94 sittings; 1932, 73 sittings: 1933, 67 sittings; 1934, 35 sittings; 1935, 55 sittings; 1936, 71 sittings; 1937, 35 sittings; 1938, 66 sittings; 1939, 51 sittings; 1940, 43 sittings; 1941, 50 sittings; 1942, 45 sittings: 1943, 48 sittings; 1944, 57 sittings; 1945, 90 sittings; 1946, 65 sittings; 1947, 92 sittings: 1948, 90 sittings.
  2. The number of sittings during the various administrations during the same period was as follows: -

Bruce-Page Ministry - From date of transfer to Canberra (9th May, 1927) to 22nd October, 1929, 145 sittings.

Scullin Ministry - From 22nd October, 1929, to 6th January, 1932, 206 sittings.

Lyons Ministry - From 6th January, 1932, to 7th November, 1938, 386 sittings.

Lyons Ministry - From 7th November. 1938, to 7th April, 1939, sixteen sittings.

Page Ministry - From 7th April, 1939, to 26th April, 1939, two sittings.

Menzies Ministry - From 26th April, 1939, to 14th March, 1940, 49 sittings.

Menzies Ministry - From 14th March. 1940, to 29th August, 1941, 70 sittings.

Fadden Ministry - From 29 th August. 1941, to 7th October, 1941, seven sittings.

Curtin Ministry - From 7th October, 1941, to 21st September, 1943, 98 sittings.

Curtin Ministry - From 21st September. 1943, to 6th July, 1945, 127 sittings.

Forde Ministry - From 6th July, 1945, to 13th July, 1945, no sitting.

Chifley Ministry- From 13th July, 1945, to 1st November, 1946, 79 sittings.

Chifley Ministry - From 1st November. 1946, to end of 1948, 199 sittings.

Communism

Mr Rankin:
BENDIGO, VICTORIA

n asked the Minister for Post-war Reconstruction, upon notice -

  1. Is it a fact that in Launceston in February he stated that assertions that the Government had not done much to combat the menace of communism had no foundation?
  2. On how many occasions has the Government taken action against Communists under the Crimes Act?
  3. What were the names of the persons against whom action was taken, and what penalty was imposed?
  4. Have any prosecutions been launched against Communists and subsequently withdrawn. If so, what were the circumstances?
Mr Dedman:
ALP

– The answers to the honorable member’s questions are as follows : -

  1. Yes, in Launceston I pointed out that the best way to combat communism is to give the workers a better standard of living and greater freedom than they would get under communism, and that that is precisely what the Labour Government has achieved with its full employment and social security policies. 2, 3 and 4. Since this Government took office hundreds of prosecutions have been instituted against persons for offences against the Crimes Act. These offences cover a wide range and include such offences as forgery, offences relating to coinage and the like. When consideration is being given to the institution of proceedings under any act all that is considered is whether there is sufficient evidence to establish a prima facie case against the accused person. His political views are not as a rule relevant to the question of hia guilt. It is accordingly not possible to furnish the detailed information asked for regarding the prosecution of Communists.

FLOUR Tax.

Mr Howse:
CALARE, NEW SOUTH WALES

e asked the Treasurer, upon notice -

What amounts have been paid annually in flour tax since its inception?

Mr Chifley:
ALP

– The amounts of flour tax paid annually since its inception are -

There have been three flour taxes and they operated in respect of the following periods: - 4th December, 1933, to 31st May, 1934; 7th January, 1935, to 24th February, 1936; 5th December, 1938, to 22nd December, 1947, when the rate of tax became nil.

Hearing Aids.

Mr Pollard:
ALP

d. - On the 4th March, the honorable member for Bourke (Mrs. Blackburn) asked a question concerning hearing aids. The Minister for Trade and Customs now desires me to inform the honorable member that no evidence is available as to the relative costs of production of hearing aids in the United Kingdom and America. The question of selling prices is one over which the Commonwealth Government has no control.

Cement.

Mr Pollard:
ALP

d. - On the 24th February, the honorable member for Herbert (Mr. Edmonds) asked whether consideration would be given to the waiving of customs duty on cement which is to be imported from the United Kingdom by the people of Queensland. The Minister for Trade and Customs desires me to inform the honorable member in reply that Portland cement imported from the United Kingdom and qualifying for tariff preference is admissible free of customs duty but is subject to 5 per .cent, primage duty. The request that the cement be admitted free of primage duty has been considered, but it has been decided that the shipments in question cannot be exempted from payment at the rate in force at the date of entry for home eonsumption. The Minister added, however, that the incidence of primage duty generally, which is a revenue duty, is given consideration from time to time with the view of affording whatever relief therefrom is found possible.

