23rd Parliament · 3rd Session
Mr. SPEAKER (Hon. John McLeay) took the chair at 2.30 p.m., and read prayers.
Mr. J. R. FRASER presented a petition from certain citizens of the Australian Capital Territory praying that the Government will take immediate action to defer the implementation of rental increases of government-owned dwellings in Canberra and conduct an inquiry into Canberra rentals at which evidence may be taken both from individuals and from community organizations.
– I desire to inform the House that the Attorney-General (Sir Garfield Barwick) will be leaving Australia to-day to appear for the Australian Government before the Privy Council on two important cases in which the Attorney-General has intervened. He will be away until early June.
During his absence, the Minister for Labour and National Service (Mr. McMahon) will act as Attorney-General. He will also represent the Minister for National Development in this House.
– In view of the urgency of the international position in certain parts of the world, I ask the Prime Minister whether he will make a statement on foreign affairs, either to-day or to-morrow, with particular reference to the continuing developments in Laos, the further discussions on West New Guinea and the new situation in Cuba. Will he outline in precise terms the Government’s policy, in respect of each of these trouble spots and state exactly what commitments, if any, have been entered into by the Government on behalf of Australia should the position deteriorate in any one of these areas?
– I was under the impression that on Tuesday of last week I made a statement about our policy on Laos. I direct the honorable gentleman’s attention to it.
In Cuba events are, as yet, rather too uncertain to lend themselves to a statement in this House. As to West New Guinea, I am, as the honorable gentleman knows, engaged with my colleagues in discussions with a distinguished representative of Indonesia. Yesterday, he had a discussion with a number of Ministers. This morning, he had a further discussion with me, and, before he leaves Australia, I propose to have a further discussion with him because the time to be given to any one of these discussions is really rather brief.
I inform honorable members that when these discussions have concluded I propose to make a statement to the House about the matter under circumstances which will enable the House to discuss it.
– I ask the Prime Minister whether he will consider giving aid to the people of Tonga - known as the Friendly Island - who have suffered severe damage in a hurricane and are reported to be facing a famine. May I remind the House that there are very friendly relations between Australia and Tonga and that Queen Salote has made frequent visits to this country?
– Order! The honorable member had better ask his question.
– The islanders are devoted to the British Commonwealth and leading Tongans have been educated at Newington, the Wesleyan college at Stanmore, and at the University of Sydney for a century.
– This most unhappy event in relation to which we express our deep sympathy with the people of Tonga was brought to our notice yesterday. The aspect of the matter raised by the honorable member is now under close examination and I will say something about it as soon as I can.
– Is the Treasurer prepared to do anything about so-called “ fringe “ financial institutions, particularly insurance companies, which are lending people money at rates of 15 per cent, and 20 per cent, for dubious commercial ventures that are doomed to financial failure from the outset, but refuse to provide advances for housing, no matter how great the need? I refer to the Standard Insurance Company Limited, amongst others, which has put up its shutters in the last few weeks, and its subsidiary projects such as H. and P. Credits and “Delfino”, the sheep export ship.
– Order! I think the honorable member is giving information.
– The Treasurer needs it.
– The honorable member will ask his question.
– lust as you say, Sir. How can the credit squeeze bc effective when legitimate business is curtailed while these bandits of big business pursue their own mad course to bankruptcy? With regard to insurance companies, can the people’s money be protected in some way such as that in which the policy-holders’ funds are protected? Will the Treasurer agree that the activities of the insurance companies literally scream for investigation?
– With due respect to you, Mr. Speaker, and your tolerance in these matters-
– That is a reflection on the Chair.
– No. My remarks are not intended as a reflection on the Chair, as the Chair will appreciate. No one has greater respect than I have for Mr. Speaker. The point I am trying to make is that to answer the question asked by the honorable member for Parkes in its detail would lead me into arguments and comments which would be quite beyond the limits of the Standing Orders. As the honorable gentleman knows, this Government has given a great deal of attention - far more than any government before it of which I am aware - to the problem which has developed of banking or quasi-banking operations being conducted outside the normal banking channels. Already an interim measure directed to part of that particular problem is on the statute-book.
Since that measure was drafted, a great deal of work has proceeded inside the Treasury and other departments. I hope to be able to inform the House of the outcome of our consideration of these matters at no distant date. Some of the questions raised by the honorable gentleman go beyond the competence of the Commonwealth Parliament. They relate to aspects which more appropriately come within the jurisdiction of the law officers of the various States.
It is certainly not true that insurance companies have not made finance available for housing purposes. A total ot nearly £30,000,000 came from the insurance offices for this purpose last year. The speculative activities to which the honorable gentleman referred have certainly been curbed as a result of policies adopted by this Government - policies which I regret to say have been consistently attacked by honorable gentlemen opposite.
– My question is directed to the Minister for Repatriation. Will he make representations to the PostmasterGeneral, on behalf of war widows, with a view to restoring concessional allowances for war widows in respect of radio and television licences?
– The honorable member for Ballaarat has asked me a question about certain concessions, not directly related to war widows’ pensions, which used to be available to certain war widows. The position is this: In the last Budget the pensions and domestic allowances of war widows were quite considerably increased. Before that time, war widows who had no other income were entitled to receive the minimum social service pension which, in itself, entitled them to a concession on television and radio licences and to certain travel concessions given by the State governments. The increases in the last Budget, to which I have referred, have lifted the income of war widows above the maximum amount of income allowable for a social service pension, so the widows are no longer entitled to the concessions mentioned. I have discussed this position with the Postmaster-General and it is clear that the concessional fees for radio and television licences are not available under the existing law. The travel concessions, of course, are entirely the affair of the State governments and cannot be affected by anything that this Government can do.
– I ask the Minister for Territories whether he is aware of a statement made by Dr. Peters in the “Australian Medical Journal “, on 22nd October, 1960, as follows: -
In the Maprik area, it has been shown that up to 60 per cent, of babies die before attaining the age of about 18 months.
Also, is the Minister aware that on the medical evidence the figure for Papua and New Guinea, as a whole, is about 30 per cent.? What is the attitude of his Administration to this problem? Does it believe that malaria is one of the main causes of this astonishingly high rate of infant mortality? If so, what is being done to eradicate malaria in this area? If the Administration cannot fix an early target date for the eradication of malaria, will it refer the matter to the World Health Organization?
– I am not personally aware of the statement in an article by Dr. Peters, but I am, of course, very well aware of the facts to which the honorable member has referred. If he had been paying close attention to the course of events in Papua and New Guinea, he would not have had to wait for that article to appear, because, in this House, I and other speakers on both sides have discussed with some care and concern this particular basic problem of health in the Territory. It is one of the major problems with which we deal in our administration of the Territory. It is a problem which existed long before we went there and. it is- one to which we have given a. top priority in our administration.
The honorable member asks what we are doing about the problem. The appointment which Dr. Peters himself held in the Territory of Papua and New Guinea was one directed to the control and eradication of malaria and the work that he did at Maprik was work in- a malaria control centre. It is quite true that malaria is a disease which is endemic over a large part of the Territory, and; I think I would be correct im saying that apart from the effect it has, itself, it breaks down the fortifications of health and provides an entrance for other diseases.
We are embarking very vigorously on the whole task of improving the health and the hygiene of the people. In that task - and particularly in the eradication of malaria - we work in the closest possible cooperation with the World Health Organization. Several of our leading officers, under scholarships and fellowships provided by the organization, have studied abroad, and as the result of their studies with the organization have introduced methods into the Territory to deal with this problem more effectively. We have also had the advantage of visits by experts of the World Health Organization, who have helped us in planning our campaign.
– I direct a question to the Treasurer. I refer to the announcement by Dr. Coombs, the Governor of the Reserve Bank of Australia, that £17,700,000 worth of the frozen deposits held by that bank will be released to the trading banks. Does this mean that special credit assistance will be available to primary producers, to enable them to increase their investments in their farms and so boost production?
– The Governor of the Reserve Bank has made it clear that this release does not involve any change of credit policy. He has pointed out that whereas in the first quarter of the year it is normal for advances to fall because of seasonal factors, in the second quarter it is normal for advances to increase, as income tax payments have to be made and liquidity tightens generally in the banking system. The bank, in order to sustain the liquidity of the banks, has found it desirable to make these releases from the statutory reserve deposits: The Governor has taken the opportunity to stress again what has already been stated in connexion with earlier releases by the bank, and also in directives issued by him, to the trading banks concerning policies they are to apply. He has said again that preferential treatment is to be given to exporters, particularly those in the- rural and mining industries.
– I wish to ask a question of the Prime Minister in his capacity as Minister for External Affairs, ls the Government prepared to assist in arranging a tripartite top-level conference between Australia, Indonesia and the Netherlands, as a preliminary step to resolving the future ot Dutch New Guinea, in accordance with the universal desire, and the stated aim of Indonesia, that this problem be settled by negotiation?
– The answer to the honorable member’s question is, “ No “. The reasons for that answer will, I think, appear when I make the statement that 1 promised to make next week.
– I direct my question to the Minister for Trade. I do so because the subject-matter of the question is concerned with the period when the right honorable gentleman was acting as Prime Minister. Is it a fact, as alleged by the Tasmanian Premier, that Tasmania has not been invited to conferences between the State governments and the Commonwealth Government on priorities for national works and the allocation of finance for such works? Also is it a fact, as again alleged by the Tasmanian Premier, that representatives of other States have been engaged in talks on this subject, although Tasmania was not notified that such talks had commenced?
– The position is that there has been no conference, and no suggestion of a conference, on the specific matter mentioned by the honorable member for Franklin - priorities for public works. The Prime Minister announced before he went overseas recently that the Commonwealth would be prepared, as a part of its plan to expand our export income, to consider, in certain contingencies, arriving at special financial arrangements with some States to enable the carrying out of great public works which, upon completion, would have immense and enduring value in contributing to the increase of our export income. The Prime Minister enumerated the four principal works that the Commonwealth had in mind. They were, first, the provision of roads in north
Australia to assist the beef and mineral industries; secondly, the improvement of facilities in coal ports for the purpose of increasing our coal exports; and, thirdly and fourthly, the standardization of gauge of two railway lines, one in South Australia and one in Western Australia. These works were identified because of their immense potential value in increasing export earnings, and also because, in each case, it was considered that, on the face of it, the financing of the work was beyond the capacity of the State or States concerned. There has been no conference of Ministers or Premiers on this, but officers of the States have been asked to come to Canberra to engage, without commitment, with Commonwealth officers in a preliminary examination of the planning of those works.
– Can the Treasurer explain the buoyant speculation on stock exchanges while Australia’s army of unemployed is growing to record proportions? Have the wealthy stock exchange dealers any advance information that has not been disclosed to the public which justifies their spirited business transactions while many firms are still retrenching employees due to lack of demand for their products?
– I think it is a fact that over recent weeks there has been some continuing portfolio investment by overseas investors, perhaps on an even larger scale than at most earlier points of time. If that has been the case, it is a reasonable assumption that this is a mark of the confidence which those investors feel in the expansion and general economic growth of Australia.
The honorable gentleman has pointed to the level of unemployment in this country. I clarify his reference to unemployment by saying that presumably he is referring to unemployment registrations. It would be misleading to give anyone outside this country the impression that there is chronic unemployment in Australia of any significant dimensions because last month, for example, nearly 10,000 new work vacancies were notified each week to the Department of Labour and National Service. That surely is not a mark of any stagnation in our internal economic affairs. But returning to the viewpoint of the overseas investors, I point out that whereas in the United States of America there is a general unemployment level of upwards of 6 per cent, and in Canada of something like 11 per cent., to have a level of unemployment in Australia of under 2 per cent, represents a degree of prosperity which justifies the confident assumptions of these investors. lt is a pity that inside Australia we do not have a more balanced perspective on this matter. 1 commend to the honorable gentleman the realistic statement that was made by the president of the Australian Council of Trade Unions or even to what was, at that stage in Australia’s history, the realistic statement of the honorable member for Parkes on the level of unemployment which should be expected.
– My question is directed to the Minister for Primary Industry. After waiting patiently for five months I now ask what has resulted from my long-continued advocacy of some definite action by the Commonwealth Government to combat the spread of skeleton weed in the Victorian wheatlands?
– The honorable member’s advocacy has borne some fruit, or perhaps I should say inspired action. At the last meeting of the Australian Agricultural Council the State Ministers supported my recommendation that this problem should receive closer consideration by the Commonwealth Scientific and Industrial Research Organization and, if necessary, assistance should be granted from the Commonwealth extension fund. This matter is being considered and a plan has been worked out to step up the attack on this weed. Included in this plan is examination of the possibility of finding a means of biological control.
– The Minister foi Trade will be aware that the 49 per cent. Australian share-holding in Volkswagen (Australasia) Proprietary Limited has been acquired by the overseas parent company. As the Minister has often stated that the Government prefers a partnership of local and overseas capital, I assume that it does not approve this latest take-over. Was the Government consulted in this matter? What prospects are there for exports of motor cars now that all the substantial Australian manufacturers are wholly owned overseas?
– I am not aware whether the Government was consulted or informed before this event took place. It would not necessarily be a matter for the Department of Trade; but I see no particular reason why the Government should be consulted. I have stated inside and outside the House a point of view on partnership between Australian industry and investors and overseas industry and investors, and I believe that, associated with this capital move within the Volkswagen company, there is a suggestion that, at a later date, the Australian public, as distinct from some Australian companies, will be given an opportunity to take a share interest. I will check whether I am right and whether something has been stated along those lines; but 1 believe it will be proved in the near future that a number of companies, including the Volkswagen company, will increase the export of motor cars from Australia.
– I direct a question to the Treasurer. Will the flow of overseas investment to Australia be affected in any way by the new policies of the United Kingdom Government as announced in the 1961-62 Budget that has just been presented by the British Chancellor of the Exchequer?
– I have not been able to study the details of the United Kingdom Budget as fully as I would wish; but my first reading of the cables that have reached me and what I have seen in the press indicate that the Chancellor of the Exchequer has set out to equip himself with the necessary economic instruments in order to keep the economy of the United Kingdom on an even keel, and to enable it to meet the fluctuations which inevitably occur in any progressive economy in a way that would maintain steady progress inside that country. Of course, there has been over the years a steady flow of investment capital from the United Kingdom into Australia, and that position is being maintained. I should think that far from weakening our prospects, success in the measures that the earliest of the ‘Exchequer -has announced should ensure not only “that this flow will -continue, but that we may perhaps also look to some increase.
– My question is directed to the Prime Minister. Is it a fact that at the opening of an Australian productivity conference held at the University of Melbourne on 8th February last, the Prime Minister in a “Let’s Produce More” address said that “ increased productivity was the .greatest task confronting Australia “? ls the Prime Minister aware that there are approximately 82,000 unemployed registered with the Commonwealth Employment Service who are anxious to contribute to the national production effort? Will the Prime ‘Minister state what plans the Government has to enable these Australian workmen to participate in the campaign for greater production? Finally, does the right honorable gentleman see anything .inconsistent in launching an appeal for greater production while imposing government restrictions which have enforced a substantial reduction of production in a number of industries?
– Oddly enough, what the ‘honorable member says I said I did say. It was Tight then, and it is right now.
– Will the Minister for Trade inform the House whether the system of referring the question of temporary duties to the Deputy Chairman of the Tariff Board to protect an industry in trouble from excess imports is being availed of by industry generally? How many industries have approached the Department of Trade in this connexion this year, how many have been referred to the Deputy Chairman and in how many cases has protection been accorded?
– The system under which the Government is prepared to refer to the Deputy Chairman of the Tariff Board a question involving the levying of a temporary duty after a case has been submitted to the Department of Trade by a panel of the industry concerned, is in operation. I will secure for the honorable member the statistics for which he asks - that is, on the number of industries that have made an approach and the cases in Which action has followed. I can say now, however, that ‘the system has been continuously in operation. During the last week I have referred to the deputy chairman for consideration for temporary duty the case of nitrogenous fertilizers and the case of woollen piece-goods. In the last couple of weeks I have been able to report that, consequent upon the study by the deputy chairman, and a report, temporary protective action has been taken in respect of acrylic yarn and in respect of gelatin. To-day I have been, as I had intimated I expected to be, in close and final consultation with senior officers of the department in respect of the cases -of .the timber industry and the plywood industry. I ,now find myself in the position to reach a judgment in these matters but, due to .circumstances in these industries, brought out by the analysis -that has been undertaken, I propose to ask my colleagues in the Cabinet to give me the benefit of their advice at the very earliest opportunity.
– My question is directed to the Postmaster-General. I ask him whether he is yet in a position to indicate when national television stations will be established in rural areas throughout Australia. I further ask him: Does he now intend to license a second commercial television station in each region in Australia, and thus give to the viewers of this nation a choice of programme?
– The Government’s policy regarding the establishment of national television stations in country areas was announced by me at the same time as I announced the policy on the third phase of television. I can inform the honorable member that the Postmaster-General’s Department, the Australian Broadcasting Commission and the Australian Broadcasting Control Board have been working on the various matters that have to be determined in this phase of television. As far as the national television service is concerned, tenders have been called for the necessary equipment and, in the majority of cases, the sites have been chosen and the “work is proceeding quite satisfactorily.
It will, of course, be some time, as I said when I made the original announcement, before the national stations are in operation, because the department will have to provide thirteen such stations.
The honorable member also asks when a second commercial television station is likely to be established in, I take it he means, each of the areas at present being served by one commercial station in this third phase. In that regard, I made the Government’s policy quite clear that, for the present, we were licensing one commercial station only in each of those country areas. I made it clear that that did not mean that any monopoly was being given to the stations concerned, but meant that at some time in the future, when the initial stations have had time to become established and operative, and when the manner in which the stations are operating can be judged from the reports which will come in, consideration would be given to whether a second station should or should not be established. Obviously, that stage has not yet been reached, and may not be reached for a considerable time.
– Has the Minister for Territories had time to consider the plans of the Deputy Leader of the Opposition in relation to the future of Papua and New Guinea? Do those plans differ in any way from the frequently expressed policy of the Leader of the Opposition? Further, has the Minister examined the qualifications of those two honorable members to put forward a policy for the Territories? Has he been informed by the Australian Labour Party executive, the real masters of the Parliamentary Labour Party-
– Order! I think the honorable member is going beyond a question, and is stating an opinion.
– Has the Minister been informed by the A.L.P. executive of its decision in relation to the proposals submitted?
– I have had no formal communication from the Australian Labour Party saying what particular policy it has approved for Papua and New Guinea. I have heard a story to the effect that a proposal for consideration by the conference was prepared by a group of members and was to be submitted by the Deputy Leader of the Opposition.
– That is completely untrue.
– But the submission did not take place because of the superior wisdom, which I respect, of the Leader of the Opposition. I do not know how far I should comment on this.
– Do not comment at all, because you have no basis.
– If the Leader of the Opposition will be patient, I will pay him, as 1 was about to pay him, a compliment and a most sincere compliment. I would say this: Not only because of the position that he occupies as Leader of the Opposition, having, one assumes, the undivided support of all those who stand behind him, but also because of a real respect for the attention he has paid to the problems of Papua and New Guinea, I personally would always pay the closest respect to any opinion that the Leader of the Opposition expressed on this subject. Over a number of years, long before New Guinea was very much in the public eye, he went to some trouble, in visiting the Territory, studying its problems and discussing those problems with people in the Territory, to inform himself on the question. So far as the Deputy Leader is concerned, I can record an impression that on this, as on so many other public questions, New Guinea is to him just another rung of a borrowed ladder.
– Will the Treasurer inform the House whether it is a fact, as has been widely claimed, that the Government’s credit restriction policy has caused unexpected damage to commerce and industry throughout Australia? Further, will he inform the House of the steps the Government intends to take to combat this damage to commerce and industry and to arrest the alarming increase in unemployment in every State? Will he confirm that there is widespread alarm amongst the members of the Government parties, due to the publication of a letter by the Victorian Chamber of Manufactures emphasizing the position that I have referred to in my question?
– The honorable gentleman does not appear to have followed very closely the course of events in this country over recent months. He attributes damage to the policies of the Government. He should be aware that the Government set out to cure a boom situation which had all the classic symptoms of developing into an economic crash. We who have been in this Parliament rather longer have not been without experience of the situation that can develop when a government does not grapple effectively with a boom situation which is generating its own critical symptoms. By moving as we did towards the end of November, we averted a situation which could have had all the consequences of what I shall continue to describe as a classic boom-bust situation emerging from excessive demand which was building up inside the Australian economy.
Undoubtedly, as a result of the firm measures taken at that time, there have been adjustments of a major character in some sections of the economy, and undoubtedly those adjustments have caused discomfort and even hardship in particular directions. I have said before, and I say it again, that we regret this. I have also said before, and I say again, that had this action not been taken the discomfort and hardship would have been a thousandfold worse than they have been under the policies of this Government. Most people recognize that the Australian economy is in far better balance now and certainly is not likely to see a repetition of the disastrous circumstances that emerged during a Labour term of office in the ‘thirties.
