House of Representatives
24 November 1953

20^th Parliament · 2^nd Session

GWYDIR. ELECT ORAL DIVISION
QUESTION
- SCRAP METAL
QUESTION
- EMPLOYMENT
QUESTION
- SOCIAL SERVICES
QUESTION
- LONG-RANGE WEAPONS ESTABLISHMENT
QUESTION
- HOUSING
QUESTION
- TELEPHONE SERVICES
QUESTION
- IMMIGRATION
QUESTION
- SUGAR
QUESTION
- GOVERNMENT LOANS AND FINANCE
QUESTION
- COMPULSORY UNIONISM
QUESTION
- URANIUM
QUESTION
- IMPORTS
QUESTION
- ROYAL VISIT TO AUSTRALIA
QUESTION
- PUBLIC SERVICE
QUESTION
- OIL AND PETROL
QUESTION
- TAXATION
QUESTION
- COLOMBO PLAN
QUESTION
- MR. R. G. MENZIES, M.P
QUESTION
- CEREBRAL PALSY
QUESTION
- TRADE UNIONS
QUESTION
- INDONESIA
QUESTION
- SNOWY MOUNTAINS SCHEME
QUESTION
- CIVIL AVIATION
QUESTION
- NORTHERN TERRITORY
QUESTION
- MICA
LIFE INSURANCE BILL 1953
TARIFF PROPOSALS 1953
- Customs Tariff Amendment (No. 1) ; Excise Tariff Amendment (No. 1) ; Customs Tariff (New Zealand Preference) Amendment (No. 1)
- In Committee of Ways and Means:
TARIFF BOARD
- Elastics
- Files
NATIONAL HEALTH BILL 1953
PAPERS
ANSWERS TO QUESTIONS
- Rubber
- Department of Works

Mb. SPEAK= (Hon. Archie Cameron) took the. chair at 2.30 p.m., and read prayers.

page 402

GWYDIR. ELECT ORAL DIVISION

ISSUE of WRIT

Mr SPEAKER:

– I have to inform the House that I have, this day, issued the writ in connexion with the by-election for Gwydir electoral division, and that the dates fixed were those announced to the House 011 the 18th November.

page 402

QUESTION

SCRAP METAL

Dr EVATT:
BARTON, NEW SOUTH WALES

– In the absence of the Prime Minister I direct a question to the Treasurer which relates to a matter of general concern. I refer to the extent of the export from Australia to Japan of scrap iron and COPper. Will the Treasurer endeavour to obtain for the House a statement of the extent of the export of these materials, which has now been brought under control by quotas, and the estimated change, in the quantity exported as the result of the imposition of quotas? The adverse effects of these exports on Australian industries have recently been referred tq by the Associated Chambers of Manufactures of Australia. Will the right honorable gentleman also state, as far as he is able to do so, whether these materials are being used in Japan for ship-building purposes, and if so whether for the construction of merchant ships or naval vessels?

Sir ARTHUR FADDEN:
Treasurer · MCPHERSON, QUEENSLAND · CP

– I shall take into account the observations made by the right honorable gentleman with a view to presenting him with the information that he desires.

page 402

QUESTION

EMPLOYMENT

Mr WHEELER:
MITCHELL, NEW SOUTH WALES

– Has the Minister for Labour and National Service been informed that the Sydney Metropolitan Water Sewerage and Drainage Board has fallen behind its work schedule because it cannot find enough labour? Is the Minister aware that the board is advertising for workers and that, due to, the labour shortage, it has been unable to spend approximately £500,000 of its annual works estimates? Does not this fact reflect a healthy trend in the unemployment situation ?

Mr HOLT:
Minister for Immigration · HIGGINS, VICTORIA · LP

– I know that the Sydney Metropolitan Water Sewerage and Drainage Board has been experiencing some difficulty in securing all the labour it requires. Officers from that body have, been working in conjunction with those of the Commonwealth Employment Service and the board has been advertising extensively in order to obtain the required labour, I know that their requirements have not yet been fully met; and that fact indicates the tightenof the labour situation that’ is developing throughout Australia. I am unable to say whether the board is behind schedule for this year. I have no information on that point. But it is interesting to note that, according to the latest figures, only 12,600 persons are at present drawing unemployment benefits. That is the lowest figure for this year, whilst, at the same time, 37,600 work vacancies exist, that is, an average of three vacancies to each person drawing unemployment benefit. That is a considerable improvement upon the position that existed earlier this year.

Mr BRUCE:
LEICHHARDT, QUEENSLAND

– Is the Minister for Labour and National Service aware that within the next month it is expected that four meat works in Queensland will close down, involving the dismissal of a large number of workers, and that every sugar mill in Queensland will be closed before the end of this year? Has he taken this into consideration?

Mr HOLT:

– As Queensland members are aware, a seasonal movement of labour from north Queensland occurs every year. At the height of the sugar and meat seasons in that State, employment reaches its peak, and, as the honorable member for Leichhardt has pointed out, it tapers off towards the end of the season. It has been traditional for casual workers to go to North Queensland during the meat and sugar seasons, and return to the south as the seasonal demand for labour in the southern States, approaches its peak. If the honorable member has in mind specific instances of men who have been employed on casual work in the north being now unable to obtain employment, I should be glad if he will inform me of the facts. I shall be pleased to see that those men are placed in suitable employment. I assure him that we are going to be sorely pressed to provide all of the seasonal labour required in Victoria; South Australia, and some parts of New South Wales.

page 403

QUESTION

SOCIAL SERVICES

Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP

– Does the Minister for Social Services recognize the importance of making a statement to the Parliament with respect to the agreement with the United Kingdom for reciprocity in the provision of social services ? If so, will he find a way of making such a statement and refuse to be easily discouraged from doing so? Will he arrange for copies of the agreement to be made available to honorable members? Also, will an opportunity be provided to the House to discuss this important agreement?

Mr TOWNLEY:
Minister for Social Services · DENISON, TASMANIA · LP

-! remind the honorable member that some months ago I attempted to make a statement on the subject that he has raised, but I was refused leave to do so. It was one of those occasions when there was a little unneighbourliness on both sides, and I happened to be No. 3 in the argument and was refused leave by the Opposition as a result. Incidentally, I believe that the honorable member for East Sydney figured in that incident. It will be somewhat difficult to arrange for an opportunity to be given to the House to debate that statement at this Tate stage in the session. I shall be pleased to discuss that matter with the VicePresident of the Executive Council. I shall also see what can be done to make copies of the agreement available to honorable members.

Mr STEWART:
LANG, NEW SOUTH WALES

– My question is directed to the Minister for Social Services. As the payment of pensions will fall due on Christmas Eve, will the Minister make arrangements for that pension day to be brought forward to Tuesday, the 22nd December, in order to give pensioners an opportunity to purchase their Christmas supplies?

Mr TOWNLEY:

– The payment of pensions is not just a matter for the Department of Social Services. The

Postal Department is directly concerned because it handles the mail. However, the Department of Social Services is discussing the matter with the Postal Department with the intention of making arrangements for the early payment of pensions before Christmas.

Mr PETERS:
BURKE, VICTORIA

– When the previous Labour Government was in office in 1949 it provided 10s. a week in respect of every child in an institution. As the Menzies Government £1 has depreciated in value until it is worth only half as much as the 1949 £1, will the Treasurer consider doubling the amount so paid, in order that the children concerned will not suffer as a result of the niggardly policy of this Government?

Sir ARTHUR FADDEN:
CP

– The question asked by the honorable member touches upon a matter of policy.

page 403

QUESTION

LONG-RANGE WEAPONS ESTABLISHMENT

Mr BERRY:
GRIFFITH, QUEENSLAND

– I ask the Minister for Supply whether certain valuable equipment which was on the secret list Kas been stolen at the Long-Range Weapons Establishment at Woomera ? If so, has he any information to give to the House on this matter?

Mr BEALE:
Minister for Supply · PARRAMATTA, NEW SOUTH WALES · LP

– Last week, my attention was directed to an incident which occurred, not a Woomera but at Emu Field, where the recent atomic tests took’ place. What happened was that when the British scientists and other officials left that area, they left a certain amount of equipment for which they had Hu further use. This was not known by the Australian officials when they took over that equipment. It is alleged that tinEnglish officials had told the troops that they could have some of the items of the equipment. It is further alleged that the troops, acting on that intimation, sell out large parcels. Our suspicions were aroused because of the size of the parcels and the frequency with which they were put through the ,post office at Woomera. Inquiries were made and it was discovered that articles were being sent out which could not have come within the category of the alleged “gifts” to which I have referred. We have since located those particular articles.

Mr WARD:
EAST SYDNEY, NEW SOUTH WALES

– Marvellous!

Mr BEALE:

– The honorable member would not have located them; he would have had some fellow in his office looking after them. But we have located them, and appropriate action is being taken.

page 404

QUESTION

HOUSING

Mr GALVIN:
KINGSTON, SOUTH AUSTRALIA

– My question is addressed to the Minister for Social Services, who administers the War Service Homes Division. In view of the fact that the Campbelltown Council in South Australia may declare as unfit for habitation certain war service homes built at Hectorville, which have proved to be of faulty construction, will the Minister visit South Australia in an attempt, not only to solve the serious problem concerning those homes, but also to restore confidence to the many other ex-service men and women who are awaiting the allocation of homes by the division and are now afraid that they may be allocated homes of similar construction to those at Hectorville?

Mr TOWNLEY:
LP

– It is a little difficult for me to give a comprehensive reply, at question time, to the matter raised by the honorable member for Kingston. The homes at East Payneham, to which he has referred, are built on a peculiar kind of soil, which is also found in quite a number of other places in South Australia. I understand that some 10,000 homes in parts of Adelaide are similarly affected. I point out to the House that de War Service Homes Division has discharged every obligation that it has to ex-servicemen. However, the division, feeling that it has, in addition, some degree of moral obligation in this matter, has gone the “ second mile “, as it were, and made certain offers to the purchasers of the cottages. For example, the division has announced that it will make a further advance to the ex-servicemen in order to enable them to have the defects made good. I explain, in passing, that the defects are cracks which have occurred in the houses as the result of the subsidence of the soil, due to heat and moisture and there is no known remedy for this condition. The division has said that it will willingly repurchase the dwellings from dissatisfied ex-servicemen, grant them further financial assistance, and allow them to apply any credits to the purchase of a new home. The division will also allow the occupants of the houses to carry on as tenants, and will later if they so desire, provide them with homes in another area. The division has also informed the ‘persons concerned that, subject to their approval, it will take two of the houses for experimental purposes, and put either a bitumenemulsion or a concrete path round each of the dwellings, because it is suggested such treatment may overcome the trouble. If that treatment proves satisfactory, the division will then grant an extra loan to the other owners for similar work. In the meantime, certain ex-servicemen have taken the opportunity to sell their homes at a substantial profit. In twelve cases that I examined, the profits ranged from £993 to £1,680. One house was sold, with the furniture, at a profit to the exserviceman vendor of £2,760. So, obviously, ex-servicemen still have a reasonable equity in the cottages. The South Australian branch of the Returned Sailors, Soldiers and Airmen’s Imperial League of Australia has invited me to visit that State with a view to making an inspection of the houses, and I have replied that I shall go there as soon as convenient. I am not an expert architect or builder, but our own divisional architects have inspected those properties, and architects and builders outside the Public Service have been invited to express an opinion about them, and each has said that he has found no evidence whatsoever of constructional defects. They all agree with the statements and recommendations of the officers of the division.

page 404

QUESTION

TELEPHONE SERVICES

Mr DAVIDSON:
DAWSON, QUEENSLAND

– My question to the Postmaster-General arises from the negotiations that has been in progress for a number of years for the installation of an automatic exchange at Mackay. Following numerous representations by me, the Postmaster-General informed me on the 11th May last that a requisition was about to be placed with the Department of Works for the purchase and erection of a prefabricated building to house the automatic equipment. So far, there is no evidence that the work is about to begin. Will the Postmaster-General advise me when the commencement of the actual work of installation can be expected?

Mr ANTHONY:
Postmaster-General · RICHMOND, NEW SOUTH WALES · CP

– I consider that the installation of automatic equipment at Mackay should have a high priority. As the honorable member for Dawson has mentioned, arrangements were put in hand some time ago for the erection of a prefabricated building. Components of the prefabricated building are now being manufactured and it is hoped that very early next year the manufacturing will be sufficiently advanced for the Department of Works to let the contract, and that the building will be ready for the transfer of the mail-room activities at Mackay towards the latter part of 1954. Work will then proceed on the necessary alterations to the Mackay post office for the installation of the automatic equipment.

page 405

QUESTION

IMMIGRATION

Mr KEON:
YARRA, VICTORIA

– Is the Minister for Immigration aware that amongst immigrants from the East who landed in Australia last week-end were a number of people who had been refused permission even to leave the ship while it was in port in the Philippines because of their Communist activities in the East? What is the reason for importing these Communists into Australia? Does the Government not consider that there are already enough Communists here without importing others?

Mr HOLT:
LP

– I agree absolutely with r.he latter part of the honorable member’s question, and I should welcome a little more activity on the part of the honorable member himself and of his colleagues in checking the activities of Communists inside Australia instead of worrying about the activities of Communists outside Australia. Nominated immigrants arriving in Australia from the East would only be close relatives of people who are already settled in Australia and would have been subject to suitable security inquiries by the authorities both in Australia and in the East where there is British representation or where we have our own representation as in Hong Kong. They would be European immigrants who had been checked beforehand. I have not heard any other complaints on the lines of that mentioned by the honorable member, but I shall examine his statements.

Mr BIRD:
BATMAN, VICTORIA

– Has the Minister for Immigration given consideration to the report recently issued which shows that there has been a sharp and steady decline in the rate of immigration over the last twelve months, and particularly during the quarter ended the 30th September, when the excess of arrivals over departures was only 6,400? Can the decline bc attributed to the reluctance of people from other countries to settle here because of the housing shortage, or is it because Government agents overseas are no longer seeking large numbers of potential settlers?

Mr HOLT:

– As I have said on other occasions in this House, there has been a decline in the flow of immigrants during the last twelve months. That has been partly a consequence of Government policy, and partly a result of factors operating both in European countries and in Australia which have had some effect on inducement to move from Europe and from the United Kingdom to Australia. An improvement of the economic situation in Europe, a lessening of fear of a third world war, and brighter prospects in the United Kingdom and on the Continent have affected the situation. The reduction of the number of work opportunities in Australia at that time also had some effect. However, circumstances in Australia now are stimulating the flow of immigrants again and we are confident that we shall be able to attract a considerably larger number of new settlers to Australia in the immediate future. I have no fears on the score of housing, because about 220,000 houses have been constructed during the last three years under this . Government compared with about 120,000 houses during the last three years of Labour’s term of office.

Mr KEON:

– My question, which is directed to the Minister for Immigration, is in relation to the naturalization ceremonies that were conducted recently by the Department of Immigration in several municipalities in Melbourne. Why did not the department invite the federal members for the respective districts in which those ceremonies took place in order that those members might have an opportunity of attending them and of displaying interest in the swearing in of new Australians?

Mr HOLT:

– I did not know that honorable members had not been invited. A departmental submission in relation to this matter was placed before me recently. The problem is not as simple as it may seem, because senators also are entitled to be considered. The department does not desire that these naturalization ceremonies shall be made an occasion for a lot of speech-making. If federal members were invited. State members might think that they should be invited too. I remind the honorable gentleman that the matter is not free from difficulty, but I can assure him that I am sympathetically disposed towards having local members and senators present on such occasions. In fact, I welcome the interest of local members and of senators. If satisfactory arrangements can be made with the local authorities which assist in the conduct of these ceremonies, I shall see that they are made.

page 406

QUESTION

SUGAR

Mr HULME:
PETRIE, QUEENSLAND

– Can the Minister for Labour and National Service inform the House whether there is any substantial accumulation of sugar stocks at mills or on wharfs in Queensland? Will the Minister also inform the House, in the light of the Labour position on the wharfs, what plans are in hand for the handling of more sugar in Queensland ports?

Mr HOLT:
LP

– I have made a close examination in recent days of the position at northern ports and whilst I do not claim that the handling rates are as satisfactory as I should desire, I. assure the honorable member that the movement of sugar cargoes has been proceeding according to the original estimate and at the rate worked out by the Government with the representatives of sugar interests. Provided there is no interruption through industrial causes between now and the end of the season, not only should we be able to move cargoes at the planned rate, but also we should have a smaller carryover than was originally thought. We are watching the matter closely, and at present there is no cause for special action beyond that already taken.

– It is not intended that the resources of government should be bought wholly in Switzerland. The loan is not a tied loan. The £6,000,000 will contribute towards the general financial resources of the Commonwealth.

page 407

QUESTION

COMPULSORY UNIONISM

Mr OSBORNE:
EVANS, NEW SOUTH WALES

– -Has the Minister for Labour and National Service been informed of the proceedings of the third annual congress of the International Confederation of Free Trade Unions, a world-wide international organization of non-Communist trade unions, which was held at Stockholm a few months ago? Was Australia represented at it, and was the Australian delegation truly representative of the Australian industrial movement ? Is it correct that the congress affirmed the principles of free trade unionism and adopted the following resolution : -

A fundamental human right is the right of workers to organize freely in trade unions, national unions and confederations of their choice without interference from governments, employers or other non-trade union forces.

Did the Australian delegation support this resolution, and does it represent the views of the industrial movement throughout Australia? If so, is it correct to conclude that the present activity of the. New South Wales Government in trying to enforce compulsory unionism has nothing to do with the industrial movement but has its origin solely in politics?

Mr HOLT:
LP

– I understand that a resolution along the lines indicated by the honorable member was adopted at the conference that he has mentioned, but I shall check the exact text of the statement to see whether I can give him more information on the subject. I understand that Australia was fully represented at that conference by officially selected representatives of the trade union movement of this country, and the spirit of the resolution would appear to be directly in line with the terms of resolutions that were carried by a previous conference of the International Labour Organization, at which the Australian trade union movement was also represented. It certainly would appear from the text of the resolution, and its spirit, that it is utterly inconsistent with the line of policy now being followed by some Labour governments in this country.

Dr EVATT:

– Will the Minister for Labour and National Service forward a copy of the question that was asked by the honorable member for Evans, and the Minister’s answer thereto, to the Queensland Liberal party, the platform of which contains the principle of compulsory unionism?

Mr HOLT:

– I discussed this matter with leading members of the Queensland Liberal party at the annual conference of the federal council of the Liberal party of Australia, that was held recently in Canberra. At that conference the Queensland representatives were party to a unanimous resolution which condemned compulsory unionism as inimical to the interests of the trade union movement.

Mr DALY:
GRAYNDLER, NEW SOUTH WALES

– Has the Minister for Labour and National Service seen a statement which has been attributed to the General Secretary of the Queensland Liberal party to the effect that compulsory unionism had been a plank of the platform of the State Liberal party since it was formed ten years ago ?

Mr SPEAKER:

-Order! Is that statement based on a newspaper report?

Mr DALY:

– As far as I know, this statement was made over the air. The Secretary of the Queensland Liberal party added that the party did not intend to make any move for the deletion .of this plank from its platform. Will the Minister for Labour and National Service state whether the

Secretary of the Queensland Liberal party was a member of a delegation which interviewed him recently and whether members of the Liberal party in this House are unanimously against compulsory unionism in view of the fact that the Queensland Liberal party subscribes to the principle of compulsory unionism?

Mr HOLT:

– I am quite familiar with the details of the approach of the Queensland liberal party to this subject. I do not understand the honorable member’s apparent attempt to link the policy of the Queensland Liberal party with that of the Labour party in New South Wales, which has not adopted various aspects of the trade union policy of the Queensland Liberal party. For example, I understand that the Queensland Liberal party is opposed to the use of trade union funds for political purposes and that it is in favour of a public audit being made of trade union funds. I have yet to learn that those items of policy have been adopted by the Labour party. In any case, whatever may have been the plank of the platform of the State division of the Liberal party, I can only repeat for the information of everybody that the supreme policymaking body of the Liberal party, which is representative of all the States of the Commonwealth, has recently unanimously adopted the resolution that I previously referred to. I have no doubt of the attitude of the members of the Liberal party in this House. They are opposed to the undemocratic and totalitarian approach which has characterized the attitude of Labour governments in this country in respect of this matter. It is an aspect of policy which even members of the Labour party on the opposite side of this House have cause to regret. However, there is one important distinction between the Liberal party and the Labour party. Having stated our platform and policy, we .attempt to give effect to them. That attitude is in marked contrast to the attitude of the Labour party towards its printed platform.

Mr CALWELL:
MELBOURNE, VICTORIA

– I ask the Minister for Labour and National Service whether it is not a fact that during the whole course of his political and ministerial career he has never disputed the right of the Waterside Workers Federation of Australia to impose a system of compulsory unionism on the waterfront? Has that been his attitude despite the fact that the union not only requires persons who are employed on the waterfront to be members of the union, but also requires persons to be members before they are able to obtain work on the waterfront? Moreover, is.it not a fact that no waterside worker has the benefit of a conscientious objection safeguard or anything of that sort.

Mr HOLT:

– A. long statement would be needed to deal adequately with the position on the waterfront as distinct from other work sections of the community. The Waterside Workers Federation of Australia, in connexion with waterfront work, functions under legislation that has been passed by this Parliament which imposes upon the union certain obligations in return for the registration of its members. The waterside worker, in effect, enters into a contractual relationship whereby in consideration for binding himself to be available for work during certain periods he receives a preference in relation to work on the waterfront. Neither this Government, nor the previous Labour Government has ever excluded by legislation the possibility of non-union labour being employed on the waterfront. Indeed, in some parts of Australia, at the present time, non-union labour is employed on the waterfront, during seasonal periods, and that practice is not inconsistent with our general approach to the whole matter of waterfront employment.

page 408

QUESTION

URANIUM

Mr SWARTZ:
DARLING DOWNS, QUEENSLAND

– Can the Minister for Supply give the House any information in relation to recent reports that there were prospects of locating large deposits of uranium in Queensland? Should uranium be discovered in commercial quantities in that State, will responsibility for the development of deposits rest on the Queensland Government?

Mr BEALE:
LP

Sir ARTHUR FADDEN:

– I withdraw it. I have never been the sole passenger on any aeroplane, and I have never at any time abused the concessions to which I am entitled.

page 411

QUESTION

NORTHERN TERRITORY

Mr SWARTZ:

– I ask the Minister for Territories whether work is still proceeding on the construction of a new wharf at Darwin? Is it a fact that over the last twelve months there has been a large increase in the rate of construction of private homes and commercial and industrial buildings in Darwin?

Mr HASLUCK:
LP

– The answer to the first part of the honorable member’s question is “ Yes “. The answer to the second part of his question also is “ Yes “. One of the most remarkable things that have happened in the Northern Territory over the few years during which this Government has been in office has been the way in which private enterprise has responded to the opportunities that have been afforded. Previously, those opportuntiies did not exist.

page 412

QUESTION

MICA

Mr NELSON:

– Will the Minister for Supply inform the House whether any decision has been reached in connexion with the continuation or suspension of the Australian mica pool ? If the Minister has not reached a decision, will he do so before the next sale of mica is held early next month in central Australia. ?

