25th Parliament · 1st Session
The House met at 2.30 p.m.
The Acting Clerk. - I desire to inform the House of the unavoidable absence of the Speaker, who is on parliamentary business overseas. In accordance with Standing Order No. 14, the Chairman of Committees will take the chair as Acting Speaker.
Mr. ACTING SPEAKER (Mr. Lucock) thereupon took the chair, and read prayers.
Mr. LUCHETTI presented a petition from certain citizens of the Commonwealth praying that action be taken, through Constitution alteration referendum proposals, to give the Commonwealth power to make laws for the advancement of the Aboriginal people and prevent the making of laws which would discriminate against any person bom or naturalised in Australia.
Petition received and read.
– I wish to inform the House that the Treasurer (Mr. McMahon) left Australia on 16th September for Canada and the United States of America. In Canada, the Treasurer will attend the meeting of the Commonwealth Economic Consultative Committee, comprising the Finance Ministers of the Commonwealth. In the United States, he will attend the annual meeting of the International Monetary Fund and the International Bank for Reconstruction and Development. I shall act as Treasurer during Mr. McMahon ‘s absence.
– I desire to ask the Prime Minister a question. Has the Government decided to send a third battalion of Australian troops to Vietnam in the near future? Earlier this year, the Prime Minister said that the position would be reviewed from time to time. Has any review taken place? According to senior defence officers, the sending of a third battalion to Vietnam has already been determined. Will the Prime Minister make an announcement about this important matter before election day, 26th November?
– The answer to the first part of the honorable gentleman’s question is: “ No “. As to the second part, what he has said remains the position. I am not aware of the views expressed by officers of the Services to whom the honorable member refers. As to whether or not any announcement of Government intentions should be made, 1 have already stated the general attitude of the Government in that we do conduct a review from time to time. When any review is conducted which requires a public announcement, that announcement will be made.
– My question is directed to the Minister for Health. I refer to the statement by the Director-General of Health in regard to the activities of medical detailers. It seems unlikely that the business houses concerned would employ more people than is necessary to cover the field. In addition to calling on general practitioners, as stated by the DirectorGeneral, do these representatives also call on specialists, chemists, hospitals, diagnostic laboratories, Government departments such as the Repatriation Department and the Department of Territories, State authorities, and in many cases veterinary surgeons? Is the Director-General’s ratio of one detailer to five or six general practitioners sadly out of line with the facts? Whilst the medical profession is amply trained in recognising symptoms of disease, how else than through the activities of detailers could a busy doctor find out what is available for him to prescribe for specific conditions?
– Of course, the opinions expressed by the Director-General in his report to the Parliament are his own. I have no reason to doubt that what the honorable gentleman says about the additional activities of detailers is correct. But at the same time, the Director-General has formed the conclusion that the activities of large numbers of detailers is one of the factors responsible for the rising cost of the pharmaceutical benefits scheme, and I have no reason to doubt that that assessment is correct.
– I direct to the Minister for the Navy a question concerning a dispute over payments made to professional and other officers in connection with trials of ships afloat or approved by the Naval Board. Has the Minister received a letter from the Association of Architects, Engineers, Surveyors and Draughtsmen of Australia indicating that as from 15th August last their members would not participate in any further trials of ships afloat unless payment was made in accordance with the practice adopted prior to April 1965? Will the Minister assure the House that he will treat the claim of the Association as urgent and take action to meet it, and thus avoid a possible extension of this dispute?
– Quite a lot of correspondence has passed between me and this Association. As far as I can ascertain - and I am pretty certain - all payments have been made according to the conditions that were laid down. It is true that conditions have changed recently because of the introduction of new types of ships. At present my Department is conducting a survey of the terms and conditions of payment to these officers, and I can assure the honorable member that the Association will be consulted by my Department before finality is reached as to those terms and conditions.