– I wish to make a personal explanation.
– Order! Does the honorable member claim to have been misrepresented?
– I claim to have been misrepresented by a newspaper report, Sir
– The honorable member will have an opportunity to make a personal explanation at a later stage in compliance with the forms of the House.
– My question is directed to the Postmaster-General. Has the honorable gentleman any information to give to the House about the fourth phase of television in this country? Does he not agree that the policy in this phase should be to establish television in areas where people have been waiting patiently for it rather than to extend television services in areas which are already served by this medium?
– I have stated several times in recent months in this chamber that immediately the Australian Broadcasting Control Board had completed all the arrangements and provisions that it had to make in completing the third phase of television, I would require the board to apply itself to the fourth phase of the extension of this medium, and particularly the form it should take and the areas that should be served. I had a conference with officers of the board only on Monday last. Although the third phase is not yet entirely off the board’s books, so to speak, nevertheless, the board is in a position to begin directing its attention to the fourth phase, and the consideration of this phase is to begin shortly under my general direction. The idea is that we shall have a small departmental committee to go into the various problems that will arise in this fourth phase.
Honorable members will realize that, although some of the areas to be served by the fourth phase have a population density equal to that of areas which are already being served under the third phase of the scheme and will therefore present no very great problem, the population density in some areas to be covered by the fourth phase is much less and those areas have special problems which will have to be carefully considered. I should think that the formation of a small departmental committee to examine these matters thoroughly and then to report back to the Government through me will mean that the fourth phase will be considered within the next few months. I do not expect to get a report from the board within, say, a week or two, because the task is quite a big one and the problems are considerable.
The honorable member for Lyne referred to the desirability of providing in the fourth phase services in areas which are not already served rather than the extension of existing services. With that contention, I completely agree.
– I address my question to the Minister for Trade. I ask him: Has he seen a statement attributed to the manager of the Tasmanian Timber Association, which was made yesterday, to the effect that more than four weeks have now elapsed since the timber industry made approaches to the Government and that in this time conditions in the industry have worsened considerably? In view of the seriousness of the matter, and in particular the unemployment which has resulted, especially in Tasmania, is the Minister in a position to intimate when the industry is likely to be given a decision on its approaches to the Government?
– I mentioned this matter in mylast answer to a question. I said that to-day, in accordance with intimations which I have given in the Parliament as recently as yesterday, I had concluded examining the position of this industry in conjunction with senior officers of the Department of Trade, and that I had reached the conclusion that, in view of certain features of the situation, I ought to request consultation with my colleagues in the Cabinet before a final decision was made. I have the authority of the Prime Minister to say that this Cabinet consultation will take place just as soon as it can conveniently be arranged.
– My question is addressed to the Minister for Labour and National Service. I ask him: Has his attention been directed to a recent statement by Mr. Docker, as advocate for the Waterside Workers Federation of Australia before the Full Bench of the Commonwealth Industrial Court, to the effect that the federation will engage in stoppages of work whenever it elects to do so, regardless of whether such stoppages are contrary to the act concerned, the award or the court’s order? Is it a fact that these stoppages involve great cost to the economy and represent a direct charge on the community, and are therefore against the public interest at a time when we are seeking to keep costs down?
– I have read of the statement made by Mr. Docker to the Industrial Court recently that, no matter what the terms of the act or the award might be, the union itself would engage in strike action should it decide to do so.
Opposition Members. - Hear, hear!
– The Opposition says “ Hear, hear! “ I think it is perfectly true to say that the waterside workers should recognize that it costs from £800 to £900 a day to keep a ship in port and that, in the long run, the people who pay the additional cost needlessly forced upon the community by the actions of the Waterside Workers Federation are the Australian consumers themselves. I hope that when it is next listening to Mr. Docker the Industrial Court will continue to make it perfectly plain to him that it will not tolerate illegal actions by the Waterside Workers Federation which can result only in inflicting increased costs upon the Australian people.
– For the information of honorable members, I lay on the table of the House the following papers: -
Postmaster-General’s Department -
Fiftieth Annual Report, for Year 1959-60.
Financial and Statistical Bulletin for Year 1959-60.
Auditor-General’s Report on Post Office Commercial Accounts for Year 1959-60.
I ask for leave of the House to make a statement in connexion with the Report of the Postmaster-General’s Department.
– My annual report for 1959-60 which has been submitted to His Excellency the Administrator refers to the establishment by the Government of an ad hoc committee to examine and report on the Post Office commercial accounts and to the decisions of the Government on the committee’s report. The accounts for 1959-60 have been prepared on a basis which reflects these decisions. lt may be helpful to honorable members to have information relating to the terms of reference of the committee, its recommendations and the decisions of the Government thereon in more detail than has been given in my annual report. This statement has accordingly been prepared.
The committee was appointed in September, 1959, with the following terms of reference: -
To study and report on -
In considering these matters the committee was invited to have regard, among other things, to the services which have been rendered by the Post Office up to 30th June, 1959, at uneconomic rates in accordance with Government direction or policy. The committee was also asked -
To study and report upon the basis for the preparation of the commercial accounts of the Post Office, with particular reference to the matters referred to in term of reference (1) and also, as the committee sees fit, to
Cb) the basis on which the Post Office contribution to meet superannuation, pension and furlough payments should be calculated and shown; and
The membership of the committee was - Sir Alexander Fitzgerald, O.B.E., B.Com., F.A.S.A., F.C.I.S., F:C.A.A. (chairman); Mr. Gerald Packer, C.B.E., B.Sc; Mr. L. B. Evans, F.A.S.A.; Mr. E. W. Easton, M.A., B.Com., of the Post Office; and Mr. J. F. Nimmo, M.A. (Econ.), of the Department of the Treasury.
The committee did not reach complete agreement on all matters and presented two separate reports. One of these - the majority report - is subscribed to by Sir Alexander Fitzgerald, Mr. Evans and Mr. Nimmo. The other - the minority report - represents the views of Mr. Packer and Mr. Easton.
Notwithstanding the presentation of the two reports, there was a measure of agreement on the following important matters: -
Post Office on funds made available subsequent to 30th June, 1959, at the ruling longterm bond rate.
For the convenience of honorable members I have had prepared a summary of the conclusions and recommendations of the committee as contained in the majority and the minority reports. This summary will be made available to any honorable member who desires it.
The Government has considered some of the recommendations of the committee but for the time being has limited its attention to those necessary to establish the permanent form of the commercial accounts of the Post Office and to permit the accounts for 1959-60 to be presented. In relation to these matters it has decided -
The amount of the net financial advantage as at 30th June, 1959, on which the Post Office is required to make an annual contribution will be £340,000,000.
Office each year subsequent to the 30th June, 1959, will be subject to an annual interest charge at the rate of the longest term Commonwealth public loan raised in Australia at about the time each advance was, or will be, made.
Mr. Speaker, this agreement also has been reached and the balance sheet as at 30th June, 1959, which I laid on the table a little while ago, reflects the decisions of the Government
Decisions have still to be made on several other matters relating to the Post Office accounts; these include-
In addition to dealing with certain of the recommendations on the commercial accounts of the Post Office made by the committee set up under the Chairmanship of Sir Alexander Fitzgerald, the Government has in mind giving some thought to a number of other matters relating to the finances of the Post Office, which it considers to be relevant to its future financial status. Some of these have been referred to in the minority report of the committee.
When the Government has made decisions on these outstanding matters, I shall inform the Parliament accordingly. As honorable members know, however, the Auditor-General has audited the commercial accounts for 1959-60 and his certification has been appended to the balance sheet at the 30th June, 1960.
The Auditor-General made a special request to me that his certification should be tabled as it marks the establishment of quite a new era, so to speak, because previously he has not been able to certify the accounts. The balance-sheet is included in my annual report for 1959-60, which will be available to honorable members.
I now lay on the table of the House, for the information of honorable members, the following paper: -
Reports of the Ad hoc Committee of Inquiry into the Commerical Accounts of the Post
Office together with an addendum to the Report of the majority of the committee and comments on the addendum by the minority - and move -
That the papers be printed.
Debate (on motion by Mr. Crean) adjourned.
– I wish to make a personal explanation in respect of an article which appeared in the “ Sunday Telegraph “, of 16th April, 1961, which was referred to by the honorable member for Phillip (Mr. Aston) in a question which he directed to the Minister for Territories (Mr. Hasluck). But for the fact that the question was asked by an honorable member who is Deputy Government Whip, and the Minister bothered to answer it although it was based on a lying report, I would not have bothered to do what I am now doing. I would simply have ignored the statement. However, as the Minister has paid some attention to the report, I must now state quite categorically that the statement was absolutely untrue. At no stage did I or any one else, to my knowledge, submit a report to any sub-committee, conference, or any other body within the Australian Labour Party recommending the four points that are alleged in the article signed by Mr. Alan Reid to have been recommended by me.
It is equally untrue that the Leader of the Opposition (Mr. Calwell) made any attempt to prevent a discussion of the document which was submitted to the conference by the sub-committee which dealt with Papua and New Guinea. As the Leader of the Opposition indicated by way of interjection at question time, that report was untrue. The Leader of the Opposition did not attempt to prevent a discussion of this matter. The committee’s report was, in fact, discussed by the federal conference of the Australian Labour Party and, with very minor alterations, was adopted and is now the policy of the Australian Labour Party.
The report also alleges, amongst other things, that it was proposed that the cost of carrying out the recommendations which, as I have stated, were adopted by the conference would have to be borne by the Australian taxpayers. That, again, is an untruth, because the report of the committee, which was adopted by the conference and which will be published in due course in the newspapers, makes it quite clear that the burden of meeting the cost of the economic development of New Guinea should be borne by the United Nations.
– I take a point of order. The honorable member for Hindmarsh (Mr. Clyde Cameron) sought leave to make a personal explanation, claiming that he had been misrepresented. He has now set out to deal with matters affecting the Leader of the Opposition (Mr. Calwell), the Deputy Leader of the Opposition (Mr. Whitlam) and various other people in circumstances not related to the particular matter raised by the honorable gentleman. If his general purpose in doing so is to throw a reflection on the reliability of the reporter concerned, that is understandable as an objective, but in that case I think he should go further and say whether various other Labour policy matters which Mr. Reid has reported are similarly inaccurate. I think you will agree, Mr. Speaker, that the honorable member went beyond the limits of a personal explanation.
– The honorable member for Hindmarsh sought a hearing from the House on his claim that the press had misreported him in connexion with a certain episode. Provided that he did not debate the matter - and I do not think he did - he was quite in order.
– In accordance with the provisions of the Public Works Committee Act 1913-1960, I present the following report: -
Report relating to the proposed construction of Commonwealth offices at Toowoomba, Queensland.
The reference of this proposal to the committee arose from a suggestion made to the Minister for the Interior and Minister for Works (Mr. Freeth) that examination of it might assist in establishing principles to be adopted in planning similar buildings elsewhere. The committee has made such a study and, arising from it, offers some suggestions for consideration when similar buildings are being planned in provincial cities.
Ordered to be printed.
Debate resumed from 13th April (vide page 825), on motion by Mr. Harold Holt -
That the bill be now read a second time.
.- This is a further superannuation measure which proposes to make some amendment to the Defence Forces Retirement Benefits Act 1959. The Opposition does not oppose the measure but I want to offer what I hope will be some constructive criticism. This measure is a result of the Allison Report of 1957. The Allison committee was set up by the Government in 1957 to report on some aspects of pay and allowances for members of the serving forces and on some aspects of retirement benefits. It was not until November, 1959, that the measure was brought before this Parliament. It largely superseded the superannuation act which was then in force and which had been introduced by the Chifley Government in 1948. It is conceded that the legislation at that time did require amendment and I understand it was amended year after year. I have no doubt that this Parliament is indebted to the Allison committee for the work it did in connexion with retirement benefits generally and pay allowances although I, together with some other members of the Opposition, would, if we had the opportunity, be critical of some of the allowances that have been made available in accordance with this report. Nevertheless, we concede that the committee did rectify some anomalies which had existed and I think that, by and large, it can be said that the report has been adopted by this Parliament with the approval, in the main, of the serving members of the defence forces.
I believe it is extremely important that the Allison report, as adopted by this Government, should take into consideration all aspects of service, because it should be remembered that most servicemen retire in the prime of their lives. I point out - and no doubt the Minister will concur - that all officers below the rank of lieutenant-colonel are required to retire from the services at the age of 47.
– Not all.
– I accept the Minister’s correction, but I understand that the age is 47 years.
– On the average.
– The Minister can put it in that way if he wishes, but the fact remains that these officers retire in the prime of their lives and certainly at a time when it is very difficult for them to transfer from one form of employment to another and when they are faced, possibly, with providing for the education of their children. In this respect, I believe that this Parliament has a duty to ensure that the retirement benefits paid not only to officers but also to non-commissioned officers and other ranks, and particularly to widows and children, are commensurate with what we consider should be an adequate retirement allowance. Some of the anomalies in that respect have already been overcome. I have already said that in the opinion of the Opposition some of the benefits are far less than they should be, having regard to the buoyancy of the Defence Forces Retirement Benefits Fund to-day. But the Opposition has no complaint to make concerning this bill. The measure merely proposes some minor amendments to the existing act, which was introduced into this Parliament in 1959.
Unfortunately, there are no figures available from the Commonwealth Actuary which would give some indication to the Opposition of the degree of buoyancy of the fund at this stage and enable it to make some constructive suggestions concerning the matters to which I have already referred, such as the inadequacy of the payments, particularly to widows and orphans. The Minister now proposes three principal amendments. The first merely grants an extension of time to personnel who had elected not to contribute for part or whole of the additional pension provided by the act of 1959. The second amendment confers on servicemen who, I understand, elected in 1948 not to join the scheme then available, an opportunity to contribute for a pension.
The third amendment is interesting. The Opposition pointed out, when the amending bill was introduced into this Parliament in 1959, that there would be some difficulty in this respect. The amendment refers to the formula which set the entitlement at one and one-half times the amount of the contribution. I understand that when the measure was introduced into this House it was pointed out that some members contributing under the new scheme - gratuity at a fixed amount for each year of service - would receive less than they would have received under the 1948 scheme. That criticism has, in point of fact, been substantiated and so I am glad to see that the Minister has provided an amendment which will allow some serving officers of the defence forces to receive benefits under the one and one-half times formula which will mean, in effect, that they will have the advantage of a higher rate of income. Broadly, they are the three amendments that the Minister proposes.
As I have already indicated, the Opposition does not intend to oppose this measure. I have already referred to the fact that the one and one-half times formula has now been upheld for members of the Forces, but there is one other point in the bill on which I want to dwell for a few moments. During his second-reading speech the Minister made reference to those members of the Services who are prematurely retired. I prefer to use another term because some serving members are compulsorily retired and they are the people with whom I am concerned at this moment. A serving member of any of the armed forces may retire for a variety of reasons. He may be invalided out of one of the services. He may retire of his own volition. But there are some who - as we know - as the result of the re-organization of the Army, in particular, have been compulsorily retired, and in that instance I believe that they are entitled to far greater consideration than they have received in the past or will receive in the future.
The Minister is fully aware that representations have been made to him recently concerning one member of the services - a non-commissioned officer - who has been compulsorily retired though he had a number of years to serve under the original terms of his contract. This man receives a far lower rate of pension than he would have received had he been able to complete the full length of service. I believe that a person who is compulsorily retired from the services should get the benefit that would have been paid to him had he completed the length of service for which he contracted. This bill makes no allowance for cases of that nature. The Minister merely refers to it as premature retirement, but premature retirement takes on a different aspect when a member of the Services is compulsorily retired. That is what is happening to-day.
Serving members of the Army - particularly those who have had long service - are being compulsorily retired by the Minister and get lower rates of pension unless they are prepared to pay in a lump sum the amount which would enable them to qualify for a full pension. There are many members of the Services, particularly noncommissioned officers and other ranks, who are not in a position to make a lump sum payment in order to qualify for their full pension entitlement. I suggest that this is one matter to which the Minister should give serious consideration.
The other point to which I wish to refer relates to widows. Under the amended act a widow receives five-eighths of the pension that would have been payable to her husband. We know that there are some superannuation schemes in this country which regard as the widow’s entitlement threequarters of what would have been the husband’s due. In view of the buoyancy of the Defence Forces Retirement Benefits Fund at this date, it should be possible for the Government to accept the higher rate of three-quarters rather than the fiveeighths. I suggest that five-eighths of what would have, been the husband’s entitlement is a very small amount for a widow to live on and educate her children as she would wish. In the circumstances, this is one matter that the Minister should consider when the legislation is being amended at some future date. We know that conditions generally have improved.
I join with other honorable members on both sides of the House in congratulating the Minister for Defence (Mr. Townley), and the present Minister for the Army (Mr. Cramer) and the Ministers who have preceded him, on the way in which they have effected improvements generally in the armed services. I know the conditions that obtained before the Second World Wax. I know the conditions that obtained, in many cases, during the Second World War, and I know that since that time not only this Government but also other governments have endeavoured to effect improvements in the conditions generally of serving members of the armed services. I believe that these improvements have been effected in large measure, and that the lot of members of the services to-day is far better than it was between the two world wars.
I think the Minister may also be congratulated on the fact that improvements have been effected in the general rates of pay of members of the services. Undoubtedly a serving member to-day is much better off financially than was his counterpart in one or other of the armed services at any time between the two world wars. Some improvements, as I say, have been effected, and I also acknowledge that the measure we are now debating represents a further attempt on the part of the Minister to improve the existing legislation.
The Opposition does not intend to oppose the measure, which merely provides for the minor amendments to which I have already referred. I would suggest to the Minister, however, that he should consider the two points I have raised. The first concerns a serving member of the armed forces who is compulsorily retired, and the second has regard to the question of fixing an equitable rate for widows of ex-servicemen. I have no doubt that there are many other matters that could be dealt with in discussing legislation of this kind, but the fact is, of course, that the bill deals only with certain minor amendments. The Labour Party does not intend to oppose the legislation, and I merely repeat, in conclusion, that I hope that the Minister will consider the points to which T have made reference.
.- I am pleased to hear that the Opposition is not opposing this measure. It is, as the honorable member for Bass (Mr. Barnard) has said, a very simple measure, designed to correct certain anomalies that have become apparent in the operation of the act. I think we all join in expressing appreciation, as I know the Government does, of the work that was carried out by Sir John Allison and his committee in 1957. That committee conducted a prolonged and exhaustive inquiry. All aspects of the matter with which this legislation is concerned were considered in the way for which Sir John Allison has become quite famous. He is very thorough in his work. He and the other members of the committee deserve congratulations for what they achieved.
Although there may be some who disagree with certain minor aspects of the committee’s investigations, I think everybody accepts the fact that, in the broad, the inquiry had an excellent effect on the services, because it resulted in much better conditions, on the whole, than servicemen had ever before enjoyed. The problems of members of the forces were fully considered. Even though those problems were not always solved in the way in which servicemen would have liked them to be solved, they were all given exhaustive consideration.
The fact that the committee’s function was splendidly performed is evident when we realize that since 1959 we have not had occasion to prepare any amendments to the legislation except those that are now before us. I hope that the House will not confuse the amendments that we are now considering with the provisions of the special act that was recently introduced in connexion with retirements brought about by a reorganization of the Army, and by the retrenchment scheme that was then undertaken. Those retrenchments were caused mainly, of course, by the fact that the national service training scheme was abolished. Those who had been engaged in instructing trainees - and there were large numbers of them - had to be retrenched. Special legislation was introduced to provide compensation over and above that which would have been available under the provisions of the act which it is now proposed to amend by means of the bill before the House.
I assume that there will not be a lengthy debate on this matter, and I assure the House that I do not wish to speak at length on it myself. Section 44 of the principal act provides that a member serving at the date of the introduction of that act may elect not to contribute for the additional pension provided by the act, and that such an election shall be made within four months of the date of commencement of the act. Clause 3 of the bill grants a further period of two months during which a member who elected not to contribute for all or part of the additional pension may revoke that election and become a contributor for additional pension. Later clauses of the bill, clauses 9 and 10, provide an extension of time to 1st August, 1960, during which time members who had previously elected not to contribute to the Defence Forces Retirement Benefits Fund might elect to become contributors.
It might be pointed out at this stage that the bill before us more or less confirms something that has already been done. In administering the provisions of the legislation it was found impossible to let all members of the three services know the benefits to which they were entitled, or to make them conversant with all the ramifications of the legislation. Some of them, therefore, were induced not to elect to contribute when, perhaps, if they had considered the matter in the light of the full information that was available, they might have decided to contribute. We found that there was a good deal of confused thinking in relation to this matter. At a later date, therefore, in anticipation of this legislation, all servicemen were contacted and given full information about the matter. At this point of time all those who wish to elect to contribute have done so. This legislation, therefore, really confirms something that has already been accomplished.