Mr BEALE:
LP

– The question, of the continuation or otherwise of the mica pool is under consideration by the

Cabinet. I hope that a decision will be reached in the near future. The honorable member for the Northern Territory was with me when I visited- the Harts Ranges some months ago and he will be conversant with some of the difficulties! that confront the industry. In an endeavour to resolve them, the Government has been considering carefully the whole matter including- the winning of mica and, more important still, its sale. In that connexion, the Government has instituted various inquiries abroad. I hope that some experts from England will be able to visit Australian soon and advise the Government upon the production of mica and its grading and classification. Those matters have been, closely associated with Australia’s difficulty in securing world markets for Australian mica. I assure the honorable member that the Government is doing its utmost to assist the industry.

page 412

LIFE INSURANCE BILL 1953

Motion (by Sir Arthur Fadden) agreed to -

That leave be given to bring in a bill for an act to amend the Life Insurance Aft 1D45-50.

page 412

TARIFF PROPOSALS 1953

Customs Tariff Amendment (No. 1) ; Excise Tariff Amendment (No. 1) ; Customs Tariff (New Zealand Preference) Amendment (No. 1)

In Committee of Ways and Means:

Mr ERIC J HARRISON:
Vice-President of the Executive Council and Minister for Defence Production · WENTWORTH, NEW SOUTH WALES · UAP; LP from 1944

[3.29]. - I move - [Customs Tariff Amendment (No. 1).]

That tho Schedule to the Customs Tariff 1933-1952 be amended as hereinafter set out, and that, on and after tho twenty-fifth day of November, One thousand nine hundred and fifty-three, at nine o’clock in the forenoon, reckoned according to standard timo in the Australian Capital Territory, Duties of Customs be collected in pursuance of the Customs Tariff 1933-1952 as so amended.
That, without prejudice, to the generality of paragraph I of these Proposals, the Governor-General may, from time to time by Proclamation declare that, from a time and date specified in the Proclamation, the Intermediate Tariff shall apply to such goods specified in the Proclamation as are the produce or manufacture of any British or foreign country specified in the Proclamation.
That on and after the time and date specified in a Proclamation issued in accordance with the last preceding paragraph, the Intermediate Tariff shall apply to such goods specified in the Proclamation as are the produce or manufacture of a British or foreign country specified in that Proclamation.
That any Proclamation issued in accordance with paragraph 2 of these Proposals may, from time to time, be revoked or varied by a further Proclamation, and upon the revocation or variation of the Proclamation, the Intermediate Tariff shall cease to apply to the goods specified in the Proclamation so revoked, or, as the case may be, the application of the Intermediate Tariff to the goods specified in theProclamation so varied, shall be varied accordingly.
That in these Proposals, unless the contrary intention appears - “ Proclamation “ mean a Proclamation by the Governor-General, or the person for the time being administering the government of the Commonwealth, acting with the advice of the Federal Executive Council, and published in the Commonwealth of Australia Gazette ; “ the Intermediate Tariff “ mean the rates of duty set out in the Schedule to these Proposals, in the column headed “ Intermediate Tariff “, in respect of goods in relation to which the expression is used.

[Excise Tariff Amendment (No. 1).]