– My question is directed to the Minister for Social Services. I should like to recall to the honorable gentleman that a question was directed to him in this House in May this year on the subject of class A widows. In that question he was requested to endeavour to obtain an increase in the general rate of pension, an extension of the permissible income applying to children, and an increase in the educational allowance. Bearing in mind the fact that the first two requests have since been granted, I ask the honorable gentleman: Will he continue to recognise the need and urgency of granting an education allowance to the class A widow, so that she may be spared the inhibitions and complexes resulting from the necessity for her or her child to seek, with the knowledge of the child’s school friends, welfare assistance by way of exemption from payment for text books, library fees and sports commitments?
– The honorable member has brought this matter to my notice on many occasions, not only here i.n the House but also outside. In fact, I think there are few members who have worked more actively in the field of assistance for civilian widows.
– Then why has the Minister not done something about it?
– As the honorable member has explained, he has asked for three things. The first is that the general rate of pension be increased, and this, as the Leader of the Opposition is aware, has been done in this year’s Budget. Secondly he has asked that the amount of permissible earnings be extended, and this also has been done. As to the education allowance, this has been considered in the past but, as with many other things in the field of social welfare, it is not always possible to do everything that one would like. 1 can assure the honorable member that his request has not been forgotten; but if he compares the pension and permissible earnings of civilian widows wilh those applying to other members of the pension community, I think he will agree that civilian widows are fairly well treated at the present time.
– I wish to ask a question of the Minister for Trade and Industry. Has he read a statement by Mr. Douglas Jay, President of the Board of Trade in Great Britain, to the effect that Australia should import much more from Great Britain and that since 1947 an inflow of capital to Australia to the extent of $2,500 million has come from Great Britain? Is not this figure of $2,500 million the amount by which the value of goods imported into Australia from Britain has exceeded the value of goods exported from Australia to Britain? In other words, is it not the extent of Australia’s adverse balance of trade with Great Britain during the period in question? If this is so, will the right honorable gentleman suggest to Mr. Douglas Jay that Great Britain should import more from us and export less to us?
– It is true that we have imported from Great Britain in recent years more than we have sold to her, but there is no mathematical relationship between the amount of capital inflow and the value of imports from Britain. The truth of the matter is that all Australians have wanted this country to develop at a pace faster than would have been possible using only our own savings, and there have been accretions of exchange available from investment in this country which have been used to sustain the tempo of our growth and development. While this has been going on, Australia has been importing from many countries other than Great Britain, but I can point out that while the proportion of our total imports coming from Britain has fallen over the last 10 years from 40 per cent, to about 28 per cent, the value of imports has increased from $600 million a year to some $760 million a year.
– My question is directed to the Minister for Primary Industry. Has consideration been given to the provision of subsidy on nitrogen fertilisers held by resellers at the date of the commencement of the nitrogen fertiliser bounty, 16th August? Will provision be made to enable such a benefit to be passed on to primary producers?
– The Government has now decided that all stocks of nitrogenous fertilisers held by resellers at midnight on 16th August last, the time from which, as the Treasurer announced, a bounty on nitrogenous fertilisers would be paid, would be subject to the bounty. Holders of unsold stocks will have to comply with the requirement of the Minister for Customs and Excise that they get a declaration of stocks form from their suppliers, complete it and return it to the suppliers, who will then make the necessary claim.
– My question is directed to the Minister for Air. I ask: Has he any later information about the cost of the Fl 11 aircraft? What are the hidden costs that are being referred to by the Senate investigation committee in the United States of America? Does the Minister still insist that the base price of each of these aircraft will be $5.3 million? What will be the total cost of the 24 machines? Does his estimate include the cost of spares and accessories and also reconnaissance gear? What will be the cost of the missile system that will be needed for the aircraft?
– As I have announced to the House, the cost of the aircraft will be the figure conveyed to us by the United States authorities -$US5.95 million each. The additional cost of reconnaissance equipment, longer wing tips and the strengthened undercarriage has already been announced to the House. I have also told honorable members that a mission is at present overseas investigating the numbers and types of spares and the ground handling equipment that will be needed. When the mission has returned and presented its report to me, I shall be in a better position to announce the cost of these items. As I have told the House on other occasions, while the mission is engaged on its taskI cannot do more than Testate the estimates that already appear in the Budget Papers.