The right of election not to contribute for additional pension, granted under section 44 of the principal act, is similarly extended to 1st August, 1960. The extended times of election provided have already expired, but elections have been accepted by the Defence Forces Retirement Benefits Board in anticipation of the amending legislation.
Clause 4 contains an amendment that is consequent upon amendments effected by clauses 9 and 10.
The honorable member for Bass referred to clause 5, about which I shall make some remarks. Section 58 of the principal act provides that a member contributing for additional pension for his rank at the commencing date of the 1959 act who retires before his due date of retirement, and who has therefore paid to the fund less than sufficient to pay for his share of the increased pension entitlement, shall receive a lesser pension, or full entitlement on payment of a lump sum. The reduced pension and the lump sum payment are determined by the board on the advice of the Commonwealth Actuary. The section also provides that the board, in making a determination, and the Commonwealth Actuary in advising the board, shall have regard to factors mentioned in sub-section (2).
Clause 5 provides that section 58 shall have application not only to a member who is contributing for the additional pension for his rank at the commencing date of the 1959 act but shall also apply to a member who is contributing for additional widow’s pension or for the additional pension due as a result of a subsequent promotion. A lump sum payment made in accordance with the section shall be treated as contributions and the Commonwealth Actuary shall have regard only to the factors mentioned in sub-section (2.).
Clauses 6 and 7 amend sections 62 and 63 of the principal act which provide for gratuity payments for officers who were serving at the commencing date of the 1959 act. This relates to the one and one-half times formula to which the honorable member referred. In this case provision is made for whichever is the greater amount - that provided previously or that provided under this amendment - so justice will be done in relation to this aspect.
Clause 8 is merely a drafting amendment. Clauses 9 and 10 amend sections 71 and 75 of the principal act and provide an extension of time to 1st August, 1960, during which members who elected in 1948 not to become contributors to the Defence Forces Retirement Benefits Fund may revoke that election and elect to become contributors for full benefits as from 2nd July, 1948. Some members who made their election in 1948 were brought into line by the 1959 act, and this proposal now gives them justice too. Under sections 71 and 75 such revocations and elections must be made prior to 14th April, 1960, but because of the large number of men involved it was not possible to complete all administrative action before that date. The clause extends to 1st August, 1960, the period for election under these sections.
Clauses 11 and 12 are merely amendments consequent upon the amendments in clauses 9 and 10. 1 am sorry that 1 have delayed the House by explaining the proposals, but I think I have given a general picture of what has happened in relation to this matter. We seek merely to revoke a position which arose so that ex-servicemen may avail
Themselves of the real intention of the original act.
The honorable member for Bass referred to the early retirement of ex-servicemen. This was one of the major considerations when the Allison committee was determining the kind of pension that should be paid and other matters. I agree with the honorable member that the men who retire - great numbers of them at 47 years of age and officers at 55 years of age - are relatively young men. However, they have served a good part of what is perhaps the most valuable period of their life and, therefore, I think that they are entitled to some consideration from the country. The original act was intended for that purpose.
The honorable member mentioned those who had been compulsorily retired. Unfortunately there are times when serving soldiers have to be retired to meet the needs of the Service, and although, as the honorable member has stated, they do contract to serve for certain periods, this contract is not in quite the same category as an outside contract for employment because inherent in all contracts for service in the forces is the condition that the serviceman can be retired at any time to meet the needs of the service. The men enter into the contract on that understanding. There is no deception about it. That is a fundamental condition of engagement whether it is for six years, twelve years or for any other period. The fundamental basis of it is that they can be retired to meet the needs of the service if that is found to be necessary, and it is on that understanding that they enter the service. I agree that this should not be done except in extreme circumstances, and I am sure that it is not done unless it is most essential, as was the case recently when large numbers were retired because of the reorganization of the Army which made it impossible to employ these men further in useful occupations. I am sure it is not right to continue to employ people who cannot be profitably engaged.
I shall have a further look at the matter relating to widows to see what the implications are. I know that it was taken into consideration, but I am prepared to have another look at it to see what can be done if anything needs to be done.
Generally speaking, I think that this is a bill which the House can approve without very much further waste of time. I appreciate the Opposition’s action in not opposing the measure.
.- I endorse the support that has been given to this bill by my colleague, the honorable member for Bass (Mr. Barnard) on behalf of the Australian Labour Party, and I do not propose to cover the ground that has been adequately covered already. However, on behalf of some people who have been good enough to write to me, I should like to make known a grievance that they have in relation to pensions paid by the Defence Forces Retirement Benefits Board to officers and men who have been boarded out of the Army because of ill health.
One case that rather exemplifies the complaint is that of a major who was retired because he had a coronary heart disease. At the time of his retirement he was placed on what is called the class A pension entitlement. That was all very well although he did feel that he was given a pretty raw deal. He had joined the services before the war, had seen active service during the war and he felt that given time while within the service he possibly could have recuperated sufficiently to be able to continue in his occupation. However, that was not to be and he was discharged and given the highest classification of pension entitlement provided by the board.
By close attention to his health and by diligently following out the instructions of specialist medical advisers this gentleman recuperated sufficiently to be able to engage in very light clerical work with a local government department. After a period on this very light work at a comparatively low salary compared to what he was earning in the Army and to what he would have been able to earn as a healthy man prior to his enlistment, he was called up for reexamination to decide the degree of his working capacity. The board found that he had not absented himself from work. That seemed to be the main point of the examination - how much time he had had off work while engaged on these light clerical duties.
In his letter to me he stated that he had been offered various lucrative posts, especially with ex-servicemen’s clubs as secretary-manager at a commencing salary of £1,500 a year, but he had had to refuse them because he had been told by his medical adviser not to accept any responsible position but to keep to the pretty routine kind of jobs involving as little tension as possible. Because of his economic circumstances and because he had to maintain a family, this man diligently followed his light job and did not absent himself from it except when his health did not permit him to do otherwise. He stuck at his job and that reacted against him. His diligence and independent spirit - the things that we like to laud in people - worked against him. This fact brings to mind something that we hear in repatriation cases. The fellow who used to go on sick parade time and time again and go before the medical officer now has a record and it is easier for him to qualify for repatriation benefits than it is for the kind of man who was only on sick parade when he had to be - the independent kind of person who did not want to be a loafer on the service. The man to whom I have referred followed his task most diligently. His is not an isolated case. I know of others in the same category. He stuck at the job only to find that because of his diligence his pension was reduced. He told me that sometimes he could have cried with the pain in his chest from his heart complaint, but he stayed at work. As a result, his pension was reduced to the lower class “ B “ invalid classification. He is a man of independence and integrity and one can imagine his feelings of injustice and frustration.
He carried on correspondence with the Defence Forces Retirement Benefits Board and pointed out that he could easily have done what many other persons would have done and left his work on the ground that he was sick. If he had done that, he would not have lost anything. He has pointed out to me that apparently he had been penalized because he told the truth about himself. He could have said that be was sick and absented himself from work, but he forced himself to keep going instead of going to bed every time he had a pain in his chest. He complied with medical advice in not allowing himself to become an invalid until it was absolutely necessary. Only by doing that was he able to maintain himself and keep himself at work.
Now he has to pay the penalty by having his incapacity in relation to civil employment assessed at less than 60 per cent. His pension has been reduced by approximately £3 a week. His income has fallen by that amount because he is a man of spirit and continued in his employment. This man’s position has been made worse because he will reach the statutory retiring age of 60 years in November of this year. The Minister may correct me if I am wrong, but I understand - and it has not been denied by correspondence from the board - that if his health deteriorates again this year after he has turned 60, as it well might do because of his disability, he cannot get back to a class “ A “ pension that was provided originally.
This man is suffering an immediate loss of salary but in addition when he is finally compelled to retire from his present position in which he performs light clerical duties, he will not be able to get his original pension restored even if his health deteriorates and he is not able to work at all. This is the person who is judged to be less than 60 per cent, incapacitated. In his letter to the delegate of the Defence Forces Retirement Benefits Board, this man stated -
The medical examination carried out on 20th July, 1959, revealed that despite the fact that T suffered a coronary occlusion in the Middle East in 1941 at the age of 34 years, another serious one in 1954 at the age of 47 years, I have in 1959 at the age of 52 years and 10 months improved in health to such an extent that my degree of incapacity is now considered less than 60 per cent.
This man has paid the penalty principally - I will not say wholly - because his work record shows that he stuck at his job when he might well have done what others have done and taken a “ sickie “ as they call it. This man has quoted to me the cases of others with a similar complaint who have written to the newspapers. One person that he quoted wrote1 -
I was discharged in May, 1954 at the age of 52, the retiring age being 55. I received a pro rata pension of about £5 5s. a week after having contributed for 27 years. That was quite in order, but I was told that my pension was to be reduced because “ my incapacity in relation to civil employment was less than 30 per cent.”
Quite obviously I could not, as a married man, exist on £5 5s. a week and to gain employment after 31 years in the Services, at the age of 52, was an achievement in itself.
I purchased a copy of the D.F.R.B.F. Act and found that if I were fortunate enough to earn (at present day values) more than two-thirds of my earnings in the Army (six years ago) they could even suspend payment.
I shall view the next recruiting poster with diffidence especially the one which states, “ Earn a pension while you are still young enough to enjoy it”.
I hope the Minister will be able to help in this matter. I acknowledge gratefully that the Government has remedied some of the anomalies that were contained in the 1959 act. That will be of some help; but it seems that the provision that a person who retires because of ill health is subjected to an assessment later in terms of his work potential, based on evidence of work performed, will penalize those whom we laud most - the diligent, persistent worker of honesty and integrity who sticks at his job. That is what worries me, and I hope the Minister will be able to do something about this anomaly soon.
.- I appreciate the fact that previous speakers have referred to the anomalies that exist under the Defence Forces Retirement Benefits Act of 1948 and 1959 and that possibly those who follow me will also refer to those anomalies. It is quite true that there are anomalies and they have grown over a period of years. We trust that in due course full attention will be given to the representations that are being made to the Government on these points. The Parliamentary Draftsman himself has said that the 1948 legislation was one of the most complex pieces of legislation that he has drafted, and the 1959 act is only second to it in that regard. That indicates the complexities of the legislation that is to be amended by the bill before the House.
I rise principally to give some reasons for these amendments. They follow, in general lines, three series. The first refers to the members who, by virtue of the original act of 1948, were given the right to elect not to contribute to the fund which was established under that measure. Those people elected not to come into the fund and relied rather on the other Service benefits such as deferred pay or the gratuity payments provided in the various Service regulations. Under the original act, this right of election not to contribute for the benefits under the Defence Forces Retirement Benefits Act was held over until four months after the proclamation of the original act. After that, all those who had not elected to contract out were absorbed into the scheme and made their contributions.
However, by an amendment to the 1959 act which was consequent upon the findings of the Allison committee, the door was again opened to members who had contracted out to come into the scheme because it was felt that perhaps the position had not been fully explained or expressed to them, or that in many cases the men had not fully understood the purport of what the 1948 act was offering to them. Honorable members should realize that with naval personnel serving in ships outside Australia on various widespread stations it was difficult and not always possible to get across the message of what was to be done and what benefits were inherent in the making of these contributions. As a result, by 1960, there were still some 900 members of the services who had contracted out and still could, if given the opportunity, contract in. Advice to this effect having been given, the date for the closing of such applications was set at 14th April, 1960. But as, at about that time, most of our naval forces were distributed around the South Pacific area, it was necessary to extend the time for receipt of those applications. The time was extended to 14th August, 1960, largely by departmental action, and the purpose of part of the first series of amendments is to validate that extension.
It is interesting to note that of the approximately 900 who remained out prior to 1960, 175 members came into the scheme. The extension was granted because it was considered that no member should be refused the right to take up these benefits merely because of lack of information of their availability and perhaps because of the unwieldiness, in the circumstances, of the administrative machinery.
The first series of amendments also seeks to validate an extension to 14th June, 1960, in the cases of members who were already contributing to the fund and who had the right to elect not to contribute for the increased benefits.
The second series of amendments deals with officers who were serving in the forces prior to 1959. Under the original act, those officers were entitled to a gratuity equivalent to one and one-half times their own contributions to the fund. But, in 1959, following the Allison committee’s recommendations in this regard, it was decided to make this gratuity a fixed monetary sum. When I say a fixed monetary sum, I mean a monetary sum which varied in accordance with certain factors but which was expressed, in fact, as a monetary sum and not as a rate of one and one-half times the amount of personal contributions. This was done in the 1959 act, but it was later discovered that approximately 74 officers, if they were compelled to accept the lump sum gratuity, would be getting a smaller sum than they would have received if they contributed at the old rate of contribution and received the one and one-half times benefit on retirement. So, the second series of amendments will preserve to them the right to the one and onehalf times formula in accordance with their particular rates of contribution prior to the 1959 act.
The third series of amendments deals again with the cases of members who are at present contributing for increased benefits but who retire on a pension prior to their due date of retirement. Under the 1959 act provision was made in these cases for a reduced pension to be paid, or, if the member cared to contribute a lump sum to the fund, he could then get the full pension. Tn addition to these contributions for normal pensions there is provision in the act to allow contributions for additional benefits such as a pension for the member’s widow, and additional contributions for higher pensions as a result of promotion. If a man is promoted, he has the right to apply for an increased pension. There was no provision that these additional contributions were also to be covered by the provision whereby a member could obtain a reduced pension actuarially based or pay a lump sum for the full benefit. The second series of amendments does, in fact, extend to a member the right to cover himself for these additional benefits in the form of a pension, for the widow or an increased pension upon promotion.
The other amendments in this third series simply clarify the provision in the original legislation that the Defence Forces Retirement Benefits Board and the Commonwealth Actuary would take certain factors into account in arriving at their decision, lt is quite patent that the Actuary, when arriving at his decision, would take cognizance of the various factors applicable and place them before the board, which would then make its decision based on that information.
The other amendments are merely minor drafting amendments. As I see in the bill nothing but extensions of privileges to members of the services, which are in their interests and to their benefit, I commend the bill to the House.
.- 1 note with pleasure that at least one Government supporter is prepared to get behind the Minister, particularly as that supporter is a man trained in military matters who can give the Minister the benefit of his experience. I note with some pleasure also that it is a colonel who has come to the Minister’s aid. In the old army days there was a comic song that we used to sing which went -
If you want to see the colonel, I know where he is -
He’s hanging on the old barbed wire.
That is where the colonel is hanging to-day. 1 do not see any other supporters coming to his assistance. We had expected a fairly reasonable debate from the Government which initiated these changes. We went thoroughly through the original bill and it was carried through. The members of the Opposition who handled our side of it have some experience, and we gave support in a general way to some of the conclusions of Sir John Allison and his committee.
The honorable member for Maribyrnong (Mr. Stokes) after a quite reasonable speech - which I hope to emulate - said that this was the biggest compensation and pension scheme ever to come before the draftsman. What a lot of rubbish! We have in operation huge superannuation and pension schemes, and we have plans of all sorts going All democratic countries to-day believe in compensation, superannuation and pensions for most government employees. The trouble is that the military mind will not think in the terms of to-day, and for that reason an anomalous position has arisen. The scheme was, of course, difficult. It was quite revolutionary to give the poor old foot-slogger a pension at the end of his days, to give him a lump sum gratuity or some benefit after you had used him up. But this has now occurred. To the military mind it seemed that the men might be getting too much, and there was more of a pull back on the organizational side than a desire to go too far.
We feel that we must support the measure, but with the reservations that the scheme could have been stronger and the anomalies could have been watched earlier. But the bill is now before us, and the Minister has put a reasonable case. The honorable member for Bass (Mr. Barnard), who led for the Opposition, has agreed that we will accept the bill as it stands. I listened to the Minister and I heard him say something about Army matters that filled me with misgivings. He did say - there is no disagreement on this - that men retire at 47 and officers at 55 years of age. That is so. as we all know, despite the advertisements.
– That is not wholly right.
– I am merely quoting you.
– There are differences, of course.
– Yes, but as a general proposition, that is true. Under this system, use is made of a man until he reaches middle age and then he is put on the scrap heap. The Minister knows that is true even of brilliant officers, and it is true of the man in the ranks. As the honorable member for Barton (Mr. Reynolds) has shown, there has been in some instances a callous disregard for soldiers who have served faithfully and well but who have been caught by ill health. When this is considered in conjunction with some of the other matters that have been mentioned by the Minister, we begin to see that things are not as rosy as they look.
The Minister said further that the paramount consideration is not the soldier but the needs of the service. A man may be retired at will. There ought to be strong limitations to this, because all that is being done by this system is to put a loading on the serviceman’s insurance - that is all it is; his superannuation and his welfare. Everything may be all right if the man serves to the ultimate retiring age, but probably not one man who enlists - we are more concerned with the men than with the officers - reads the small print on his agreement. I suppose the attestation papers to-day are not very different from what they were years ago. The serviceman, therefore, may not be aware of the situation unless it is explained to him.
– They all know it.
– Is it presented to them formally or by the word-of-mouth furphy that you get in the Army? I would say nobody knows it. The serviceman is retired if the Army wants to retire him. The Minister, who is aware of the results of these anomalies, knows that a man can be put out of the services at will. What does that “ will “ depend on? Is it related to the demands of the services having regard to defence needs, or is it subject to some political occasion that calls for retrenchment? All these matters hedge around the tenure of his service and the size of his eventual pension, gratuity or retirement allowance. When the Minister next has a look at this legislation, he would do well to keep in mind that these are matters of public interest and the anomalies should be corrected. These pensions provisions are considered reasonable. Let us make them generous. The advertisements seeking recruits are colourful, glamorous and designed to attract the best people into the armed services. Let the requirements of the services be alined with the acknowledgment that those who serve should also be well remembered.
It would be quite foolish of me to say that this legislation is not an improvement; we have already said that it is. But the power to retire a man at will, in my view, loads the insurance as if he were in ill health or suffering from, say, a 40 per cent, disability. No serviceman knows what will happen to him. As I have said, who reads the little print in the attestation form? Men can well be trapped. Obviously many have been confused when 900 of them, as has been said, did not know whether to contract out or to come in again. Therefore, they definitely had not been told. They were just at a loose end. The result is that the time limit, originally fixed as 14th April, has been extended to August so that these men can be brought into what is now considered by the Government to be a reasonable scheme. As I said before, we are not canvassing every issue, but I thought these points should be raised.
There is another matter I should like to raise while we are talking glibly of the new and wonderful opportunities in the services, and that is the miserable little action of the Government in taking away the postal concessions of servicemen. Servicemen at army camps, at naval bases and aboard ships at sea, and at air force stations were entitled to the franked postage of a penny or a little more, but this was suddenly raised to a charge of fivepence. That is not in conformity with the Allison report or the alleged generosity we are showing to our servicemen in this country and overseas.
When we think of the future of the man who elects to serve, we should recall the disorganization that resulted from the reorganization of the Army into a pentropic force. Men came tumbling out of the Army, men who had never believed, because of their ability, their skill and their dedication to their country, that they would become redundant. But this happened because some one had a new idea and the Army was reorganized into a pentropic force. With this reorganization, a lot of men became redundant. But we cannot just say that a man is redundant and leave it at that. Surely the serviceman must perforce have as much industrial protection as the ordinary worker has. Indeed, the serviceman should have more because he is working for the defence of his country. When this new army scheme was introduced, we on this side of the House criticized it most strongly. Now the Government is at sixes and sevens over compensation and pensions. The man who elects to take a gratuity instead of other payments finds himself at a disadvantage, and the Government is scrabbling around in the sand trying to re-adjust the position so that it will look reasonable enough.
Because of these matters we would urge that in future, the Government should look not merely at the military planning side but also at the human side - the effects on the lives of the men in the services. We all know how a furphy gets round in the Army and how it can result in loss of morale if the men feel that something has been put over them. In the present situation, there has been plenty of gossip of this sort.
I take no further point, except to say that although we support the bill in principle, we do believe that the next time the Minister is having a look at the legislation, he should bring it closer to the general trend of compensation. There are two frightfully low grades in this community. One is the low rate of pensions or emoluments given to a serviceman on retirement, and the other is the inadequate compensation awarded by Commonwealth authorities to servicemen for injuries sustained while not on army duty. I would go on record as saying that the Commonwealth compensation law is the lousiest compensation law in Christendom.
Not long ago my attention was drawn to a case and I fought strenuously for it. It concerned a young married serviceman who was involved in an altercation with a new Australian in a canteen. The new Australian afterwards proved to be demented. After some bantering words, which the average Australian would take as comradely chatter, the new Australian came back with a knife and literally cut the throat of the serviceman and the serviceman died. It could not be said that he died in the pursuit of his army duties because he was off duty and drinking in the precincts of the Moorebank camp. The Minister knows of this case. A generous kindly Government, loaded with medals and full of patriotism, gave £200 to the widow after a fight up hill and down dale extending over eighteen months.