Public Service.

Mr Chifley:
ALP

y. - On the 10th March, the honorable member for Bourke (Mrs. Blackburn) asked a question on the subject of salaries of female members of the clerical and professional grades of the Commonwealth Public Service. Further to my interim reply to the honorable member’s question, I wish to state that the remuneration in the Commonwealth Service consists of two parts - a basic wage and a margin for skill. The Service basic wage is fixed by the Commonwealth Public Service Arbitrator, having regard to the basic wage fixed by the Commonwealth Court of Conciliation and Arbitration. Owing to the different assessment of need for males and females, it is £62 per annum less for adult females than for adult males. Subsequent cost of living adjustments make the present differences £93 per annum. The same margins of skill, however, are paid to males mid females.

CommonwealthDisposals Commission : Irregularities.

Mr Fadden:

asked the Minister representing the Minister for Supply and Development, upon notice -

  1. What are the particulars of unsatisfactory features in accounting and the irregularities in the disposal by the Commonwealth Disposals Commission of residual surplus property purchased from the United States armed forces in Australia, mentioned in paragraph 159 of the Auditor-General’s latest report?
  2. Where was this property situated?
  3. On whose authority was the Commonwealth Disposals Commission allowed to appoint an independent commitee to investigate irregularities of its own officers?
  4. What was the nature of their irregularity or irregularities proved against each officer concerned ?
  5. What was the name of the officer and the exact nature of the disciplinary action taken?
  6. What are the other unsatisfactory features of the transactions referred by the Auditor-General to the Disposals Commission for further explanation or comment, and what was the nature of the commission’s reply?
  7. What further action is to he taken, or has been taken, in respect of such unsatisfactory features of these transactions?
Mr Dedman:
ALP

n. - The answers to the right honorable gentleman’s questions are as follows: - 1. (a) With regard to that portion of the question which deals with unsatisfactory features in accounting, the purchase of these United States Army Air Corps stocks was made by the Department of the Treasury on the basis of “ as is where is “ and the United States stock lists prepared some months earlier were used as the basis for a stores accounting record of the stocks taken over. Because of the very favourable nature of the contract the Commonwealth was amply covered with regard to any possible discrepancies. Actually the position to date revealed surpluses amounting to £404,983 as against deficiencies amounting to £387,641. These figures represent the values according to United States Army Air Corps list or catalogue price and have no relationship to the sale value in Australia. It was recognized by the Department of the Treasury and Commonwealth Audit that the commission would be responsible under normal treasury regulations for the quantities ascertained as a result of physical stocktake. The Audit contention is that until inventories were taken adequate accounting control over the stocks did not exist. As physical stocktaking would have occupied many months and as much of the technical equipment was in urgent demand by govern ment and operating aircraft companies it was decided, with the agreement of Treasury, that disposals could proceed without a physical stocktaking. A further accounting query raised by Audit related to the disposal in one or two cases of the residues of a particular class of aircraft spares which were delivered to a purchaser on an “ as is where is “ basis. The purchasers in each case had submitted without recourse to a physical count of stock, the highest tender for the residues as listed in the United States stock sheets and the labour costs in physically counting the stores would probably have amounted to a higher figure than the amount tendered. In these circumstances disposal was effected without count and this action was endorsed by the Disposals Commission in session.

  1. The irregularities which in the main were in the nature of departures from approved disposals procedure were covered in the reports of the Auditor-General, the Independent Committee and the Commonwealth Disposals Commission’s agendum and minute which were laid on the table of the Parliamentary Library in June, 1948.

    1. Bulk of stocks were located at the United States Army Air Corps depots at Eagle Farm, Brisbane, and Garbutt, Townsville. Relatively small quantities had been loaned to private firms by the United States forces for the purpose of servicing United States aircraft and other small quantities were located in various parts of the Commonwealth.
    2. The independent Committee was appointed by the Commonwealth Disposals Commission in consultation with Treasury. The honorable member has already been advised as to the composition of the committee, none of whom were associated in any way with the commission’s activities. 4 and 5. The answers to these questions are fully covered in the documents referred to above which were tabled in the Parliamentary Library. 6 and 7. The Auditor-General’s report makes reference to other features, but not necessarily unsatisfactory features as mentioned in the honorable member’s questions, and those matters on which the Auditor-General requested further comment have been fully dealt with by the Disposals Commission in its reply.

Cite as: Australia, House of Representatives, Debates, 17 March 1949, viewed 22 October 2017, <http://historichansard.net/hofreps/1949/19490317_reps_18_201/>.