– I address a question to the Minister for Labour and National Service. Has the Government’s adult training plan been scrapped because of opposition by the unions and the Labour movement generally? Was the Government’s plan designed to overcome the shortage of skilled tradesmen? Will Labour’s opposition mean that skilled migrants will be absorbed in the highly paid skilled positions while untrained Australians will have to accept lower paid jobs?
– The Government and my Department have put forward for discussion a number of proposals relating to adult training. Discussions have gone on for quite a while and are now about to be resumed in another form. Naturally, opinions about the best methods of training differ widely. I certainly would not isolate any particular group, Labour or otherwise, as having a view distinct from that of everybody else. The Government’s scheme is designed to help make up the grave shortage of skilled tradesmen that we have in so many fields. I would say that for many years to come there will be plenty of opportunities for both skilled men whom we train here and those who come from overseas. I remind the honorable gentleman that at present in the electrical and metal trades we have five or six vacancies for every skilled man offering for employment.
– I address my question to the Prime Minister. I preface it by saying that last April I asked a question about the Australian Government’s attitude to the bombing of Hanoi and Haiphong. The right honorable gentleman’s reply on that occasion did not disclose what the Australian Government’s attitude was. Indeed, its attitude was not known until the United States of America bombed those two cities. The Prime Minister then said that he would go all the way with L.B.J. Is this still his attitude? Does this view extend to the bombing of the dams and waterways of North Vietnam and to the invasion of that country by land forces?
– I do not indicate a view of hypothetical situations, but my previous support was given in relation to the bombing of carefully selected targets in the areas of the cities mentioned by the honorable gentleman and in respect of which exercises designed to enable the greatest measure of precision to be applied had been carried out over a considerable period. The Australian Government was aware of the nature of the action contemplated and the measures which had been taken to ensure that danger to civilians was reduced to a minimum and that the targets were undoubted military targets. At the time, I indicated my lull support for the policy - a support which continues.
– I ask the Minister for Trade and Industry a question. Is Australian industry paying sufficient attention to design, inspection, packaging and general quality of manufacture? Has the Minister’s attention been directed to recent adverse criticism in Asia which could affect the expansion of sales of our products? What are manufacturers doing in these fields? What action is embraced by the Government’s programme to help remedy any defects?
– It has never been my custom to be satisfied with any state of progress or development but always to feci that there is scope for improvement. This is the general attitude of the Government. I think it may be said that Australian packaging and design are pretty good and are progressing, but this is not the end of the matter. The Government is financially supporting an Australian design council for the explicit purpose of getting novelty in Australian design, identifiable with the Australian origin of the product. The council’s purpose will be to make products attractive to the customer with a view to increasing sales. Very importantly, the council will be concerned with design of a kind that produces economies at the point of production. As regards packaging, perhaps 15 years ago the former Department of Commerce and Agriculture commenced a series of exhibitions of packaging in this country, bringing well packaged products from all parts of the world to the attention of Australian producers in order to show them the scope that existed for improvement. That campaign has continued ever since.
– I ask the Minister representing the Acting Minister for External Affairs: What action, if any, has been taken by the Government to provide emergency relief for the people of Indonesia during their present desperate and critical period? Has any action been taken to enlist the support of the generous Australian public to alleviate the plight of the needy Indonesians - our nearest neighbours? Now that the Indonesian Government has returned to the comity of nations through the United Nations and its agencies, will the Government show our goodwill and humanitarian consideration by giving aid to Indonesia and encouraging the public to do likewise?