When we speak about compensation, another case which concerned a constituent of mine comes to mind. A young serviceman was ordered into a jeep and told to ford a flooded river. He was drowned. The compensation first offered to the mother of this eighteen-years-old boy, who was her sole support, was £200. The Minister knows of this case, also. The man was Private Jones. Mrs. Jones is a constituent of mine and I fought valiantly to have the amount of compensation increased. In despair the mother came to me and said: “ Let it go. They have no heart even after what my boy tried to do for his country. I will take the £200. I cannot fight any more.”
The Government should look at these matters. It should not preen itself on what it considers a sound superannuation scheme; it still has a long way to go. I issue these warning words: When these anomalies are next being considered, have a good look at them. The present scheme may be a very strong advance on what has gone before, but the Government should take another move forward. If it did, it would have the support of this side of the House and of the Australian people.
The final point I make again is that the Minister should have a look at the tragic circumstances surrounding matters such as those referred to by the honorable member for Barton. To allow these anomalies to persist does not help recruiting and generally it does not help the services. It does not foster esprit de corps in any force and as we have only small forces in our services, there must be esprit de corps. We are very proud of our forces. They are almost a corps d’elite Let us therefore ensure that these anomalies are not left to some dreary old army board, with the members of it nodding over their port. Let us have some one tough and sensible and aware of what is happening to-day. We should have some reform, particularly in this scheme.
Those are the only points I make to the Minister. T know that he is sympathetic in discharging the duties of his portfolio, but I ask him not to be trapped into taking the advice even of his colonel. He must be on top of the brass or he will never be able to do the job that the Government has allotted to him.
.- Mr. Deputy Speaker, I always take great pleasure in following the honorable member for Parkes (Mr. Haylen), who, I know, takes a great interest in these matters. I am pleased to hear him go on record as emphasizing the rights of ex-servicemen and saying that they should be given a fair go, and so on. I think that many honorable members on both sides of the House forget that their words do go on record and that their remarks are available to be checked on similar subjects but under different circumstances.
The honorable member for Parkes, in his preamble, referred to the honorable member for Maribyrnong (Mr. Stokes) as the colonel supporting the Minister for the Army (Mr. Cramer). I could not help being struck by the tone of voice which the honorable member for Parkes used when referring to the honorable member for Maribyrnong, who was a colonel in the Army and who had a very successful career in that service. I say frankly that I did not appreciate the tone used by the honorable member for Parkes or his observations about the brass and the dull heads, or whatever were the terms he used, on the Military Board. The persons concerned are very fine gentlemen who volunteered to serve their country, who have served for many years, and who well merit the respect of every one in this House. I am quite sure that honorable members generally give them that respect.
I am most grateful, as I am sure is every other honorable member, for the support which has been accorded to this measure on both sides of the House. I think that all honorable members will admit that it is not 100 per cent, perfect. Many things need to be done. As time goes by, we find that weaknesses have shown up, and I hope that these will be corrected. I trust that as mistakes become apparent the Government will be prepared to look into them and amend the Defence Forces Retirement Benefits Act, just as it is doing by means of this measure.
The honorable member for Parkes said that all this talk about confusion over the system of pensions and the like was a lot of balderdash. That was the effect of his words, although I forget the exact terms which he used. I am willing to give the honorable member the greatest possible credit if he can explain clearly the detail of the formulas and figures used in working out this system of pensions. If he could do that, I would take my hat off to him. I have taken the trouble to turn up the “ Hansard “ report of the consideration in committee of the Defence Forces Retire ment Benefits Bill 1948, on 3rd June, /948. Mr. Archie Cameron, who was then member for Barker, asked Mr. Dedman, who was at the time Minister for Defence, a specific question about the formula used in calculating the contributions payable by the Commonwealth. I forget who was Treasurer at that time, but 1 suggest that even he must have been amazed at the reply given by Mr. Dedman, who stated that the formula was (A - B) – A X C.
– What is difficult about that?
– This is the formula which the honorable member for Parkes said was quite simple. The point that I am trying to make - and I accept this as it was stated quite honestly by the honorable member for Maribyrnong - is that since this formula was first introduced, despite the many amending measures, there has been a lot of confusion among both commissioned officers and other ranks in the services about the exact ramifications of the formula. The consideration of this bill affords an opportunity to reconsider this matter.
I turn now to another point concerning which I am rather in agreement with the honorable member for Barton (Mr. Reynolds). I have recently had referred to me the case of a young Fleet Air Arm officer who, if my memory serves me correctly, went to England after he had completed his training and passed out at the end of his course. On his return to Australia, he was posted to the Naval Air Station, at Nowra, in New South Wales. The day before he was to join his ship, he crashed on the tarmac at Nowra. As a result of his injuries, he was granted a 100 per cent, pension, I believe. This young man has been in a very serious nervous condition and is paralysed right down one side of his body. He has quite considerable ability and has endeavoured to study in order to make something worth while of the life which has been completely ruined for him. I understand that under the terms of the principal act persons who receive 100 per cent, pensions have to come up for medical examination every year. Approximately three months ago, the case of this young Fleet Air Arm officer was brought to my notice, and I was told that his pension had been reduced from 100 per cent to. I think, about 75 per cent.
– I agreed at the time that the reduction was shocking. When 1 took the matter up, I found that the reduction was due not so much to the policy of the Government - 1 say this in all fairness - as to the attitude of one of the medical officers in charge of the case, who said: “ You have a job. You are able to earn some money. Therefore, we have to reduce your pension by a certain percentage.” The Government restored the rate of pension to 100 per cent, immediately the case was brought to its notice. I saw another doctor who said it was ridiculous that men with disabilities which entitle them to a 100 per cent, pension, and who have no hope of recovery, have to come up for reexamination every year. I feel that once a person receives a 100 per cent, pension with no hope of physical improvement, any income that he could earn ought to be a matter for himself and that he should continue to get his pension.
I think that there is in this respect a difference between procedures relating to the Defence Forces Retirement Benefits Fund and those relating to repatriation pensions. Perhaps the argument is that, in one instance, the disability is sustained in wartime and, in the other instance, the disability is contracted in peace-time. However, I consider that a pilot who is a permanent officer of the Fleet Air Arm, who is prepared to serve in war should it occur tonight or to-morrow and who has crashed in training should be treated in the same way and given the same facilities as are repatriation pensioners.
As 1 said earlier, I think that there are some anomalies in the defence forces retirement benefits scheme. I am sure that honorable members on both sides of the House are aware of those anomalies and are working to investigate them and see how they can be removed. I hope that we all will work together to ensure that disabled servicemen receive a reasonable and satisfactory reward for the sacrifices which they have been prepared to make in times of either war or peace. Slanging of the permanent defence forces and their officers should not be indulged in in this House. There is no more glorious profession than that of the serviceman who signs on to serve his country and who is prepared to die in certain eventualities. I know that nobody really intended to belittle men who were prepared to serve in that way. I am sure that we all agree that we should do everything possible for those who have been disabled, and I am sure that we all will do our best for them.
Question resolved in the affirmative.
Bill read a second time, and committed pro forma; progress reported.
Message recommending appropriation reported.
In committee (Consideration of Administrator’s message):
Motion (by Mr. Cramer) agreed to -
That it is expedient that an appropriation of revenue be made for the purposes of a bill for an act to amend the Defence Forces Retirement Benefits Act 1959.
Resolution reported and adopted.
In committee: Consideration resumed.
Bill - by leave - taken as a whole, and agreed to.
Bill reported without amendment; report adopted.
Bill - by leave - read a third time.
Debate resumed from 13th April (vide page 826), on motion by Dr. Donald Cameron -
That the bill be now read a second time.
– This bill seeks to make five amendments to the National Health Act. The first of them seeks to make an alteration to the definition of “ contributor “. The Minister has assured the House that the proposed amendment is purely of a machinery nature, but it would have been very much better if, instead of merely introducing a machinery amendment, the Minister had introduced an amendment of substance dealing with the position of a contributor by seeking to remove the qualification that a contributor must belong to an approved private fund before he is eligible to obtain Commonwealth benefit. It seems particularly unfair, and indeed politically immoral, that a person should be deprived of a benefit payable from the Commonwealth Treasury simply because he does not belong to a private society. That qualification appears to interfere with the right of the individual citizen and with freedom of association. But, beyond that, the man himself is a taxpayer who is paying into the Treasury according to his income, and, in his time of adversity, he should have full right to draw assistance from the Treasury in the form of health benefit irrespective of whether he belongs to a private society. That is the view of the Labour Party, and an ensuing Labour government will make that alteration to the act.
The second amendment proposed by the Minister relates to multiple operations, and again is of a machinery kind. At the present time, where more than two operations are performed and the amounts specified in the act as benefits are not the same for each of those operations, the law provides that the doctor shall receive such amount not exceeding £22 10s. as the Director-General may prescribe. The proposed amendment retains the maximum bar of £22 10s. but provides that the formula upon which the Director-General has so far acted shall now be written into the legislation itself. If accepted, this will mean that in future, where more than two operations are performed, a doctor may receive the amount specified in relation to any one of such operations, half of the amount specified in relation to any other of those operations and one-quarter of the amount specified with respect to remaining operations. As I have said, the upper barrier of £22 10s. is to be retained.
I thought the Minister would have looked after his professional colleagues in the British Medical Association a little bit better than this. He has taken no account of the increase in the cost of living, or the decline in money values since this maximum amount of £22 10s. was fixed.
– For how long has it been fixed now?
– I shall have to ask the Minister that, but certainly for several years. I should have very much preferred the bill if, in relation to operations, simple or multiple, the Minister had introduced an amendment seeking to provide for a salaried specialist and surgical service in public hospitals so that every patient in those hospitals would have the right either to choose his own doctor, and to pay him, or to have his operation performed by a salaried specialist on the staff of the hospital who would have no other interest in the patient than that of the patient’s health. In other words, he would have no monetary interest in performing an operation upon the patient. I have, as I am sure all honorable members of the House have, the highest respect for the medical profession as a whole; but the members of the medical profession are no better and no worse than the common run of humanity and there are certainly among their members some medical adventurers. Any one who has had close connexion with hospitals over a period of years will not be unaware of doubts whether a number of operations are performed largely for the fee rather than because, in the opinion of the surgeon, they are required. Therefore, I should have been delighted if, in this bill, the Minister had made provision for salaried specialist and surgical services to be available in public hospitals to all patients who require them. But that amendment to the act also will have to await the election of a Labour government. It is part of our policy, and we will put it into effect at the first opportunity.
The third amendment proposed by the Minister is one with which I am sure every honorable member can be in agreement. It simply seeks to tighten up the ability of the Director-General to recover from the proprietor of a private hospital the amount of Commonwealth benefit which has been paid to that proprietor of a private hospital when the proprietor himself has not passed the benefit on to the patient. Apparently, in some cases unscrupulous proprietors of private hospitals accept the Commonwealth benefit but bill the patient for the full amount, including the amount of Commonwealth benefit. Hitherto, there has been a technical difficulty in the way of recovering the amount from the proprietor of the private hospital, and the proposed amendment seeks to close up that loophole.
– Are there any penalties imposed if proprietors do not pass on the benefit?
– I do not see any reference to penalties, but, up to now, the position has been that the DirectorGeneral has not been able to recover the amount from the proprietor of a private hospital unless the Director-General has been able to show that he himself has paid the benefit to the patient concerned. In some cases, the patient concerned has gone away and his address has been unknown. But the fact remains that the proprietor of the private hospital has benefited by keeping the amount of Commonwealth benefit in his pocket. Under the proposed amendment, it will be possible to remedy that anomaly.
The next amendment proposed by the Minister relates to special accounts and seeks to bring about a slight easing of the present restrictions on the limitation of total benefits under the special account system. If the proposed amendment is accepted, then, in future, where hospitals charge theatre fees and for drugs, dressings, special nursing and laundry, it will be possible for a special account contributor to receive benefit with respect to those amounts if he has subscribed to a table sufficient to provide a benefit of that size. Up till now, it has not been possible for a subscriber to the special account to receive more than the gross fee charged by the hospital, excluding all those extras of which I have spoken. So, that amendment is good, again, as far as it goes. I again regret that the Minister has not chosen to go further.
I feel that special attention needs to be directed to the position of pensioner contributors to medical and hospital benefit funds. I think that most members, if not all, will have had cases in which a pensioner who has subscribed for a fund benefit at one of the higher rates has found, under the operation of the special account, that he is penalized where formerly he benefited. Before the special account was inaugurated that pensioner was able to obtain a cash payment from the benefit society. Now, no matter how high the rate of benefit for which he subscribes, he can receive no cash benefit whatever and the total amount payable to the hospital from the special account does not do more than cover the cost of his treatment in the public ward.
– That is not quite correct.
– It may not be quite correct. I will be glad if the Minister will explain this to the House in more detail later. It is the position as I have encountered it, and to the best of my knowledge. I had a case the other day at Bombala, particulars of which I have sent to the Minister, in which a pensioner had subscribed, I think, for many years under table 4B. His wife was admitted to hospital and, in due course, he expected to receive some cash payment because the hospital raised no charge in respect of his wife - or so be understood. Then he found that, solely because he was a contributor to the fund, paying £5 or £6 a year, a charge was raised in respect of his wife. The amount was received from the hospital benefits society but the cash payment which he would formerly have received in such circumstances was denied to him. I wrote, also, to the secretary of the fund concerned and I understood from his answer that the position is as I have given it to the House, but I will appreciate a further explanation from the Minister.
– Is this action intended to force the pensioners out of the scheme?
– It does appear that there is no benefit whatever to a pensioner in belonging to a scheme for public ward treatment. If treatment in an intermediate or private ward is required there may be some benefit to him in continuing to belong to the fund, but in nearly every case he no longer receives any benefit from his membership whatever.
While we are on the subject of the special account, I direct the attention of the Minister to the system which has been adopted by some of the funds of sending to the patient, before it will pay the benefit, a form to be completed by his doctor. There are two points about this: The first is that it is sometimes very difficult to get the doctor to fill in the form. The second point is that while the fund makes the filling in of that form essential to the payment of a benefit, it excludes itself from the liability to pay the cost of having the doctor fill in the form. The certificate has to be obtained by the patient at his own expense and then sent to the society. This appears to me to be a method adopted by the societies to ensure that as many as possible of their cases can be transferred to the special account at the expense of the Commonwealth Treasury. Although the contributor may have subscribed to the fund for a considerable time, by this method the society relieves itself of the obligation of paying any benefit to him.
The form to which I have referred contains questions for the doctor to answer relating to such matters as the earliest date on which any symptom of a condition may have been or was noticeable to the patient. That means, for example, that some one who has no reason whatever to suspect that he had an ulcer but who had for years suffered from dyspepsia or indigestion finds himself shut out from payment of benefit by the society on the grounds that he was suffering from a pre-existing illness. He is then transferred to the special account from which not more than the amount of the public ward rate is payable. That seems to mc to be of considerable benefit to the society and a disability to the Government, to the special account and, of course, to the patient.
I have recently had a letter from a hospital board in my electorate. I think that the board may be wrong, but I have sent this letter on to the Minister. It states that the amount now being paid from the special account in respect of patients is actually less than the public ward charge at the recently increased rates operating in public hospitals. I do not know whether that is correct or not. Certainly, I feel that payments from the special account should at least keep pace with any increase of the public ward rate. I am speaking, of course, of New South Wales.
The board of this hospital also informs me that, according to the legislation under which it operates, the board is not allowed to put a special account patient into an intermediate or private ward, no matter to what benefit table he belongs. This may also be wrong, but if it is, the Minister should clear it up publicly.
– There is nothing in the National Health Act to say that.
– 1 am glad to have that assurance from the Minister. The fifth amendment proposed by the Minister deals with the Pharmaceutical Benefits Advisory Committee. The Minister proposes to increase the number of doctors on that committee from four to six. In future, instead of the British Medical Association nominating six doctors out of which the Minister would choose four, the association will nominate ten doctors out of which the Minister will choose six. This will apparently give the British Medical Association a larger measure of control of the committee than it has had in the past. I do not know whether that is altogether good.
It seems that there were reasons for the balance which was originally established when, I think, there was a pharmacist appointed by the Department of Health, a pharmaceutical chemist nominated by the chemists’ guild, and four doctors. In other words, there were four doctors out of six members. Now there will be six doctors out of eight members. That will be so unless the Minister chooses to appoint - as he takes here the right to appoint - a pharmacologist to the committee. I am not a specialist in these matters. I take it that a pharmacist dispenses drugs and prescriptions and I know what a pharmaceutical chemist is. The Minister in his speech did not explain his reason for proposing to take the right to appoint a pharmacologist who, I imagine, is an expert in the theory of pharmacy.
– There has always been a pharmacologist on the committee.
– I thought that this proposal was a new one. Thank you very much for the correction. Is there a pharmacologist on the committee now?
– Yes. There always has been.
– Thank you. While dealing with the subject of the Pharmaceutical Benefits Advisory Committee I should like to direct the attention of the Minister to the difficulty in persuading some doctors to prescribe a drug from the list which is approved by the committee for benefits under the act. I do not know how this difficulty can be overcome. Cases occur in which a doctor prescribes a drug which is not listed and which costs the patient, sometimes, pounds a week to obtain. When one refers this matter, through the Minister, to the committee, the reply which comes back very often is that the drug will not be added to the list and an indication is given that there is a suitable alternative on the list which the patient could obtain without cost or at a cost of only five shillings. I do not know whether there is any way in which members of the medical profession could be persuaded to take more notice of the list and ensure that, where there is a suitable alternative on it, they do not prescribe a proprietary drug which is not on the list and which sometimes costs a quite poor patient a very considerable sum of money to obtain, when apparently equal benefit could be obtained by the use of a drug that is on the approved list.
– The doctors just regard the list as being inadequate for their purposes.
– That is so, in some cases. Indeed, it appears to me that in some cases at the present time the fault lies with the doctor concerned, who does not take enough trouble or has not enough knowledge to take advantage of the drugs on the list, or else is one of those fashionable doctors who is always prescribing the very latest thing that the drug house briefer brings to his attention. That is one class of case. The other is where a doctor prescribes a drug which is not on the list and, when you make inquiries from him, he gives a certificate that, in his opinion, there is no other drug suitable for the treatment of the particular patient for the condition from which he suffers. When you have evidence of that kind and can send it to the committee, sometimes, in due course, you receive a decision from the committee admitting that drug to the list - and sometimes not. When the drug is not admitted to the list you are not given any explanation or reason to satisfy you as to why it is not done. The decision is arrived at in camera. I realize that the committee cannot sit in public, but it would be helpful if some indication or reason could be given as to why a drug, which a doctor certifies is the only one which can assist his patient to recover his health, is not placed on the list.
The other reference that I wish to make to the deliberations of this very valuable committee is that it very often takes an exceedingly long time to reach its decisions. You put up a case for the admission of a particular drug to the list and in the meantime a constituent is often paying pounds a week for that drug; and sometimes many months go by before you receive a reply and a decision from the committee. It would be helpful if the work of the committee could be expedited. Perhaps the appointment of two additional doctors would help in that way.
The other matter that I wish to mention in relation to the Pharmaceutical Benefits Committee is the immensely high charge being made in Australia for a number of proprietary preparations, in comparison with the cost of having the same preparations dispensed by a pharmaceutical chemist in his shop. Very often the cost of a proprietary preparation is two or three times as high as that of an identical preparation prepared by a chemist in his shop. That seems to be an act of brigandage against the Commonwealth. In cases where these great drug houses are not prepared to reduce their prices to what is obviously reasonable in the circumstances, that would seem to be reason for disciplining them by taking their products off the list until they are prepared to bring their prices down. This procedure would, of course, place doctors at the slight inconvenience of having to write prescriptions setting out the items comprising the preparation. But doctors have been doing that for very many generations and the fact that in recent years they have become increasingly accustomed just to writing on the prescription the name of some proprietary line should not make them unwilling to revert to the system of writing out a detailed prescription where the proprietary line is barred by the Government because of the profiteering price asked for it by the manufacturers.
Those are the principal matters to which I wish to direct the attention of the House. The Opposition does not oppose the bill. We feel that the amendments in it are, on the whole, reasonable and useful, and we are only sorry that they do not go very much further.
.- As the honorable member for Eden-Monaro (Mr. Allan Fraser) has said, this bill is only an amending measure the purpose of which is to rectify certain hospital benefit schedules which have been in operation and to do certain things in regard to the special accounts to which he made reference, in addition to increasing by two the number of members of the Pharmaceutical Benefits Advisory Committee. In his opening remarks, the honorable member said he regretted that the bill did not provide for the removal of the qualification that a member of the community had to belong to a benefit society or fund in order to obtain a benefit under the present government scheme. 1 emphasize that if that were done, every hospital and friendly society would go out of business to-morrow, because there would be no necessity for them to continue in the community as such. As the honorable member subscribes to the idea of nationalization of health societies, that is what he would like to see take their place.