That the Schedule to the Excise Tariff 1921-1952 be amended as hereinafter set out, and that, on and after the twntyfifth day of November, One thousand nine hundred and fifty-three, at five o'clock in the forenoon, reckoned according to standard time in the Australian Capital Territory, Duties of Excise be collected in pursuance of the Excise Tariff 1921-1952 as so amended. [Customs Tariff (New Zealand Preference) Amendment (No. 1.)] {: type="1" start="1"} 0. That, on and after the twenty-fifth day of November, One thousand nine hundred and fifty-three, the provisions of these Proposals have effect for the purposes of the Customs Tariff (New Zealand Preference) 1933-1952 in lieu of the provisions of section eleven of that Act. 1. That goods be deemed to be the produce of New Zealand if they are unmanufactured raw products of New Zealand. 2. That goods be deemed to be the manufacture of New Zealand - {: type="a" start="a"} 0. if the goods were wholly manufactured in New Zealand from materials of one or more of the following classes : - {: type="i" start="i"} 0. unmanufactured raw products ; 1. materials wholly manufactured in New Zealand or Australia, or in New Zealand and Australia ; and 2. imported materials which the Minister has determined, by notice in the *Gazette* to be manufactured raw materials ; or 1. if the goods were partly manufactured in New Zealand, the process last performed in the manufacture of the goods was performed in New Zealand and - {: type="i" start="i"} 0. not less than one-half of the factory or works cost of the goods is represented by the value of labour or material, or of labour and material, of New Zealand or of New Zealand and Australia ; 1. not less than three-quarters of the factory or works cost of the goods is represented by the value of labour or material, or of labour and material, of New Zealand and the United Kingdom or of New Zealand, Australia and the United Kingdom ; or 2. in the case of goods of a class or kind not commercially manufactured in Australia, not less than one-quarter of the factory or works cost of the goods is represented by the value of labour or material, or of labour and material, of New Zealand or of New Zealand and Australia, and the Minister has not determined, by notice in the *Gazette,* that the provisions enacted to give effect to this clause do not apply in relation to those goods or to a class of goods in which those goods are included. 3. That, for the purposes of the provisions enacted to give effect to paragraph 3 of these Proposals, the Minister may, by notice in the *Gazette -* {: type="a" start="a"} 0. specify the manner in which the factory or works cost of goods or the value of labour and material is to be determined ; and 1. determine that goods, or goods included in a class of goods, shall be deemed to be goods of a class or kind not commercially manufactured in Australia. 4. That, for the purposes of the provisions enacted to give effect to clause (ii) of sub-paragraph (b) of paragraph 3 of these Proposals, material which, under the New Zealand British Preferential Tariff, is treated as having been wholly produced or wholly manufactured in the United Kingdom be deemed to be material of the United Kingdom. 5. That, in these Proposals - " the *Gazette "* mean the *Commonwealth of Australia Gazette* " the Minister " mean the Minister of State for the time being administering the Customs Tariff (New Zealand Preference) 1933-1952, or that Act as amended from time to time, and include any Minister of State or member of the Federal Executive Council for the time being acting for or on behalf of that Minister ; the New Zealand British Preferential Tariff " have the same meaning as in the Customs Tariff (New Zealand Preference) 1933-1952 ; " unmanufactured raw products " mean natural or primary products that have not been subjected to an industrial process, other than an ordinary process of primary production, and include, without limiting the generality of the foregoing - {: type="a" start="a"} 0. animals, and parts of animals obtained by killing, including bones, hides and skins (raw or sun dried) ; 1. greasy wool ; 2. plants, and parts of plants, including raw cotton, bark, fruit, nuts, grain, seeds (in their natural state) and unwrought logs ; 3. minerals in their natural state and ores ; and 4. crude petroleum. The Customs Tariff proposals which I have just introduced are a consolidation and re-introduction of two Customs Tariff proposals which were introduced in the Parliament on the 5th March, and the 9th September, last. This consolidation will facilitate discussion by honorable members when the proposals are being debated during the present parliamentary session. In addition these proposals contain several new amendments as the result of further inquiries by the Tariff Board. These new amendments cover engine cleaning waste, metal working lathes, files and rasps, valve spring removers for internal combustion engines, elastics, and polyethylene plastics. At a later stage I shall avail myself of the opportunity to table the relevant Tariff Board reports. The new duties will operate as from 9 a.m. on the 25th November. Attached to the proposals is a " Summary of Alterations " which sets out in convenient form a comparison between the proposed duties and those provided for in the Customs Tariff 1933- 1952. The Excise Tariff proposals and the Customs Tariff (New Zealand Preference) proposals are merely reintroductions of the proposals introduced earlier this year and they contain no new amendments. Honorable members will be accorded full opportunity at a later stage in the present session to discuss these proposals. Progress reported. {: .page-start } page 423 {:#debate-28} ### TARIFF BOARD Reports *on* Items. {: #debate-28-s0 .speaker-KNX} ##### Mr ERIC J HARRISON:
WENTWORTH, NEW SOUTH WALES · UAP; LP from 1944 -- I lay on the table reports of the Tariff Board on the following subjects: - >Metal-working lathes. > >Engine cleaning waste. {:#subdebate-28-0} #### Elastics Tools and other articles imported as standard equipment with machines and appliances. Valve spring removers or lifters. Plastics ( polyethylene ) . {:#subdebate-28-1} #### Files At present, copies of the first three reports mentioned only are available for circulation to honorable members. {: .page-start } page 423 {:#debate-29} ### NATIONAL HEALTH BILL 1953 [No. 2]. Declaration of Urgency. {: #debate-29-s0 .speaker-KNX} ##### Mr ERIC J HARRISON:
Vice-President of the Executive Council and Minister for Defence Production · WENTWORTH, NEW SOUTH WALES · UAP; LP from 1944 is an urgent bill. Question put - >That the bill be considered an urgent bill. The House divided. (Mr. Speaker - Hon. Archie Cameron.) AYES: 54 NOES: 49 Majority . . . . 5 AYES NOES Question so resolved in the affirmative. AllotmentofTime. Motion (by **Mr. Eric** J. Harrison) proposed - That the time allotted in connexion with the bill be as follows: - {: #debate-29-s1 .speaker-JWU} ##### Mr ALLAN FRASER:
Monaro · EDEN-MONARO, NEW SOUTH WALES · ALP -- The submission of this motion, completely unnecessarily, indicates that the Government has developed an absolute mania for gagging and repressing. It appears that theGovernment has now reached the stage at which it cannot bear to have its measures debated. This bill consists of more than SO pages. It contains 140 clauses and two schedules, which set out the provisions of a large number of separate health schemes which the Minister for Health **(Sir Earle Page)** has described, and the blouse recognizes, as being of the utmost importance. The debate on the second reading was gagged, and now the Government proposes, without offering one word of reason or justification for its action, to limit consideration of the measure in committee to one and half sitting days. That is an outrageous abuse of the Government's power and, on behalf of the Opposition, I protest in the strongest terms against such action. M r. Cramer. - The Opposition has had many months in which to study the measure. {: #debate-29-s2 .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The honorable member for Bennelong **(Mr. Cramer)** is correct when he says that honorable members have had many months in which to study the measure outside the House. Why then should the time available in the House now be limited to less than two days? The Opposition desires to propose many amendments to the bill but, as a result of the application of the " guillotine" the committee will be prevented from giving adequate consideration to those amendments. How badly and faultily the Government's legislation is drawn is shown by the fact that the November,. 1953, version of this bill differs so greatly- {: #debate-29-s3 .speaker-10000} ##### Mr SPEAKER: -- Order ! The honorable member may deal only with the proposed allotment of time. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The time proposed to be allowed is utterly inadequate. More time is required in order to enable the committee to consider the amendments which the Opposition desires to submit in order to remove defects in the bill. The faulty nature of the hill is indicated by the large number of amendments which the Government itself has already found it necessary to make to it. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The honorable member must confine his remarks to the allotmentof time. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The time proposed to be allotted allows only a few hours for the consideration of this important measure. {: .speaker-KE8} ##### Mr Kekwick: -Why is the honorable member wasting time now? {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- If the honorable member for Bass **(Mr. Kekwick)** regards it as a waste of time for another honorable member to assert the right of the committee to consider a measure fully he discloses a poor appreciation of his duty as a member of the Parliament and also of the duties of the committee. I repeat thatthe Opposition desires to move a large number of amendments to the bill. By the application of the " guillotine " the Government is preventing the Opposition from exercising its right in that respect. That is the ground of my protest. The Vice-President of the Executive Council **(Mr. Eric J. Harrison)** did not advance one reason why it should be necessary for the Government to curtail discussion on this measure. It is well known that the Government has very little other legislation to introduce. - **Mr. SPEAKER.-** Order! {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The Government has not indicated any reason for hurrying the current session to a close. {: .speaker-10000} ##### Mr SPEAKER: -- Order- ! The honorable member's time has expired. {: #debate-29-s4 .speaker-KMD} ##### Mr OSBORNE:
Evans .- It is obvious that the committee and the public outside- {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The motion before the Chair has nothing to do with the public outside. The honorable member may discuss only the proposed allotment of time. {: .speaker-KMD} ##### Mr OSBORNE: -- The proposed allotment of time is reasonable. Obviously, the honorable member for Eden-Monaro **(Mr. Allan Fraser)** has raised purely a technical objection. During the prolonged debate on the motion for the second reading of the measure honorable members opposite had ample opportunity to debate the bill, but at that stage they advanced only a series of barren arguments. {: .speaker-10000} ##### Mr SPEAKER: -Order! The nature of the second-reading debate has nothing to do with the motion now before the Chair. {: .speaker-KMD} ##### Mr OSBORNE: -- On the motion for the second reading the Opposition had ample opportunity to indicate its objection to the measure, but it made signally little use of that opportunity. It is obvious, therefore, that honorable members opposite do not require a longer period to consider the measure at this stage. The nature of the amendments they submitted on the second reading indicate clearly that they are put forward for tactical reasons only, and the allot ment of time now proposed for the committee stage is quite adequate. Honorable members opposite are being merely technical in this matter. {: .speaker-10000} ##### Mr SPEAKER: -- Order! The honorable member must confine his remarks to the motion before the Chair. {: .speaker-KMD} ##### Mr OSBORNE: -- If, in fact, honorable members opposite were given the opportunity to accept additional time for consideration of. the measure in committee, and such . provision involved the extension of the current' sessional period, it is perfectly clear what their decision would be. In a way, I should rather wish that the Government would give them that opportunity. All of lis know that the intention is that the Parliament shall adjourn at, the end of next week. {: .speaker-KX7} ##### Mr WARD:
EAST SYDNEY, NEW SOUTH WALES · ALP; LANG LAB from 1932; ALP from 1936 -- Let it sit on. {: .speaker-KMD} ##### Mr OSBORNE: -- It is perfectly obvious that members of the Opposition do not desire anything of the sort. The honorable member for Eden-Monaro has raised a purely technical objection. It is clear that he and his colleagues are anxious that the consideration of the measure should be concluded a3 soon as possible because the debate on it so far has been wholly discreditable to them. {: #debate-29-s5 .speaker-KGX} ##### Mr HAYLEN:
Parkes .- The application of the "guillotine" on this occasion indicates the outrageous nature of the Government's approach to legislation. First, with a flourish of trumpets, the Minister for Health **(Sir Earle Page)** declares that this measure is the most important bill of the century. Then the Prime Minister **(Mr. Menzies)** goes for a private tour, and his deputy gag.= the committee. {: .speaker-10000} ##### Mr SPEAKER: -- Order! The Prime Minister's actions are not under discussion. {: .speaker-KGX} ##### Mr HAYLEN: -- This is a most important bill, and it is peculiarly a measure for consideration in committee. Therefore, the proposal to limit that consideration to one and a half days is altogether wrong. The whole position has been brought about by the famous "gagster'' who sits at the opposite side of the table. ' {: .speaker-10000} ##### Mr SPEAKER: -Order! The honorable member must not refer to the VicePresident of the Executive Council as a " gagster ". {: .speaker-KGX} ##### Mr HAYLEN: -- I did not refer to him as a gangster. {: .speaker-10000} ##### Mr SPEAKER: -- Order! The honorable member will withdraw the term " gagster ". {: .speaker-KGX} ##### Mr HAYLEN: -- I withdraw it. If there is any merit in the Government's contention that this bill is a memorable piece of legislation and, as I have said, it is peculiarly a bill for consideration in committee - it consists of 80 pages - let us discuss it fully. The curtailment of debates, on the scale practised by this Government, makes a farce of parliamentary government, and the VicePresident of the Executive Council is the worst offender in that respect. He comes into the chamber- {: .speaker-10000} ##### Mr SPEAKER: -Order! The VicePresident of the Executive Council is not under discussion. {: .speaker-KGX} ##### Mr HAYLEN: -- I am sorry, **Mr. Speaker,** that for a moment I imagined lie might have been under discussion. In view of the circumstances, I consider that the original move made by the honorable member for Eden-Monaro is perfectly valid. Now members are not to be allowed an adequate opportunity to consider this Kill in committee. We are to be effectively jagged, and we shall not be able to move the numerous amendments that we desire to submit for consideration. The Minister for Health has declared that this bill is the greatest piece of health legislation in this generation- {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The legislation is not now under consideration. {: #debate-29-s6 .speaker-JLZ} ##### Mr ANTHONY:
PostmasterGeneral and ' Minister for Civil Aviation · Richmond · CP "3.51 1. - Members of the Opposition are demanding more time than is proposed for the consideration of this bill in committee. They conveniently overlook the fact that the Labour Government was in office for eight and a half years, and evidently did not have time to submit comprehensive health legislation to the Parliament. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The record nf the Opposition is not under discussion. {: .speaker-JLZ} ##### Mr ANTHONY: -- I deeply regret that it is not. If it were under discussion, honorable members opposite would be adopting a different attitude now. {: .speaker-KGX} ##### Mr Haylen: -- The Government will need a. health scheme when the result of the Gwydir by-election is announced. {: .speaker-10000} ##### Mr SPEAKER: -- Order! TheGwydir by-election is not under discussion. {: .speaker-JLZ} ##### Mr ANTHONY: -- It will be under discussion next week, **Mr. Speaker,** but not in this chamber. I point out that theLabour Government used the "guillotine " more frequently than has thepresent Government. {: .speaker-KGX} ##### Mr Haylen: -- That is not so. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! {: .speaker-JLZ} ##### Mr ANTHONY: -Opposition members, if they will examine the proposed allotment of time in connexion with thisbill, will see that the committee proceedings are not due to conclude until 10.50 p.m. to-morrow. So far, no Opposition member has expressed a worth-while idea on this bill, but I contend that any member of the Labour party who gets a worthwhile idea in the meantime will have ample opportunity to explain it. Of course, the protest voiced by the Opposition about a curtailment of debate is simply to conceal the fact that the Labour Government did not have sufficient time in eight and a half years to introduce a comprehensive health bill. **Mr.** DALY (Grayndler)' "3.55].- I join with other members of the Opposition in protesting against the ruthless suppression of discussion by the Government. This important bill consists of 139 clauses and a schedule which embraces 701 items, every one of which is of vital interest to all honorable members, and particularly to the enlightened members of the Labour party. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The proposed allotment of time is now the subject of discussion. {: #debate-29-s7 .speaker-6V4} ##### Mr DALY: -- I have come to that point, **Mr. Speaker.** We cannot, 'in the time allotted, consider as fully as we desire, all the clauses of the bill, and the items of the schedules. The Government has 68 supporters, and the Opposition has 55- {: .speaker-10000} ##### Mr SPEAKER: -- Order! That matter is not the subject of discussion. {: .speaker-6V4} ##### Mr DALY: -- Members of the Opposition desire adequate time in which to state their views on this bill. We are not like the dumb supporters of the Government, who refuse to participate in this debate, because they do not know anything about the subject. Members of the Labour party have been gagged again and again- {: .speaker-10000} ##### Mr SPEAKER: -- Order ! {: .speaker-6V4} ##### Mr DALY: -- We have not had adequate time to discuss this bill. Each of the 55 members of the Labour party is eager to speak on various clauses- *Government members interjecting,* {: .speaker-6V4} ##### Mr DALY: -- Approximately eleven hours have been allowed for the consideration of this bill. Therefore, every honorable member will have only five minutes in which to speak on 139 clauses and the schedules. You, **Mr. Speaker,** when you were a private member, were prominent for your capacity to debate various subjects concisely, but even you could not have adequately summed up the clauses of this bill in five minutes. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! My capacity is not under discussion. {: .speaker-6V4} ##### Mr DALY: -- Opposition members also desire to submit important amendments to various clauses. How are we to express our views adequately on various amendments when the debate is to be so curtailed? Why is the Government in such a hurry to conclude the consideration of this bill ? Honorable members are prepared to devote the whole of this week and next week to it. Indeed, we have plenty of time between now and Christmas to examine the measure thoroughly. Of course, we are perfectly well aware that Government members are running away to take part in a by-election campaign or in so-called goodwill tours. They are campaigning in their respective electorates, so members of the Opposition are denied adequate time to consider this bill. {: .speaker-10000} ##### Mr SPEAKER: -- The honorable member is not entitled to discuss the whereabouts of Government members. {: .speaker-6V4} ##### Mr DALY: -- I regret that I have digressed, **Mr. Speaker.** I invite the Vice-President of the Executive Council to explain to the House his reasons for the proposed curtailment of the debate. Is it because he has become what may be termed gag-happy? {: .speaker-10000} ##### Mr SPEAKER: -- Order ! {: .speaker-6V4} ##### Mr DALY: -- The Vice-President of the Executive Council has merely moved the proposed time-table, and has not attempted to explain why the introduction of the "guillotine" is necessary. {: #debate-29-s8 .speaker-C7E} ##### Sir EARLE PAGE:
Minister for Health · Cowper · CP -- Opposition members who complain that the proposed allotment of time in connexion with thi? bill is not adequate, are extraordinarily inconsistent. I recall that the Chifley Labour Government introduced health bills in the middle of the night, and pushed them through all stages in two hours. When I wished to speak on them. I was gagged. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The fact that the Minister has been gagged in the past is not now under discussion. {: .speaker-C7E} ##### Sir EARLE PAGE: -- The time allowed for the second-reading debate and for consideration of this bill in committee is longer than the whole time allowed by the Labour Government in eight and a half years for consideration of itf health bills. Earlier, a comprehensive amendment was moved on behalf of the Opposition- {: .speaker-10000} ##### Mr SPEAKER: -- Order! That amendment has been dealt with. {: .speaker-C7E} ##### Sir EARLE PAGE: -- I was merely pointing out 'that the amendment dealt with- {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The Minister may not refer to the second-reading debate. {: .speaker-C7E} ##### Sir EARLE PAGE: -- This bill consists almost wholly of measures which have already been passed by the Parliament or- {: .speaker-10000} ##### Mr SPEAKER: -Order! The only matter that the Minister may discuss at this stage is the proposed time limit. {: .speaker-KX7} ##### Mr Ward: -- Does not the Minister understand ? {: .speaker-10000} ##### Mr SPEAKER: -Order ! The honorable member for East Sydney **(Mr. Ward)** must remain silent. {: .speaker-C7E} ##### Sir EARLE PAGE: -- This bill incorporates health measures that have already been passed by the Parliament, or regulations that have been allowed by it. {: .speaker-10000} ##### Mr SPEAKER: -Order ! The Minister may not deal with those matters. {: .speaker-C7E} ##### Sir EARLE PAGE: -- The proposed allotment of time is ample to enable honorable members to discuss any new matters that have been incorporated in the bill. The time allotted for the consideration of clauses 1 to 14 will expire at 5 p.m. to-day. Those clauses deal with preliminary matters, interpretations, and certain parts of the national health services which have been in existence for many years. Some of the amendments forecast by Opposition members, who claim that they wish to repair omissions in the bill, are unnecessary, because those matters are, in fact, covered in the bill. The time allowed for the consideration of clauses 15 to 37 will not expire until 9 p.m. to-day. The subject-matter of those clauses has already been debated at great length. {: .speaker-10000} ##### Mr SPEAKER: -- Order ! The Minister may not refer to the second-reading debate. The time allowed by the Standing Orders for the consideration of this motion has expired. Questionput- >That the motion *(vide* page 424), be agreed to. The House divided. (Mr. Speaker - Hon. Archie Cameron.) AYES: 54 NOES: 50 Majority . . 4 AYES NOES Question so resolved in the affirmative. *In committee:* Consideration resumed from the 20th November *(vide* page 399). Clauses 1 to 5 agreed to. Clause 6 - (1 . ) The Minister or the Director-General may in relation to amatter or class of matters, or toa State or part of the Commonwealth, bywriting under his hand, delegate any of his powers and functions under this Act (except this power of delegation and powers and functions under section ninety-four of this Act). {: #debate-29-s9 .speaker-JWU} ##### Mr ALLAN FRASER:
Monaro · EDEN-MONARO, NEW SOUTH WALES · ALP -- I move - >That, in sub-clause (1.), after the word " delegate ", the following words be inserted : - " to an officer or to a person included in a prescribed class of persons ". The words which I propose should be inserted appeared in the version of this measure presented to the House in March of this year. They have been struck out of this bill for a reason which is not apparent. As the sub-clause stands, the Minister for Health **(Sir Earle Page)** would have unlimited power of delegation. Apparently when the original version of the bill was drafted the Minister recognized that there should be some limit on his power of delegation, and no reason has been given for the removal of the safeguarding words " to an officer or to a person in a prescribed class of persons ". Apparently the Minister could delegate authority to any person in the Commonwealth the very wide and important powers that he will exercise under this measure. I hope that the Minister will agree, upon further examining the provision, that the omission of those important words has not improved the measure but rather has injured it. The words should be restored so that there may be a proper limit on the Minister's powers of delegation. {: #debate-29-s10 .speaker-C7E} ##### Sir EARLE PAGE:
Minister foi- Health · Cowper · CP -- This change was suggested by the States in order that we may be able to delegate power not only to Commonwealth health officers, but also to the State health authorities. The need for the delegation of power to the States is obvious. A great variety of matters included in this bill will have to be dealt with by State health authorities and not by Commonwealth authorities, and our intention is that the States should be adequately covered. 111-. DALY (Grayndler) [4.9].- I support the amendment moved by the honorable member for Eden-Monaro **(Mr. Allan Eraser).** In spite of the explanation given by the Minister for Health **(Sir Earle Page)** I believe that the words referred to by the honorable member for Eden-Monaro should be inserted in the clause. As the honorable member for Eden-Monaro has said, almost unlimited powers will be conferred upon the Minister unless the clause is amended. There is always a danger in conferring unlimited power upon a Minister, no matter who may agree to the proposal, and the amendment would provide adequate protection against the ruthless misuse of such power by the Minister for Health, who for the present happens to be the right honorable member for Cowper. I understood the right honorable gentleman to say that the State governments agreed to the proposal embodied in this clause. It is strange to hear of the Minister taking any notice of the State authorities, because his usual line of conduct when dealing with the States in health matters is to adopt a stand-over role, as happened when he refused to give the States money for hospitals unless they submitted to his domination. Such incidents suggest that the Minister should not have unlimited powers. There should be safeguards against any abuse of power. ' Although the States may have agreed to the Government's proposal, and although the Minister may think that he will not exercise the proposed power wrongly, >t would be wiser to adopt the amendment and place his capacity to do so beyond doubt. The proposal by the Opposition should not be viewed in a party political spirit. It is constructive and is intended to assist the Minister. I know that the right honorable gentleman is a genial kind of fellow and may not abuse his power, but in some matters he has already indicated that he is prepared to go to the limit in the exercise of powers that have been conferred upon him. I have mentioned one example already. In the circumstances, especially as the national health scheme is of vital importance to all Australians, I am not willing to allow the clause to remain in its present form. The Minister should not be given authority to do exactly as he wishes in this matter without being subject to any restraining influence. The amendment is clear and concise and the honorable member for Eden-Monaro has explained it in simple terms. The Minister, therefore, must understand its purpose. He should accept it at once if he wishes to protect the interests of the people against the possibility of any misuse of power in the future. At least he should agree to consider it with a view to meeting the wishes of the Opposition. If he proposes to force the bill through the Parliament and to reject all proposed amendments, we might as well forget our constructive suggestions and make no further attempt to debate the terms of the bill. There is no justification for. forcing an important measure of this character through the Parliament without regard for the considered proposals of the Opposition. It is obvious from the way in which Government supporters sit behind the Minister and listen to his words without comment that they are not prepared to accept our suggestions or to consider the merits of our amendments. The **CHAIRMAN (Mr. Adermann).Order!** There is no occasion to reflect on honorable members. Get on with theclause. {: #debate-29-s11 .speaker-6V4} ##### Mr DALY: -- I made only a passing reference to the attitude of Government supporters. {: #debate-29-s12 .speaker-10000} ##### The CHAIRMAN: -- Passing references of that nature will not be allowed. {: .speaker-6V4} ##### Mr DALY: -- My remarks referred to the amendment submitted by the honor able member for Eden-Monaro and to the clause, to which the amendment relates. I may have deviated slightly from the provisions of the clause and the amendment, but I was about to return to the bone of contention after I had elaborated on the attitude of the Government and its supporters to the constructive proposals of the Opposition. Evidently we are to be fobbed off with the statement by the Minister that the clause in its present form is acceptable to the State governments. That answer does not satisfy me. The Minister should endeavour to justify his decision to reject the amendment. The State governments probably have not heard of it. Therefore, the Minister's attempt to bolster up his attitude by saying that they have approved of the clause in its present form is not satisfactory. Certainly it is not satisfactory to the Opposition, and it should not be satisfactory to Government supporters. The Opposition intends to move extensive amendments to various important clauses of the bill. I know that the time available for the discussion of those clauses and the proposed amendments is limited, but if the Minister intends to dispose of each proposal with a speech that lasts for only one or two minutes, it hardly seems worthwhile for us to press our proposals. I know that Government supporters would like the Opposition to withdraw the amendment to this clause. They know that, if it were accepted, it would probably cause a great deal of inconvenience to the Minister and to those who draft the Government's legislation. However, that is a minor matter and should not affect the issue in any way. The important fact is that the amendment has been designed for the purpose of safeguarding the people against the ruthless misuse of power by the Minister. Therefore, it should be embodied in the clause. I concede that a Minister should have extensive powers in order to enable him to carry out the duties of *his* office efficiently, and I believe that, subject to reasonable limitations, he should have full scope to exercise his personal authority in matters that fall within his jurisdiction. Nevertheless, the delegation of unlimited power to an individual bristles with dangers. We should do everything possible to safeguard the interests of the people against the abuse of such powers. I earnestly appeal to the Minister to re-examine this issue. When all is said and done, it is not unreasonable to ask him to consider the Opposition's proposal. He may have studied the clause carefully before it was inserted in the bill in its present form, but that does not mean that he has thought of every possibility. The submissions of the honorable member for Eden-Monaro, which were made in a temperate and constructive way, have merits that warrant the acceptance of the amendment by the Government. They should appeal particularly to the Minister because he, of all people, should realize the importance in a democracy of protecting the people against the abuse of power by a Minister. Having said so much, there is little more that I need to say in support of the amendment. {: .speaker-KFQ} ##### Mr Gullett: -- Hear, hear! {: .speaker-6V4} ##### Mr DALY: -- Apparently Government supporters are prepared to jeer at the Opposition and blindly follow the lead of the Minister. I should like to hear some considered opinions on the amendment from honorable gentlemen on the Government side of the chamber, who knew nothing about the terms of the bill until it was presented to the Parliament by the Minister. The bill leaves much to be desired from the point of view of the Opposition, and of the people generally, and constructive and reasonable proposals, such as the amendment submitted by the honorable member for Eden-Monaro, deserve to be considered carefully. The clause is dangerous in its present form and it should be amended. For that reason, I support the proposal of the honorable member for EdenMonaro. {: #debate-29-s13 .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- It is obvious from the nature of the remarks made by the honorable member for Grayndler **(Mr. Daly)** that he has no conception of the purpose of the clause. When the Minister for Health **(Sir Earle Page)** explained the clause to the honorable member for Eden-Monaro **(Mr. Allan Eraser),** who moved the amendment, I understood the honorable member to nod his head to indicate his agreement with the Minister. Apparently the honorable gentleman accepted the Minister's explanation. The clause provides for the delegation of powers and functions in connexion with the approval of doctors, the approval of hospitals, supervision of the operation of the health scheme, and so forth. These are largely matters of concern to the States. The Minister has explained that the clause has been discussed with the State governments and that they are in agreement with its provisions. We can have every confidence in the Minister's assurance. It is no argument to talk, as the honorable member for Grayndler talked, of the Minister being a standover merchant. Such expressions are mere propaganda, not argument. The question at issue is whether or not the terms of the clause, in relation to the delegation of powers, give effect to the wishes of both the Commonwealth and the States. The Minister has assured the committee that he has discussed this matter with the States, and that both the Commonwealth and the States desire the clause to be retained in its present form so that they both may exercise their respective functions. It did little credit to the honorable member for Grayndler for him to say, in the face of the Minister's positive declaration, that he did not believe that the States have heard of it. There can be no real discussion of the clause on that basis. The wording of the relevant clause of the first bill was altered in order to meet the wishes of those who will have to administer the scheme. As I' have already pointed out, the honorable member for Eden-Monaro appeared to indicate that he accepted the Minister's explanation. Amendment negatived. Clause agreed to. Clauses 7 and 8 agreed to. Clause 9 - {: type="1" start="9"} 0. -- (1.) The Governor-General may provide, or arrange for the provision of - {: type="a" start="a"} 0. . . . 1. Diagnostic and therapeutic services for medical practitioners and hospitals ; {: #debate-29-s14 .speaker-JVA} ##### Mr MORGAN:
Reid . -I move - >That, in sub-clause (1.), paragraph (b), the words " for medical practitioners and hospitals " be left out. As this provision is different from the relevant provision in the first bill, it is obvious that the Minister for Health **(Sir Earle Page)** has received further instructions from his real masters, the Federal Council of the British Medical Association, since that measure was introduced in March last. {: .speaker-KFQ} ##### Mr Gullett: -- I rise to order. As only a limited number of copies of the proposed amendments has been circulated, it is impracticable for all honorable members to study the effect of the amendments. The **CHAIRMAN (Mr. Adermann).Order** ! The honorable member for Reid **(Mr. Morgan)** should make clear the effect of the amendment. {: .speaker-JVA} ##### Mr MORGAN: -- The clause, as drafted, provides that the GovernorGeneral may arrange for the provision of diagnostic and therapeutic services only for medical practitioners and hospitals. Why should not these services be made available also to clinics? I contend that the services of radiologists, physicists and other specialists should *he* made available to clinics. It is obvious that the Minister received instructions from the Federal Council of the British Medical Association in connexion with the preparation of his second bill. It was announced in the press soon after the Government was returned to office that a national health scheme would not be introduced into the Parliament until after a British medical congress had been held in Brisbane. Since then the Minister has engaged in a number of discussions on this subject with the Federal Council of the British Medical Association. *The Medical Journal of Australia* reported in its issue of the 10th September, 1952, as follows : - >Visit by Tins Minister for Health. The Minister for Health, **Sir Earle** Page, visited the Federal Council on Friday, August 22, 1952, and discussed with them during the greater part of the day matters relating to the Pharmaceutical Benefits Act and the Pensioner Medical Service. A free interchange of views took place, and then the Minister left the meeting. The following paragraph also appeared in that issue of the *Medical Journal of Australia : -* >General MEDICAL Services. > >The Federal Council had before it a statement issued by the Commonwealth Department nf Health in reference to the proposed scheme for the provision of medical benefits under a national health service, and also a copy of the proposed subsidies for minimum and optional services. This gave rise to a good deal of discussion . . . the Federal Council adopted a resolution, based on the lines of the Victorian Branch letter, that the profession in Australia should refuse its co-operation in a scheme of Government-subsidized medical benefits under the National Health Service Act, HMS. It urged the repeal of that legislation -and its substitution by an Act acceptable to the profession. After the Federal Council had heard the views of the Minister, and had received his assurance that a National Health *Act* would be brought down by the Government early in 1953, it offered its continued co; -operation in the preparation of tho medical benefits scheme. lt is significant that the clause provides that diagnostic and therapeutic services may be provided exclusively, for medical practitioners and hospitals. Both the British and New Zealand health schemes envisage the establishment of health centres at which diagnostic and therapeutic services will be provided. Apparently the Minister considers that such clinics should be attached to public hospitals hut not elsewhere. I point out that it is undesirable for persons who wish to obtain diagnostic advice to have to go to public hospitals, where the atmosphere is not always congenial. They have to state the nature of their business to gatekeepers or inquiry clerks, and there is generally an atmosphere of strict discipline. In my electorate there is a health clinic at which about 20,000 attendances were registered last year. I consider that sufferers from tuberculosis and other diseases should be able to seek radiological and X-ray services in a relaxed atm 0. > > **Mr.** *Morgan.* sphere. There is no reason why diagnostic and therapeutic services should be provided exclusively for the benefit of medical practitioners and hospitals. This aspect of the matter should be elucidated by the Minister. I am reminded of an experiment that was conducted at the Massachusetts General . Hospital in America. An autopsy that was conducted oil 3,000 persons who died in that institution revealed that medical diagnosis had been correct in only 52 per cent, of the eases. The trend in modern medicine is set out in the following article that appeared in the *Medical Journal of Australia, in* its issue of the 20th September, 1952 :- > >Medicine and Humanity. > > *By Morris C. Davis, M.D., F.R.A.O.I'.. Physician to In-Patients, Alfred Hospital. Melbourne.* > >To-day as never before there arc influences at work which make man an integral part of the things about him. More rapid transport and wider communications oblige him to seel; a broader outlook. He talks across vast spaces, at *in* simple turn of a dial he tunes in to the life of every land, and soon by television he will see into the most remote corner of the earth. So there dawns on him a new thought, a new way of life. Previously with his existence bounded by limited experiences, his life moved along unruffled within the confines of his own allotment. Now, whether he desires it or not, factors of increasing complexity make him answerable to countless environmental issue* that may equally influence his well-being. No longer must lie choose between black and white, but between a myriad of intermediate hues. This demands refined judgment and time for decision, yet by the very nature of his progress he is deprived of opportunity for contemplation. He therefore develops a tentative uncertain attitude, preferring no decision to an erroneous one. Such immobility in an elastic ever-changing environment produces tremendous nervous strain and results in functional disturbances identical with those produced by morbid pathological change. Medicine, therefore, concerned as it is with the individual's total well-being, must no longer limit its attention to the anatomical components of a person, but must survey all the physical, mental and social factors that make up life's programme. > >This attitude is reflected in the recent statement by the World Health Organization, wherein health is defined not merely as the absence of disease but .isa state of harmonious balance between physical, mental and social factors - " a state of complete physical, mental and social well-being ". Disturbance of this balance from elements entirely outside of the individual constitutes as real a cause of disease as does pathological change. In the health centres established under the British national health scheme, which the former British Minister for Health described as the key to that scheme, provision is made for trained social workers to be attached to the centres to consider various factors that affect a patient's condition. An illness may be due to social environment or industrial conditions, which are very important in this industrial era, when many men work with chemicals and gases that may affect their health. Social environment, industrial conditions, and domestic and financial problems must be considered. Those matters are outside the ordinary province of a medical practitioner and call for the services of trained social workers, psychologists and the like. Social workers, psychologists, physiotherapists, dentists and dieticians should be in attendance at health centres. It is recognized now that diet has a great bearing upon health, and that it is important in the pre-natal and ante-natal care of mothers and children, but it is a subject to which medical students do not devote much study. {: #debate-29-s15 .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable gentleman has exhausted his time. {: #debate-29-s16 .speaker-KGP} ##### Mr HAWORTH:
Isaacs .- If the amendment moved by the honorable member for Reid **(Mr. Morgan)** were accepted, clause 9 would read - >The Governor-General may provide, or. arrange for the provision of - > >aerial medicaland dental services; > >diagnostic and therapeutic services; > >teaching . . . I can understand why the honorable member has suggested that the words " for medical practitioners and hospitals " be. deleted.. If the words weredeleted, a government would be permitted to establish diagnostic and therapeutic centres throughout the community, run solely by the Government. That would be in. conformity with the platform of the Labour party, which states that medical services should be nationalized. {: .speaker-K8B} ##### Mr Curtin: -- We shall do it sooner or later. {: .speaker-KGP} ##### Mr HAWORTH: -- The honorable member for Watson **(Mr. Curtin)** has stated that medical services will be nationalized sooner or later. We desire to prevent that from being done, and this clause will do something to prevent it.. We do not want diagnostic and therapeutic services that are nothing more than regimented sick parades. Services of that type would completely destroy the doctor-patient relationship that exists to-day. The words " for medical practitioners and hospitals " have been written into the clause with the. object of preventing the nationalization of medicine. Under the clause in its present form, public health and tropical medicine services could be established, as well as centres for X-ray examinations and radium treatment. I shall be surprised and disappointed if the Minister for Health accepts the amendment moved by the honorable member for Reid. The clause is a good one. which, as I have said, will help to prevent the nationalization of medical services. I know the honorable member for Reid would like diagnostic and therapeutic centres to be established throughout the country, from which all health services could be provided free by the Government. Then we should have the regimented sick parades that the members of the Opposition desire. {: #debate-29-s17 .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- I am sorry to have to say again that the amendment shows clearly that the Opposition does not really understand the bill. The words " for medical practitioners and hospitals " are essential. They do, not make diagnostic and therapeutic services exclusive to medical practitioners, as the honorable member for Reid **(Mr. Morgan)** has suggested. {: .speaker-JVA} ##### Mr Morgan: -- That is the way in which I read the clause. {: .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- That is because the honorable member does not understand it. {: .speaker-KGP} ##### Mr Haworth: -- I think he does. {: .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- I shall do my best to explain it to the honorable member for Reid. The clause will permit diagnostic and therapeutic services to be established, for instance, in a district in which there is a large country town. A diagnostic laboratory or a pathological laboratory could be established - it might be a branch of the Commonwealth Serum Laboratory, for instance - and medical practitioners and hospitals could make use of it in the interests of patients. If the words " for medical practitioners and hospitals " were omitted, medical practitioners and hospitals would be denied the facilities of such laboratories. The words will not limit the use of the services exclusively to medical practitioners and hospitals. They have been inserted in order that medical practitioners and hospitals will be able to use the services in the diagnosis and treatment of disease. The words do not preclude the Minister for Health **(Sir Earle Page)** from establishing diagnostic centres for other purposes, but they make it plain that, when services of this nature are required, the Minister has power to establish them and to make them available for use by medical practitioners, in the interests of people generally. If the words were omitted, the Minister would not have such power. Therefore, it is obvious that they must remain in the clause. The honorable member for Reid talked about what he called psychologists and the like, the investigation of tuberculosis and so on. The words " for medical practitioners and hospitals " have been inserted in the clause so that the psychologists and X-ray specialists will be available in the treatment of disease. {: #debate-29-s18 .speaker-C7E} ##### Sir EARLE PAGE:
Minister for Health · Cowper · CP -- Onbehalfofthe Government, I resist the amendment. I cannot understand why the Opposition has suggested that the words be omitted. During the eight years that the Labour party was in power before this Government came into office, institutions of this kind worked in conjunction with medical practitioners and hospitals. The present Government parties established many diagnostic and therapeutic centres before World War II. If I am not misinformed, the Labour party established one at Wollongong during the period it was in office, and possibly another elsewhere.' In every case, I think, the centre has been established in association with hospitals. The centre at Launceston is associated with a hospital, as are those at Lismore and Tamworth. It is impossible to make the centres function satisfactorily and comparatively inexpensively if we do not utilize the facilities that are available in hospitals. Having seen a great deal of country practice I can say that such services are of extraordinary value. We have one in Canberra at present. Amendment negatived. Clause agreed to. Clauses 10 to 14 - *by leave* - considered together. {: #debate-29-s19 .speaker-JWU} ##### Mr ALLAN FRASER:
Monaro · EDEN-MONARO, NEW SOUTH WALES · ALP -- 'Clause 14, sub-clause (1.), reads as follows: - >Where a contributor incurs medical expenses in respect of a professional service specified in the First Schedule to thisAct and under the rules of the registered medical benefits organization to the medical benefits fund of which the contributor pays contributions the contributor is entitled to a fund benefit equal to or greater than the amount specified in that Schedule in relation to that service, Commonwealth benefit of the amount so specified is payable subject to and in accordance with the provisions of this Part. I move - >That in sub-clause (1.) the wordcontributor " be left out with a view to insert in lieu thereof the word " person ". Later I shall move that the following words be left out : - " and under the rules of the registered medical benefits organization to the medical benefits fund of which the contributor pays contributions the contributor is entitled to a fund benefit equal or greater than the amount specified in that schedule in relation to that service ". The amendment is most important. Its effect would be to remove the necessity for a person to belong to a private fund or a friendly society. It would ensure that every person who otherwise would be entitled to a Commonwealth benefit would receive that benefit by right, as a citizen and as a taxpayer, without any obligation to belong to a private society. If this amendment is carried, as I hope that it will be, it will be necessary to make many consequential alterations to the bill. For example it will be necessary to make an alteration also in clause 15. Clause 14 refers to the First Schedule to the bill and clause 15 refers to the Second Schedule. The objection to this clause is that it unduly restricts the number of Australian citizens who are entitled to medical benefits. Under this clause, instead of being a national scheme embracing the whole of the people of Australia, the Government's scheme becomes a partial scheme embracing only those who belong to particular societies. That, the Opposition contends, is entirely wrong. The adoption of the amendment that I have moved would enable all those who suffer from a chronic illness and elderly people to obtain the Commonwealth benefit in respect of medical attention. As has already been mentioned, many of the private funds to which people are now required to contribute as a condition of obtaining the Commonwealth benefit have a very high level of expense. I have already cited, the case of the Medical Benefits Fund of Australia which collected £401,000 in contributions- during the year ended the 30th June, 1953, and paid, only £166,000 in benefits in the same period. At that time I pointed out that the general expenses of that fund totalled £53,000 during that year, but in doing so I omitted to state that, in addition to that amount, the sum of £40,000 was shown as expenses in the appropriation account of the fund. Whilst that fund paid out £166,000 in benefits during the financial year, it also paid about £100,000 in management expenses in the same period. Nobody should be required to belong to such a society as that as a condition of obtaining a benefit for which he has already paid in the form of taxation at the appropriate rate. The purpose of the amendment is to remove that restriction and give to all the people of Australia, by right, the medical benefits that the Commonwealth provides. {: #debate-29-s20 .speaker-K8B} ##### Mr CURTIN:
Watson -- I support the amendment that has been moved by the honorable member for Eden-Monaro **(Mr. Allan Fraser).** I think that the scheme that is outlined 'by the bill is a. preposterous proposition to put forward in a democratic community. Sub-clause (1.) of clause 14, of the bill reads as follows : - >Where a contributor incurs medical expenses in respect of a professional service specified in the first schedule of this Act and under tho rules of the registered medical bene fits organization to the medical benefits fund of which the contributor pays contributions the contributor is entitled to' a fund benefit equal to or greater than the amount specified in that schedule in relation to that service, Commonwealth benefits of the amount so specified is payable subject to and in accordance with the provisions of this Part. In this clause, the man who has paid £45 a year into the National Welfare Fund is denied the right to receive a benefit in respect of medical services that he may require. This clause is a denial of democratic justice and the Minister for Health **(Sir Earle Page)** should have no hesitation in accepting the proposed amendment. The clause constitutes a denial of the rights of people suffering from chronic illnesses such as asthma, blood pressures, hernia and arthritis. For many years the trade union movement spent much time and had much trouble in establishing that men suffered from certain diseases due to their employment in certain industries. Now, the Government proposes to deny people their just dues in connexion with medical benefits. I appeal to the Minister for Health to accept the amendment because when the people of Australia feel the impact of clauses such as this they will wonder why the Government has inserted them in the bill. Have they been inserted at the behest of the governing body of the medical profession, the British Medical Association, or have they been inserted as a result of an oversight on the part of the Minister? I speak for my constituents in supporting the amendment. I do not know how the Government can justify its action in denying the people the right to benefit from the National Welfare Fund into which they have paid £160,000,000. I doubt whether this clause is constitutional. If it were challenged in the courts I do not think that it would hold water. I believe that in such a. case the courts would have no compunction in preventing the Government from carrying out its intention. I support the amendment, and I hope that the Minister for Health will give full consideration to the submissions of the Opposition, and will not deny the people of Australia the benefits that will accrue to them if the amendment is accepted. The people who contribute towards our social services as well as those who suffer from chronic diseases should be the first consideration of the Government, and the Opposition's amendment should be accepted. {: #debate-29-s21 .speaker-C7E} ##### Sir EARLE PAGE:
Minister for Health · Cowper · CP .- The Opposition's amendment is aimed at the destruction of the whole purpose of the bill, and at the insurance system that has been working well for some years. Therefore, it should be closely examined, and the reasons why we shall not accept it should be fully stated. It has been said that, under the Government system, the expenditure of the friendly societies will be very heavy. The position is, and the honorable mem-' her for Port Adelaide **(Mr. Thompson)** can support me in this, that only 8 per cent, or 10 per .cent, of the revenue of friendly societies will be Used in their part of the administration of the scheme. Indeed, organizations will not be approved by the Government unless they show that they can keep their expenses below at least 15 per cent. The American authorities have faced the same problems as we are now facing, and they have discovered that many big American organizations that irc participating in the health scheme have reduced their expenses to 4 per cent, or 5 per cent., and that the average is S 'per cent. That system is a very satisfactory alternative to the creation of a l uge bureaucratic organization, the cost of which might we'll run into millions of po mds. Lord Beveridge has stated that the cardinal error made by the United Kingdom in its health scheme was the rejection of two proposals that friendly societies should be used to 'administer the scheme. Lord Beveridge, in a book written in 1948, stated - >In rejecting two important proposals in the Report, for the use of friendly societies to administer State benefits .for sickness and allied purposes to their members . . . the Act commits the State to setting up a centralized bureaucratic machine. Whether any such machine can grapple with the fundamental problem of sickness benefit, of reconciling sound finance with sympathy and intimate local handling is uncertain. The Government of 1911 sought the maximum of co-operation between the State and voluntary agencies in the field of social insurance. The Government of 194G has divorced the two completely. > >The greatest danger of the present situation is not on the side of the friendly societies. They will survive; if they do not do so, their place would be taken by new forms of- VOl U,tary organization. The real danger - it is great as well as real - is on the other' side of the divorce. Will the State be able to create a machine capable of doing what the 'affiliated orders did in the most difficult of all forms of social insurance, of combining soundness with sympathy in administration of cash benefits to the sick? Will the State be able to avoid the evil alternatives of extravagance and of harshness? The present rulers of the State have lightheartedly taken on a task without as yet having shown understanding of its nature. Now let us consider what the position of the patients would have been if Labour's scheme had been adopted. The last Labour Government introduced a scheme which provided that where a person consulted a doctor and the consultation fee was 10s. 6d., the Government would pay 5s. 3d. and the patient would be required" to pay '5s. 3d. Under this Government's scheme the Government, together with the insurance organization, will pay 12s. or 13?. 6d. of a. consultation fee of 15s., leaving the patient to pay only ls. 6d. If a .person has a major operation that costs £25 under this scheme the Government and the insurance organization will pay £2,2 10s. and the patient £2 10s. Under Labour's scheme the patient was required to pay £12 10s., while the Labour Government proposed to pay -only £12 10s. {: #debate-29-s22 .speaker-KYC} ##### Mr POLLARD:
LALOR, VICTORIA -- But under the Labour Government's scheme the .patient would also have received his friendly society's benefit. {: .speaker-C7E} ##### Sir EARLE PAGE: -- Apparently the honorable member for Lalor **(Mr. Pollard)** now wants two schemes. He wants a huge bureaucratic organization, and a scheme embracing the friendly societies as well. In other words, he wants oil and water to mix. I suggest that that is merely stupid nonsense which will not affect the greatest supporters of this scheme, which are the friendly societies themselves. They support the scheme 'because they know that it will allow them to continue with, . and even greatly to expand their beneficent work. In New Zealand a person gets 7s. Od. in respect of a consultation with a doctor, and a fiat-rate payment at the rate of 7s. 6d. a visit towards a midwifery fee. The rest he pays himself. Despite what was said some time ago by the honorable member for Ballarat **(Mr. Joshua),** 88 per cent, of the patients who enter Royal Prince Alfred Hospital are insured for hospital and medical benefits. The whole system proposed by the Labour Government was characterized by meanness. For instance, the last Labour Government proposed to pay only 10d. a mile for attendance to sick persons, but this Government is paying 4s. a mile. What was the position of patients generally under Labour's scheme? How many doctors implemented the Labour Government's scheme under which the word " person " was substituted for the word "contributor"? Not one! {: .speaker-10000} ##### The CHAIRMAN: -- Order ! The time allotted for the consideration of clauses 1. to 14 has expired. Question put - >That the *word* proposed to be left out **(Mr. Allan Fraser's amendment)** stand part of the clause. The committee divided. (The Chairman - Mr. C.F. Adermann.) AYES: 53 NOES: 48 Majority . . 5 AYES NOES Question so resolved in the affirmative. Amendment negatived. Clauses 10 to 14 agreed to. Clauses 15 to 25 agreed to. Clauses 26 to 37 - *by leave* - considered together. Clause 26 (Claims by registered organizations) . {: #debate-29-s23 .speaker-JWU} ##### Mr ALLAN FRASER:
Monaro · EDEN-MONARO, NEW SOUTH WALES · ALP -- I move - >That, at the end of clause 26, the following new sub-clause be inserted: - " (.2.) *A* medical practitioner who has rendered a professional service for a person shall, on request by that person, supply to him a statement in writing giving particulars of the professional service and of the charge made therefor.". Clause 26 deals with claims by registered organizations. The purpose of the clause which I suggest should be added is to ensure that doctors shall, on request by patients, be required to supply to their patients a statement of the services which they have rendered, so that the patients, in turn, may supply such particulars to the organizations of which they are members in order to obtain benefits. I can scarcely imagine that the Minister for Health **(Sir Earle Page)** will decline to accept this proposal, because the legislation which he has introduced will not be workable without it. Clause 26 requires the production of vouchers before a contributor is entitled to claim and receive benefits. The vouchers which he must produce necessarily and obviously include accounts and the receipts from doctors, but the bill before the committee does not impose any obligation upon a doctor to supply such documents. That is, therefore, an obvious omission from the legislation. The clause which I have proposed will remedy that position. Its inclusion will not harm the legislation. Instead, it will tend to make the scheme introduced by the Minister more workable. I have no doubt that the right honorable gentleman will agree that if a doctor renders a service to a patient, receives payment from the patient and refuses to supply a statement of the service rendered or a receipt for the money paid, the patient will be thereby, deprived of the right and opportunity to obtain the benefit for which he paid his contribution to an approved society. In addition, he will be prevented from receiving the Commonwealth benefit which the Minister intends him to receive. Throughout this bill it is notable that the Minister has been most tender of the susceptibilities of members of the medical profession. Nowhere in the bill, as far as I am able to see, has he placed the slightest obligation on members of that profession. At the moment, I am not quarrelling with his failure to impose obligations on them in relation to other provisions of the measure, but surely this is an obvious obligation which he .must impose upon them if his own scheme is to be made workable. The position is, first, that the doctor may refuse or omit to provide any receipt or statement to the patient. The patient then would be debarred from obtaining the refund that is provided by this bill and he would be completely debarred from obtaining from the friendly society the benefit for which he had paid a contribution to that society. Secondly, the doctor may provide a statement in such a general form that it would be unacceptable to the society and unacceptable to the Commonwealth Department of Health as evidence of the service that had been rendered. That is happening throughout the Commonwealth. Patients are experiencing very great difficulty and delay in obtaining from the Commonwealth and from the societies the benefits for which they have subscribed. I do not think that it is a common occurrence for a doctor to refuse to provide a statement of account or a receipt. {: .speaker-KIF} ##### Mr Hulme: -- How does he receive payment if he does not provide it? {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- In some cases he is paid without providing a statement or receipt because he simply takes the cash and puts it in his pocket. {: .speaker-KIF} ##### Mr Hulme: -- That is the patient's fault. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- I do not say that it happens frequently. I should think that the occasions on which a doctor would refuse to provide a statement of account or a written receipt would be infrequent, but I think the honorable member for Petrie **(Mr. Hulme)** would agree that doctors frequently fail to provide statements in the form that is acceptable to the society and to the Com mon weal th. {: .speaker-KIF} ##### Mr Hulme: -- He should not be paid until he does. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The honorable member says that the doctor should not be paid until he does. That is not the position. The position is that the patient must pay the doctor before he can obtain a receipt, before he can submit that receipt to the society, before the society can examine the receipt and before it can pay the benefit to him. {: .speaker-KIF} ##### Mr Hulme: -- Then the doctor is out of pocket. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The patient may ask for a receipt for a payment, but in many cases the receipt that is issued by the doctor is not in a form that is acceptable to the society. But the patient does not know that. The patient takes away the receipt in good faith and he presents it to the society for payment. When the society receives the doctor'^ statement or receipt and examines it. it finds that the receipt is not. in a form which gives the society the information that is necessary. Furthermore, the society discovers that the statement or the receipt is not in a form that would be acceptable to the Commonwealth Department of Health before the department paid the health benefit. The manager of any society could inform honorable members that he is frequently faced with the difficulty that is associated with vague and inadequate statements of detail that are supplied by doctors to patients. {: .speaker-K7J} ##### Mr Cramer: -- How would the patient know, in any case? {: #debate-29-s24 .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- The honorable member for Bennelong **(Mr. Cramer)** asked how the patient would know in any case. He may not know, but the doctor knows. There should be a legal obligation on the doctor to provide the information in a form acceptable to the society and the Department of Health. He is the only person capable of supplying it. {: .speaker-KZE} ##### Mr Roberton: -- Why does he not supply it? {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- I do not know why he does not. He may not do so for any one of a number of reasons. It may be because of carelessness or dilatoriness or disinterest. The fact remains that in a large number of cases the inadequate and vague statements of account which are issued by doctors cause delay in the payment of benefits by both the Commonwealth and the friendly societies. I hope that the Minister for Health will accept the amendment. If opportunity offers under this ruthless application of the " guillotine ", the Opposition proposes to move further amendments. One of the proposed amendments provides for the insertion of the words "set forth in the Third Schedule " after the word " arrangement" in clause 31 (2.) (a). The purpose of the proposed amendment is to ensure that the arrangements that are made with the federal council of the British Medical Association under clause 31 (2.) (a) shall be published as a schedule to the bill so that honorable members will know the arrangements that they approve. There is no need to stress that fact. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable member's time has expired. **Mr. THOMPSON** (Port Adelaide) 5.16]. - Proposed new clause 26a seeks to impose upon doctors the obligation to do something which the Minister for Health **(Sir Earle Page)** expects them to do. If honorable members were no see the accounts that are issued bv doctors, they would understand the need for such a clause. I have mentioned on other occasions that I have a lot to do with friendly society work. For several years a friendly society would refund to its members 10s. for each visit that they made to a doctor. That was the position in my own lodge. A member would bring in his account and he would say, "I have paid the doctor this account ". The account that was rendered by the doctor might show an amount of £10 or £12 for services that were rendered from, say, the 1st June to the 20th August, but it might not show how many visits the doctor had made. The fact remained that the member was entitled to receive from his society 10s. for each visit. We would send that person back to the doctor in order to obtain the necessary information. If a person who is insured with a society goes to a doctor and the doctor gives him an account which shows that from the 1st June to the 20th August there were ten visits, the society is satisfied. Under the present system, the society would then pay to the patient ten times 6s. plus the same amount for the government subsidy. Another difficulty arises in relation to an account which covers the performance of an operation. Under the First Schedule to the bill, a patient is entitled to a payment of, say, £6 each from the Government and from the society. Under the Second Schedule, he is entitled only to the amount paid by the Government unless the society has made provision in its rules for payment under the Second Schedule. If a doctor shows on his account, " Operation for the removal of a breast " and that is all that he shows, and if the patient pays the account, the question is raised as to whether the doctor refers to the simple operation under the First Schedule or to the major operation under the Second Schedule. If the doctor were obliged to indicate the number in the schedule, the society would be able to see whether it was, say, operation No. 54 or operation No. 532. At present, the doctor is not compelled to do that. I agree that the majority of doctors submit their accounts properly, but other doctors do not include that information. The grand secretary of one society informed me that he communicated with one doctor in order to ascertain which operation was performed so that the society would know the amount that had to be refunded to the patient. The doctor replied that it was nothing to do with the lodge officer but rested between himself and the patient. The patient had to be asked to obtain the information from the doctor so that the friendly society could recognize the account and pay the amount that was due. The Government does not pay anything until after the approved society has paid the amount for which it is responsible. The society has to apply to the Government for its share of the amount and unless the form shows the relevant details, the society cannot get the money. The fault does not lie with the patient. Often he cannot get the information unless he is prepared to argue with the doctor or the person who makes out the doctor's account. The purpose of the amendment is to require the doctor to set out information when the patient asks for it so that the treatment can be identified and the society can pay the patient and apply to the Government for the amount. The Opposition is not trying to put anything over the doctors in. advancing this amendment. The facts that I have placed before the committee are not hearsay. I have seen, numerous accounts showing only that the bill is for services rendered. Sometimes it shows that the service has extended from one date to another but many accounts do not state the number df visits paid by the doctor to the patient. The honorable member for Batman **(Mr. Bird)** stated in this chamber last week that sometimes there was a delay of seven or eight weeks in the payment of amounts clue. Those delays occur for the reasons that I have stated. Approved societies are unable to determine from the accounts the amount that they must pay. If they pay too much, they cannot get it back and they withhold payment until they get the requisite information from the patient or the doctor. The doctor does not want to make out an account twice. If a person is npt entitled to a refund, it does, not matter. He simply pays the bill and that is the end of it. But if the patient is entitled to a refund, he must have evidence on his account, to show the treatment for which he paid the. doctor.. The amendment does not interfere with the proposals that are contained in. the bill. It is merely intended to simplify payment and obviate delays. {: #debate-29-s25 .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- The matter that has been raised by the honorable member for Port Adelaide **(Mr. Thompson)** presents a real problem. The honorable member has drawn attention to an aspect of the matter to which the Minister for Health **(Sir Earle Page)** might well be asked to give consideration. It is not a simple matter to include this proposal in the desired form. First, I propose to refer to the submission of accounts. In any case, the doctor has to submit an account if the patient is to get any benefit under the provisions of the bill. The amendment that has been moved by the honorable member for EdenMonaro **(Mr. Allan Fraser)** dealing -with that matter does not appear to me to have much force because the process has to be initiated by the doctor's account. I cannot see any point in putting anything about the account into this bill. Unless the doctor renders the account, no action under this measure can ensue. There is a problem, however, in the. question of certification because obviously an approved society must know for what it has to pay. The British Medical Association has been most insistent upon this point and has done its best to impress upon doctors that they must: give an approved organization the information that it requires on the form that it supplies.' At present that is done more or less by agreement. Obviously it must be' done. But the doctor is in a dilemma when he tries to determine how much he should disclose. A great many patients object to having a full' diagnosis of their ailment and details of the treatment displayed upon a certificate. It is not sufficient to state in the amendment that, the information must be supplied on request by the person concerned, because sometimes a patient asks for a diagnosis or a certificate about an illness when the doctor does not feel justified in giving it. The doctor may adopt that attitude because he thinks the patient is not sufficiently responsible, or the patient's family may object. There may be other reasons. The patient may bc a minor and the family may ask for a certificate. Later, when the patient is no longer a minor, he may object to the information having been given. So the question of certification is not easy. {: .speaker-KVT} ##### Mr Thompson: -- An indication must bc given of the type of tho operation. {: .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- Exactly. There is much force in the statements that have been made by the honorable member for Port Adelaide as to quoting the number in the schedule. If the Minister will examine that aspect to determine whether the difficulty of supplying the information could be overcome, T (1(, not believe that the medical profession would consider that it was being asked to do something improper. The approved societies must have the information so that they can make payments without undue delay. Accordingly I a3k the Minister whether he will give some consideration to certification under clause 26 of the bill. T suggest that action might be taken along the lines that have been suggested by the honorable member for Port Adelaide and that a number in the schedule might be quoted rather than, the technical details of the operation, the diagnosis or the treatment. The difficulty in connexion with the number of visits could be overcome easily, but the particulars in the schedules are *a* more difficult matter. **Mr. E.** JAMES HARRISON (Blaxland) * ~>.27'.* - In .stating that the matter under discussion presents a problem, the honorable member for Oxley **(Dr. Donald -Cameron)** has made an admission that is of some value. However, I suggest that the matter of the number of visits by a doctor is equally as important as the designation of the number in the schedules. The number of visits can be obtained from one source Or another. {: .speaker-K7J} ##### Mr Cramer: -- How would the patient know? {: .speaker-C7E} ##### Sir Earle Page: -- That information in list bc obtained from the doctor. It is obtained from the doctor now. No doctor i< paid unless he includes that information. {: #debate-29-s26 .speaker-KNM} ##### Mr E JAMES HARRISON:
BLAXLAND, NEW SOUTH WALES · ALP -- Unless the doctors have changed their practice in the past twelve months- {: .speaker-C7E} ##### Sir Earle Page: -- They have done so since the 1st July last. {: .speaker-KNM} ##### Mr E JAMES HARRISON:
BLAXLAND, NEW SOUTH WALES · ALP -- There is still great difficulty in getting information with regard to the number of visits that a doctor pays to his patients. That is particularly the case when patients are in private wards and the doctors visit them periodically during their hospital visits. Unless there is a clear stipulation that the visits must be listed, the patients will virtually have to keep an account of the number of visits that they receive from the doctors. There is agreement between the Opposition and the Minister for Health **(Sir Earle Page)** upon some aspects of this measure, and one of them is that the system should not be allowed to run wild. I believe that the doctors should stipulate clearlythe number of visits that they pay to. patients. If that is left to the patients,, extra visits might be added to the list for the purpose of collecting 6s. or 12s. for each of them. {: .speaker-C7E} ##### Sir Earle Page: -- If 30, the patient would have to pay an additional amount. {: .speaker-KNM} ##### Mr E JAMES HARRISON:
BLAXLAND, NEW SOUTH WALES · ALP -- Not if, in fact, the visits were made by a doctor to a private ward in which the patient was accommodated. That aspect of the scheme must be taken care of. "We suggest that it will be taken care of if the proposed new clause be accepted. When the honorable member for Bennelong **(Mr. Cramer)** asked by interjection how a patient would know the number of visits made to him by a member of the medical profession he stressed the need for this amendment. Let us reach agreement on the suggestion that the number of visits and the schedule number under which the benefit is listed must be included on statements of professional service rendered by doctors. Unless that is done the patient's word may have to be accepted in substantiation of the claim. The honorable member for Bennelong has made it clear that, in his view, the amendment is necessary. We cannot afford to allow the patient to bc the sole authority responsible for furnishing information upon which a claim i? based. Ti' the amendment be accepted, an obligation will be placed upon the members of the medical profession to ensure that patients shall receive only those benefits to which they are entitled under the schedules to the bill. Au obligation should be imposed on them to supply to their patients statements in writing giving particulars of professional services rendered and the charges made therefor. In most instances no dispute will arise on that point, but the legislation should be made specific. The Minister has stressed the need for maintaining a proper balance in the relations between the patient and his doctor. The more clearly these matters are defined in the bill, the more scope there will be for the maintenance of that proper balance in the relations between the doctor and his patient that the Minister so desires. A doctor must provide information required by a registered organization before it authorizes payment of a claim. "We cannot leave it to the patient to advise the organization of the number of visits by the doctor. If that were done the scheme would be subject to all sorts of abuses. There must be a proper check between the patient and the doctor in relation to the amount paid by the organization from its own funds and those paid by it on behalf of the Government. Unless that is done the revenue cannot be properly protected. {: #debate-29-s27 .speaker-K7J} ##### Mr CRAMER:
Bennelong .- I am afraid that, in order to overcome some of the difficulties which have been referred to during this debate, we might be inclined to enmesh members of the medical profession in a lot of unnecessary red-tape. "We must do everything possible to avoid that. Claims made upon a registered organization are vetted by the organization before the payment is made to the patient from its own funds and on behalf of the Government. Virtually a double check is imposed by the organization, first when it pays money from its own funds and on behalf of the Government and, later, when it renders monthly accounts to the Director-General and furnishes full information covering the payments made. That check is outside the provisions of this bill. My principal concern is that we should not so enmesh the scheme in red-tape that it will become obnoxious to those who are concerned in its functioning. Doctors, who are so busy these days, believe that their time should not be wasted by unnecessary provisions. Their responsibilities should be stated in the simplest possible form consistent with safety, with the realization that a double check will be imposed on all payments made by registered organizations. I do not know how the Minister views the amendment. While I oppose it, he may share the view expressed by the honorable member for Oxley **(Dr. Donald Cameron)** that there is some virtue in it. I believe that the bill, as drafted, provides sufficient protection to the revenue, having regard to the double check imposed by registered organizations to which 1 have referred. The scheme is based on co-operation. The registered organizations play an important part in it, in respect of not only benefits provided from their *own.* funds, but also the government benefits. Legislation of this kind is always subject to regulations and conditions which are not necessarily stated in the legislation itself. I urge the Minister to be careful not to hinder the medical fraternity by making the scheme so cumbersome as to detract from the services rendered to the community by the members of the medical profession. {: #debate-29-s28 .speaker-JPE} ##### Mr BIRD:
Batman .- I appeal to the Minister to accept the amendment. I differ very strongly from the honorable member for Bennelong **(Mr. Cramer),** who has contended that if the amendment is accepted the members of the medical profession will be enmeshed in red tape. The majority of the members of the medical profession already furnish statements of the kind which the amendment, proposes shall be furnished by them. A minority of doctors in Melbourne have so far not given effect to the wishes of the majority of the members of the British Medical Association and do not furnish statements that are satisfactory to the registered organizations. A controversy has been raging in the Melbourne metropolitan press in regard to the length of time taken by the Hospital Benefits Association of Victoria to pay claims lodged with it.' When the controversy was at its height the newspapers asked the organization to explain the reason for the long delay in making payments. The Melbourne *Herald,* a newspaper of repute and probity in matters of this kind, conducted an inquiry into the matter. I shall quote from an article which was published in that journal recently because I regard it as apposite to this matter. The article stated - *Payments Lag.* Victorian doctors will have to forget some of their old professional aloofness and vagueness about their patients' illnesses if the Federal Government's medical scheme is to work efficiently and quickly. Assessorshandling medical benefit claims say that the biggest single thing holding up speedy payments is lack of information needed to enable them to pass the applications. The Hospital Benefits Association of Victoria has been under fire as a result of numerous complaints that members are obliged to wait for unduly long periods for payment of benefit after they submit their claims. Widespread dissatisfaction and even indignation has been caused by these delays. One listener who heard my remarks on this point during the course of my speech on the second reading last week has since informed me that he has been waiting for a period of nine weeks and has not yet received payment of benefit from that association. The association, in reply to criticism levelled against it, issued a statement in which it said - >It would help greatly in speeding up the handling of claims if doctors would include with their accounts to patients a concise description of the treatment given. There are604 different items in the schedule of medical claims, and we cannot pay out government money without exact knowledge of what treatment has been involved. > >The accounts should also show the dateof consultation and the number of visits. Many doctors are already doing this. The association claims that the delays are due to the fact that a small minority of doctors do not supply adequate details on the accounts that they render to their patients. Such delays cause inefficiency, and, consequently, the scheme is suspect in the view of many persons who have joined an approved society and have not only failed to obtain settlement of their claims, but also havenot received any advice from the society about them. The object of the amendment is simply to oblige the small minority of doctors who are at fault in this respect to fall into line with the vast majority of the doctors who show the required particulars *on* the accounts that they render to their patients. Recently, I received from my doctor an account which showed only the total amount of my indebtedness. I telephoned his receptionist and asked that the number of the visits, with the appropriate dates, be shown on the account so that I could satisfy the requirements of the society of which I am a member for the purpose of payment of benefit. The doctor complied with that request. However, the particulars were not supplied until I requested that they be shown on my account. A difficulty of that kind can be overcome by the use of a standard form. Such a procedure would simplify matters considerably. Probably, the British Medical Association could devise a form for that purpose. It would be a common-sense procedure and would not encourage red tape. {: #debate-29-s29 .speaker-KWH} ##### Mr TOWNLEY:
Minister for Social Services · Denison · LP -- Members of the Opposition have overlooked the fact that an agreement has been entered into between the approved organizations and the British Medical Association on the point that has been raised in the amendment. I should think that considerable dissatisfaction would have become apparent long before this if any great need existed for the amendment. I agree with the honorable member for Oxley **(Dr. Donald Cameron)** that important principles are involved. I cannot imagine that many doctors would accept for one moment a provision that they must show on a patient's card the history and intimate details of the professional service that had been rendered. Furthermore, very few patients would like to have such details shown on their accounts. Certainly, many women would object strongly to such a procedure. If honorable members glance at the items shown in the Second Schedule, for instance items 466 and 467, they will readily appreciate the point that I am making. I agree with the honorable member for Oxley, who, like the Minister for Health **(Sir Earle Page),** is a member of the medical profession, that the amendment raises difficult matters and requires most careful consideration. Perhaps, as he has suggested, a compromise could be worked out whereby an approved society could be adequately informed of the professional service rendered to a patient and, at the same time, the doctor-patient relationship could be wholly preserved. As the honorable member for Batman **(Mr. Bird)** has said, very few doctors have failed so far to supply satisfactory statements of accounts. The British Medical Association, which represents - the great majority of doctors in this country, has advised its members that they must supply satisfactory statements to approved societies. We must remember that the scheme has been in operation for only a few months. Difficulties are bound to *rise, but I am confident that they will be ironed out in due course. So far. a considerable measure of agreement has been achieved between the doctors and the approved societies, and I believe that those doctors who are not supplying statements of accounts in a satisfactory form will come into line with their colleagues. {: #debate-29-s30 .speaker-KFD} ##### Mr GREENUP:
Dalley .- I fail to comprehend why the Minister for Health **(Sir Earle Page)** will not accept the amendment. Apparently, some Government supporters are in favour of it. Its object is not only to protect the patient but also the doctor himself by enabling approved organizations to adhere to the letter of the law. I do not agree that acceptance of the amendment would encourage red tape or place an undue amount of work upon the doctors. Doctors are able to obtain clerical assistance. Indeed, they are more favorably placed financially under this scheme and thus are better able to obtain such assistance than they have been hitherto. The amendment seeks to insert in the measure the following ° provision: - >A medical practitioner who has rendered a professional service for a. person shall on request by that person supply to him a statement ' in writing giving particulars of the professional service and of the charges made therefor. . What is wrong with such a provision? I, personally, know of a number of instances in Sydney, involving friendly societies particularly, in which undue delay has occurred, in dealing with claims for benefit. The Government requires persons to join approved societies in order to qualify for benefit. Consequently, when a person incurs expense in obtaining medical treatment payment of benefit should not be delayed' merely because his doctor has not had time, or simply refuses, to furnish to the society a statement giving the requisite details. Undoubtedly, many medical practitioners are most obliging, but a few do not go out of their way to render a simple service to their patients. I suspect something clandestine about the whole bill. Perhaps the Minister has to run to the British Medical Association to get his instructions. It is time that this Government acted as a responsible government acts, and made provision for the correct procedure to be followed, in the interests of the people whom it is supposed to represent here. This bill will affect the lives of many people who are entitled to receive justice. I cannot understand why the Minister quibbles over this simple proposal. The honorable member for Bennelong **(Mr. Cramer)** made heavy weather of his attempt to justify the Government's attitude, and I thought that he secretly approved of the amendment, but was not " game " to support it with word and vote. I appeal to the Minister to be fair-minded in this matter. I hope that he is not acting on the instructions of the British Medical Association. The amendment, if it is adopted, may slightly improve a bad bill. I have been, in turn, a member, a grand, lodge officer, and a grand master of a friendly society in New South Wales, and quite a number of persons have informed me that the whole position is almost impossible for members of approved organizations. A doctor should supply the simple particulars of professional service for which a patient asks in order that he may recover, without delay, a benefit from a friendly society or approved organization. The last thing the Minister should do is quibble over this matter. His hostility to the amendment causes me to believe that he is acting in a clandestine manner in an effort to protect the British Medical Association. Let him treat the people fairly by accepting this simple reform. {: #debate-29-s31 .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- I merely wish to say two things about the. amendment. The first is to. remind- the Opposition that personal attacks upon the Minister for Health **(Sir Earle Page)** are no argument, one way or the other. The second is that some constitutional difficulty may complicate the carrying out of this amendment. If such a difficulty exists, the committee may well be made aware of it and proceed, in the knowledge of it, to some other conclusion. But I feel sure that, if there is a constitutional difficulty, the Minister would be quite willing to accept any reasonable arrangement which would put into practice the wishes of every one in this matter. That is to say, when a patient is seen by a doctor, the process whereby he ultimately recovers from his society the fees that he pays to the medical practitioner, shall be expedited. No honorable member wishes the payment by the friendly society or approved organization to the patient to be delayed. The last person who would wish it to be delayed is the Minister himself. No one on the other side of the chamber need have any apprehension that the Minister is wilfully obstructing sensible arrangements, because such a conception would not be based on reality. In spite of remarks that have been made about the British Medical Association this afternoon, the facts are that the asociation has done everything in its power to ensure that these arrangements shall work smoothly, and that the relevant information shall be supplied by its members to the societies. Indeed, the British Medical Association has circularized its members, requesting them to use every endeavour to give the societies the necessary information, as rapidly as possible. More than that the British Medical Association cannot do. To put the matter on no higher plane than mere self-interest, it is obviously in the interests of all doctors that these arrangements should work smoothly. But quite apart from that, what the committee wants is a sensible working arrangement, and if there is no constitutional barrier to it, I feel sure no honorable member on either side of the chamber will be glued to some form of words. If we can get a reasonable and satisfactory form of words which will ensure the objective that we all desire to attain, no one need have any apprehension, that the Minister or any honorable member on this side of the chamber will stand in the way of it. {: #debate-29-s32 .speaker-JVA} ##### Mr MORGAN:
Reid .- The honorable member for Oxley **(Dr. Donald Cameron)** has really " put it up " to the Minister for Health **(Sir Earle Page),** and we shall soon know whether he takes notice of the wishes of this chamber, or bows to instructions or directions from an outside authority. {: .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- Nothing of the sort. I referred to constitutional difficulties. {: .speaker-JVA} ##### Mr MORGAN: -- The honorable member is a practising doctor, and he knows that no big difficulties are in the way of the adoption of the amendment. He has referred to the possibility of the existence of constitutional difficulties. What could they possibly be ? This is purely a matter between doctor and patient. It is the patient's privilege. Medical practitioners have frequently claimed in a court of law professional privilege as a reason for a refusal to disclose information about a patient. That claim has not been upheld, and it does not arise again now. A patient should be able to obtain from his doctor the information that is required by an approved organization. The amendment, if it is accepted, will not affect in any way the proper functioning of the scheme. The British Medical Association has always taken a consistent stand on this matter. Under the McKenna plan, the procedure was simple, and the vital principle of the need for the preservation of secrecy was recognized. Fewer than 9,000 returns were to be made by all the medical practitioners who participated in the scheme. Under the present proposal, millions of returns will be submitted in respect of millions, of patients. Again, under the McKenna plan, the kind of service performed was to be indicated by a sign or symbol, and the information was to be sent direct to the Department of Health. Particulars about professional services, and. charges would not have been in the hands of outside persons, as will the information on the millions of forms which will be filled' in for patients and will pass through, the hand?, of the staffs of approved organizations. That kind of procedure will make secrecy impossible. So the Government is faced with a dilemma. The whole scheme will be confused, and will not function smoothly. The bill should make it possible for members of approved organizations to receive the benefits that accrue to them as quickly as possible. Doctors will not have the same difficulty of collecting outstanding fees they have had in the past, and the little extra service that is contemplated in the amendment would not put them to any. inconvenience. Some doctors already provide this service. What is good enough for a section of the medical profession should be good enough for the whole of it. I urge the Minister to accept the amendment. *Sitting suspended from 6 to 8 p.m.* {: #debate-29-s33 .speaker-JVA} ##### Mr MORGAN:
REID, NEW SOUTH WALES · ALP -- Will the Minister say whether he took the opportunity offered by the dinner adjournment to discuss this proposed amendment with representatives of the British Medical Association? {: .speaker-C7E} ##### Sir Earle Page: -- I shall answer that when the honorable member sits down. {: .speaker-JVA} ##### Mr MORGAN: -- I think the Minister might well have done that in view of the suggestion by one medical member on the Government side that the amendment is reasonable. Apparently the Minister is not prepared to take the risk that was taken by another Minister in an anti-Labour Government in New South Wales. When a bill was presented to him, he said, " Who drafted this? " When he was told that it had been drafted by the British Medical Association, he said, "I will not have anything to do with it". He was promptly relieved of his position and he retired to the seclusion of the Speaker's chair. I can quite understand the hesitation therefore of the Minister for Health. Apparently the British Medical Association is to be sacrosanct. It has no obligation to conform to any procedure that might contribute to the smooth working of this scheme. Yet it remains all powerful! Secret negotiations have taken place, and certain agreements have been arrived at between the Minister and representatives of the British Medical Association. We are now being asked to give legislative sanction to those agreements although we do not know the details of them. Eor instance, clause 31 provides that an arrangement made with the federal council of the British Medical Association shall be deemed to be an agreement entered into by the Minister under this legislation. The position is extraordinary. We are being asked to enact an agreement that has not been tabled. We have been told nothing at all about the contents of the agreement,' nor have we been told anything about the constitution of the organization with which the agreement has been made. I invite the Minister to inform us of the constitution of the British Medical Association. Has it any statutory authority? Most trade unions are constituted under some act of Parliament, but the constitution of the British Medical Association, which is to be given sweeping powers under this legislation, is being kept secret from us. The Minister might enlighten us about the agreement referred to in clause 31. I understand that it is mentioned in communications between the Minister and the British Medical Association. Surely we should know the terms of the agreement before being asked to incorporate authority for it in an act of Parliament. Otherwise we are being asked to buy a pig in a poke. An extraordinary procedure has been adopted also in relation to clause 37. There again the Minister is beholden to the British Medical Association. The Minister has divested himself of all authority in relation to the appointment of disciplinary committees. Members of those committees are to be nominated solely by the British Medical Association, a body which, as I have said, has no statutory authority whatever. The committees will have far-reaching powers over the rights of individuals. They will be authorized to decide whether or not a doctor has committed a certain breach of his agreement, and, in the event of an adverse finding, to terminate that agreement. For all practical purposes that would mean that a doctor would lose his practice. Dealing with his right of appeal the bill presented in March last provided - (4.) Upon the hearing of such an appeal, the Supreme Court may - {: type="a" start="a"} 0. admit further evidence, either orally or upon affidavit or otherwise; ('<) Permit the examination and crossexamination of witnesses; («) Affirm, reverse or modify the direction of the Minister; and («t) Order either party to pay costs to the other party. This measure eliminates that clause and provides that at the hearing of an appeal the court shall - {: type="i" start="1"} 0. . have regard to the evidence before the Committee of Inquiry and the report of the committee. In other words, no further evidence may be called, and the appellant must rely on evidence already given, probably in secret. {: #debate-29-s34 .speaker-10000} ##### The CHAIRMAN: -- Order ! The honorable member's time has expired. {: #debate-29-s35 .speaker-C7E} ##### Sir EARLE PAGE:
Minister for Health · Cowper · CP -- The amendment touches upon one of the most important machinery provisions in the bill, and it is necessary that I should explain it because there seems to be considerable confusion of thought in regard to it. What has been said in the course of this debate will assist the .British Medical Association to bring about the condition of affairs which apparently everybody wishes to see. I refer to the desire that the form of accounts should be such as to ensure their quick payment. This matter is not new to us, although apparently it is to some honorable members opposite. In my very first speech on this scheme in May, 1950, I raised this matter with the British Medical Association, and on the 29th May of that year, the association was good enough to write me a letter informing me that the following decision had been made : - >That the Federal Council agrees to the request of the Minister for Health that in any fee-for-service scheme itemized accounts lie rendered to the patient by the medical practitioner. That is exactly what is being asked for by the Opposition, and the British Medical Association has been active in its endeavours to bring about that state of affairs. In July of this year, when the introduction of the scheme was imminent, the association immediately took action to make certain that from the very beginning the accounts rendered would be in the simplest possible form so that there would be no delay in payment: For instance, on the 10th J une, the British Medical Association in Victoria sent out a circular containing the following statement: - >On 1st July, 1953, the Commonwealth Government Medical Benefits Scheme will commence. Medical practice will continue as heretofore. The co-operation of the medical profession consists in the supply to patients of receipts after payment of their accounts. Those patients who belong to Medical Benefit Organizations such as the Friendly Societies, the Blue Cross Society, or the Hospital Benefit Association, will present these receipts to their respective organizations. They will then receive a refund of a certain specified amount for each service. The medical benefit organization will in turn receive a refund from the Government of a certain specified sum not exceeding half of the total benefit . . . > >To facilitate these arrangements doctors are requested to issue receipts to those patients requesting them on receipt forms of the size and set-np of the enclosed forms *A* and B. I have copies of these forms. They cover all the points that have been raised by tha honorable member for Port Adelaide **(Mr. Thompson).** Spaces are provided for the patient's name, the date, the service given, and the fee ' charged. . Members of the British Medical Association, have been using these forms ever since the circular was distributed to them. There is another form to show that the fee has been received, which can be sent immediately to the insurance organization so that it can collect the Government's contribution as soon as possible. We desire not only to satisfy the patient but also to enable the organization to carry on its good work without being at a financial disadvantage through delay in recovering the Commonwealth benefit. On the 7th September, the Victorian branch of the association went further and issued a circular letter to members in which it impressed upon them the necessity for co-operation. That letter contained the following advice: - >Members will remember that in the circular of June 10, it was stated that in respect of a course of consultations or visits, it was necessary to specify on account forms only the commencing date of treatment and the number of visits or consultations. A request has now been received from the benefit organizations and the Commonwealth Health Department that, for the smooth working of the. scheme, it is necessary for the date of each consultation or visit to be specified. Unless this is done the benefit organizations would not bc in :i position to compute thi" rebates i lue to their members in cases where they have become unfinancial during the course of treat.ment or when they are receiving treatment during or partly during probationary periods nf membership. The inclusion of the dates of services also means that possible double payment of claims can be checked. The Branch Council decided to accede to the request and to notify members of the Branch accordingly. On the 19th October, the New South Wales branch issued another circular to its members. These are only a few of the communications that have been sent out by the British .Medical Association, a fact which shows that it is fully seised with the importance of the points that have been mentioned by honorable members to-day. As the honorable member for Bennelong **(Mr. Cramer)** has said, the doctors' payments depend upon their cooperation. The New South Wales circular of the 19th October, stated- >Since the introduction of the Commonwealth Government's Medical Benefit Scheme, delay Iia? occurred frequently in the settlement of contributors' claims, due to a lack of sufficient information on the doctors' account forms. > >To help in overcoming these delays, members are asked to supply the following information mi their accounts, viz.: - *(« ) An aesthetic Services* - The nature of the anaesthetic should lie given, e.g., intravenous, spinal, local, &e. In the case of certain anaesthetics it is .necessary to supply information as to whether the time taken in the administration df the anaesthetic was less 'than or greater than one half-hour. -Failure to supply this particular item of information may result i:i -the contributor receiving a. benefit on a lower scale. The association was considering the ink' rests of patients and wanted to -make sure that they would bc properly paid. The circular .continued - >Reference to Items 2 ami ;i:i!> >>:f the list of Commonwealth Medical Benefits 'will indicate the nature of the information required. > >Where the account rendered by the surgeon includes the anaesthetist's fee. the name of the anaesthetist is to 'be given. The fee for > >Mie administration of the anaesthetic should lie shown separately from the fee -fur the i >n')":i f ion. Where thu anaesthetist renders his account separately he must give, in addition ti.i the details of the anaesthetic, the date of the se.i vi' e and the name of the surgeon. (ti) Assistance *tit Operations.* - When the account rendered by the surgeon includes the assistant's fees, the name, of thu assistant is to be given. The length of time of tho opera- ( ion is to he stated in accordance with the time periods .referred to in Item f>2 of the list of Commonwealth Medical Benefits. Failure to supply this information may -result in the contributor receiving a benefit ou a lower sCale. Where the assistant renders his account separately, he should give the date of his services, the length of time of the operation in accordance with the time periods referred to in Item 92 of the list of Commonwealth Medical .Benefits, and the name of the surgeon. {: type="a" start="o"} 0. *Surgical Procedures.* - The nature of the surgical procedure should be stated, e.g., cholecystectomy. 1. *Pathological and Radiological Services* - 'J lie nature of the particular pathological or radiological examination should be .given, e.g.. glucose tolerance test, intravenous .pyelography, &c. The co-operation of members in this matter will be greatly appreciated. The supplying of tho necessary information will be of advantage not only to the contributor but to the doctor himself. {: .speaker-6V4} ##### Mr Daly: -- Who wrote that? {: .speaker-C7E} ##### Sir EARLE PAGE: **- Dr. .J.** 0.' Hunter, medical secretary of the New South Wales branch of the association. It continued - >It will obviate the necessity of the medical benefits organizations asking the medical attendant to supply the information at a later date. That proves that the associa tion lias been actively pursuing the aims that have been so well stated to-day by various honorable members. It has done so voluntarily and has co-operated with the Government in the .most sympathetic and earnest manner possible. I venture to say that the first, questions that -a doctor asks any patient now are, "Are von insured 4 " and " What lis the name of the organization ? so that he can send the facts to the organization. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- Do they send *thu* facts direct to the organizations? {: .speaker-C7E} ##### Sir EARLE PAGE: -- Yes. They acquaint the organizations with, details of the work that they do in order to help the scheme along. Therefore, it must be obvious to honorable members that the principles of which they have spoken are being observed in practice by *thodoctors.* Unfortunately, the amendment proposed by the honorable member for Eden.Monaro **(Mr. Allan Fraser)** is framed in such a way as to bring the element of compulsion into tb.fi matter. That is my only objection to it. The Government's legal authorities have advised me that the adoption of the amendment would undoubtedly lead to the result that followed the former Labour Government's :i attempt to enact its pharmaceutical benefits legislation. The provision would i>i' held by the High Court to Le invalid because it would involve civil conscription. I submit that there is no necessity 10 compel doctors to do the job for which the proposed new clause provides because already under the direction of their own organization, they are doing it to the utmost of their ability. They are co-operating fully in every way. In fact, the members of the British Medical Association themselves devised the common form of account to which I referred earlier. The inclusion of any compulsory provision in the clause would involve the danger of having it declared invalid, and I do not wish to take that risk, especially as there Ls no suggestion of compulsion anywhere in the bill as it now stands. Mli:. Biko- People are compelled to insure themselves in order to -obtain i Commonwealth benefits. {: .speaker-C7E} ##### Sir EARLE PAGE: -- 'The benefits are available to every man 'and woman who is willing to join an approved organization. I hope, that similar freedom will apply in relation to membership of trade unions so that people will be able to decide fin- themselves whether or not they wish to join such .bodies. There is no element of compulsion in 'the bill, and "the Government will not acid that 'element because it 'would 'almost -certainly "result in 'the legislation as a whole being declared a n constitutional. Furthermore, the insertion of compulsory provisions would 'make it necessary to add "penalty clauses also. Lt would be useless to include instructions that doctors must perform certain actions without including provisions for penalties in the event of disobedience. As soon as "penalty clauses were added, "the h;j ck les of everybody concerned would rise. Nobody should know, that better than the members of the Labour party. All goodwill would be 'lost, and goodwill is essential to the efficient working of the scheme. There must be the highest possible degree of co-operation between the doctors, the insurance 'organizations, the Government and everybody else associated with the scheme. Without goodwill, we should be in permanent trouble. Therefore, it would be very unwise for us to adopt the amendment. I have another objection to the Opposition's proposal. As a practising doctor, I know that the furnishing to a patient of a statement setting out what he is suffering from may have a bad psychological effect on him. Furthermore, it is bad 'in "principle for other people to know the details of his complaint. That is a personal matter between the doctor and his patient. The "bill requires only a minimum of information to be furnished to enable an account to :be paid. The Government believes that the insertion of an element of compulsion would destroy the validity of the clause, and possibly the bill as a whole. The doctors themselves, for about three and a half years, have extended to the Government the maximum degree of cordial cooperation. During 'the last six months we have been -successful in obtaining a degree of uniformity between the various insurance organizations. They "have formed a federal council, which is in constant communication not only with fie Government but also with the doctors and chemists' associations. Many anomalies have been overcome, and bars to insurance have been removed. They are prepared to straighten out these things provided that other organizations will not obtain an advantage as a result of restrictions that they place upon 'themselves. The Government rejects "the amendment, on the ground that it is desirable to retain that cordial relationship. {: #debate-29-s36 .speaker-6V4} ##### Mr DALY:
Grayndler .- The Opposition has .moved for the insertion nf a new clause, to read - >A medical practitioner who 'has .rendered .a professional .service for :a person shall, on request by that person, supply to him a statement in writing giving .particulars of the professional service and of the charge -mad* therefor. That is a very sensible and reasonable proposition. The honorable member for Oxley "(Dr. "Donald 'Cameron), .himself a practising doctor, 'has supported the contention by -honorable members on .this :s'ide of -the chamber. He said that he considered the proposition was one that the Minister for Health **(Sir Earle Page)** should reasonably consider. I have no hesitation in informing the Minister that the explanation that he has given to the committee on behalf of the British Medical Association is not acceptable to the Opposition. The case that has been put for the organization by the Minister, who is (the agent of the association in this House, completely disregards the opinions of average laymen in the community. I am not criticizing the doctors, as individuals, but the representatives of the British Medical Association, who have always had their way with the Minister. The right honorable gentleman has stated that he rejects the amendment because he does not wish to insert a compulsory clause which could result in the legislation being .declared invalid. Every member of this Parliament, and indeed every person in the community, knows that this measure contains a vicious form of compulsion. The members of the community are required to join an organization in order to become eligible for the government subsidy, despite the fact that an average of £45 a head is paid by them each year as social services contributions. The Minister is certainly pitting the British Medical Association against the Parliament. Why should not the doctors put down in writing particulars of the treatment that they have given to their patients in order that the provisions of the schedule can be applied? The Minister should have taken notice of the contention of a supporter of the Government, who is a practising doctor - possibly a much better medical man than the Minister himself - instead of reading to the committee documents that he had kept secret until he was forced to disclose them to-night. Instead of presenting the case on behalf of the British Medical Association as his gospel and his policy the Minister should have presented the case for the average person in the community in order to ensure that the Government's health scheme would be national rather than sectional in nature. I come now to the question of agreements that have been entered into between the Government and the British Medical Association, which are referred to in clauses 31, 32 and 33. Although it is vital for every member of the committee to know the terms of the agreements, they are not set out in the bill. The effect of the amendment to clause 31 that has been foreshadowed by the honorable member for Eden-Monaro **(Mr. Allan Eraser)** will be to force the Minister to table agreements in relation to the pensioner medical service. Why should they be kept secret between the Minister and the British Medical Association ? The Opposition is entitled to be informed of the terms of the agreements to which the Minister has committed the country. We are asked to endorse a proposal without being informed of the agreements thai have been entered into. The Minister should explain the details of the agreements to the Parliament. Clause 32 deals with agreements with the British Medical Association and clause 33 deals, with agreements with the medical profession in relation to the pensioner medical service. We should be informed of the terms and provisions of the existing agreements. Who signed them on behalf of the Government, and to what are we committed? As the honorable member for Eden-Monaro pointed out in an excellent speech on Friday last, the agreements exist only in letters that have passed between the Minister and the representatives of the association. No details have been given to the Parliament. The Minister has ignored repeated requests by the Leader of the Opposition in the Senate **(Senator McKenna)** to table full details of them. I should like to know the details of the agreement that the Minister has entered into with .the British Medical Association, particularly the arrangements that the Minister has made with **Dr. Hunter,** who, when Labour was in office, refused to permit the members of the British Medical Association to fill in government forms, because he contended that would be contrary to the ethics of the medical profession. However, the doctors are now filling in forms without demur. As those who run the British Medical Association. - I criticize only the individuals - have been prepared to turn turtle and sink their principles in order to please the Minister, I should like to see the agreements that have been entered into. I accept the proposals of the Minister with a great deal of reservation because I believe that, broadly speaking, they will be carried out in accordance with the wishes of the bosses of the British Medical Association, irrespective of their effect on the individual doctors and the members of the public generally. The point I want to make is that the Minister who is in charge of our national health scheme is under the control of an organization which has, so to speak, given him this measure on its terms and conditions. He has not taken into consideration the anomalies that are being pointed out during this debate. When the Minister replies to the submissions that we make and the amendments that we move, I do not want him to read another long letter from the British Medical Association stating why what we propose should be done cannot bc done. The only question is whether a proposal is right or wrong. If it is right, effect should be given to it by the Parliament, notwithstanding that it will offend some outside organization. The Government has a responsibility to ensure that any health legislation introduced into the Parliament will give the people complete cover. They should not be given partial cover at great expense iti e rely because complete cover does not suit some organizations. I suggest that if individual members of the medical profession, whom I respect highly, were given an opportunity to vote on many of the proposals put forward by the British Medical Association as the policy of that organization, the proposals would be rejected because they do not reflect modern trends in medicine or the opinions of the vast majority of our medical practitioners. I reiterate my contention that the Minister should place before the Parliament full details of the agreements entered into with the medical profession and the commitments associated with them. I do not wish to be told by the Minister that the measure does not provide for any form of compulsion and that no agreements embodying compulsion have been entered into. The statements made by the right honorable gentleman with regard to compulsion, and agreements with, and proposals by, the British Medical Association will not withstand investigation. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable gentleman's time has expired. {: #debate-29-s37 .speaker-KGP} ##### Mr HAWORTH:
Isaacs .- The Opposition proposes that a new clause be inserted in the bill. It is as follows : - >A medical practitioner who has rendered a professional service for a person shall, on request by that person, supply to him a statement in writing giving particulars of the professional service and of the charge made therefor. The Opposition has stated that the proposed new clause is designed to expedite payments made by hospital and medical benefits associations. On the surface, there appears to be much that could be said in support of the amendment but, on close examination, a different position is revealed. I endorse the remarks made by the Opposition that payments could be expedited if medical practitioners would state on their bills the nature of the professional services rendered. The secretary of a hospital benefits association in Victoria has told me on several occasions that payments could be expedited if that were done, because the association would be able immediately to calculate the payments that should be made to the contributors concerned. I remember reading a letter from the secretary of the British Medical Association in Victoria in which it was stated that medical practitioners could easily give the required particulars. But the amendment proposes that such particulars shall be given only on request by a contributor to an organization. Most of the people who are being treated by doctors now do not realize that a statement of the professional services rendered to them by their doctors is necessary. The scheme is a new one, and they are partially ignorant of the things that must be done to get expeditious payment of their claims. Under the proposed new clause, a doctor .would not be compelled to give particulars of the professional services he had rendered to a patient. It is probable that at least 75 per cent, of the people being treated by doctors do not realize that it is necessary to ask the doctors to state on their bills the nature of the services they have rendered. A doctor would readily give such a statement if he were asked to do so. Almost daily, medical practitioners are giving certificates of various kinds in which they specify the nature of the illnesses from which people are suffering and the reasons why, for instance, absence from work is necessary. In my opinion, the proposed new clause would not do what the Opposition wishes to be done. A patient would have to ask his doctor for a statement of professional services rendered and, as I have said, in many cases the patient would not realize that such a statement was required and would leave the doctor's consulting rooms without asking for it. Therefore, I believe that the amendment should not be accepted by the Minister. I think it would be better, by administrative action, to make it more or less compulsory for a medical practitioner to specify on his bill the services he has rendered to a patient. That could be done quite easily. {: #debate-29-s38 .speaker-KDA} ##### Mr DUTHIE:
Wilmot .- Clause 32 reads as follows : - (1.) The Minister may, on behalf of the Commonwealth, enter into an agreement with the Federal Council of the British Medical Association in Australia for and in respect of the provision by medical practitioners of medical services for pensioners and their dependants. (2.) Without limiting the generality of the matters upon which agreement may be entered into under the last preceding sub-section, the agreement shall - {: type="a" start="a"} 0. define the scope of the medical services to be rendered by medical practitioners; and 1. set out the terms and conditions of an agreement that the DirectorGeneral may enter into with a medical practitioner for and in respect of his rendering of those services at such fees and allowances as are prescribed. (3.) An agreement entered into under this section may be varied or terminated by agreement with the parties. I support everything that the honorable member for Grayndler **(Mr. Daly)** has said about this clause. It is astounding that, at this stage of our legislative history, agreements can be concluded between associations outside the Parliament and a Minister of the Crown without the representatives of the people in the Parliament, having any knowledge of those agreements. That is a dangerous departure from the practice of democratic countries, especially when the agreements are made with an association consisting of thousands of medical practitioners. At a later stage, the Opposition will move an amendment to the clause. We think it is a legitimate and democratic amendment. We shall move that a new subclause be inserted. It reads as follows : - >An agreement entered into under this section shall, as soonas practicable, be tabled in the Parliament. {: .speaker-10000} ##### The CHAIRMAN: -- Doubtless the honorable member is aware that the committee, before it can deal with the amendment he has foreshadowed, must dispose of the amendment nowbefore the Chair. {: .speaker-KDA} ##### Mr DUTHIE: -- I am aware of that. We shall ask that any agreement entered into under the terms of clause 32 he tabled in the Parliament as soon as practicable, because we believe that any agreement that involves expenditure of money by the Commonwealth should be so tabled. No association in this country has a right to receive special treatment from the Government. But the British Medical Association, one of the large associations in this country, is entering into agreements with a Minister of the Crown, and those agreements are not being tabled in the Parliament. Why should the Government single out the British Medical Association for special treatment? The Opposition realizes that agreements have to be made between the British Medical Association and the Government but we ask that such agreements be tabled so that they will notbe kept secret. These agreements will affect the lives of thousands of people and involve millions of pounds of the taxpayers' money. We, as the legislative authority of the Commonwealth, should know what is in such agreements. The action of the Minister in defying this Parliament is unprecedented. I earnestly request the Minister to give a little more consideration to this proposed amendment than he has given to other amendments. He should not ride roughshod over it as though it had been put up in a spirit of irresponsibility. The Minister seems to me to have given far more consideration to the proposals of **Dr. Hunter** than he has given those of the Opposition. Perhaps the reason that the Minister cannot accept the proposed amendment is that he has riot a doctor in the House whom he can consult concerning it. It is a wonder that the Minister has not had a special communication system installed in the chamber for the purpose of contacting tho heads of the British Medical Association whilst this bill is being debated. I put it to the Minister that the amendment that the Opposition has proposed is reasonable, rational, sensible and democratic. {: #debate-29-s39 .speaker-L19} ##### Mr LESLIE:
Moore .- It seems to me that members of the Opposition must have remarkable faith and confidence in the medical profession. One would have thought that the insults that they have heaped upon the medical profession in the course of the debate on this bill would have created some vestige of feeling in their minds that they might suffer some personal repercussions on the first occasion that they visited a doctor. But apparently honorable senators opposite are confident that, no matter what they say against the medical profession, when they consult members of that profession they will be treated honestly and fairly. Otherwise they would not have gone to the lengths that they have to insult that fine profession. Therefore, seeing that they have such faith in the medical profession, surely honorable members opposite should feel confident that doctors will handle their side of the Government's scheme in a reasonable way. The honorable member for EdenMonaro **(Mr. Allan Fraser)** proposed that a medical practitioner, at the request of a patient, could be compelled to give that patient particulars of the ailment for which he was receiving treatment. The committee should consider the serious disruption that such a requirement might cause to the normal relationship between doctor and patient. In the first place, it might not be advisable for psychological reasons for the practitioner to communicate the particulars of the ailment to the patient. In other cases, it may be inadvisable to give such information to the patient although it could be given to the members of his family. If the doctor were compelled to supply that information to the patient a dangerous situation might be created. If there were any need for compulsion we might take the bad .with the good in a good cause. But there is no. necessity for compulsion. Under the provisions of the Government's scheme, the doctor must provide information concerning thi ailment to the appropriate body in order to secure payment of his account *a>* speedily as possible. In order to understand the effect of the proposed amendment we must examine the machinery of the measure which is provided for in clause 23. That clause provides that the Government shall come in direct contact with the medical organization which must claim from the Government a refund of the money that it has paid to, or on behalf of, a contributor, and mus supply to the Government the information necessary to substantiate it? claim. The Government has no direct contact with the patient. The organization, in order to supply the necessary information to the Government, mus obtain that information from the doctor. The doctor, in turn, in order to obtain payment from the organization, must, supply the necessary information. Clause 23 provides that the benefit will be paid by the Government to the organization and that the organization will pay the benefit either to the patient or the doctor. This is an important provision because a doctor often considers it inadvisable to give information to a patient regarding an illness. In such a case, the doctor can furnish particulars of the illness to the organization which will then pay his account. Imagine what the position would be if it were dangerous for the doctor to give the patient particulars of his illness and the law compelled him to reveal that information to the patient! Obviously, cases would arise in which the doctor would have to inform the patient that he would either have to renounce his claim to medical benefits or go to somebody else for treatment. That is possible because the doctor might not be prepared to reveal to the patient the nature of the illness that he had treated. It is a normal administrative arrangement and could be dealt with in the relationship between the organization and the doctor. "If then the doctor delays in submitting the necessary information, he himself will have to wait for payment. {: #debate-29-s40 .speaker-JSW} ##### Mr BRYSON: -- The honorable member had better read the bill again. {: .speaker-L19} ##### Mr LESLIE: -- I presume that even some honorable members opposite are able to read ordinary English, and understand the terms of the measure. The bill provides that an organization shall make the payment, and does not say when or how or anything else. If I receive a doctor's bill for £10, and I am entitled to £6 benefit, I pay the doctor £4 and tell him to get the other £6 from the Government. That may be done according to this measure, and in fact it is being done at present. lt is quite obvious that honorable members opposite are reading mountainous difficulties into this legislation purely for party political purposes, in order to discredit the bill and build up the prestige of the Labour party. Clause 23 reads, *inter alia -* >Commonwealth benefit is payable to the registered medical benefits organization to the *medical* benefits fund of which the contributor pays his contribution . . . In the light of that clause the amendment moved by the honorable member for EdenMonaro is quite unnecessary, and if agreed to it would place a restriction on the operation of the scheme which could adversely affect patients, and tend to prevent that co-operation between the organizations and the medical profession upon which the whole scheme rests. Doctors normally present bills to their patients showing why their visits have been necessary. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable member's time has expired. {: #debate-29-s41 .speaker-6U4} ##### Mr WHITLAM:
Werriwa .- I rise to support the proposals of the honorable member for Reid **(Mr. Morgan).** The honorable member foreshadowed an amendment to clause 37 of the bill to provide that in any appeals from committees of inquiry to a supreme court, there should be provision for the supreme court, not only- to have regard to the evidence before the committee, and the report of the committee, but also to demand further evidence either oral, upon affidavit or otherwise, and to permit the examination and cross-examination of witnesses. This part of the bill provides for an agreement between the British Medical Association and the Government relating to medical services for pensioners. If it is found that a medical practitioner who is operating under that clandestine agreement has overcharged or falsely charged for services to patients, the committee of inquiry may investigate his conduct and report to the Minister. The Minister may then, under clause 35, reprimand the practitioner or terminate his agreement. If he terminates the agreement the doctor shall not be a party to any further agreement for a certain period. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The only amendment before the committee is that moved by the honorable member for Eden-Monaro **(Mr. Allan Fraser).** The honorable member is dealing with a suggested amendment which is not at present before the committee. The honorable member should direct his remarks to clauses 26 to 37. {: .speaker-6U4} ##### Mr WHITLAM: -- I further comment on the suggestion made by the honorable member for Reid relating to clause 37. If a medical practitioner is dissatisfied with the Minister's decision, he can appeal to a supreme court. Upon that appeal the court shall have regard .to the evidence before the committee of inquiry, and the report of the committee, but that is all that it can have regard to. Clause 121 states that a committee is not bound by legal rules of evidence, but may inform itself on a matter referred to it " in such manner as it thinks fit " ; that is, by hearsay, prejudice or anything else. One has only to look at the membership of these committees of inquiry - that is, the Director-General of Health, or his deputy, and four members selected from six nominees of the British Medical Association - to see that there is plenty of ground for injustice occurring in an inquiry by one of these committees. The suggestion of the honorable member for Reid is, in effect, the same as the provision contained in the National Health Bill presented by the Minister for Health on the 27th March last, sub-clause 4 of clause 37 of which read - {: type="i" start="1"} 0. . the Supreme Court may - (on appeal) - admit further evidence, either orally or upon affidavit or otherwise; (6) permit the examination and cross-examination of witnesses. When a supreme court is determining an appeal from a body which has heard evidence, it is loath to overrule the opinion of the body that has seen the witnesses and formed its opinion of their veracity from their demeanour. If the appeal to the supreme court is to he anything more than a form, the court, which consists of impartial and trained persons, should have the advantage of any evidence that it sees St to call according to the rules of law, and should have witnesses examined and cross-examined before it in the publicity which attends court proceedings, hi making these suggestions the Opposition is doing no more than referring to the original proposal of the Minister. This is not a controversial matter, and the suggested amendment has been put foward in an endeavour to ensure that a medical practitioner, whose reputation and part of whose livelihood may be at stake, should have the ordinary right possessed by everybody else whose reputation or livelihood is at stake. {: #debate-29-s42 .speaker-K7J} ##### Mr CRAMER:
Bennelong .- Certain amendments to this measure have been suggested, but I do not believe honorable members have been supplied with copies of the amendments and suggestions. I for one have not seen them, and it is unfortunate that they have not been made available. The honorable member for Grayndler **(Mr. Daly)** made an attack in his usual fashion on medical practitioners, and tried in. every possible way to discredit them. He spoke of an alleged agreement between the Minister and the British Medical Association. This matter has been explained by the Minister, and everybody knows that no formal agreement at all has been made, but that the terms and conditions in relation to the treatment of pensioners are covered by the provisions of the bill, and by letters which have passed between the doctors and the Minister. There is no formal agreement between the Minister and the British Medical Association. The agreement between the Government and the doctors relates to the medical services to pensioners, and is based on a surgery fee, a fee for attendance at the pensioners' homes, and certain mileage charges. {: .speaker-10000} ##### The CHAIRMAN: -- Order ! The time allotted for consideration of clauses 26 to 37 has expired. {: .speaker-KYC} ##### Mr Pollard: -- Would I be in order at this stage in recording a protest against the gag being applied ? There are dozens of honorable members who wish to speak on these clauses. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The House made a decision in this matter. {: .speaker-KYC} ##### Mr Pollard: -- A disgraceful one! {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable member for Lalor **(Mr. Pollard)** will withdraw that reflection on a decision of the House. {: .speaker-KYC} ##### Mr Pollard: -- I withdraw it. Question put - >That the sub-clause proposed to be added **(Mr. _ ALLAN Phaser's amendment)** be so added. The committee divided. (The Chairman - Mr. C. P. Adermann.) AYES: 50 NOES: 55 Majority . . 5 AYES NOES Question so resolved in the negative. Clauses 26 to 37 agreed to. Clauses 38 to 45 - *by leave* - considered together. {: #debate-29-s43 .speaker-JWU} ##### Mr ALLAN FRASER:
Monaro · EDEN-MONARO, NEW SOUTH WALES · ALP . -Clause 38, " Repeal and Saving", provides that - (1.) The Hospital Benefits Act 1951 is repeated. (2.) Notwithstanding the repeal effected by the last preceding sub-section - {: type="a" start="a"} 0. an agreement for and in relation to the provision of hospital benefits in respect of personswho are qualified patients in public hospitals in a State entered into by the Commonwealth with a State under the repealed Act shall be deemed to have been entered into in pursuance of section forty of this Act and to have been approved by the Parliament and the provisions of this Part apply to and in relation to that agreementaccordingly; I move - >That, in sub-clause (2.), paragraph (a), after the word " agreement ", first occurring, the following words be inserted: - "a *pro forma* of which is set forth in the Fifth Schedule". The simple purpose of the amendment is to ensurethat the agreement which the Parliament is required to approve under this clause shall he before the Parliament when it is asked to approve of it. The Minister for Health **(Sir Earle Page)** has been guilty of remarkable behaviour, to say the least, ininserting in this long clause the words "shall be deemed to have been approved by the Parliament ", when the agreement which is deemed to have been approved has never been before the Parliament. The Minister asks the committee to approve an agreement that has never been presented to the committee for its approval. The amendment provides that the Minister for Health shall be required to produce the agreement and that he shall make it a schedule to the bill before the committee is asked to give its approval to that agreement. That is a very simple and straightforward request by the Opposition. If therehad not been a ruthless and brutal application of the "guillotine "- {: .speaker-10000} ##### The CHAIRMAN: -- Order ! The honorable gentleman may notreflect upon a decision of the House. {: .speaker-JWU} ##### Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP -- If there had not been an inexorable use of the "guillotine", the Opposition would have moved amendments to the bill that would have required the Minister to produce to this committee various other agreements and arrangements that are referred to in the bill but which he has not given honorable members an opportunity of studying. The Opposition intends to bring to the attention of the committee and to the attention of the Minister the need to make some provision that will assist convalescent homes, benevolent homes, homes for the aged and orphanages which provide nursing care and attention for sick people. At present,those institutions are denied the full benefits that are provided for hospitals.Clause 39 (2.),which is the relevant clause, reads - >For the purposes of this Part, a convalescent home, benevolent home, home for the aged or orphanage or a part of such a home or of an orphanage which doesnot provide hospital treatment shall be deeemed not to bea public hospital or a private hospital. If honorable members look also at the definition of "hospital treatment", they willsee that these institutions are disqualified from obtaining the benefits that are needed to improve their financial position and which the nursing care that they give to so many inmates amply justifies. The Opposition hopes that the Minister will accept the suggestion that will be made in relation to those institutions. Mx; EDMONDS (Herbert) [9.13].- The group of clauses now under review bring before the committee the. whole, question of hospitalization. I express my amazement at statements that have been made by the Minister for Health **(Sir Earle Page),** not only in this chamber, but also throughout Australia. The right honorable gentleman has said that all the problems that were associated with inability to obtain beds in hospitals disappeared after the introduction of the present hospital benefits scheme. He has stated also that the scheme had placed the finances of hospitals on a much firmer foundation. That is quite understandable, because, before the scheme was introduced, people probably could not pay to hospitals the money that is now paid to them. I should' like the Minister to indicate to honorable members those features of the hospital benefits scheme that so suddenly have resulted in such a tremendous difference in the running of hospitals and which have been responsible for the provision of so many more beds. I suggest that the Minister's statements in relation to that matter are consistent with his attitude during the whole history of the hospital benefits scheme. The right honorable gentleman has taken a long time to present a tangible scheme to this committee and to the country, and he has adopted some extraordinary methods in doing so. I desire to apologize if I seem to be parochial, because I think that this chamber is not the place where the barrows of the States should be wheeled. I think, however, that as a Queenslander, I should be failing in my duty if before the conclusion of this debate I did not make some reference to the statements that, have been made by at least one other honorable member from Queensland since the introduction of the present- hospital benefits scheme. Nobody would know better than you, **Mr. Chairman,** that the statements I shall now make are true. Whether you admit it is another matter. In spite of anything that might be said in relation to the present hospitalization system in Australia, for a long time Queensland and Tasmania were the only States- that had free hospitalization systems. The Queensland. Government was determined that nothing that the Minister for Health or that the Menzies Government or that any other government might do would destroy the Queensland system. The federal Minister for Health was determined that the position should bc exactly the opposite. The Queensland. Government was very happy- with the Chifley Government's health scheme - or the McKenna health scheme, as it has been described in this chamber - because that scheme provided very clearly that no payment would be made to a hospital if a charge were made on a patient in a public ward. The scheme introduced by the present Minister for Health provided exactly the opposite, because it provided very clearly that no payment would be made unless a charge were made upon the patient. In spite of anything that might be said by the Minister or by the honorable member for Capricornia **(Mr. Pearce)** about the position in Queensland, the Minister was determined that the Queensland Government should submit to his authority, otherwise it would not receive any assistance. The honorable member for Brisbane **(Mr. George Lawson)** has referred to this matter at great length. I have here an editorial of thu *Courier-Mail* that will support my comments in relation to the Minister's attitude towards the position in Quensland. **Mr. Moore,** the Queensland Minister for Health, deserves- the greatest possible credit for the fact that he resisted the right honorable gentleman, who was forced to make a complete capitulation. If evidence in support of my statement!-: is required it may be found in this editorial. I am sure that the honorable member for Capricornia would not at cusp the *Courier-Mail* of having any sympathy with the Chifley Government or towards any other Labour government. The *Courier-Mail* stated in its editorial - >The State Government is completely justified in refusing to abandon its free public hospital system in favour of .the Commonwealth paid scheme. Queensland's free public hospital's are splendid institutions and are an example to every other State in Australia. The Commonwealth Health Minister **(Sir Earle Page)** served an ultimatum on the Queensland Government that it must charge all patients, in public hospitals or it would withdraw its. subsidy of 8s. a bed daily. The > >State Government has rejected this proposal and has decided to continue its- policy of free treatment. > >As a result of this decision, the Commonwealth subsidy ceased from last Saturday, and the State will have to find another £1,000,000 a year to maintain its free public hospital*. The pressure tactics and the dog-in-the-manger attitude adopted by the Commonwealth are difficult to understand. While the Commonwealth will give no help to public hospitals in this State in future, it will continue to pay 12s. a day towards costs in private hospitals. As **Mr. Moore** points out, it is farcical when the Commonwealth will pay £4 4s. a wenk to help people who can afford a private hospital but refuses to assist those who are compelled to use the public hospitals. > >Queenslanders have to pay the same taxes as the people in other States and the Commonwealth seems to be committing a grave injustice in withdrawing the public hospital subsidy from this State because it prefers to continue its own system. Surely the fair and right thing to do would be to make the same allowance to all States and let them conduct their own hospital service in their own way. The Queensland Government did that precisely in spite of the attitude of the Minister for Health. The policy and the slogan of the Queensland Government in connexion with its hospitals has been, in effect, " There shall be beds for all who wish to use them and they shall be free ". If the Minister had had his way, those beds would not be free, but they are free and it is to the everlasting credit of the Queeusland Government and the State Minister for Health in particular, that that position still exists in Queensland. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable member's time has expired. {: #debate-29-s44 .speaker-C7E} ##### Sir EARLE PAGE:
Minister for Health · Cowper · CP . - I give the lie direct co the honorable member for Herbert **(Mr. Edmonds).** There has been no agreement with any State which interferes with the right of that State to have free hospital beds. Every State in Australia can have free beds if it wants to do so. The Australian Government pays 8s. a day for every free bed in all States. That is a complete answer to the honorable member for Herbert. I invite honorable members to consider the position in Queensland and the views upon this matter of those who have been conducting Queensland's affairs for years. **Mr. Hanlon** was Minister for Health in Queensland for eight years. For seven years he was Premier of Queensland, and a good one. He made this statement at the conference of Commonwealth and State Ministers in 1945 about the scheme that the Chifley Government had wished on to Queensland - >I maintain that the Commonwealth's scheme is fundamentally unsound. It provides for the payment of so -much by the Commonwealth for each patient but no contribution is to be' made towards the cost of those services which prevent people from going to hospital. Under the proposed scheme there will be an influx into public wards of people who otherwise would be treated at home. **Mr. Hanlon** had more to say at the conference of Commonwealth and State Ministers in 1949 when **Mr. Chifley** was trying to force the rotten scheme applying to mental institutions down the throats of the States. Unfortunately he succeeded and that scheme has gone from bad to worse. **Mr. Hanlon** said at the conference of Commonwealth and State Ministers in 1949 - {: type="A" start="J"} 0. do not suppose that any of the Premiers thinks ho can get it both ways. If the Commonwealth's hospital contribution is increased, that fact will be taken into consideration in fixing the general Commonwealth allocation to the States. There is a catch in this hospital benefits scheme and the States were foolish to enter the agreement in its present form. Those are the words of **Mr. Hanlon.** He, though dead, still speaks and his words should warn the honorable member for Herbert. Those comments are taken from the official record of the proceedings of the conferences. If the honorable member cares to read the official correspondence that passed between the Queensland Government and the present Australian Government, he will discover that there was no attempt at compulsion at all. The Queensland Government was told at all times that if it would provide beds for all insured persons in Queensland an agreement would be signed and it could do as it liked about fees. It could charge the patients or not as it pleased. What did the Queensland Government do? It made a definite compact with the Australian Government to make available immediately many beds in country hospitals to enable insured persons to occupy them. It also stated that so soon as the nurses' home in the Brisbane General Hospital was evacuated, it would be made available for paying patients. Further, the Queensland Government stated that it would give us 200 beds in the South Brisbane Auxiliary Hospital which is being expanded at present. Every month, the Queensland Government is trying further to carry out its obligation to the Australian Government. That i3 based upon the understanding that if a man is willing to pay for service in hospital and makes provision for it while he is well, he should not have to compete with others to get a bed. In New South Wales, a realistic attitude was adopted and every hospital in New South Wales is showing a credit balance. For the first time in its history, the Royal Prince Alfred Hospital ha3 shown a credit balance. Instead of having to close 300 beds as it feared eighteen months ago it would have to do, it has been able to keep them open and equip them more adequately. The finances of the Sydney hospital have improved. The experience has been the same in Victoria and other places. I have recently visited various countries in other parts of the world. New hospitals are being built only where voluntary insurance schemes operate. That is the experience in Switzerland, Holland and Belgium. In England the authorities are spending tremendous sums of money and they hoped to build hospitals, but they have not been able to start one because of the huge cost of maintaining their health scheme which is financed from taxation. T.n discussions that took place in 1944, 1945, 1949 and 1951 the States said that they required 18s. a day for each bed to enable them to break even financially. Under this scheme New South Wales is getting 24s., Western Australia 21s., Tasmania 21s. and Victoria 18s. Because they are getting that amount their finances have been placed upon a proper basis. We must not push the poor man out in order to let the wealthy man in. On the contrary we must give a fair deal to every person in the community. {: #debate-29-s45 .speaker-JF7} ##### Mr BEAZLEY:
Fremantle .- The statement made by the Minister for Health **(Sir Earle Page)** brings up the question of rising medical costs. That is a matter which this committee must consider, especially as it is discussing the group of clauses which relate to hospital benefits. The rising cost of hospitalization invalidates the Government's administrative method of financing hospital benefits. There is an extremely interesting article by **Dr. Byrne** in the issue of the *Medical Journal of Australia* of the 7th March last, in which he gives comparative figures relative to the cost of hospitalization at the Royal Melbourne Hospital and a picture of what is happening in hospitals everywhere. He pointed out that in 1925 the Royal Melbourne Hospital had a staff of 411 for 397 beds. Including gardeners, kitchen attendants, and all other persons employed at the hospital, the ratio was then 103 staff to 100 beds. In 1952, the staff was 1,31S and the number of beds was 528. So, there is now a staff of 250 persons for every 100 beds. **Dr. Byrne** pointed out that there is a growing body of technicians, highly paid and in strong organizations, to maintain the new equipment at the hospital. There are now outpatient clinics, physiotherapists and all sorts of diverse medical personnel the like of which did not exist 27 years before, in 1925. A staff of 250 persons for every 100 beds involves a very much higher overhead cost than did a staff of 103 persons for every 100 beds. The development of medical service with its new techniques, is bringing into being armies of new technicians.' What is the effect of all of this on the ordinary income-earner? Here again, **Dr. Byrne** has given us some very illuminating figures. In 1925 the bed-cost at the Royal Melbourne Hospital was £3 17s. 2d. a week, and the basic wage was £4 17s. 6d. a week. In other words, the weekly bed-cost was considerably less than the basic wage. Last year, the weekly bedcost at the Royal Melbourne Hospital was £25 9s. 2d., and the basic wage was £11 8s. In other words, as things stand at present, a person would have to pay more than two weeks' earnings at the basic wage in order to meet the cost of Ids bed at that hospital. The Royal Melbourne Hospital, no doubt, has large out-patients' sections and modern medical equipment which most hospitals do not possess. But that tendency is true the world over. It was estimated by Lord Beveridge that a scheme such as Aneurin Bevan established in Great Britain would cost £170,000,000, but the actual cost has reached £400,000,000. **Dr. Byrne,** in his article, rather deplores the suggestion, advanced for the purposes of propaganda, that this high cost is, somehow or other, due to socialist medicine in Great Britain which was extremely expensive, when he points out that a great rise has taken place in the cost of medical services, whether conducted privately or by governments. The fact that the cost of a bed in an Australian hospital is equal to two weeks' earnings of the basic wage shows really that the subsidies of Ss. and 12s. a day that we envisage in this Parliament do not form a major contribution to the cost of maintaining hospital beds. If **Dr. Byrne's** figures are correct - £25 9s. 2d. a bed a week in the Royal Melbourne Hospital - our subsidies of Ss. and 12s. a day make no tremendous contribution towards the cost. All the evidence appears to indicate that these costs will continue to rise. The Government would act wisely if it did everything possible to cut these administrative costs. As time goes on one of the greatest embarrassments we shall have to face in connexion with this scheme will result from the tremendous number of administrations in the form of benefit societies, each maintaining separate staffs and all duplicating the work. Much as I respect the Government's attitude towards friendly societies, I" believe that if we had a centralized financial system, more money would be available to meet the rising costs of hospitals. There is only one other matter that I should like to mention. It relates to clauses 39 and 44 (2.), in which mental patients are excluded from the purview of this bill. There are two subjects that the Commonwealth, throughout its 50 years of existence, has avoided like the plague. One is marriage and divorce, and the other is mental hospital treatment. I do not think that we can avoid them for ever. We are hiding behind the fact that the enactment of lunacy laws and the general treatment of the insane were vested in the States at the point of federation. I have met psychiatrists from overseas- some of them have come here to take over our mental institutions - who have said that the treatment of the insane in Australia is years behind that of overseas countries. They have said that whereas our general hospitals have kept pace with developments overseas, it is not true to say that our treatment of the mentally ill has done so.. The States are not in a position to meet the cost involved. I do not condemn theGovernment for not having entered thefield because no Australian government has done so. But unfair burdens are cast, upon families a member of which becomes mentally ill and has to be placed in one of these institutions. Such persons have been generally debarred from social services benefitsfor a long period. Gradually thesebenefits are now being extended tothem, but the Government in this measure still continues to stand out from making contributions to their welfare and recovery. Mental illness is likeany other illness. We should not continue to maintain a differentiation between the physically ill and the mentally ill. The Commonwealth should enter the field and assist the families of mentally ill persons and help those institutions which deal with the insane. {: #debate-29-s46 .speaker-K6Q} ##### Mr BERNARD CORSER:
Wide Bay -- If there is any matter upon which the Government deserves to be congratulated it is upon the provision of medical and hospital benefits. Such criticism as has 'been levelled at Queensland in this regard is not worthy of consideration. When the Minister for Health **(Sir Earle Page)** took over his portfolio the hospitals of Australia were- " in the red " to an amount of £20,000,000, the public hospitals of Australia were overcrowded and wealthypersons occupied hospital beds while unfortunate sick people who did not havethe means to pay for a bed frequently had' to wait for weeks for admission. Thepresent Government propounded a schemewhich has already remedied the desperate position of the great city hospitalsand has enabled them to augment their nursing and other staffs and' install the most modern appliancesin public wards and private wards alike. This scheme will enable hospitals to extend their accommodation and provide greater services for thepeople. In Queensland we are fortunate, because years ago the people- built great hospitals in most of the cities and provincial towns. Public hospital facilities have not been increased in areas in which the population has not increased. However, neither Queensland nor any other State could have provided its public hospital facilities but for the contribution that has been made available to it by the Australian Government in respect of each occupied bed. Only during the last week on the public platform, political opponents of this Government have claimed that it has refused to make assistance available to the Queensland Government because the latter refused to outer into an agreement with it. The Minister for Health has absolutely denied that claim. The Queensland Government is now receiving more revenue annually in the form, of income tax reimbursement than it could possibly collect direct from taxation sources in that State. Incidentally, that is why that Labour Government is opposed to the return of the income tax power to the States. The Queensland Government was reluctant to become a party to the hospital benefits scheme because, primarily for. party propaganda purposes, the Government of that State contended that under that scheme it would have been compelled to vacate the public hospital field. That is contradicted by the fact that the scheme is now operating and the State public hospitals receive Ss. a day for each occupied bed. Under the new agreement, the Australian Government has .made available a total amount of £1,235,000 to Queensland in respect of occupied beds in public hospitals. The State is being helped to improve facilities in public hospitals because this Government has relieved it of the cost of hospitalization for age and invalid pensioners who are the most deserving section of the community. In addition, this Government provides free medical and pharmaceutical services for those pensioners. It pays to the hospitals in the State a subsidy of 12s. in respect of each bed that is occupied by a pensioner or his dependants. In view of those facts, a great blessing has been conferred upon the community. The provision by this Government of a subsidy at the rate of Ss. for each bed in public wards that is occupied by other classes of patients has already had the effect of relieving the congestion that previously prevailed in those wards. Consumptives who were a menace to mothers and infants in maternity wards and to other patients in public wards are now looked after in special institutions whose provision has been financed by the Australian Government, which is also financing the major cost incurred in caring for those unfortunate sufferers. Under that scheme it is hoped that the dread disease of consumption will 'be obliterated within a few generations. Despite this assistance, the Queensland Government has constantly claimed for party propaganda purposes that it has been unjustly treated by the Australian Government, which has conferred a benefit to the sick people of Australia through this scheme of health insurance. That claim is belied by the enthusiasm with which the Australian people as a whole have co-operated in this scheme. To-day, over 5,000,000 persons in this country are eligible to receive benefit under the scheme. In return for a payment of a few shillings a week a man can insure himself, his wife and his children for all the benefits that are being provided under this scheme. At the same time, insured patients being members of approved societies are completely free to choose their own doctor. If necessary, they can be given medical attention in their own homes and the Australian Government subsidizes the transport costs of the doctors. As a result of that provision, the congestion that previously existed in public hospitals throughout Australia has been substantially relieved. I note with pleasure that the Labour Government in New South "Wales has realized its responsibility in that respect, and has taken action to comb out of public wards persons who have adequate means to pay a few pence in insurance premiums for hospital treatment. Under the New South Wales Labour Government scheme wealthy go-getters in the community are obliged to vacate beds in public wards. Thus, more beds are being made available for persons in the lower ranges of income, many of whom have been unable for years to obtain admission to public hospitals because of the congestion in public wards. Long before Labour governments came into power in the States, modern hospitals, containing public, intermediate and private wards, had been financed by public subscriptions. It is significant that since the present scheme was inaugurated, the Labour Government in Queensland will be able to extend facilities in private wards. That is one result of the financial assistance that this Government has made available to the States generally. Other remarkable, results that it has produced include the provision of more skilful and extensive nursing staffs, greater and better facilities in hospitals generally and more skilful medical attention under improved conditions. Therefore, it cannot be said that the Queensland Government has been victimized in any way under this scheme. The citizens of that State will continue to share in the Australian Government's payment of 8s. a day whilst they are in hospital and those who wish may insure to have treatment in private wards or private hospitals. **Mr. JOSHUA** (Ballarat) '9.4S].Nothing could be more calculated to produce a cynical reaction to this measure on the part of members of the Opposition than the statement made by the Minister for Health **(Sir Earle Page)** that under the bill the Government is doing something to help the poor. The fact is that under this scheme the difficulties of that section of the community have been increased immeasurably. Part V. of the bill is entitled "Hospital benefits", but it could be more appropriately entitled " Hospital difficulties ". For the purposes of this scheme the Government has entered into an agreement with the States, but it has refused to incorporate that agreement in this measure. If thai, were done every one would know whether or not a subsidy at the rate of 12s. is being provided in respect of every bed that is occupied by age and invalid pensioners in public institutions. The fact is. of course, that under sub-clause (2.) of clause 39 that benefit is denied to pensioners in certain instances. Consequently, the difficulties of those who are endeavouring to help that very worthy section of the community have been increased. The whole clause should be redrafted in order that adequate relief may be given to elderly persons in hospital. I consider that sub-clause (2.) should be deleted. It reads as follows : - >For the purposes of this Part, a convalescent home, benevolent home, home for the aged or orphanage or a part of such a home or of an orphanage which does not provide hospital treatment shall be deemed not to be a public hospital or a private hospital. The definition of hospital treatment in sub-clause (1.) does not include the excellent treatment which is provided for elderly persons by many benevolent homes. I have a knowledge of this matter, because I have closely observed the Queen Elizabeth Benevolent Home in Ballarat, which has more than 600 inmates. Under the present plan, that institution is required to maintain a sick patient, who is completely unable to look after himself, for Ss. a day, which is £2 16s. a week. The operation of this scheme means that an aged person, as soon as he is moved into the infirmary of the home, loses £2 5s. 6d. of his pension of £3 10s. a week, which is retained by the Commonwealth. In its place a hospital benefit of £2 16s. a week, or 8s. a day, is paid to the institution. This minute extra payment of ls. 6d. a day is expected to cover all the expenses of hospitalization, which involve nursing expenses at the rate of 7s. 6d. a day, and various other expenses incurred in respect of persons who are virtually helpless. The Victorian Government i3 in a difficult position. It has commendably encouraged the removal of old. people to suitable homes in order to make proper use of hospital space. If no home for old people is available, the aged sick have to be cared for in public hospitals. That involves the use of valuable and wellequipped hospital space for people who, in point of fact, do not require it. The Canberra Community Hospital receive? the full Commonwealth payment of 12s. a day, or £4 4s. a week, and a pensioner who is an inmate also receives the full pension of £3 10s. a week, so that the hospital gets £7 14s. a week. However, the Queen Elizabeth .Benevolent Home, and similar institutions are required to provide the same kind of service for £2 16s. a week. The State induces the committees of benevolent bornes to provide accommodation for the aged sick, and thereby reduces the pressure placed upon normal hospital facilities, but at the same time, it is called upon to bear an undue portion of the -cost of treating such patients. The Victorian Minister for Health has asked the Commonwealth Minister whether he will support a proposal that infirmary wards of benevolent homes be deemed to be public hospitals, and that patients therein shall receive the full pension and the State shall get the full hospital benefit rate of 12s. a day, where the patient would qualify for it if he were in the ward of a public hospital. The Victorian Minister advised in 1952 that the Queen Elizabeth Benevolent Home and similar institutions had been approved a3 public hospitals for the purpose of receiving a payment of 8s. a day until a new agreement was negotiated. No new agreement has yet been made, and the benevolent homes are now experiencing great difficulties. A new agreement should be negotiated, because the Victorian Government,, for one, certainly does not agree with the existing agreement. I can only point out, in the short time at my disposal, that the difficulties of homes of this kind are increasing year by year, and will not be eased by this bill. The Queen Elizabeth Benevolent Home had a surplus of £3,914 in 1951, and deficits of £15,380 and £13,063 respectively in the two succeeding financial years. How can the Minister claim, with justification, the he has assisted such institutions when a surplus in 1951 is converted into deficits in 1952 and 1953? Obviously, he should make a new agreement with the States, and this bill should not be passed while clause 39 appears in its present form. This bill will increase the difficulties of wonderful organizations that are rendering a great service to the community, because they are relieving the general hospital system, and providing good hospitals for those who need them, and accommodation and every kind of comfort for elderly folk. The Labour party opposes this clause. An amendment has not been moved, because the clause should be redrafted. No honorable member should vote for this part of the bill in its present form. I hope that the Minister will carefully examine my statements, and prepare suitable amendments for insertion in the bill in the Senate. I know of no other way by which the interests of the aged people can be served. {: #debate-29-s47 .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- This amendment is not very substantial. The purpose is to provide that some *pro forma* shall be inserted in the bill in which the hospital agreement is contained. I merely point out that such a method was not adopted in the act of 1951, and that it was not called into question, or criticized, on that occasion. The purpose of this bill is to deal with principles, and once the agreement was inserted in the bill, amending legislation would be required whenever the agreement was to be varied. Surely no honorable member wishes to go to all that trouble. I now desire to say something about the provision of hospital services, and 1 shall deal first with the quite substantial points made by the honorable member for Fremantle **(Mr. Beazley).** I, too, had the advantage of reading the article by **Dr. Byrne.** It is a fact that hospital costs have risen tremendously for the reasons outlined by the honorable member for Fremantle, which include additional staff and technicians, costly equipment, and rising wages. Nonetheless, it is also a fact that since this agreement has been in operation, the Royal Prince Alfred Hospital has moved from a condition of insolvency to a state of being able to pay its way. I think that the Royal Prince Alfred Hospital is even larger than the Royal Melbourne Hospital. The honorable member for Fremantle also suggested that a central organization should be established to handle finances, instead of allowing them to be handled by friendly societies and similar bodies. I confess that the idea of reducing costs by the establishment of a government department is certainly novel to me. It is unlikely that costs will be reduced in that way, but I admit that the final answer to the hospital problem has not yet been found in Australia or elsewhere. The problem is certainly big, and mental hospitals, convalescent homes, homes for the aged, and provision for orphans are a part of it. That brings- me. to, the. remarks of the honorable member for Ballarat **(Mr. Joshua),** who- has; said that this bill will not help the poor. I believe that honors able members w.ould do well to. disabuse their minds of such an idea. This bill, provides substantially more money for the hospital system, and thereby makes more beds available. Poor persons in every State are not required, to pay for hospitalization if they cannot afford to do so, and, therefore,, the scheme will assist them. More beds will be made available to the public hospital system, because more money is to be provided for public hospitals. The scheme makes it easier for private hospitals to carry on, because many people who would otherwise occupy beds in public, hospitals will be attracted, to private hospitals. So, increased accommodation will be available to people in poor circumstances. Therefore, it. is perfect nonsense to say that the bill does nothing to help the poor. The idea that all hospital beds should be provided free of charge everywhere should receive- careful attention. There is no such thing as the provision of a service free, of charge.; If the State is to provide hospital beds free of charge to the public, it must meet the costs by the imposition of taxation... Therefore, when honorable members opposite say that there should be no insurance scheme, and that everything should be free, what they really mean is that taxes should be increased. This scheme does not proceed on that basis. It proceeds on the basis of insurance,, and in so doing it inflicts no hardship on those who cannot provide money for insurance. In fact, it assists them.. I remind the House that it is not possible to do everything at once. Let no one imagine that it is possible to bring public hospitals, mental hospitals, convalescent homes, orphanages and private hospitals into line in one great, scheme immediately. That I would characterize as precipitancy and, of course, precipitancy is the promise of the quack. It is not the principle upon which responsible parliamentarians or responsible governments can or should proceed. In conclusion I wish to say a few words, about free hospitals in Queensland. Queensland was given an opportunity to make an agreement- with the Commonwealth in precisely the same terms, as those offered to the other States-.. It w,as at. all stages within the power of the Queensland Government either to charge for beds or not to charge for them. The other States decided that a charge would be made, and Queensland decided that hospitals would be free. {: .speaker-KVT} ##### Mr Thompson: -- Wo charge is- made in Adelaide. {: .speaker-JU8} ##### Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP -- If that is so, it adds weight to my argument. The States had. power to make their own decisions. It is pure kite-flying for the Queensland Government or any of it* supporters in this chamber to say that. Queensland was forced to do anything. Queensland was not forced any more than was South Australia which, as the honorable member for Port Adelaide has pointed out, has adopted a course similar to that pursued by Queensland. The display of histrionics given by the honorable member for Herbert **(Mr. Edmonds)** to-night was sheer nonsense. He claimed that the Queensland Government had a grandiloquent slogan, something like " Free hospital beds for all ", but it.= real aim is to keep all the money it get? from the Commonwealth Government - it does not raise its own taxes - and then claim credit for providing free hospital beds which, in fact, it does not do. {: #debate-29-s48 .speaker-JUP} ##### Mr CLAREY:
Bendigo .- I wish to bring to the notice of the committee certain aspects of clause 39 and] to associate myself with the remarks of the honorable member for Ballarat **(Mr. Joshua).** Sub-clause (2.) of clause 39 prohibits convalescent homes, benevolent homes, homes for the aged and orphanages from being deemed to be public hospitals. I wish to make a strong appeal to the Minister for Health **(Sir Earle Page)** for more generous treatment of the infirmary sections, of benevolent homes and homes for the aged. As the honorable member for Ballarat has pointed out, the Commonwealth at present pays to the States 12s. a day in respect of occupied beds in public hospitals. However, the payment in respect of infirmaries or benevolent homes and homes for the aged is only 8s. a day. That means, of course, that in respect of each patient, such institutions are 4s. a day or £1 8s. a week worse off than are public hospitals. Apparently the regulations as they stand to-day are administered in accordance with an agreement with the States in which provision is made for different payments. It will be agreed by all honorable members I am sure that inmates of benevolent homes and homes for the aged are usually people who, through force of circumstances, have not been able to contribute to insurance schemes. They are old and infirm. Most of them are pensioners. Whilst an inmate is able to walk about, the home, I understand, receives £2 5s. 6d. of his pension, but immediately a pensioner goes into the infirmary, although the cost of caring for him increases tremendously, his pension ceases and the payment to the home is increased by only 10s. a week. I hope that the Minister will examine this matter to see what can be done. Surely when a patient enters an infirmary of a home the Commonwealth's subsidy should not be less than that payable in respect of patients in public hospitals. In the course of several statements, the Minister has made it clear that as a consequence of the Government's national health scheme, the financial position of public hospitals has been substantially improved. That is not true of benevolent homes or homes for the aged. There are two benevolent homes in my electorate. One is in Bendigo itself and the other at Castlemaine. In both of those homes are many people who, because of age and illness, are confined to the infirmaries, sometimes for long periods. This, of course, enables public hospitals which otherwise would have to care for those people to provide more accommodation for patients suffering from acute illnesses and for accident cases. Therefore, the benevolent homes are relieving the strain on our public hospitals. I regret to point out to the Minister that both the benevolent homes in my electorate are in the same position as that to which the honorable member for Ballarat referred. In view of the service that such homes are rendering, it seems to me most desirable that they should be placed on the same basis as public hospitals in regard to the Commonwealth's subsidy. This is very hard to deal with in an amendment because the problem can be handled better by agreement with the States than by legislative action. However, I assure the Minister that he can greatly improve the situation of benevolent homes and homes for the aged, particularly in relation to their infirmaries. I hope that he will give serious consideration to my representations on this subject. In the brief period still available to me I support the remarks of the honorable member for Fremantle **(Mr. Beazley)** on the exclusion of mental hygiene establishments from the provisions of the bill. It is unfortunate and regrettable that neither State legislation nor Commonwealth legislation acknowledges the importance of the need for adequate finance for such institutions. Modern scientific thought on the subject of mental illnesses is based on the conclusion that four beds in mental hospitals are needed for every 1,000 persons in the community. The reports that have been published by New South. Wales and Victorian mental hygiene authorities indicate clearly that every one of our mental hospitals is overcrowded. According to the last Victorian report, the number of beds in mental hospitals in that State represents one for every 3S1 persons in the community. All reports disclose gross over- ' crowding and inability to provide the sort of surgical and medical attention that the patients need. Existing buildings cannot be used to the best curative advantage, and, generally speaking, the latest healing methods cannot be employed because of the lack of medical staff, equipment and accommodation. The last Victorian report also mentioned the important fact that a young person who becomes an inmate of a mental institution and is not cured costs the community, over his lifetime, as much as £25,000. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable member's time has expired. {: #debate-29-s49 .speaker-C7E} ##### Sir EARLE PAGE:
Minister for Health · Cowper · CP .- The situation of convalescent homes, homes for the aged, and other institutions to which the honorable member for Ballarat **(Mr. Joshua)** and the honorable member for Bendigo **(Mr. Clarey)** have referred stems from the legislation that was passed in 1946. in the time of the Labour Government. They were excluded by that legislation from the hospital benefits scheme and have been kept in that position largely because general hospitals throughout Australia have been in desperate financial straits. However, now that we can see daylight, I shall consider the points that the honorable members have raised, particularly those in relation to infirmaries, and will discuss them with the Minister for Social Services **(Mr. Townley)** in order to decide whether anything can be done to help them. Unfortunately, we could not do anything about them until we had extricated the ordinary hospitals from their mess. The remarks made by the honorable member for Bendigo on the subject of mental hospitals were absolutely right. The real trouble is the terrible overcrowding in such institutions, which arises from the lack of adequate capital finance for the construction of proper buildings. That is one reason why, during the last four years, I have tried to persuade the State governments to jettison existing agreements and undertake long-range plans. I shall continue to give my attention to this problem. Unfortunately, when I spoke earlier on the subject of the hospital services in Queensland, I forgot to deal with the amendment moved by the honorable member for Eden-Monaro **(Mr. Allan Fraser).** Agreements with the States were made under the hospital benefits legislation of 1 945, which provided power for the Government, by executive act, to make such agreements. That power was continued by the 1951 legislation. The honorable member for Eden-Monaro will notice that clause 40 provides - ( J . ) The Commonwealth may enter into an agreement with a State for and in relation to the provision of hospital benefits, at such rates, and subject to such conditions, as are specified in the agreement, in respect of persons who are qualified patients in public hospitals in that State. (2.) An agreement under the. last preceding section does not have effect unless and until it has been unproved by the Parliament. That will be the position in the future, and the position that has existed since 1946 will be corrected. My law officers have advised me that the effect of the amendment, if adopted, would be to wipe fi rr *Marie Page.* out the present agreements with the Slates. The sub-clauses of clause 3S arc really saving provisions to hold existing agreements in force. Nothing would be gained by adopting the amendment. The agreements would merely be abolished. They have been in force for as long as two and a half years in some instances. There would be no advantage in inserting in this bill agreements that would become ineffective under its terms in the future. Clause 3S covers the situation adequately. {: #debate-29-s50 .speaker-JYV} ##### Mr FULLER:
Hume .- This Government stands condemned for the deterioration in the finances of public hospitals throughout Australia. It stood by in idle incompetence while uncontrolled inflation forced the cost of hospital administration to disastrous levels. It refused to increase the Commonwealth hospital benefit rate of Ss. a day for each patient in public wards, which was fixed by the Chifley Labour Government in 194S and was payable subject to the condition that there should be no charge to the patient. This Government obstinately held to that rate throughout the three highly inflationary years that succeeded its accession to office. Late in 1952 it offered an additional payment of 4s. a day for each patient in public wards, subject to the conditions that the hospital should charge the patient not less than 18s. a day and that the patient should be privately insured at his own expense for a benefit of at least 6s. a day. This Government, which professed to be eager to abolish the means test, thus enforced its re-introduction in public hospitals. State governments, restricted in their finances, were coerced, despite their protests, into accepting the niggardly and inadequate additional benefit of 4s. a day. Only the Labour Government of Queensland, which had some financial reserves upon which to draw, successfully resisted the Government's proposals to force the re-introduction of the iniquitous means test in its public hospitals. The Menzies Government, which withheld from Queensland for months even the original benefit of Ss. a day for each patient, was forced finally to give way and to restore that paltry benefit. As every honorable member knows, the Queensland Government, which formerly provided treatment in public hospitals in that State free of a means test, has been denied by the present calamitous Australian Government the additional benefit of 4s. a day in relation to patients in those hospitals. That is a gross injustice to the Queensland Government. The present Government coerced the State governments into re-introducing the means test in connexion with treatment in public wards, and it has exerted pressure on the State governments to compel members of the community to insure against hospital charges. This Government has made only an insignificant and conditional contribution to the finances of public hospitals. In doing so, it has removed the financial burden of serious illness from the Government, where it properly belongs, on to the backs of the unfortunate sick people themselves. Although the Minister for Health **(Sir Earle Page)** has repeatedly denied that this Government forced the State governments to re-introduce the means test in connexion with treatment provided in the public wards of public hospitals, one has only to read regulation No. 41 of the Public Hospital Benefit Regulations, issued by the Minister in August, 1952, in order to realize the falsity of his denials. That regulation makes the payment of the additional benefit of 4.s. a day conditional on the hospitals charging their in-patients at least 18s. a day. Many complaints have been made against the operation of the regulation by persons of moderate means throughout Australia who are unable to pay large public hospital accounts that they have incurred through prolonged illnesses. I assure the people of this country that a future Labour government will take early steps to relieve the sick members of the community from charges for treatment in public wards of public hospitals and that, subject to efficient hospital administration, adequate contributions will be made to the public hospitals to enable them to defray the cost of providing such services. At the same time, however, a future Labour government will encourage the people of this country to effect hospital insurance in order to offset additional financial strain should their normal incomes cease due to illness. This Government deserves severe censure for the present financial position of the public hospitals of this country. It .stands condemned for its inadequate provision of social services. I am sure that the result of the forthcoming by-election in the Division of Gwydir will show clearly that the Government no longer possesses the confidence of the people of this country. The Australian Labour party looks forward with confidence to the result of that by-election. {: .speaker-10000} ##### The CHAIRMAN: -- Order! The honorable member should confine his remarks to the clause. {: .speaker-JYV} ##### Mr FULLER: -- I have nothing further to add to my remarks, beyond reminding the committee that this Government destroyed the excellent hospital benefits scheme that was introduced by the previous Labour Government. {: #debate-29-s51 .speaker-KGP} ##### Mr HAWORTH:
Isaacs .- The honorable member for Fremantle **(Mr. Beazley)** stated that the contributions that are made by this Government to hospital finances are insufficient to defray their running expenses. Apparently the Opposition has lost sight of the fact that it is necessary that every part of a national health plan must be sound for the scheme as a whole to be successful. The pharmaceutical benefits scheme, which was introduced by this Government, has been of considerable benefit to both the hospitals and their patients. It has resulted in a vast increase of hospital income, and a considerable saving in hospital beds. Hospital managements throughout Australia have expressed their appreciation of these benefits. Many of them have stated that, for the first time in their history, they have been able to' meet their running expenses from income. According to a recent press report, there are now, for the first time, empty beds in tuberculosis sanatoriums in Victoria. This is evidence of the success of the scheme. Important results have made themselves manifest already. The scheme has been accepted by the people of this country. {: .speaker-10000} ##### The CHAIRMAN: -- Order ! The time allotted for the consideration of clauses 3S to 45 has expired. Question put - >That the words proposed to be inserted **(Mr.** ALLAN Phaser's amendment), be so inserted. The committee divided. (The Chairman - Mr. C. P. Adermann.) AYES: 51 NOES: 56 Majority . . . . 5 AYES NOES Question so resolved in the negative. Clauses 38 to 45 agreed to. Progress reported. {: .page-start } page 468 {:#debate-30} ### PAPERS The following papers were presented : - >Qantas Empire Airways Limited - Annual report and Financial Accounts, for 1952. > >Australian National Airlines Act - Australian National Airlines Commission - Eighth Annual Report and Financial Amounts, for year 1952-53. > >Defence Transition (Residual Provisions) Act - National Security (Industrial Property ) Regulations - Order - Inventions and Designs. > >Explosives Act - Regulations - Order - Berthing of a Vessel. > >Lands Acquisition Act - Land acquired for postal purposes - Rosebery, Tasmania. House adjourned at 10.39 p.m. {: .page-start } page 468 {:#debate-31} ### ANSWERS TO QUESTIONS *Thefollowing answers to questions were circulated : -* {:#subdebate-31-0} #### Rubber {: #subdebate-31-0-s0 .speaker-JWR} ##### Mr Chambers:
ADELAIDE, SOUTH AUSTRALIA s asked the Minister for Territories, *upon notice -* {: type="1" start="1"} 0. Is it substantially correct that the Mariboi Company, a rubber-producer in the Territory of Papua and New Guinea, received, for the year ended the 30th June, 1953, only 1s. ll3/4d. per lb. (or what other sum) for rubber which it cost the company 2s. l3/4d. per lb. (or what other sum) to produce and deliver c.i.f. and e. Sydney? 1. Is that typical or indicative of the rubberproduction situation in the Territory? 2. Is rubber production a strategic need for the Commonwealth and an economic necessity for the Territory? 3. Is the industry in a parlous or difficult and uneconomic state? *5.(a)* When rubber prices were high, did the Administration impose an export tax or levy of1d. per lb. for every 6d. per lb. which rubber brought over 2s.6d. per lb.; if not, what other export tax or levy was imposed; (6) What happened to the money so collected, and is some or all of it available now to assist the industry? 6. (a) Does the Commonwealth levy a duty of 2d. per lb. on all rubber which is produced in the Territory and which comes into Australia; if not, what is the duty; (6) Does the Government intend to remit that duty, or has it taken some other steps and if so, what steps, to assist the industry? {: #subdebate-31-0-s1 .speaker-ZL6} ##### Mr Hasluck:
LP -- The answers to the honorable member's questions are as follows : - {: type="1" start="1"} 0. The figures quoted by the honorable member are given in the annual report of Mariboi Rubber Limited. The average selling prices quoted agree broadly with my own information on prices over the period but I have no detailed information on the company's costs of production. The costs quoted are above what I am advised are the average for efficient production on plantations of mature trees of reasonable yield. 2, 3 and 4. The long-termprospects for the efficient production of rubber are considered to be good and the Government is encouraging in the Territory of Papua and New Guinea the planting of high-yielding rubber trees which are essential if average costs of production are to be kept down. Rubber is an essential commodity in peace and war and is not produced in Australia. Rubber is at present exported from the Territory at the rate of about 3,000 tons per annum and rubber production ranks after copra and gold as third in the export trade of the Territory. Rubber- producers in Papua and elsewhere claim that world market prices for rubber are at present low and in some cases unprofitable. 5. (a) Since the 31st January, 1952, duty payable on rubber exported from the Territory has been as follows: - 8. *(a) Yes,* but Territory rubber enjoys an exemption from payment of a primage duty of 10 per cent, ad valorem which applies to rubber from other countries, (b) The Papuan Planters Association has been .informed of a Cabinet decision, early this year, to the effect that any additional assistance for. the rubber industry of the Territory could only be granted after inquiry by the Commonwealth Tarin* Board. This is the procedure required for assistance to an Australian industry. I atn at present in correspondence with the Papuan Planters Association regarding this matter. {:#subdebate-31-1} #### Department of Works {: #subdebate-31-1-s0 .speaker-2V4} ##### Mr CLYDE CAMERON:
HINDMARSH, SOUTH AUSTRALIA · ALP n asked the Minis ter for Works, *upon notice -* {: type="1" start="1"} 0. When was the inter-departmental committee appointed to investigate the department's stores at Woomera T 1. What is its personnel? 2. Why has ite report not been presented to the Parliament or to the Joint Committee of Public Accounts? {: #subdebate-31-1-s1 .speaker-KEE} ##### Mr KENT HUGHES:
CHISHOLM, VICTORIA · LP -- The answers to the honorable member's questions are as follows : - {: type="1" start="1"} 0. . The 20th September, 1952. 1. Representatives of the Public Service Board, Treasury, Auditor-General's Office and Department of Works. - 3. The report of the committee was presented to me as I arranged for. the appointment nf the committee in the first instance. The Joint Standing Committee on Public Accounts dealt with this subject in its report concerning the Department of Works and did not indicate that it required a copy of the committee's report to be furnished.