– The general attitude of the Australian Government to the provision of aid where the need for it exists in Indonesia is best exhibited by reminding the honorable member that, notwithstanding that the Indonesian Government had not made clear any change in iis general demeanour, when there was a state of distress caused by inadequate food supplies in certain areas the Australian Government provided S200.000 worth of rice for Indonesia. That, itself, is a fairly clear exhibition of our attitude of mind to this question. It has not ‘been, as I recall it, the practice of this Government, or of others, to tell other governments what their needs are and to proffer particular offerings. It has been our practice, having exhibited a willingness to help, to set about ascertaining what the facts are in the country concerned - our ambassador in Djakarta is tinder instructions to this end - and to make it clear that the Australian Government would be receptive to any particular proposals advanced to it and would study such proposals. As to the encouragement that the Government has given to the general community, whether encouragement has gone beyond example I do not know. I am not closely connected with the Department of External Affairs; it may be taking some action. I will make inquiries and notify the honorable member.
– As the Treasurer is overseas on Government business 1 ask a question of the former Treasurer, now the Prime Minister. Is he aware that there is widespread dissatisfaction with the system of basing valuations of land for estate duty purposes on land sale prices? Is he aware of the many anomalies that exist in such a system? Will he cause investigations to be made with a view to establishing a system that will provide valuations more in line with reality?
– Complaints of the character indicated by the honorable gentleman did not reach me in my former post as Treasurer. I do not know of any recent developments that would have come to the attention of my colleague, but I shall have the text of the honorable gentleman’s question carefully studied and will supply him with a considered answer.
Mr. GRIFFITHS__ I address a question to the Prime Minister. Is there any truth in a recent report that Australia House, London, is somewhat obsolete and does not measure up to the Australian Government^ requirements in Britain? If the report is correct, does the Government intend to demolish or vacate the building in the foreseeable future? If it does, will the right honorable gentleman, before taking action which might involve the Government i.i spending some millions of dollars of public money unnecessarily, provide an opportunity for either the Parliamentary Standing Committee on Public Works or another committee of the Parliament to visit London to ascertain whether it is expedient to provide new Australian Government offices in Britain, as someone apparently thinks it is?
– I can appreciate the honorable gentleman’s zeal and the diligence he brings to his duties on the Public Works Committee. There have been discussions inside the Government regarding adequate and efficient accommodation for Australia’s needs in London. I shall bring myself up to date with the latest developments and shall supply to the honorable gentleman a written reply that will cover this matter as far as it is competent for me lo express myself on it at the present time.
– I direct a question to the Minister for Trade and Industry. I refer to a recent statement by the President of the British Board of Trade, Mr. Douglas Jay. May .1 ask whether Mr. Jay is here for the purpose of weakening our local tariff structure? Has he been fully informed as to our real problems regarding export of our manufactured products, and does he realise that we are not in such a favorable geographical position as is England for obtaining volume export markets?
– I am delighted that Mr. Jay, who at present is in the chamber, has come to Australia for the very purpose of familiarising himself with the Australian scene and presenting to us the problems, needs and desires of United Kingdom industry and of the Government of the United Kingdom. 1 am sure, too, that he is here also to inform himself on circumstances in Australia. I am certain that it would never be the purpose of the President of the Board of Trade to weaken Australian industry. Rather is it his function to try. just as it is my function to try, to increase the exports of our respective countries in a reciprocal manner. I believe there is always scope to do this to the mutual advantage of both sides, and that there is no need to weaken our own industries in the course of any bargaining in which we may engage.
– I ask the Minister for the Army whether it is a fact that a number of Australian troops who served in Vietnam have since undergone psychiatric treatment in Australia. If this is a fact, can he say how many have been affected in this tragic manner? Could the Minister arrange to make a full statement on this matter?
– I have only seen some reports in the Press in relation to this matter. I should imagine that the honorable member also has seen them. I shall make specific inquiries to see whether there is any information that can be given to him.
– I direct to the Minister for Defence a question relating to the integration of the armed forces. Has any progress been made beyond the integration of the medical and dental stores? If so, is it intended that more progress will bp made?