The fact is that over the last ten years this national health scheme has grown in size, as have the hospital and medical societies, which have increased the benefits to members of the community in a way which none of us, eight or nine years ago, thought would be the case. Only the other day I was reading the report of the Director-General of Health to ascertain the manner in which these medical and hospital benefit societies have increased, and I found that 73 per cent, of the community are now members Of those societies. The members of those societies have the feeling that they are not getting charity from the community and they have a say as to what doctor they will go to and what hospital they will attend. They are not being directed to a particular doctor or hospital. They have a feeling of independence of any charity or government scheme, and if anything has made this scheme work better than another, that is what is responsible. The national health scheme as it operates in this country to-day is better and is recognized as being better than any similar scheme in the whole of the British Commonwealth.
– Who recognizes it as such?
– Only a few years ago I was speaking to the Minister for Health in Great Britain on this very matter. He said he only wished that the United Kingdom had adopted a scheme similar to that in operation in this country at the present time. He said that the scheme operating in this country has done much to build up that independent spirit and overcome a tremendous number of difficulties that exist in England but which do not exist in Australia. The authorities cannot control the scheme in the United Kingdom, where so many people are waiting in doctors’ surgeries that it is not possible for a doctor to be able to examine and investigate all his cases as he would like to do. As a consequence, doctors have had to send patients to hospitals, and this has simply created another bottleneck. That kind of situation, of course, does not exist in this country.
I believe the honorable member for EdenMonaro did his party an injustice by raising this subject, because he has merely directed attention to the very bad record of the Labour Party in the field of health and medical services. As the honorable member knows, the previous Labour government was in office for nearly ten years, and it had an opportunity of laying the foundations of an effective national health scheme. It did not do so, however, and it was only in the last year or two in which it was in power, in 1948 or 1949, that the Labour government applied itself to the problem in anything like a practical way. The scheme that it introduced was administered, if I remember rightly, by Senator McKenna, as Minister for Health, but all that the honorable senator achieved was to get ancillary services and the government offside, if I may use that term, with the medical profession. He seemed to be able to upset everybody administering the services provided under the health scheme, and he really achieved nothing. The scheme was a great failure, as honorable members opposite well know. One reason why the members of the medical profession became offside was that Senator McKenna said to them, in effect. “You do as I say. Otherwise, instead of being partially nationalized you may be completely nationalized.”
– You know he never said anything like that.
– Well, I was present at several conferences at which Senator McKenna set out what he proposed to do.
He said to the representatives of the professional bodies, “ This is what I want you to do “. When one of those at a meeting asked, “ What will happen if we do not do it? “ he was told, “ Well, you will be made to do it “. That was Senator McKenna’s remark. I can remember him saying those very words at a meeting in the Treasury building in Spring-street, Melbourne. He said, “ You will be made to do so.” In other words, “ You will be nationalized if you do not do so, and you will then have no alternative “.
Since the inception of the national health scheme as we know it to-day, in about 1951, new services have been added and old ones improved, and this bill proposes to continue that process. Clauses 6 and 7 of the bill have reference to the special accounts. The special accounts provisions in 1951 were, if I may say so, only a pipe dream of this Government. No one thought that the system could possibly operate in the manner in which it has operated. It was introduced specifically to assist persons with chronic illnesses or what are generally known as pre-existing ailments, and it provides the maximum fund benefit for such persons. No insurance company, of course, would ever think of insuring a person with a preexisting ailment or suffering from a chronic illness. However, after investigation and research into the operation of the hospital benefits scheme in the years following 1951, the Government came to the conclusion that it was possible to provide benefits for such people from the special accounts that it then proposed to establish. The provisions that the Government introduced at that time lifted a tremendous load of worry from persons suffering from chronic illnesses and pre-existing ailments. If the Government had done nothing more in the field of national health than introduce these special accounts, it would have made a tremendous contribution towards our national health services. The fact that these people could not be given adequate assistance represented a great weakness in the scheme that previously operated, and the fact that this anomaly has been removed reflects great credit on the Government.
The hospital and medical benefits scheme is constantly under review. As time goes on we will see even greater improvements in the scheme, and contributors will derive more and more benefits from membership of hospital and medical benefits societies. The fact that so many people in the community belong to these societies shows that the community generally has given them its approval. At the present time the people who contribute in some form or other to hospital or medical benefits societies represent 73 per cent, of the population. It should also be remembered that a large section of the population, covering, for instance, aged persons, receive benefits without having to belong to these societies and are not taken into account in calculating this 73 per cent.
– There are others receiving repatriation benefits.
– As the Minister has reminded me, another large section of the community receives benefits through the Repatriation Act. Having in mind the fact that very many people receive medical benefits without having to belong to benefits societies, it can be concluded that the 73 per cent, of the population to which I have already referred covers practically everybody else who is eligible to join the hospital and medical benefits societies and to receive benefits therefrom.
I wish to refer also to a statement made by the honorable member for Eden-Monaro which I thought was rather unfair. I believe the honorable member has quite an extensive knowledge of this bill. He usually leads for the Opposition in debates on measures of this kind. He referred to the provision in clause 4 for the payment of benefits to persons undergoing operations, and to the provision in that clause for a maximum payment of £22 10s. He suggested that the payment should be very much higher. He implied that £22 10s. would not buy much to-day in the way of an operation. He did not say, however, that the fact is that the £22 10s. is the Commonwealth’s contribution - which has been increased from a considerably smaller amount - and that this amount will be supplemented by benefits to be paid by the hospital benefits society, which will bring the total amount up to £60.
– I think you have missed the point I was trying to make.
– That was the impression I gained from your remarks. I felt that you were chiding the Government for providing an inadequate payment.
– I merely said that the Government had not taken into account the effect of inflation and had not made a consequent alteration.
– I believe the Government has considered all aspects of the matter, because one would have to undergo a series of major operations before the cost would exceed £60.
The bill further amends certain provisions having to do with pharmaceutical benefits. It increases the membership of the Pharmaceutical Benefits Advisory Committee. The Minister did not give any reasons why this increase was necessary, but I can see some benefits that will flow from it. A larger panel on the committee will mean a much wider knowledge and a greater appreciation of the drugs that constantly are becoming available to the Australian community. I think that it will do what the honorable member for Eden-Monaro would like to see done; it will accelerate the availability of all new drugs that will be of benefit to the people.
I hope that the time that elapses between when a request is made to the department for inclusion of a drug on the list and when it is available to the patient will be lessened. A lengthy period sometimes elapses between the announcement of a new drug and its availability but perhaps there are very good reasons for that. It may be that sufficient stocks of the drug are not available to meet the requirements of the community. This is not the fault of the pharmacist; it is simply because the manufacturer does not have a sufficient amount available to distribute it throughout Australia. If the Minister were to announce the availability of a certain drug before arrangements had been made for its distribution a tremendous amount of inconvenience and frustration would be caused to patients, doctors and pharmacists. However, there are times when unnecessary delays have taken place. I believe that this is due largely to the fact that the committee does not meet often enough to consider whether new drugs should he included on the list, and a back-lag of drugs awaiting decision could be created.
Large numbers of new drugs are becoming available all the time. Science does not stand still. The committee should meet as frequently as is necessary. It is important that it meet often because if the pharmaceutical industry has to wait for a considerable time before a drug is made available to the public, the industry stands to lose revenue. After all, one has to realize that the Government spends very little money on medical research. I think the amount is about £250,000 annually. The greatest amount of research is done by the industry which is spending tremendous sums of money in this avenue and, in so doing, is saving the Government a good deal of expense. The Government should be as co-operative as possible to assist the industry to have new drugs made available quickly.
When the Minister last introduced a bill dealing with this matter he referred to the wide range of pharmaceutical benefits on the free list, and stated that a doctor would not be hampered in his medical discretion by any consideration of the cost of a prescription. That is important, and I am glad to know that it is so. The consideration of cost being removed, one might well say that the hallmark of a drug’s efficacy to-day is whether it is available for 5s., that is to say, whether it is on the pharmaceutical list. If it is not, it cannot be any good.
– Do you claim that?
– No, T claim that that is the kind of thing that might be said because we have such a wide range of available drugs on the free list and because the Minister has stated that any drug that is any good is on the list. In those circumstances, some members of the pharmaceutical industry could claim that if the drug is not on the list the committee has decided that it is no good. The committee has a great responsibility in this matter because it has to vet every new drug that comes on to the market.
Behind the introduction of all new drugs is a tremendous amount of research. The pharmaceutical industry claims that £100,000,000 is being spent in this country every year on drug research, so when the committee is deciding whether a drug should be on the list it has a good deal of information to assist it in arriving at a decision. It also bears a heavy responsibility because, as the Minister has said, it is not a question of cost, but a question of the drug’s efficacy.
It is important that the committee should be comprised of the most experienced men, and it is equally important that it should co-operate as much as possible with the pharmaceutical industry. Two years ago, the United Kingdom Minister for Health set up the Hinchcliffe commission to investigate matters relating to the cost of drugs, particularly those that were on the pharmaceutical list. The commission reported in these terms -
The cost of research must be provided in the price of medicine and reasonable profit is essential if the industry is to be encouraged to invest capital in continued development projects.
The community should bear that factor in mind when it tends to condemn the pharmaceutical industry for the tremendous cost that is involved in our national health service. About £25,000,000 is spent every year on pharmaceutical benefits, but one must remember that at least £100,000.000 is spent every year in research on drugs. Not all drugs that are brought on to the market succeed in their purpose. The situation often arises in this very highly competitive industry in which a large percentage of the revenue that is appropriated for research is almost wasted overnight. That is what happened when new antibiotics were found to treat pneumonia. Years of research had been put into the investigation of a certain drug, and a tremendous amount of money had been spent. The drug was put on the market but it had not been in use more than two or three months when another antibiotic was found to be much more efficacious than the previous drug. The result was that the money spent on research was wasted. So one has to be rather careful in criticizing the amount of money that pharmaceutical services cost in view of the tremendous amount of research that is behind them.
I sincerely hope that the newly constituted Pharmaceutical Benefits Advisory Committee will give due consideration to some of the problems the pharmaceutical industry is up against. We are very fortunate in Australia because the Government is getting the best of two worlds for the taxpayers. It is spending little money on pharmaceutical research itself and, at the same time, is becoming the principal purchaser of drugs in Australia at very little cost. The Government can accept or reject drugs from the pharmaceutical list. The only thing it cannot do is to force the pharmaceutical industry to spend large sums of money on research into new drugs.
A situation could be reached where the Pharmaceutical Benefits Advisory Committee became too difficult and not sufficiently co-operative with the industry. That is exactly what has happened in the United Kingdom and in Europe. The governments of countries concerned have been so harsh in some of their restrictions that they have tended to stifle research work on new drugs. I hope that situation will not arise in Australia, and that co-operation between the Department of Health and the Pharmaceutical Benefits Advisory Committee will help the industry in every possible way. I hope that it will facilitate the introduction of new drugs on the market, if necessarythrough the pharmaceutical free list, and that the public will get the benefit of those drugs. All of us want the industry to continue to apply itself to the job of finding new cures for the relief of pain, improving production techniques and maintaining standards which will continue to be equal to those available anywhere else in the world. To maintain such an arrangement requires the co-operation not only of industry, but also of the department within the Government itself.
I am sure the Government will continue to review its national health service. Only by amending and adding to our present service can we keep pace with world science. The fact that the Minister has introduced this bill and made certain alterations, including the appointment of additional members to the Pharmaceutical Benefits Advisory Committee, is evidence of the Government’s bona fides. I commend the bill to honorable members.
.- The honorable member for Isaacs (Mr. Haworth) is a more credulous person than I take him to be if he is convinced, on the flimsiest of evidence, that the Australian national health scheme is the best in the Commonwealth of
Nations. As a matter of fact, the honorable member has only to talk to any number of British immigrants who come to Australia and ask them how our health scheme compares with that in the United Kingdom and he will get rather a severe jolt. I have in my possession a report by the Minister for Health in New South Wales, Mr. W. F. Sheehan, who has only recently returned from the second Commonwealth and Empire Law Conference. Mr. Sheehan took the opportunity to examine public health schemes in Canada and the United States of America. While I do not intend to delve deeply into his report, it is worth noting that Mr. Sheehan stated at page 6 -
I have no hesitation in asserting that FederalState relations and co-operation in both the United States of America and Canada can be an object lesson to those in Australia.
On some other matters which are rather relevant to this debate, Mr. Sheehan said that in Canada, for example -
The Federal act prescribes that in order to participate, the province must make insured services available to all the residents of the province on equal terms and conditions. Thus there can be no exclusions on grounds of nationality, age, income- and I ask the Minister to note - or pre-existing condition.
All persons receive equal treatment. Another important passage which I ask the Minister and the honorable member for Isaacs to note is -
Length of time for which insured persons are entitled to receive insured services depends solely on medical necessity. No arbitrary limitation may be imposed in regard to entitlement in connexion with length of stay in hospital.
In other words there rs none of the business that we have in this country whereby benefits are reduced after a person has been in hospital for 84 days. The report continues -
On the other hand, where it is not considered medically necessary for an insured patient to have treatment in hospital his insurance entitlement does not apply.
The report of the Minister for Health in New South Wales also states that in Canada, 92 per cent, of the Canadian people are covered by the national health scheme compared with 73 per cent, in Australia, a figure to which the honorable member for Isaacs referred. Supporters of the Government proclaim ours to be a marvellous health scheme. I acknowledge that it is improving, but I remind the Government that the Australian national health scheme does not provide for such important health services as dental treatment It provides for a very limited optical treatment and there is no provision for such specialized services as physiotherapy. Nothing is provided for patients who have to go into mental hospitals. Even an age pensioner entering hospital is denied his pension, and the State Department of Health is deprived of the proportion of pension it normally attracts for persons who go into benevolent institutions.
Hospitals in every State of Australia are grossly overburdened. It has been said that pensioners under the pensioner medical service do not have to insure for hospital treatment. The simple fact is that most elderly persons find it almost impossible to gain admission to public hospitals anywhere and certainly in the metropolitan areas of Australia. They are legally entitled to free admission to a public ward, but in fact, most public hospitals will not take longterm patients and most of the elderly people who seek admission suffer from heart conditions or other long-term illnesses. Elderly people have recognized this fact as disclosed by the Minister for Health (Dr. Donald Cameron) in an answer to a question that was asked by the honorable member for Moreton (Mr. Killen). The honorable member asked -
How many contributors to medical or hospital benefit funds established under the National Health Act are contributors to the special accounts?
The Minister replied that at 31st December, 1960, the figures were medical, 16,757, and hospital, 288,495. That means just what I said - they can get medical treatment by presenting their card, but they cannot get free hospital treatment in the same way. The Minister for Health in New South Wales, and many other responsible authorities, have advised pensioners that even if they have a pensioner medical service card they will find it darned difficult to gain admission to any of the overcrowded public hospitals in any State for long-term treatment.
When this health scheme was introduced one of the things it was supposed to do was to provide adequate hospital facilities. It was lauded on that account; but in fact to-day the scheme does not provide anything like adequate hospital accommodation. I remind honorable members that while the Government has often given the impression to the public that it is a great benefactor through the pensioner medical service, the simple fact is that the Commonwealth provides in respect of the hospitalization of pensioners only an amount of 8s. a bed a day to public hospitals. I was told only last Saturday by the chairman of the board of the St. George District Hospital - one of the biggest public hospitals in Sydney - that the average cost of maintaining a bed in his hospital is £35 a week. About the same figure would probably apply in all other public hospitals in Sydney, and no doubt elsewhere in Australia. So, in other words, the Commonwealth contributes the basic amount of £2 16s. a week towards the hospitalization of each pensioner, compared with the average cost of maintaining a bed of £35 a week. Yet the Government and its supporters claim that this is the best national health scheme in the British Commonwealth.
Not even all pensioners are covered by the scheme. The Government in October, 1955, introduced a means test so that thenceforward large numbers of age pensioners in receipt of a full or part pension were debarred from benefit under the pensioner medical service, and from free hospital treatment, and from the right to free medicine under the pharmaceutical benefits scheme, simply because they received £2 a week or more in income, apart from their pensions. The result was that many of these poor souls are worse off now than are people who are receiving full pensions, which attract these other concessions. Yet honorable members opposite talk about the great virtues of this scheme.
In a few weeks probably a very high proportion of the membership of this Parliament, along with thousands of other members of the community, will be knocking on doors in connexion with a fund-raising campaign for the National Heart Foundation. They will be begging from door to door, one might say, in order to obtain funds that are not otherwise available to enable the carrying out of urgently needed research. Not .only is the amount of research being done at present inadequate, but it has not been co-ordinated so as to achieve efficiency and economy in the way the Commonwealth should co-ordinate it. My friend, the Minister for Health in New South Wales, has directed our attention to the good example set by Canada in this respect. The federal departmental head in Canada consults regularly with the heads of the departments of health in the various provinces, in order to be able to advise the Federal Minister frequently on the needs of Canada’s health scheme. As a result, there is a happy, co-ordinated and co-operative joint scheme in Canada, operated between the federal and the provincial authorities, of a kind which seems to be missing in this country. The Minister should recommend to the Government that we try to emulate Canada’s example.
While the matters to which I am referring are not strictly within the ambit of the bill, I think they are worth mentioning. We have heard a lot in the last year or so about hospital treatment in non-recognized hospitals. Those are hospitals which are not recognized for benefit under the Government’s scheme. I find that about half of the people who have entered such hospitals for treatment have had their claims for benefit rejected. These rejections are the result of an amendment passed through this Parliament last year or the year before. I can quite understand how this happens, but I think that it is most unjust that these claims should be rejected in the cases to which I shall refer. The amendment provided that people who enter these nonrecognized hospitals for treatment will attract Commonwealth benefit only if they satisfy two conditions. First, they must be receiving treatment equivalent to the treatment they would receive if they were able to gain admission to a public hospital. Secondly, they must be suffering from a disability which would normally be treated in a public hospital. It is on that second condition that most people are debarred from benefit. A person suffering from a heart complaint, for instance, which needs more than home treatment or out-patient treatment, and calls for a lengthy stay in hospital, is usually told by the public hospital that there is no accommodation available because the treatment might last over months in the hospital, and there are no facilities for such lengthy treatment there. That person may then enter one of these private non-recognized hospitals for treatment. When the patient makes application for the benefit the claim is rejected because the patient was treated for a disability in regard to which the public hospital had refused admission. But the reason that the public hospital would not accept the patient was not the nature of the disability, but the lack of accommodation to enable long-term treatment. That is what is happening to many unfortunate people on the special account, who enter non-recognized hospitals for treatment. Incidentally, I hope that the Minister will be good enough to take notice of these points when he reads “ Hansard “ later.
There is also the unfortunate business regarding mental hospitals, to which I have referred before. Part of the problem which is making it so difficult for the State authorities to maintain their mental hospital services as adequately as required is that pensioners who enter these hospitals find that their pensioner medical card gives them no entitlement to treatment. The Commonwealth does provide something towards the capital cost of providing mental hospitals, but gives nothing towards their running costs. That is bad enough, but the fact is that many pensioners who should never be in mental hospitals are in such hospitals to-day simply because they cannot obtain treatment in public hospitals. All they are suffering from is senility or part-senility. The Director-General of Public Health in New South Wales - and I suppose this applies also in other States - has, year after year, referred to the fact that mental hospital facilities are being over-taxed simply because many pensioners who should not be in mental hospitals are there only because no public hospital facilities are available for them. The States have to carry that burden, and they receive no contribution from the Commonwealth to meeting the cost of upkeep of these hospitals. That is another reason why it is so ludicrous for the Government to tell us that its health scheme is the best in the world, or even in the British Commonwealth. I acknowledge that the scheme has its virtues, but let us not blind ourselves to the fact that we have a long way to go before we are providing anything like the ideal kind of health services that we should be providing to the people.
I referred before to the inadequate provision of specialized services such as dental services. Dentists say that it is a most worrying thing when parents come to their surgeries to have two or three children treated. Perhaps the parents themselves need treatment, and the dentists know that they cannot afford it. They feel bad about having to send such people a bill for treatment, when they know that no assistance will come from the Government in the in the payment of the bill. Of course, the costs of dentistry, along with other costs, have zoomed in recent times, and this places a tremendous financial burden on those concerned. The Australian Labour Party, in each of its most recent election programmes, has shown its desire to provide health schemes to cover these specialist services. Many people are referred by doctors for physiotherapy treatment, which is intimately connected with their medical treatment; yet for some reason physiotherapy is not included in the services covered by the scheme.