Cite as: Australia, House of Representatives, Debates, 24 November 1953, viewed 22 October 2017, <http://historichansard.net/hofreps/1953/19531124_reps_20_hor2/>.

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House of Representatives24 November 1953

GWYDIR. ELECT ORAL DIVISION

Mr SPEAKER:

QUESTION

SCRAP METAL

Dr EVATT:BARTON, NEW SOUTH WALES

Sir ARTHUR FADDEN:Treasurer · MCPHERSON, QUEENSLAND · CP

QUESTION

EMPLOYMENT

Mr WHEELER:MITCHELL, NEW SOUTH WALES

Mr HOLT:Minister for Immigration · HIGGINS, VICTORIA · LP

Mr BRUCE:LEICHHARDT, QUEENSLAND

Mr HOLT:

QUESTION

SOCIAL SERVICES

Mr ALLAN FRASER:EDEN-MONARO, NEW SOUTH WALES · ALP

Mr TOWNLEY:Minister for Social Services · DENISON, TASMANIA · LP

Mr STEWART:LANG, NEW SOUTH WALES

Mr TOWNLEY:

Mr PETERS:BURKE, VICTORIA

Sir ARTHUR FADDEN:CP

QUESTION

LONG-RANGE WEAPONS ESTABLISHMENT

Mr BERRY:GRIFFITH, QUEENSLAND

Mr BEALE:Minister for Supply · PARRAMATTA, NEW SOUTH WALES · LP

Mr WARD:EAST SYDNEY, NEW SOUTH WALES

Mr BEALE:

QUESTION

HOUSING

Mr GALVIN:KINGSTON, SOUTH AUSTRALIA

Mr TOWNLEY:LP

QUESTION

TELEPHONE SERVICES

Mr DAVIDSON:DAWSON, QUEENSLAND

Mr ANTHONY:Postmaster-General · RICHMOND, NEW SOUTH WALES · CP

QUESTION

IMMIGRATION

Mr KEON:YARRA, VICTORIA

Mr HOLT:LP

Mr BIRD:BATMAN, VICTORIA

Mr HOLT:

Mr KEON:

Mr HOLT:

QUESTION

SUGAR

Mr HULME:PETRIE, QUEENSLAND

Mr HOLT:LP

QUESTION

GOVERNMENT LOANS AND FINANCE

Mr WARD:

Sir ARTHUR FADDEN:CP

Dr DONALD CAMERON:OXLEY, QUEENSLAND · LP

Sir ARTHUR FADDEN:

Mr BRYSON:WILLS, VICTORIA

Sir ARTHUR FADDEN:

Mr BRYSON:

Sir ARTHUR FADDEN:

QUESTION

COMPULSORY UNIONISM

Mr OSBORNE:EVANS, NEW SOUTH WALES

Mr HOLT:LP

Dr EVATT:

Mr HOLT:

Mr DALY:GRAYNDLER, NEW SOUTH WALES

Mr SPEAKER:

Mr DALY:

Mr HOLT:

Mr CALWELL:MELBOURNE, VICTORIA

Mr HOLT:

QUESTION

URANIUM

Mr SWARTZ:DARLING DOWNS, QUEENSLAND

Mr BEALE:LP

QUESTION

IMPORTS

Mr RUSSELL:GREY, SOUTH AUSTRALIA

Sir ARTHUR FADDEN:CP

QUESTION

ROYAL VISIT TO AUSTRALIA

Mr NELSON:NORTHERN TERRITORY, NORTHERN TERRITORY

House of Representatives
24 November 1953

Dr EVATT:
BARTON, NEW SOUTH WALES

Sir ARTHUR FADDEN:
Treasurer · MCPHERSON, QUEENSLAND · CP

Mr WHEELER:
MITCHELL, NEW SOUTH WALES

Mr HOLT:
Minister for Immigration · HIGGINS, VICTORIA · LP

Mr BRUCE:
LEICHHARDT, QUEENSLAND

Mr ALLAN FRASER:
EDEN-MONARO, NEW SOUTH WALES · ALP

Mr TOWNLEY:
Minister for Social Services · DENISON, TASMANIA · LP

Mr STEWART:
LANG, NEW SOUTH WALES

Mr PETERS:
BURKE, VICTORIA

Sir ARTHUR FADDEN:
CP

Mr BERRY:
GRIFFITH, QUEENSLAND

Mr BEALE:
Minister for Supply · PARRAMATTA, NEW SOUTH WALES · LP

Mr WARD:
EAST SYDNEY, NEW SOUTH WALES

Mr GALVIN:
KINGSTON, SOUTH AUSTRALIA

Mr TOWNLEY:
LP

Mr DAVIDSON:
DAWSON, QUEENSLAND

Mr ANTHONY:
Postmaster-General · RICHMOND, NEW SOUTH WALES · CP

Mr KEON:
YARRA, VICTORIA

Mr HOLT:
LP

Mr BIRD:
BATMAN, VICTORIA

Mr HULME:
PETRIE, QUEENSLAND

Mr HOLT:
LP

Sir ARTHUR FADDEN:
CP

Dr DONALD CAMERON:
OXLEY, QUEENSLAND · LP

Mr BRYSON:
WILLS, VICTORIA

Mr OSBORNE:
EVANS, NEW SOUTH WALES

Mr HOLT:
LP

Mr DALY:
GRAYNDLER, NEW SOUTH WALES

Mr CALWELL:
MELBOURNE, VICTORIA

Mr SWARTZ:
DARLING DOWNS, QUEENSLAND

Mr BEALE:
LP

Mr RUSSELL:
GREY, SOUTH AUSTRALIA

Sir ARTHUR FADDEN:
CP

Mr NELSON:
NORTHERN TERRITORY, NORTHERN TERRITORY

Mr HASLUCK:
Minister for Territories · CURTIN, WESTERN AUSTRALIA · LP

Sir ARTHUR FADDEN:
CP

Mr TOM BURKE:
PERTH, WESTERN AUSTRALIA

Sir ARTHUR FADDEN:
MCPHERSON, QUEENSLAND · CP

Mr DAVIES:
CUNNINGHAM, NEW SOUTH WALES

Sir ARTHUR FADDEN:
MCPHERSON, QUEENSLAND · CP

Mr CASEY:
Minister for External Affairs · LP

Mr CREMEAN:
HODDLE, VICTORIA

Sir ARTHUR FADDEN:
MCPHERSON, QUEENSLAND · CP

Mr J R FRASER:
ALP

Sir EARLE PAGE:
Minister for Health · COWPER, NEW SOUTH WALES · CP

Mr EDMONDS:
HERBERT, QUEENSLAND

Mr HOLT:
LP

Mr CASEY:
LP

Mr FULLER:
HUME, NEW SOUTH WALES

Sir ARTHUR FADDEN:
CP

Sir ARTHUR FADDEN:
CP

Mr HASLUCK:
LP

Mr BEALE:
LP

Mr ERIC J HARRISON:
Vice-President of the Executive Council and Minister for Defence Production · WENTWORTH, NEW SOUTH WALES · UAP; LP from 1944