– The honorable gentleman may rest assured that a good deal of study is being given to this problem in the Australian defence environment. Apart from the integration of the stores to which the honorable member referred - the medical and dental stores - we are looking currently at Army aviation and matters of that kind. I am sure that the honorable member will understand, perhaps better than most, the enormous difficulties attending a problem of this magnitude. We would not want to hasten too much with it; we would seek ways of economising so that we might produce a much greater defence effort for a fixed expenditure.
– I ask the Minister for Health whether he is aware of a statement made in the Victorian Legislative Assembly last Wednesday night by the honorable member for Geelong West, Mr. Neil Trezise, that pensioners in the Geelong area receiving treatment as outpatients at the Geelong and District Hospital have been charged a compulsory minimum fee of 20c a visit. Will the Minister advise me whether such charges for pensioners are valid under the relevant Commonwealth Act? If they are not valid, will he inquire into the present position? Similarly, will the Minister consider what additional assistance can be given to hospitals for the treatment of pensioner outpatients so as to avoid any charges being levied on hospitals for the services given?
– I have not yet seen the statement to which the honorable gentleman refers but I shall study it and attempt to assess its implications. I say, however, that the pensioner medical service is designed to provide service of a general practitioner nature by doctors enrolled in the pensioner medical scheme. In addition to this, we provide a contribution to the State Governments for the free hospitalisation of pensioners in public hospitals. The pensioner medical scheme has never included, nor is it intended that it will include, the cost of services provided by doctors in hospitals. Traditionally these are the responsibility of the State governments, whether they be provided through the honorary practitioners or the full time salaried medical staff. This covers the point about outpatients. What State Governments do in the provision of outpatient services to pensioners or anyone else is entirely their own responsibility.
– I ask the Minister for Health: Has any survey been made of the possible likelihood of the introduction of brucella or other diseases during the forthcoming six months during which new regulations to govern the importation of cheese are to be held in abeyance? If, as the Minister has said, there is a danger to health and life in the importation of cheese made from unpasteurised milk, how does the Government justify its decision to withhold the implementation of these regulation;; for six months?
– This matter has been under consideration for some time, in fret, the National Health and Medical Research Council made its first recommendation on this in 1961. For a number of reasons there has been a good deal of assessment of the matter, particularly in relation to the framing of regulations. The possibility of the introduction of Brucella Melitensis into Australia has become steadily greater. Brucellosis is a disease which is causing growing concern. As I said in the House the other day, it is spreading and no doubt will become worse. However, I make the point that the matter having been under consideration for a considerable time, an additional period of six months to enable our trading partners overseas to meet our requirements is hardly likely to create a really drastic health risk to the Australian people. I make the point loo that some State Governments have passed legislation to provide that Australian cheese must be made from pasteurised milk: but not all State Governments have yet taken this action. When the additional period of six months has ended, overseas manufacturers of cheese who wish to export to Australia and Australian manufacturers of cheese will be on a similar basis.
– My question is directed to the Prime Minister. Has the Government’s attention been directed to the fierceinterest in and strong support displayed in southern New South Wales and northern Victoria for the request by the New South Wales Government for financial assistance from the Commonwealth to establish a university college in the Riverina? Has the Government received any recommendation from the Australian Universities Commission in relation to this matter? Has the Government yet made a decision on it? 1 direct the Prime Minister’s attention to the fact that J have received many communications this week supporting the project.
– The Government is well aware of the very considerable interest being shown in this proposal not only by residents in the i.rea mentioned but also by a wider audience inside New South Wales and beyond. The matter hus engaged the attention of Cabinet. My colleague, Senator Gorton, who represents ms in another place, will, I understand, make a statement later today covering a wide range of matters of educational interest, but it is doubtful whether he will be able to indicate any finality on the subject to which the honorable gentleman has referred. Our own consideration of it will be a continuing one.