I should like to touch on another aspect and that is the registration of hospitals under the Commonwealth scheme. The present position has created a problem for some hospitals, which have tried to obtain registration under the scheme. People who cannot obtain admission to a public hospital must enter a private hospital. This is commonplace when minor surgical operations are required. Cases of tonsillectomies, particularly for children, and other minor surgery are referred by doctors to these private hospitals, which are quite efficient, apparently. Many doctors operate on patients there. Admittedly, the hospitals do not provide a full-time service. They do not provide night treatment, but they do provide all the necessary facilities for operations. As T have said, the patients are referred by many doctors to these hospitals. The State Department of Health registers the hospitals for its purposes, but the Commonwealth will not register them under the scheme and will not provide benefits for those who make use of them.
The point at issue, surely, is whether the institutions provide a desirable standard of service. If they provide the service, though it may be only part of the total service required, and if they relieve our over-taxed public hospitals, why not register them, even if it is only registration of a limited nature, and why not provide benefits for the many people who are compelled to make use of these hospitals? The hospitals have the approval of the medical fraternity. I understand that some members of the medical fraternity are part-owners or have some proprietary interest in these institutions. This is not always so, but it does happen in some instances.
I turn now to another matter and this relates to the pharmaceutical benefits scheme. Like the honorable member for Eden-Monaro (Mr. Allan Fraser) and others who have spoken in this place, I believe that the formulary does on occasions inflict injustices. The Minister may by now have received a letter from me in which I refer to a desperate young man in my electorate. This rs not an isolated matter; this happens on many occasions. This young man, who has had a skin complaint almost since birth, has been treated by many doctors and has been given various forms of treatment. Now a skin specialist, I think at Royal Prince Alfred Hospital in Sydney, has hit on something that not only appears to be relieving this poor unfortunate fellow of pain but indeed seems to be curing him of the complaint. The doctor says that nothing on the formulary looks as if it would effect a cure. This young man is 24 or 25 years of age. He now must pay the specialist and the local doctor who treats him three times a week to apply the treatment. He must also pay for the very expensive medicines used and in one period of three weeks these cost him £18. Here is a young, ordinary man - he is a shop hand, if I may call him that - and he must pay a good portion of his wages year after year for medical treatment. 1 thought the health scheme was designed to relieve sick people of worry and insecurity. I believe that, whatever may be said of a socialist scheme-
Sitting suspended from 6 to 8 p.m.
– Prior to the suspension of the sitting, I had made some critical observations about the national health scheme, and as the sitting was suspended I was discussing in particular what I regard as deficiencies in the pharmaceutical benefits aspect of the scheme. I had mentioned a case in which specialist advice was that the medicines provided by the formulary did not meet the requirements of the patient. This one particular case could be multiplied many times in the experience of many members of the Parliament in their dealings with their constituents.
I suggest that the pharmaceutical benefits scheme is rather lacking in flexibility. I am aware of the existence of the Pharmaceutical Benefits Advisory Committee, which is mentioned in the bill. That is an expert committee which advises the Minister for Health. But there are many medical authorities of eminent standing in the community who, nevertheless, are not happy with the formulary. Their pragmatic experience in these matters has convinced them that there are medicines other than those in the formulary that will relieve pain or effect cures. The great problem, of course, is that many of these medicines that are not included in the formulary are very costly. As a result, many ordinary working people like the man I mentioned just before the suspension of the sitting are in difficulty because they have to spend a large proportion of their weekly income on specialist treatment and on drugs and medicines. In the case which I mentioned, about £18 was spent on medicines in three weeks. I visited my own local general medical practitioner last Friday for a check, and he made out three prescriptions for me. One was for a medicine which was on the free list and the other two were for medicines which were not on the list.
– It is just as well the honorable member was not ill.
– The honorable member can see that I am all the better for those medicines. These days, getting prescriptions is a bit like taking tickets in lotteries. A person is lucky to find that one prescription out of three is for a drug which is on the free list.
People who already endure much pain and suffering, to say nothing of mental distress, are subjected to great financial hardship by the inadequacy and inflexibility of the pharmaceutical benefits formulary.
I suggest that there ought to be a little more flexibility and that there should be provision for some appeal tribunal which could consider individual cases. A patient may be able to submit substantial medical evidence that although his treatment is not the kind that would ordinarily be prescribed for the complaint from which he suffers, it is the best and most effective treatment for him. We all know how individuals vary, not only in their psychological and personality make-up, but also in their physical constitutions, and flexibility should be provided in the pharmaceutical benefits scheme in order to allow for these variations. I suggest that there should be provision for appeals by individuals who require costly medicines which apparently are suited to them but which are not in the formulary. The practitioners who prescribe these medicines are not just quacks who have set themselves up in business here and there. They are people of extremely high standing. Indeed, I suggest that many of them are of a standing equivalent to that of the members of the Pharmaceutical Benefits Advisory Committee. All that I am asking is that respect be shown for the professional status of eminent doctors and specialists who prescribe costly drugs not in the formulary and who believe that the formulary is not adequate to meet the needs of particular patients.
As I have said, many of these drugs and medicines which are not listed in the formulary are very costly. Many doctors of my acquaintance have suggested that they all are too costly and that there is gross profiteering in the production of drugs and, more particularly, in their distribution. Only the other day, a local practitioner pointed out to me that many of these drugs are imported and that the Commonwealth levies customs duties on them, thereby increasing the cost. In many instances, this increases the cost to the Commonwealth in the long run of imported drugs which are provided free under the pharmaceutical benefits scheme.
I make a positive suggestion the adoption of which would help to solve this problem. I imagine that the operations of the Commonwealth Serum Laboratories could be very greatly extended in order that these costly drugs may be produced in Australia. I am sure that these laboratories could pro duce drugs at a cost much lower than that at which they are obtained from other sources, and particularly from overseas. Only to-day, I read in a newspaper that an officer of the Commonwealth Serum Laboratories had made a statement about the long delay in providing for the enlargement of the facilities of the laboratories in order to permit much more research to be undertaken. The officers of the laboratories recognize that a lot of necessary research remains to be done and that greater financial provision is required if the research needs of this country are to be met. I think that the Minister for Health ought to give a good deal of attention to this matter.
I have only a few minutes left, and I have time to mention only one other matter in this rather quick survey of the national health scheme. This is a matter to which I and other honorable members have directed attention on previous occasions. At the outset of my remarks, I referred to the many deficiencies in the national health scheme with respect to the lack of provision for dental treatment, optical treatment and specialist services such as physiotherapy. I also mentioned the anomalies in the special account procedure and the new means test introduced by the Government in respect of the pensioner medical service. I want to deal now with optical services. The strange anomaly in this respect is that if a person is to attract Commonwealth benefit and fund benefit for optical treatment, not including spectacles, he must be treated by an eye specialist or an ophthalmologist. If he is to attract full benefits, he has to be referred to the specialist or ophthalmologist by a suitable person, just as a patient who goes to any other specialist will attract the full Commonwealth and fund benefits only if he first goes to his general practitioner and is referred by the general practitioner to the specialist. There is a parallel between the two classes of treatment.
With respect to optical treatment, a person attracts full Commonwealth and fund benefits if he is referred by a general practitioner but not if he is referred by an optometrist. I am well aware of the very solid training that optometrists have to undertake. These days, they have to get the equivalent of a Bachelor of Science degree and they undertake intensive study in a highly specialized field. I suggest, with all due respect to my colleagues in the ranks of the general medical practitioners, that optometrists are infinitely better qualified to diagnose eye troubles than are general practitioners, and optometrists would be just as well fitted to refer people to ophthalmologists and specialists as are general practitioners. The fact is, of course, that about three-quarters of the people who seek treatment for eye troubles go to optometrists or opticians, and more particularly to optometrists. But if an optometrist refers a patient to an ophthalmologist, the patient will not receive full Commonwealth and fund benefits. However, if a general medical practitioner, who probably knows very little about eye troubles, refers the patient, full benefits are paid.
The optometrists suspect that this restriction is merely a way of diverting patients from optometrists into the hands of the local general medical practitioners, and they are therefore very ‘ suspicious of this aspect of the national health scheme. I think that very recently the Minister has been made well aware of the criticisms of the scheme that are made by the optometrists, and I am hopeful that in the very near future he will remedy what I regard as a serious anomaly that affects both the optometrists and the thousands of people in the community who seek treatment from them.
Order! The honorable gentleman’s time has expired.
.- Mr. Speaker, this is the first bill to amend the National Health Act with which the Parliament will have to deal this year. In 1953, 1955, 1957 and 1959, the Parliament was asked to amend the principal act in various respects, but chiefly by substituting new schedules of the Commonwealth benefits which are paid for medical treatment. The Parliament is regularly asked to amend the schedules immediately after the biennial meeting of the federal council of the British Medical Association. The motivation in these matters is, not the desire to reduce the expenses of patients, but the desire to guarantee the fees of the doctors. The next biennial meeting of the federal council of the British Medical Association will be held during the recess of the Parliament, and, accordingly, during the Budget session once again, we shall be again amending this act to oblige the doctors.
The present amendments are rather simple. I propose to devote my attention to two aspects of them only - those relating to the Pharmaceutical Benefits Advisory Committee and to hospital benefits. The Pharmaceutical Benefits Advisory Committee is one of the devices by which, under the administration of the right honorable member for Cowper (Sir Earle Page) and his successor, the present Minister for Health (Dr. Donald Cameron), the Commonwealth has evaded its responsibility with respect to health services. It is one of the devices by which the Commonwealth chooses to delay, not for medical but for budgetary reasons, the provision of pharmaceutical, medical and hospital benefits for Australian citizens and residents. It is one of the devices by which the Australian public and its representatives in this Parliament are precluded from examining the administration of the Government. The Minister has never published, and has consistently refused to publish, the names of the men who are appointed to the Pharmaceutical Benefits Advisory Committee. He has never even published the name of the officer of his own department who is appointed to the committee. I have asked the Minister many questions on the subject and he used to reveal to us what the committee’s recommendations were. But a couple of years ago, he decided that these also should be confidential. It is now no longer possible for anybody to ascertain what the recommendations of the committee have been as to the inclusion of drugs on the free list, their removal from that list, or the reason for the delay in carrying out either of those processes. The committee is a greater mystery now than ever before.
The Minister has also inadvertently or deliberately confused the position still more. One does not really know when the committee meets or how it conducts its deliberations. One does not know who belongs to it; one does not know what its decisions are, and it is very difficult now to obtain information about its methods of operation in any respect. Let me illustrate that by referring to some of the answers the Minister has given to questions I have asked him without notice, and on notice, in recent months. The. last additions to the free list became available on 1st November, 1960. The last meeting of the Pharmaceutical Benefits Advisory Committee before that date was on 18th March, 1960. Thus by one method or another the provision of these benefits was delayed for seven and a half months. I know that the last meeting of the committee prior to 1st November was on 18th March because the Minister told me so in answer to a question I put on the notice-paper, and which he answered on 30th August.
To make the position even more confusing, on 5th October last, when I asked the Minister why there had been such a delay in making available the drugs which he had promised to make available a couple of months earlier on the recommendations of the committee, he told me that the committee’s deliberations took a very long time because it had to examine a very large list of drugs. I interjected -
You told me the committee last met in March.
The Minister said -
The committee commenced to meet then, but it has held a number of meetings since.
That was on 5th October. I then placed on the notice-paper a question asking the Minister to reconcile this statement that the committee had last met on 18th March with his other statement that it had commenced to meet in March but had held a number of meetings since. This is what the Minister told me on 22nd November last -
At the March meeting the committee decided to make extensive investigations regarding the matters before them and for this purpose informal communication took place between the members who reside in different States. Some members of the committee did meet from time to time, but there was no further formal meeting of the full committee until 4th November.
In fact, there was only one meeting of the committee before those drugs became available, and that was seven and one-half months before they became available. Therefore, the Minister’s reply to my question without notice, on 5th October, Was inaccurate.
I have asked him further questions, sometimes by correspondence, on these subjects. For instance, I wrote to him on 24th October last with the suggestion that certain drugs - takadiastase. pepsin and pancreatin - should be considered for inclusion in the free list. Then, as I have already told the House, the committee met on 4th November. On 8th November, the Minister acknowledged my letter and said -
I will be pleased to refer your representations in this matter for the consideration of the Advisory Committee at its next meeting and I will write to you again when I have the committee’s advice regarding the tablets.
On 9th March, I again wrote to the Minister concerning the absence of any further decisions, and on 7th April, he wrote to me -
Since writing to you last-
That is, since 8th November - a meeting of the Pharmaceutical Benefits Committee has been held and consideration given to this matter.
He also said -
Whilst all of the business arising from the meeting has not yet been finalised, I am in the position to advise that the committee was not prepared to recommend that these tablets be made available as a benefit.
I later asked the Minister, by way of question on notice, on what dates the committee had met since 4th November, and his answer was -
The committee has not met since 4th November.
What, then, are the facts? The letters which the Minister has sent to me are quite obviously inaccurate. He told me that the matter would be referred to the committee. He told me so after the committee last met. Five months later, he told me that the committee had decided that it would not recommend the inclusion of these drugs on the free list. Then he told me in answer to a question on notice that, in fact, the committee still had not met since he first wrote. In other words, the Minister’s replies are not accurate in any sense. I have spoken, so far, only about the inclusion of drugs on the free list.
I come now to the removal of drugs from the free list. The Minister has stated that drugs are added to, or removed from, the free list only on the recommendation of the committee. He has been quite categoric in saying that. On 15th September, 1959, he answered a question by the honorable member for Batman (Mr. Bird) in these terms -
The question of whether drugs are placed on or removed from the list of pharmaceutical benefits for pensioners, or indeed for the general population, is decided on the advice of a committee of experts.
Again, on 27th October, 1959, he told the honorable member for Yarra (Mr. Cairns) that drugs are placed on the list, or taken off it, on the advice of a highly expert committee.
The latest example of the removal of a drug from the list concerns the drug androstanolone. This was one of the drugs which became available on 1st November, 1960, presumably on the recommendations of the committee which had last met on 18th March. It might have been recommended at earlier meetings of the committee. But in giving this date I assume that a recommendation of the committee comes into force at the first date on which new drugs become available after the committee has met. On 24th November, 1960, the Minister for Health issued a public statement in these terms: -
Steps have been instituted immediately, on the advice of the Pharmaceutical Benefits Advisory Committee, to alter the listing of the drug and the restriction on its use will apply from 1st January.
I am not cavilling at the reasons which the Minister gave for restricting the use of this very expensive drug - a drug which, in fact, was not required for many of the purposes for which it was being prescribed by doctors. But it will be noticed that the drug became available on 1st November. The meeting of the committee was held on 4th November. Unless the Minister can assert that the committee, by 4th November, had already recommended the removal of androstanolone from the free list, in this case a drug has been removed from the list without any recommendation of the committee at all, because there has been no meeting of the committee since 4th November.
In earlier years when I commented on the delay in implementing the decisions of the committee, the Minister had been ungracious enough to blame, among other people, the Parliamentary Draftsman. So thereafter I always asked the AttorneyGeneral (Sir Garfield Barwick) the date on which the instructions were received and fulfilled by the Parliamentary Draftsman. In actual fact, never more than a month elapsed and on this occasion one week elapsed between receipt and fulfilment of instructions by the Parliamentary Draftsman. So there is no question that the Parliamentary Draftsman is responsible for any of the delays in this matter. Is it necessary for the committee to recommend the removal of any of these drugs? If it is, how is it that this drug was removed from the free list without the recommendation of the committee?
On the subject of drugs, I shall make a few general remarks. The honorable member for Barton (Mr. Reynolds) very properly stated that the whole of the scheme had been a bonanza for the drug companies. There is no form of foreign investment which has proliferated so luxuriantly as the subsidiaries, affiliates, and licensees of the drug companies. I shall mention the American companies which have mostly established subsidiaries in Australia since this scheme came into operation. They are Eli Lilly International Corporation, Johnson and Johnson, Merck and Company Incorporated, the Dow Chemical Company, Sterling Drug Incorporated, The Upjohn Company, Vick Chemical Company, Warner-Lambert Pharmaceutical Company Incorporated, the Pfizer Corporation and the Monsanto group. From the United Kingdom there is Allen and Hanburys Limited, the Wellcome Foundation Limited and the famous firm of Beecham. From West Germany there is Farbwerke Hoechst Aktiengesellschaft. We have been very fortunate, to a certain extent, in the formulae and skill which must have flowed from this investment, but we are certainly paying most handsomely for this know-how.
From now on, the work of the Commonwealth Serum Laboratories should be augmented. Here I rely on an answer given a month ago by the Minister for Health to the honorable member for East Sydney (Mr. Ward). The Minister said that the Commonwealth Serum Laboratories do not compete on the Australian market with the products of the privately owned drug houses except in some classes of penicillin and insulin. It is not necessary for the Australian Government to subsidize the drug houses as lavishly as it has been, in effect, subsidizing them. Significantly, there has been by no means the great increase in the price of penicillin and insulin that there has been in the price of all other drugs. The prudent, the patriotic and the economic arrangement would be for the Commonwealth Serum Laboratories to manufacture under licence from the foreign drug companies. There is no reason whatever why Australia, with the facilities of men and equipment already in this country, could not manufacture any of these drugs. We would pay very much less for them.
I pass now to the question of hospital benefits. The cost of hospitals has been taken up by the State Health Ministers, year in and year out, with the Commonwealth Minister. When the Chifley Government made an arrangement with the States for subsidizing occupied hospital beds, the understanding was that a third of the cost of maintaining the beds would be met by the Commonwealth through its direct grants to the States; one-third would be met by the States out of their consolidated revenue; and the remaining third would be met by the patients. The Commonwealth, in effect, has frozen its direct grants to the States. It has, of course, increased its payments for hospitals but in the form of subsidies to hospital benefit organizations. That is, Commonwealth assistance to the hospitals is now given principally through the component of patients’ fees. But now the States pay from their consolidated revenue, not a mere third of the cost of conducting hospitals, but more than one-half of the cost. The patients still pay a third, the Commonwealth paying part of that, and the Commonwealth pays the remaining one-sixth or one-seventh of the cost directly.
As earlier speakers have pointed out, there is not the co-operation between the Federal and State governments in conducting hospitals in Australia as there is in the United States of America, or as there is in Canada between the federal and provincial governments. Under the Constitution, the Commonwealth has power to provide medical and dental services. It has maintained hospitals under the defence power for ex-service personnel. The Commonwealth is now meeting a much smaller percentage of the cost of conducting other hospitals than it did in the 1940’s. This cost has been particularly onerous to the Australian public since a means test has since been applied to public ward beds. The
Menzies Government cancelled the scheme which the Chifley Government established by agreement with the States for a five-year plan under which a patient-
– It still exists in Queensland.
– That rs the one State which still has that scheme. Queensland is still able to provide a certain number of beds in public wards because it was doing so before the uniform taxation scheme came into operation. That rs, Queensland’s finances were geared to that procedure. But the Country Party-Liberal Party Government in Queensland has, in fact, reduced the number of beds available to the general public in public wards. At all events, in all the other five States, even the wealthiest, it has been necessary to impose once again charges in public wards of hospitals and the only way that persons can be exempted from fees in public wards is if their means are really restricted. Here again it is very difficult to get any information from the Minister. I have stated that the State Ministers for Health have constantly pleaded with the Commonwealth to restore the original ratio of one-third, onethird, one-third between direct Commonwealth grants, State revenue and patients’ fees.
The Minister did attend a meeting of the State Ministers in the first year after he took office in 1957. Last week I asked him the following question, upon notice -
The Minister’s reply was -
I have not been supplied with a record of the proceedings at meetings of the State Health Ministers since I last attended.
That was an inaccurate reply. Not only was it lacking in frankness, but I think I can establish that it was lacking in truth. The Minister attended a meeting of the State Ministers for Health in 1957. He discussed the resolutions of the 1958 conference of Ministers with a deputation of those Ministers. For that statement I rely on a question I asked the Minister and the reply he gave me on 7th May, 1958. On that date I asked the Minister -
Is it a fact that he had a discussion, over three weeks ago, with the New South Wales, Victorian and Queensland Ministers for Health on the resolutions carried at the conference of all State Ministers for Health last January?
His reply to that question included these words -
I did have a conference a short time ago with the three Health Ministers mentioned by the honorable gentleman.
That is, the Minister did, in April, 1958 or thereabouts, have a discussion with three of the State Health Ministers who conferred with him concerning the resolutions passed at the meeting of all the State Health Ministers in January, 1958. Was it, therefore, a frank or a correct answer to give last week? I remind the House that he said -
I have not been supplied with a record of the proceedings at meetings of the State Health Ministers since I last attended.
The record of the State Health Ministers’ conference held next year in Brisbane includes an interesting passage. Sir Lyell McEwin, the Liberal Minister for Health in South Australia, said’ -
I move - “That a delegation from this Conference, comprising the Ministers of Health from New South Wales, Victoria, and Queensland wait upon the Commonwealth Minister for Health and discuss matters arising from this Conference having as a basis the arguments set forth by their officers.”
Mr. E. P. Cameron, as he then was, the Liberal Minister for Health in Victoria, then said -
I second the motion.
The motion was agreed to. In fact, that delegation did meet the Commonwealth Minister for Health and put the resolutions of the 1959 conference to him. I believe that similar resolutions were carried and that the context of those resolutions was conveyed to the Minister as the result of the meetings of the six State Health Ministers in Sydney in January last year and in Perth in January this year. I have not the transcript of the proceedings of the State Health Ministers’ meetings in those years, but I have the transcripts of the meetings in the previous years. They are published and are available to anybody who chooses to go to the Government Printers of the States concerned - that is regarding the meeting m Melbourne in January, 1958, and in Brisbane in January, 1959. The Minister’s reply to me was obviously sheer shuffling. He stated that he did not receive a record of those proceedings, but in fact the Ministers called upon him on at least two occasions and they wrote to him on all four occasions.
The significance lies in the contents of those resolutions. I shall not go into all the matters upon which the State Health Ministers have sought a relaxation or alteration of the Commonwealth’s attitude. They cover such matters as migrant patients in mental hospitals, the payment of hospital benefits and age or invalid benefits to medical patients and increased hospital benefits generally. I shall confine myself to the resolutions which have been passed concerning the increase in the payments which the Commonwealth makes to the States for each occupied bed. In Melbourne in January, 1958, the State Health Ministers unanimously resolved -
That having regard to the recent increase in the additional hospital benefits rate from 4s. to 12s., the Commonwealth Government be approached with a view to increasing proportionately the basic rates of 8s. and 12s. paid to the States under Hospital Benefit Agreements.
In Sydney in January last year, the State
Health Ministers unanimously resolved -
In Perth, in January last, the State Health Ministers unanimously resolved -
The base rate of 8/- per day should be increased to at least 28/- per day; or the base rate of 8/- per day and. the additional benefit of 12/- per day should be increased by 20/- per day.
This is not just a party political matter, because the State Health Ministers are Liberal Party, Country Party and Labour Party and, year in year out, they all are unanimous in pleading with the Commonwealth Government to maintain the obligation that it undertook fourteen years ago, or to adhere to the spirit of that agreement. Such increase as took place in the years after the war in hospital standards was due to the participation of the Commonwealth in hospital administration and services. That can only be maintained in this country, as it is in other federal systems where there is a disproportion between the financial resources Federal and State, or provincial, by the Commonwealth Government maintaining its obligation.
I now refer quite briefly to the surpluses of the hospital benefit funds which the Commonwealth sponsors.
– Order! The honorable gentleman’s time has expired.
.- I want to say a few words on the subject under discussion, particularly as it relates to one or two matters concerning pensioner medical services. But before doing so I shall refer the House to the answer which I received from the Minister for Health (Dr. Donald Cameron) in reply to a question in connexion with the free medicine scheme. The new proposals whereby 5s. is payable to families or individuals for the first 5s. of of the charge for a prescription came into force on 1st March, 1960. I asked the Minister -
How many prescriptions have been supplied since this date?
That was under the new scheme, and his reply was -
In the eleven months to the 28th February, 1961, payment was made for 17,448,497 prescriptions, not including prescriptions dispensed for pensioners.
I was further advised that none of these prescriptions was worth less than 5s. I then asked -
What was the cost to (a) the Government and (b) individuals of prescriptions supplied on the new basis?
The Minister replied -
For the prescriptions referred to in (2.) above, the cost to the Government was £14,720,665 and the cost to individuals was £4,257,193.
This means, in effect, that individuals in this community, in addition to paying extra income tax for what is supposed to be a free medicine scheme, are bearing 20 to 25 per cent, of the cost of prescriptions through the 5s. charge that is levied for every prescription that is dispensed. Although the Government talks of its free medicine scheme, the public should keep in mind that it is paying for the scheme, not only in income tax directly levied, but also by a charge for each prescription which covers at least 25 per cent, of the cost of drugs supplied.
– That is not a free scheme!
– Of course it is not. The people are paying, I suppose, more than 50 per cent, of the actual cost of the medicines they receive. This is a startling commentary on a scheme which was introduced by a government pledged to remove all means tests on social services. The figures are exceedingly interesting. They show that the Government has taken from the public, in payments for prescriptions, about £4,250,000, to which it cannot be said to be entitled in any way.
– What nonsense you talk!
– The honorable member finds it hard to understand me, because I am talking sense. On one of the few occasions when he happens to be awake he ventures to interject, not being able to understand the proposition that I have clearly put forward. It is obvious that the Government is putting one over the people. The national health scheme is far from free, and it is far from being as comprehensive as is desirable. I was also advised by the Minister -
In the eleven months to 29th February, 1960, Commonwealth expenditure on general pharmaceutical benefits was £17,574,112, including approximately £4,000,000 for drugs supplied to pensioners from the then general list of benefits. From 1st March, 1960, payment for pensioner benefits, which are provided free of charge, has been recorded separately.
I point out these facts to show that the people are bearing practically the full cost of medicine supplied under the national health scheme.
With regard to pharmaceutical benefits, I wish to make some remarks concerning pensioners. It is worth repeating again and again that this Government was elected on a policy which involved the abolition of the means test on social services. That policy is embodied in an historic document which is available for all to study. It is interesting to note that on 31st October, 1955, a most vicious means test was imposed on pensioners desiring to obtain medical benefits cards. From that date, any pensioner receiving more than £2 a week in addition to his pension was not eligible to obtain a medical benefits card. A pensioner couple receiving in the aggregate more than £4 a week in addition to their combined pensions were similarly debarred from obtaining free medical benefits.
This change of procedure was undoubtedly dictated to the Government by the British Medical Association, and the Government, as usual, capitulated to that august body. The position now is that a large number of pensioners are not entitled to a medical benefits card because they happen to be receiving, say, £2 ls. a week in addition to the pension, or, in the case of pensioner couples, £4 2s. a week over and above their combined pensions. This has caused glaring anomalies. Some pensioners receiving a good deal more than £2 a week in addition to the pension are also enjoying free medical benefits because they qualified for them before 31st October, 1955. Others with much lower incomes are denied these free medical benefits, lt is possible to find brother and sister earning the same incomes, one receiving free medical benefits and the other being denied them.
Anomalies by the thousand can be found in the operation of the new merged means test. Honorable members on all sides of the House are constantly approached by people who ask why they are denied benefits when they know of others in better financial circumstances who are receiving those benefits simply because they qualified for them before 31st October, 1955. I do not know what the saving to the Government has been by the introduction of this means test, but in a Budget of £1,700,000,000, I hardly think the cost would be noticed. It appears to me that there cannot be, by any stretch of the imagination, any justification for denying free medical benefits to certain people, while extending them to others more favorably situated financially, simply because they were receiving such benefits before 31st October, 1955. I do not wish to take the benefits away from the pensioners who are now enjoying them, and who were originally granted them at a time when the Government was temporarily carrying out the policy on which it had been elected. I believe, however, that many thousands of others should also be granted similar benefits.
The Opposition has consistently brought this matter to the attention of the Government. There have been occasions on which we have proposed this question as a matter of urgent public importance for discussion by the House. The Government, however, has been completely unmoved by our approaches. I assure the Minister once again that many thousands of people are being denied benefits to which they are entitled. Many of them have incurred heavy medical expenses and have had to suffer real hardship because they have been denied these benefits. I urge the Minister to review the position, in the interests of justice, so that pensioners receiving a little more than the permissible income may be granted this assistance to which they are justly entitled.
Let me suggest to the Government that it should speed up the process of including on the official formulary drugs that are, from time to time, considered necessary. At present we frequently find :hat a considerable time elapses, after a decision is taken to include certain drugs in the formulary, before they are actually placed on the official list. I believe also that an investigation should be carried out to ascertain why certain drugs, which have been on the formulary for a long time, are suddenly deleted from it. It seems to me that some kind of favouritism is being indulged in, some firms being able to have their drugs included in the formulary without great difficulty, other firms finding it most difficult to arrange for the inclusion of drugs which they distribute. I can see no reason at all why the Government should not do what it frequently suggested should be done by the Labour Government when it was in office, and have all available medicines, or all those that might possibly be needed, included in the formulary. I see no reason why the list should not be complete in every detail, or why various drugs should be deleted from time to time. When the Labour Government introduced the original scheme, the then Opposition claimed that it was a socialistic scheme, and that the Government of the day was taking one of the first steps towards socialism. We know now, of course, that the present Government does not hesitate to go socialistic when it suits its political tactics. The Chifley Government was criticized by the then Opposition, which suggested that the formulary should cover a complete list of drugs. It appears logical to me that this Government, which includes many members of the then Opposition who levelled thai criticism, should not adopt the suggestions that were made then, and provide an unlimited formulary.
This matter is of some importance, because many unusual medicines are sometimes necessary for the treatment of various ailments, even though the Government might make some arbitrary decision that such medicines are not sufficiently useful to be included in the list. lt seems amazing that in devising a national health scheme the Government has made no provision for one of the most important aspects of national health, dental treatment. In the Government scheme there is no provision whatsoever for dental health, even that of children. This is alarming when we remember that, a survey carried out not so long ago revealed that nine out of ten people in Australia have bad teeth. Notwithstanding this startling fact, the Government has made no attempt to safeguard the dental health of the people. When the Labour Government was in office it was in the process of training dental nurses, and it was about to embark on a scheme under which the dental health of the people would have been protected. In this day and age when the figures available indicate that the teeth of Australians are amongst the worst in the world, something should be done to make free dental treatment available to all sections of the community. If the Government will not go that far at this stage, at least it should make free dental treatment available to the children in the schools so that the basis of good health will be established and maintained in that important aspect. No health scheme, irrespective of who introduces it, can be said to be complete unless it covers this essential sphere of health. I do not doubt that the Minister for Health as a medical man realizes from his own knowledge of these matters the contribution that would be made to the general health and welfare of the people of this country if dental treatment were provided as it should be and as it is in other parts of the world.
Another great failing in the health scheme is in relation to optical treatment. It is amazing! The Government apparently does not want the people to have good teeth and it does not care much whether they go blind. Those two gaps in the scheme are glaring anomalies and indicate the need for liberalization. Optical and dental treatment are very important and I hope that the Minister, when replying, will tell us what the Government has in mind and whether consideration will be given to these aspects.
The Deputy Leader of the Opposition (Mr. Whitlam) dealt with the matter of free hospital treatment. The Government should be reminded now that when a Labour government was in office it set up an all-party committee to consider matters relating to social services. I was honoured to be a member of that committee which included also Senator Sir Walter Cooper, Sir Frederick Stewart and other members of all parties. After a most searching investigation the committee recommended unanimously that hospital treatment be completely free of any means test. The government of the day accepted that recommendation and a scheme was introduced. It is to the eternal discredit of the present Administration that it abolished that scheme, which was of great benefit to the people, and restored the means test - one of the most degrading features of days gone by, which denies many people the hospital treatment to which they are entitled. Only one State, Queensland, was able to maintain free hospital treatment. That was because the Labour Government of that State had built up certain reserves. Although the gun was held at the head of the State Government by the Commonwealth Liberal Government, the Queensland Government insisted on giving the people of that State free hospital treatment. Unfortunately, however, the scheme is on the way out because Queensland has been cursed by the election of a Liberal-Country Party Government, which does not believe in free hospital treatment and cannot finance it in any case.
It is no good saying that Labour’s scheme would not work. It was working and would have continued to work if the Commonwealth Government had followed its election promise to put value back into the £1. Instead, it allowed all costs including hospital costs to run riot, and hospital fees increased so steeply that a substantial increase in hospital benefits would have been necessary. The Government would have done well to follow the policy which was laid down by the present Minister’s Labour predecessor and which had the endorsement of an all-party committee of this Parliament.
That policy provided for free hospital treatment. This could have been ensured quite easily by increasing the Commonwealth’s hospital subsidy. It started at 6s. a day, then went to 8s. but it has not kept pace with increasing costs. I see no reason why it was necessary to abandon Labour’s scheme and to revert to the old means test system. The Labour Government proved that the scheme could be administered in a progressive way and this Government at least should have maintained the scheme and refused to re-impose the means test which is working to the detriment of the sick, the aged, the infirm and the needy.
While I appreciate that there may be many good points in the present national health scheme, I make these few observations because I believe the Government should be reminded that had it not been for a Labour Administration none of these matters would be under discussion now. Labour’s social service proposals were always bitterly opposed by the members of the present Government parties who to-day take credit for what is being spent on social services. The real basis and foundation of our social security was laid down by Labour Governments in Australia, particularly in the Federal Parliament, in the face of bitter opposition. Therefore, I think it is well to remind the Government that the scheme contains many anomalies. The provision of free medicine was introduced by a Labour government. The scheme could be made much more beneficial if it included all drugs and if the people were not charged 5s. for each prescription as they are to-day, as well as being taxed to meet the cost of the scheme.
I see that the honorable member for Mallee (Mr. Turnbull) has looked up. He was one of the bitter critics of the social services scheme. To-day he is reformed and emancipated, and he praises this great social services scheme as something that was introduced by a Liberal free-enterprise government. That point of view is advanced continually so I think it is well to let the people know the background and to place on record the fact that credit must go to a Labour Administration for having laid the basis of our social welfare scheme. If Labour had continued in office, that scheme WOUld have been well-nigh perfect to-day but it is being destroyed by this Government which seeks to save money at the expense of giving com- plete social security to the people generally. I make these few constructive comments in the hope that the Government will learn from the wisdom of my remarks.
– This bill reminds me of the practice of a company which manufactures motor cars in Australia. Every year or so the company introduces what it calls a new model and gives it new initials, but in reality it is just a face-lift. This bill is really only a facelift of the National. Health Act. The Minister for Health (Dr. Donald Cameron) when introducing the bill admitted1 quite candidly that it was really only a machinery bill designed to overcome certain disabilities in relation to the administration of the act and would do nothing much to give relief to the people. I shall tell the Minister how he can provide a little relief in one respect.
If a person over 65 years of age suffering from a chronic illness is a patient in a hospital and is listed on what is called the special account, he cannot receive more from the hospital fund than the actual hospital account even though it may amount to only £20 and he has contributed for £30. This has been done in an effort to conserve the Government’s funds. If a person is under 65 years of age and is insured with a hospital fund to receive £30 a week, including the Government’s contribution, should he be in- hospital, and the hospital, account comes to only £20, he receives the full £30. The Minister now has proposed an amendment to the act designed to enable people over 65 years of age who suffer from a chronic illness to receive the full amount for which they are insured.
The special account system causes hardship to many people. Consider my own case. I have been in a hospital fund and a medical fund since their inception. In fact, for very many years before that I was in a friendly society medical fund. It is now well over half a century since I started contributing, as a juvenile in a lodge, for medical attention. As soon as I reach 65 years of age I have to go on to the special account and cannot obtain the benefits that a person under 65 is able to obtain. Let us see how this will affect the people generally. Take the matter of hospitalization, which is the one with which I am most concerned. When the Chifley Government first introduced the hospital benefits scheme, by agreement with the States, the Commonwealth paid 6s. a day for every bed occupied in a public hospital or in a public ward of any hospital, provided that no charge was made to the occupant of that bed. At that time, the Royal Adelaide Hospital, which had 600 or 700 beds, was a public hospital. The effect of those provisions was that the hospital did not send a bill to anybody, but it was paid 6s. a day for every occupied bed. The patients did not have to pay into a fund.
There has been a remarkable change since then. The Government has increased the payment for each patient to 8s. a day. If a patient is not a contributor to a hospital benefits fund1, the hospital deducts 8s. a day from the account, and the Government pays that amount to the hospital. But if a patient contributes sufficient to a fund to get a benefit of £2 2s. from the fund, the Government contributes another 4s. a day, making a total of 12s., towards the patient’s hospital benefit. If the patient pays for a benefit of £6 6s., the Government contributes 20s. a day.
This Government has not approached’ the subject of hospital charges from the point of view of the needs of the people, lt is prepared to pay more to a person who can afford to contribute to a hospital benefits fund, and less to a person who cannot afford to dp so. The Australian Labour Party is definitely opposed to that principle. We are opposed to preference being given to a person simply because he can afford to pay into a fund. The policy of the Labour Party is to pay the same benefit to a person whether he joins a fund or not. We do not believe that the Government should say to the people, “ Unless you are prepared to join a hospital benefits fund, we will not give you more than 8s. a day “. This may appear to some people to be a good way to get the people generally to do something for themselves, but let us consider the case of the pensioner. When the system of hospital benefits was first introduced, the Government paid 6s. a day to the hospital for each patient and the pensioners did not pay anything. The Queensland Government stood out and it still provides free hospital treatment. The Royal Adelaide Hospital was a public hospital until several years ago, and pensioners were not charged for treatment unless they had an income.
The position is altered now. Just over twelve months ago, the Government introduced a new set of rules. It informed the Royal Adelaide Hospital that it must charge £3 a day for every bed occupied in the ordinary public wards no matter who occupied them. If the hospital authorities were satisfied1 that a patient could not pay £3 a day, the charge could be reduced to 10s. a day. A pensioner who goes into hospital to-day is charged a minimum of £3 10s. a week out of his pension of £5. I asked the hospital authorities what a pensioner could do in those circumstances because he would have to pay rent for his house or a room while he was in hospital and at that time he would have only £1 7s. 6d. a week left out of his pension after paying the hospital. The pension rate then was Ss. less than it is to-day. I asked how the pensioners were going to live. The hospital authorities said they were advising the pensioners to join a hospital fund.
I attended meetings of pensioners in my own district. I told them what the minimum charge would be under government regulations and that they would have to find £3 10s. out of their pensions. I told them that by paying 9d. a week into a hospital benefits fund, they would get a benefit of 38s. a day from the fund and the government contribution. But then I found there was another side to the question. A person who came to me said that his father had been in hospital for some months. He was sent a bill for £3 a day. Because the patient’s wife had £160 in the bank, the hospital would not reduce the charge to the minimum of £3 10s. a week. If a pensioner owns a motor car, he is told, “ You can pay £1 a week above the minimum “.
I admit that there is no reference to this matter in the bill, but I take the opportunity to put the facts before the House so that the Government will understand the great disabilities under which these people are suffering. Some persons might think that a contribution of 9d. a week to a hospital benefits fund is not much; but even the Government has recognized that a single pensioner paying rent for a home needs additional assistance to the extent of 10s. a week. In other words, the Government has recognized that every shilling counts with the pensioners. I suggest to the Minister for Health (Dr. Donald Cameron) that more should be done by way of hospital benefits.
The Deputy Leader of the Opposition (Mr. Whitlam) referred to conferences that had taken place between State Departments of Health and Ministers for Health and what they had asked for. I am not going to dwell on that aspect because we know that Ministers in charge of health, education and housing in the various States all want more from the Commonwealth to enable them to carry on. All this is linked with the general feeling in the States that the Commonwealth should be the benefactor. Many people do not like the welfare state. They did not like the Australian Labour Party when we introduced the welfare state provisions into Australia.
Some years ago I was in Tasmania when Dr. Fisher, who was then the Archbishop of Canterbury, spoke in the big City Hall in Hobart after church on a Sunday night. I was one of the big congregation that assembled. Dr. Fisher spoke on the welfare state. He told the audience what was being done in England and he referred to the objections that were raised to the welfare state when it was introduced by a Labour government. He said, “ Now, no government would dare to do away with the welfare state in England or in any other country where the people have experienced its benefits “. The position is the same here. I do not think the Government would want to do away with the welfare state; no government would dare to do so. The situation is the same throughout the world. Some thirteen years ago I happened to get into conversation with a lady from one of the Scandinavian countries while I was returning to Australia by sea from San Francisco. We talked about social services. This occurred during the Chifley Government’s term of office, not long after that government had introduced its national health scheme, and while it was still trying to bring in a free medicine scheme. She was amazed to discover that in a country like Australia we had such poor facilities and social services to aid afflicted people in the community, and she told me about what was done in that field in the Scandinavian countries.
Consider the position in Great Britain to-day. The British authorities do not get down to all the detail we get down to in regard to entitlement to free health services. They do not tell people that the cost of an operation must be shared between the health service and the patient. Their attitude is that if it is necessary for a person’s health that he enter a hospital for treatment or for an operation, the health service will pay the bill. Honorable members may say that there is a weekly contributory scheme of national insurance operating in Great Britain. That is quite true, but the British Government pays a tremendous sum directly to maintain the British health services. Not all the cost, therefore, is met by the beneficiaries of the service through their weekly national insurance payments. It must be remembered also that amounts paid by British taxpayers in weekly national insurance payments are allowable deductions for income taxation purposes. On the other hand, the Australian taxpayer pays a huge amount in income tax in order to finance Australia’s social services and health service. So although Australian taxpayers do not contribute to the cost of these services on a weekly basis as in Great Britain, they contribute in the form of income tax.