– Is the Minister for Social Services aware of the United States booklet published on social services a% recently quoted by Mr. D. O. Parsons, Federal Secretary of the Associated Superannuation and Provident Funds, to a convention in Sydney? Did Mr. Parsons refer ironically to a passage therein which said that a small group of countries provided pensions potentially to any resident but subject to income or means tests and that this group included Australia, Saudi Arabia, South Africa, and Trinidad and Tobago? Will the Minister publish for the information of the House a full list of the world countries in this category so that we may assess our ranking on the international roll of shame in backward social services?
– I have not heard of the booklet or of the occasion upon which the statement was made by, I think the honorable member said, a representative of the United States of America. At the same time I would assure the honorable gentleman and other members that the social service system operating in Australia compares more than favorably with that in any other country. In a comparison honorable members will find, perhaps, that some factors are taken into account in some countries which are not included within the framework of our social services. In comparisons I have seen and from the general climate of our own social service recipients, there is no doubt that Australia compares more than favorably with other nations and that we are well to the front. I shall look at the statement with a view to seeing just what is the allegation to which the honorable member has referred. Notwithstanding that, I assure the honorable gentleman there is nothing of which I know within our social service system which has not been examined and is not subject to constant examination in the present as it will be in the future.
– Will the Minister make a statement and supply the information?
– I have said that I will look at the question to see just what it is that the honorable member requires. I assure the Leader of the Opposition that in a comparison with other countries Australia does not suffer.
– My question is directed to the Minister for Health. In the interests of the prevention of the introduction of foot and mouth disease to Australia by way of imported meats, particularly dog food, will the Minister give this subject the same consideration as he is now giving imported cheese with its danger of introducing Brucella melitensis?
– I shall be glad to look into the implications contained in the honorable gentleman’s question. However, I would point out that the quarantine services are very much alive to the dangers and difficulties associated with the importation of foot and mouth disease or other exotic diseases into Australia in food or by any other means. I would be very surprised to find that the possibility the honorable member mentions had not already been looked at. I am aware that in respect of a considerable number of imported foods the regulations require that the food shall be heated to a certain point at which it is known the viruses will be killed. However, I shall examine the example raised by the honorable member to see whether there is any loophole or any difficulty in relation to it.
– I ask the Minister for Social Services a question. A year ago I asked him how far negotiations had proceeded for the States to legislate for compensation for the victims of crimes of violence and for the Commonwealth to legislate for the victims to receive such compensation without losing social service benefits. Since several State Governments have referred to the Commonwealth’s irresolution in this matter and since the Social Services Bill which the Minister has introduced makes no provision on it, I ask again how far negotiations have proceeded for a reform which is now well established in Britain, New Zealand and California.
– I well recall the question asked of me by the Deputy Leader of the Opposition. Since then, J have had occasion to try to ascertain what specific schemes have been put forward by individual Stale Governments. At this stage, the position remains that if compensation is paid by way of capital grants it will bc treated as capital and, if compensation is paid by way of regular payments, it will be treated as income. No specific schemes have been put by any State Government to my Department and consequently it has not been possible to examine any proposals in detail. However, if any State Government should have a specific plan, the officers of my Department, and the Government, will be happy to consider it in the context in which it is put to us.
– by leave - My colleague, the Minister for Housing (Senator Dame Annabelle Rankin), has supplied me with information about the growth of the Housing Loans Insurance Corporation from 30th June - the end of the period covered by the annual report I have tabled today - to 13th September. I should like to pass this information on to honorable members. The report of the Housing Loans Insurance Corporation shows that at 30th June 1966 the Corporation had insured, or had undertaken to insure 809 housing loans to a value of $6.3 million. I am pleased to be able to announce that as at 13th September these figures had risen to 1,413 loans for an amount of $11 million. At the present time the Housing Loans Insurance Corporation is insuring housing loans at a rale in excess of $25 million per year. Details of these most recent figures are shown in table form. With the concurrence of honorable members, I incorporate the table in “ Hansard “.
– I move -
That, in accordance with the provisions of the Public Works Committee Act 1913-1965, it is expedient to carry out the following proposed work which was referred to the Parliamentary Standing Committee on Public Works and on which the committee has duly reported to this House: - Erection of a Migrant Hostel at Randwick, New South Wales.