I am sorry that we are not now having a complete overhaul of the National Health Act instead of merely giving it a face lift in respect of some of its provisions, such as the provision regarding operations. I wish we were dealing with the act in a wider sense. It is all very well for the Government to say that people should do something to help themselves, but I remind the Minister that there are many people who are having a very tough time. I want to hark back to the position of people who are over the age of 65 years. I could tell honorable members of case after case in nearly every street in my electorate of families the father of which has died, the children are all married, and the mother is failing in a great effort to keep the home going for herself. Finally her health reaches the stage where she needs nursing attention. It is not that she needs treatment at home by a doctor, or treatment in a hospital; she need nursing attention which she cannot have at home, so she must go into a nursing home. Directly she does so she, or her relatives, must pay £15 or £18 a week in fees to the nursing home. That is the general weekly,
Another sad aspect of the position of such old people is the impairment of their hearing through age. Whilst they do not go stone deaf, they have great difficulty in hearing, and sometimes people are reluctant to visit them because it is so difficult for them to make these hard-of-hearing old people understand what they are saying. Marry of those old people do not possess hearing aids, and cannot afford to buy them. We have made one step forward in making hearing aids available free to people who are entitled to benefits under the repatriation legislation. I am constantly telling age pensioners that if they served in the forces in war-time they should apply for a service pension instead of their civil pension, because, although the amount of pension they receive will be the same, they will be entitled to treatment in repatriation hospitals, free hearing aids and so on. They also ‘will still be able to have attention at home (from .their local medical officer in exactly the same way as they receive it under the pensioner medical service.
There is an anomaly between drug prescribing under the repatriation service and drug prescribing under the pharmaceutical benefits scheme. The repatriation doctor is not limited as to the drugs he may prescribe which a patient may obtain free. The doctor may prescribe a special drug which will be of great advantage to the patient. I can tell the Minister that I do not know how many transfers of old people from the pensioner medical service to the repatriation health service I have been responsible for as the result of the advice that I have given. I give those people that advice only because I feel that they
The extension of repatriation health services to cover such people has been in operation for only .a few years, but it is a step forward. I appeal to the Minister for Health to-night to take a similar step forward for the benefit of ordinary pensioners who are not entitled to transfer to the repatriation pensions field. The Department of Health might at least make hearing aids, and even dentures, available free to these people. Honorable members opposite may say that that .is the job of the States. The plain fact is that no State does that job or accepts that responsibility, so these people continue to suffer under a great disability.
Now I come to a matter that has been raised by a number of members on this side of the House - the approved list of drugs available for 5s. per prescription under the pharmaceutical benefits scheme. It is rather remarkable that in order to receive Commonwealth hospital or medical benefit it is necessary to be in a hospital or medical fund, but in order to receive a prescription for 5s. it is not necessary to belong to any fund. Whether a patient has an income of £100 a week or is like the ordinary run of person receiving only £15 a week, he is entitled to have a prescription filled at a cost to him of only 5s. That is another anomaly into which the Government might look.
Honorable members may say that payment of contributions to a hospital or medical fund is not a heavy burden on people. They would be amazed at the number of people who come to me and tell me that they are now receiving pensions and ask whether they should still pay into a hospital or medical fund. I tell them that they do not need to belong to a medical fund provided they are eligible for the pensioner medical service. There is an anomaly here. If a pensioner and his wife have an income of £3 a week, they are entitled to a medical card. If one dies and the other continues to receive the income of £3 a week, the medical card is recalled. This would not have been so some seven years ago. Let me illustrate another anomaly. A pensioner may have no income and is given a medical card. In order to supplement his pension, he obtains a job and earns £5 a week. The department knows that he must furnish an income tax return for this amount, and when the return is furnished the medical card is withdrawn.
When this scheme was first introduced, it was a free medical system. A pensioner getting a pension of as little as Ss. a week was given a medical card. I remember the Minister for Health in those days - not the present Minister - saying that this showed that pensioners received greater benefits under his Government than they had received under a Labour government. Full use was made of the fact that even those receiving a pension of Ss. a week could obtain a medical card. 1 do not know that it was altogether the Government’s fault that this provision was removed some years ago, but when the scheme was amended, we found that if a pensioner had income of more than £2 a week, he could not get a medical card.
That cut down the matters about which the Government was rightly able to boast. It also created two classes of pensioners, with a clear division between them. Whereas the pensioner whose income did not exceed £2 a week could obtain a medical card, the Government held that those receiving more than £2 a week could afford to pay for their medicines. However, some of those who could not obtain medical cards were hurt, and this was particularly so with single persons. If single pensioners receiving a pension of £5 a week have an income of £2 2s. a week, making a total of £7 2s. a week, they are not entitled to a medical card. These persons if they are widows or widowers, probably pay the same amount of rent, as was paid before the spouse died. Expenses have not been halved, but because the income exceeds £2 a week, the pensioner is not entitled to a medical card.
These are the matters that stick in the gullet, if I may use that expression. I know it has been put that a couple in receipt of a pension of £10 a week and income of £7 a week, or a total of £17, should not receive free medical services. I quite accept that. Some of these people are better off than the working man is. But the point is that there is a great difference between a couple with a total of £17 and a single person with £7 2s. I have noted through the years that immediately a line of demarcation is introduced, whether it be in union affairs, social services or anything else, difficulties arise. It is very difficult for those who administer this scheme to say to Smith, who has an income of £2 ls. a week, “You are not entitled to a medical card “, whilst saying to Jones, who has an income of £2 a week - only ls. less - “ You are entitled to a medical card “. I know the argument that applies when larger amounts are involved, but I think we should recognize our national responsibility to maintain the good health of the community, and we should see to it that our health services are extended so that every one is entitled to the fullest measure of medical attention and hospital treatment, whether he is able to pay into a fund or not. We do not think that the right of entry to a fund, through which the Government will pay a portion of a person’s medical expenses, should depend on the ability of that person to pay the remainder of the expenses or the contributions to the fund.
I do not desire to say any more on this matter. 1 have tried to put the main points, as I see them. I appreciate that in this bill the Minister has tried to effect general improvements to the scheme, but these improvements, except for one small matter, are only administrative. I hope that something more will be done. I know that the Minister may say that these people over 65 years of age did not join a fund.
Order! The honorable member’s time has expired.
– The honorable member for Port Adelaide (Mr. Thompson) and other Opposition members have put the views of the Australian Labour Party on public health very well and very forcefully. We support the bill, but we think it does not go far enough. We think it is a very small advance and we hope either this Government will do the right thing and do all that we wish to see done or we will do what we think ought to be done when we become the Government.
– About when will that be?
– It will be after the next election. The honorable member for Mallee will probably still be in the corner of the Mouse where he now sits but he will be supporting an Opposition. I do not think he will need to change his seat in the next Parliament, because that is where he sat once before. However, I do not wish to be diverted by any observation of the honorable member for Mallee.
I will not detain the House very long. There were one or two matters 1 thought ought to be mentioned in addition to those that have already been mentioned. We of the Labour Party have always contended that the health of the community is a matter of paramount importance, that medicines and hospital treatment should be made as cheap as possible and every benefit of science and of medical skill should be made available to every member of the community without charge and without discrimination. That is the objective. We will reach it gradually and, of course, it will have to be paid for, but we believe that the community will benefit when that desirable situation is reached.
I happen to have in my electorate the Commonwealth Serum Laboratories. I have always had an unhappy feeling, as have all Opposition members and people outside the Parliament, that this Government did try to sell the Commonwealth Serum Laboratories and that this Government would sell the laboratories if it could. The laboratories were established not by a Labour government but by a non-Labour government. We think that the Government is under pressure from a certain element in its own ranks - the ranting element dedicated to the doctrine of free enterprise, which would destroy the Commonwealth Serum Laboratories or reduce the efficiency of the organization and then sell it for a part of what it is worth.
– There is no basis for that.
– I am glad to have the assurance of a back-bench member, the honorable member for Bruce, that there is no justification for believing the Government ever had any intention of selling the laboratories. A few years ago, every evidence was available that the sale was about to be made. Be all that as it may, this is the situation with the Commonwealth Serum Laboratories to-day: The manufacture of penicillin in the laboratories is, according to my information, now suspended entirely. If that is so, the Government has much to answer for. If that is so, the Government should tell the House why such a step has been taken.
I am told, too, that penicillin is now being produced by private firms because they can make more profit out of it. If, at enhanced profit to themselves, private firms can make this penicillin which used to be made by the Commonwealth Serum Laboratories, there is no reason why the Commonwealth laboratories should not make this life-saving and most important drug - and make it in very great quantities. The story which I hear is that the Commonwealth Serum Laboratories are losing money at an increasing rate. That could be. I see no reason why an institution of this sort which is benefiting the community greatly should not be put on a commercial basis and be expected to make profits as well as serve the public interest. I should like the Minister for Health (Dr. Donald Cameron) to explain here what is happening to the laboratories to-day, or have an explanation made when this bill is before the Senate. If there is any justification for the suspicion that everything is not right in the Commonwealth Serum Laboratories, an investigation ought to be made by the Public Accounts Committee, by any other authority of this Parliament or by the Department of Health itself, and the results of that investigation ought to be made known to the general public.
My suspicions as to what is happening are always aroused when I read the trade and financial columns of the capitalistic press. In to-day’s Melbourne “ Age “, I read the story of Sigma Company Limited, wholesale druggists and manufacturing chemists.
– That company is a bushranger!
– I was going to describe it as a bandit, but out of respect for the honorable member for Wide Bay (Mr. Bandidt), I shall settle for the term “ bushranger “. This company increased its profit in the year ended 31st January last by £47,068- from £426,505 to £473,573. Its capital increased during the year by £174,880, and its group assets rose from £2,541,741 to £2,914,250. All this information was given in the directors’ report. Then they served up this delectable morsel, which is reported by the newspaper in these terms -
Directors say that Japanese products being marketed by Sigma are showing handsome profits.
Of course they are. This company is making profits not only in its own factories, warehouses and ethical divisions, as they are termed, in Australia, but also from the importing of Japanese products into Australia - an activity which is putting Australians out of work. If this organization can make these profits, so can the Commonwealth Serum Laboratories make profits. I ask the Minister to investigate this matter and have the facts reported to the Senate, and to report them later to this House.
The only other thing that I have to say is that the Australian Labour Party is more convinced than ever that the repatriation hospitals throughout Australia ought to be used to care for returned soldiers of World War I. whether or not their illnesses are war-caused, as is the rule in the United States of America. Indeed, in the United States, all World War II. veterans are so catered for. We also ask that cancer be made an acceptable disability for repatriation purposes and that a more sympathetic attitude be taken in all these matters. We do not accuse the Government of lack of sympathy, but we ask it to be a little more progressive in its approach to these problems, because public opinion is swinging around very strongly in favour of greater acceptance by governments in Australia, and particularly the Commonwealth Government, of more responsibility for the welfare of people who are ill, whether their illnesses are war-caused or non-war-caused - whether the people are servicemen or exservicemen or whether they are civilians. People who are ill to-day ought to get the best possible treatment at the minimum possible charge so that in the long run the community will be healthier. If all this is valued on a cash basis, society as a whole will be found to have made a very wise investment in spending money in this way.
– in reply -
Mr. Deputy Speaker, the debate on this bill has ranged very widely over the whole of the National Health Act. 1 do not intend to traverse the entire field through which the debate flowed, but shall confine myself largely to the bill. However, to begin with, I should like to say one or two things. Honorable gentlemen opposite have had a great deal to say about the deficiencies which they allege exist in the act and about various alleged anomalies to which they have directed attention, but it is a fact, as I think the Deputy Leader of the Opposition (Mr. Whitlam) pointed out, that all that this bill deals with is a few rather minor amendments of the principal act. When there is occasion again to make major amendments of the National Health Act, I shall be fully prepared to debate all the major amendments which then come under consideration. At this stage, Sir, I should like to say that although honorable gentlemen opposite have been very keen to point out what they regard as deficiencies in the present act, they should not forget that when this Government took office, there was no national health service at all, with the exception of a scheme for some totally inadequate payments to hospitals - a scheme under which every hospital in the country was going bankrupt.
Let me now come to the bill which the House is considering, Mr. Deputy Speaker. The first of the amendments which, it will make to the National Health Act deals with the definition of “ contributor “. Speaking of that amendment, the honorable member for Eden-Monaro (Mr. Allan Fraser) said that he believed, and that the Australian Labour Party’s policy was, that it ought to be unnecessary for any one to be a contributor to an insurance organization in order to receive Commonwealth benefit.
– Hear, hear!
– Let me just point out to the honorable member for Lalor something that I have pointed out in this House before: The inevitable result of enacting legislation to make such provision would be to destroy the benefit organizations and to nationalize the entire provision of benefits under the National Health Act.
– That would give the people the benefits to which they are entitled, and that is the main thing.
– Honorable gentlemen opposite are in favour of the nationalization of health services. We understand that.
– What would be wrong with it?
– A great many people in Australia think that there would be a great deal wrong with it. The plain fact is that the Australian Labour Party is once again confirming its intention to nationalize health services in Australia if it ever has an opportunity to do so.
I now go on to deal with the special accounts. I do not think that I need to discuss all of the amendments to be made to the principal act by this bill. I think that some of them are quite well understood. A great deal has been said about the special accounts to-day. In fact, one clause of this bill provides for limitations on the total benefits provided under the special account procedure. In spite of all that has been said in this House from time to time about the operation of special accounts with respect to hospital benefits, there is apparently still a good deal of misunderstanding among honorable gentlemen opposite about what happens to patients who are transferred to special accounts.
– There is no misunderstanding at all.
– I am talking about hospital benefits. If a contributor is transferred to a special account, he is not really put at a disadvantage. In fact, in many instances, the contributor is given an advantage, because he is still entitled, if he incurs hospital expenses, to benefits equal to those provided in the table to which he belonged, provided that those benefits do not exceed the hospital charge. That is to say, if he is insured under a high table and he goes into a hospital where the charge is equal to the benefit for which he is insured, he is entitled to receive benefits at that rate. If he goes into a hospital where the charge is lower than the table under which he is insured, it is true that then he only receives benefit equal to the hospital charge. But when he has exceeded his maximum benefit period, then, instead of going down to no fund benefit at all, as he used to do before-
– That is after 91 days?
– Yes. In those circumstances he then receives indefinitely payment at the special account rate until the end of twelve months and he can then return to the maximum rate for which he is ensured. There is really no disadvantage suffered by the introduction of special accounts; on the contrary, a great many people have been advantaged.
Now let me come to the questions that have been raised in connexion with the Pharmaceutical Benefits Advisory Committee. My honorable friend, the honorable member for Isaacs (Mr. Haworth) asked for some explanation of our putting more doctors onto the advisory committee. The reason is a quite simple and very good one. It is that, with the introduction of the great many new drugs and preparations in recent years, we feel that it would be an advantage to have a wider range of therapeutic experience represented on the committee. Therefore, it is proposed to increase the number of doctors on the committee.
The Deputy Leader of the Opposition (Mr. Whitlam) made many complaints about very little. He complained that the names of the committee members were not divulged. The attitude which I have always adopted, and which I have made plain in answer to questions in this House before to-day, is that, while this is not a secret committee and the names of the personnel are not secret, these gentlemen are engaged in a busy practice and discharging very onerous duties - and they are onerous duties - and I do not think it is fair for their names to be broadcast and made public so that they might then be subjected to all sorts of pressures to have other drugs put on the list. This is especially so as they act in an unpaid capacity. If either members of the medical profession, members of the public, or honorable members of this House consider that other drugs should be placed on the list, it is perfectly easy for them to make approaches to either the Director-General of Health or myself and their requests will be considered.
The Deputy Leader of the Opposition went on to say that, there had been great delay in the inclusion of drugs on the list. There is a delay, and for very good reasons. I say nothing against the research that is done in the laboratories. It is necessary. Indeed, I pay tribute to the organizations and companies who carry it out. But the real criterion can only be, not the research carried out in the laboratory but the result of therapeutic experience, and it would be quite wrong if every new drug which was tested in the laboratory was immediately assumed to be suitable for clinical use. Only clinical experience can tell us whether it really ought to be on the list or not. For that reason alone, some time must elapse between the development of a new drug and its inclusion on the list.
Another reason is that if we were changing the list every few months we would have both the medical profession and the pharmaceutical profession in confusion. Every time a new drug is put on the list, or taken from it, all doctors in Australia must be notified, all chemists in Australia must be notified and arrangements must be made about pricing. A whole series of complicated arrangements has to be made, and it would simply make confusion worse confounded if, every couple of months, we were suddenly to add to or subtract from the list. In the interests of proper dispensing, proper diagnosing and commonsense, we do not do that.
The Deputy Leader of the Opposition referred to other matters. Let me say that they were minutiae in the general scheme of things. He had a great deal to say about them, but most of them do not really matter at all. For instance, he complained about the dates on which the committee met and when I said it met. The committee does not hold a great many formal meetings, although, of course, the advice of the committee is available to the Minister almost at any time. It was perfectly true for me to tell the Deputy Leader of the Opposition that drugs are not removed from the list without the advice of the committee. Of course, it is true to make that statement. I hardly think that it is worth my while bothering to go into the other objections that have been raised about what State Ministers have said to me and what I have said to State Ministers. The plain facts are that the answers which I have given to the Deputy Leader of the Opposition have been quite true and no amount of rhetoric will put them into any other kind of context.
Reference has been made to-night to finance for hospitals. After all, there is a Federal Constitution under which the States are the bodies responsible for hospitals. There is not one State in the Commonwealth which would for one moment agree to the Commonwealth assuming any responsibility for its hospitals or for the management of those hospitals. If they charge pensioners who are in their hospitals, that is the business of the States. The Commonwealth Government does not force them to make the charge. But it is a fact that the payment made directly by the Commonwealth Government by way of Commonwealth benefit and Commonwealth additional benefit in the last financial year amounted to approximately £18,500,000. The fund benefits attracted by the payment of those Commonwealth benefits amounted to another £12,000,000. So, directly and indirectly, the State hospitals received something like £30,000,000 last year as a result of the operations of the National Health Act, a great deal of it being paid directly by the Commonwealth Government. To say that the Commonwealth Government starves the State hospitals for funds is to create a quite false impression. Not only do the State hospitals attract to themselves this amount of money because of the operations of the national health service, but they are free to allocate from all the payments and reimbursements from Commonwealth funds under the Commonwealth and States financial arrangements whatever funds they wish to their hospitals. To attempt to shift the burden of hospital debt on to the Commonwealth’s shoulders is an exercise which we all understand, but which, in fact, has really no substance.
Question resolved in the affirmative.
Bill read a second time, and committed pro forma; progress reported.
Message recommending appropriation reported.
In committee (Consideration of Administrator’s message):
Motion (by Dr. Donald Cameron) agreed to-
That it is expedient that an appropriation ot revenue be made for the purposes of a bill for an act to amend the National Health Act 1953- 1959, and for other purposes.
Resolution reported and adopted.
In committee: Consideration resumed.
Bill - by leave - taken as a whole, and agreed to.
Bill reported without amendment; report adopted.
Bill - by leave - read a third time.
House adjourned at 9.53 p.m.
The following answers to questions were circulated: -
n asked the Minister representing the Minister for Air, upon notice -
What amount was spent by the Royal Australian Air Force in connexion with the recent search for the Carpenter family in north Queensland?
– The answer to the honorable member’s question is as follows: -
The Royal Australian Air Force is called upon many times throughout each year to engage on mercy missions. In such cases where the possibility of saving lives exists consideration of the costs associated with these ventures would seem inappropriate. In this case the Royal Australian Air Force flew two aircraft for a total of 14 hours 35 minutes at an estimated cost of £1,154.
ser asked the Minister for the Interior, upon notice -
– The answers to the honorable member’s questions are as follows: - 1. (a) 732 houses; (b) 157 flats. 2. (a) 306 houses; (b) nine flats. 3. (a) 72 houses; (b) one flat.
n asked the Minister for Territories, upon notice -
– The answers to the honorable member’s questions are as follows: -
In addition, a five-year plan for the reconstruction of the Stuart and Barkly Highways was commenced in 1958-59 and an amount of £499,900 was spent on this project.
These figures do not include sums spent by the Darwin City Council upon roads in Darwin. Special Commonwealth grants were made to the council for construction, reconstruction and arrears of maintenance of town roads amounting to £10,000 in 1957-58 and £65,000 in each of the years 1958-59, 1959-60 and 1960-61.
Cite as: Australia, House of Representatives, Debates, 19 April 1961, viewed 22 October 2017, <http://historichansard.net/hofreps/1961/19610419_reps_23_hor30/>.