The proposal referred to the Committee involved the erection of a new hostel to accommodate 1,000 persons, including migrants and staff, and to replace the existing Bunnerong Hostel. In reporting favorably on the proposal, the Committee recommended that the design of the accommodation blocks be amended to provide a toilet in each of the family units at an estimated additional cost of $15,000. It is proposed to accept this recommendation. On the concurrence of the House in this resolution, the work can proceed in accordance with the Committee’s recommendations.
– There is one small comment that 1 would like to put on the record in reference to this migrant hostel. I am very pleased that the Government has seen fit to accept the Committee’s recommendation that a toilet be incorporated in each of the family units. We are all aware of the very poor conditions that exist in many migrant hostels. This is not because the Government wants to keep the standard down. The Government’s attitude is shown in the design of this new solid type building, which is the first migrant hostel to be built in Australia purely and simply for this purpose. The accommodation in it will be of a very good standard, lt was envisaged right from the start that each unit would contain, for instance, a wash basin for hot and cold water, built-in wardrobes, individual cupboards, divan type beds and single beds in the lesser rooms for children. This is all most praiseworthy and we are very pleased to see it happen.
The comment I want to make is this. I believe the design of the building is still institutional. We bring these people from overseas. They are very largely British migrants. We are looking for skilled people, and they would have had reasonable jobs in their own country before deciding to come here. The conditions in a migrant hostel in which they are accommodated when they first arrive here will affect their whole outlook on Australia. I do not believe that we should go so far as to make permanent accommodation available for them. This would be a big mistake. These people are purely transitory and the whole purpose of the hostel is to provide them with suitable accommodation - that is the expression that is used, but I think it should be comfortable accommodation - until they can find out what sort of jobs they want and where they will work, and until they can make arrangements to provide their own homes. In view of this it is highly desirable that they should not stay in these hostels for very long. I am speaking on this subject today only because I was a minority on the Committee. I believed that what we were doing was to have a separate toilet block with separate showers, in the centre of each building, with wings coming off it in which the accommodation would be provided, lt has been accepted that toilets should be provided in each unit. The additional cost of this is not very great, because there is a saving through not providing toilets in the big block: in fact, it is much the same. In future planning I would like to see consideration given to doing away with the shower block and having a shower and toilet in each unit. This would not cost very much more, because there would be a saving in the cost of the central block.
One of the arguments against this proposal is that if the units were made completely self contained in this way, so that there would be a room for the parents and rooms for children, and were well furnished and provided with all amenities, including a shower and toilet, people would not want to leave them. This is a valid argument. But I submit that we should be providing accommodation of this type for people coming to Australia who are to be absorbed into our way of life. This is the sort of accommodation we ourselves would expect. However, because accommodation at these migrant hostels is subsidised heavily to enable migrants to get a start in Australia, we should put a limit on how long people may stay there. Some people manage to stay in these hostels for two or three years. This would be unthinkable if accommodation of the type I have suggested were provided. Perhaps if migrants did not find suitable private accommodation for themselves within, say, six months, the Government could say: “ We are sorry, but the subsidisation of your rental will not continue any longer, and you will have to pay a very much higher rent if you stay in the hostel “. I believe that people would then find accommodation for themselves.
– I do not want to say much, but I am indebted to the honorable member for McMillan (Mr. Buchanan) for having indirectly drawn attention to one of the great sins , of omission for which this Government must stand condemned. In quite an eloquent and gentlemanly way the honorable member drew attention to the fact that for 17 long weary years the migrants who have come to this country have waited for this miserable cheeseparing Government to do something about migrant hostels. It is true that we have waited 17 long weary years in vain for the Government to do anything to meet this very urgent need. Is it any wonder that we cannot get British or other migrants of a suitable type to come to Australia, when all we can offer them on arrival is accommodation in these old fashioned, cold, dreary Nissen-type huts.
– This is not so. The accommodation is improving.
– The honorable member for McMillan says that this is not so now. But it was so for years and years. That was all we could offer. I know that, because I come from a State where such places are still in existence. As the honorable member for Kingsford-Smith (Mr. Curtin) reminds me, Bunnerong has one. It is only now that the Bunnerong hostel is being replaced. At the hostel at North Glenelg in South Australia one can see the same type of thing; Nissen-type huts without any sign of the friendliness we would expect in a strange country. For migrants the first impression is the most lasting. Is it any wonder that they return to their own country as soon as their two years are up? I do not blame them.
Of course the honorable member for McMillan says that it would be necessary to limit the time that the migrants could stay in hostels. One advantage of the present situation is that there is no need to put a time limit on the occupancy of hostel accommodation, because they are so disgustingly uncomfortable, unhygienic, cold, dreary and uninviting that no-one stays in them for one second longer than they have to. This brings me to another important point.
– Is the honorable member referring to the toilets or the accommodation?
– People might find greater comfort in the toilet than in the other parts of the building. It could very well be that the toilets to be built at the Bunnerong hostel will be far more inviting than the houses that people have to live in in places like Finsbury and North Glenelg. The Government ought to be making finance available so that not only migrants but Australian-born people who need homes could get them on a low deposit. This is the answer. This is what the Government has to do if it wants to correct the present anomaly whereby people come here from overseas after all sorts of fancy promises have been made to them. That is a fact. At Australia House in London potential migrants are promised the world if they come to Australia. Good housing, wonderful jobs-
– Order. I suggest that the honorable member is getting a little away from the subject matter under discussion. I suggest that he keep to it.
– Yes, I may have been, Mr. Deputy Speaker. To return to the subject, I am pleased, as one who fought for many years to see decent hostel accommodation provided for migrants, that at long last, after 17 years, the Government has stirred itself to the point of making some effort at one particular centre, Bunnerong. So far it appears to be doing nothing at all to improve the position of the migrants at North Glenelg or at Finsbury, in my own State. I hope that these two places are attended to shortly and that the Minister for Shipping and Transport (Mr. Freeth), when he jumps to his feet - I can see that he is getting ready to do so - will be able to give us some ray of hope for the future so far as they are concerned.
– in reply - I rise only to correct some very far from truthful statements made by the honorable member for Hindmarsh (Mr. Clyde Cameron). He should know they are false. I believe such statements do grievous damage to Australia’s immigration programme. Incidentally, they have very little to do with the matter before the Chair. The honorable member said that migrants were encouraged to come to Australia as a result of hearing glowing promises. He knows very well that, so far as the Government is able to do so, in countries from which we draw migrants we tell them the truth and the real facts about Australia. The honorable member said that they are promised the world. He knows that this is not true. He spoke about the high percentage of people who return to their own countries after spending two years in Australia. He knows that only a very small percentage of migrants return and that many of those come back to Australia again. His statements are falsehoods, and it is very damaging to Australia’s immigration programme for the honorable member to make them in this House. I thought he was a good Australian. I now ha.-e doubts about that.
I used to have a little bit to do with Commonwealth migrant hostels when I was Chairman of the Commonwealth Immigration Advisory Council. Getting people to leave these hostels was one of the Government’s greatest problems. It was not because those concerned were short of means. One case that came to my personal knowledge concerned a person who, with his wife and family, was staying at a hostel and had built and sold two houses while living there. So I throw back to the honorable member for Hindmarsh some of the quite false and damaging statements he has made for some obscure political motive of his own.
Question resolved in the affirmative.
Consideration resumed from 1 5th September (vide page 1009).
Department of Health.
Proposed expenditure, $11,509,000.
.- Recent increases in public hospital bed charges have highlighted the fact that the
Government’s so-called national health scheme is a quite dismal failure. We must surely all agree that one of our most important objectives should be to build up a nation of very healthy people, and to do this we must start from the very beginning. Our efforts to ensure healthy children, for instance, must begin even before the children are born. We must make it possible for everyone to obtain the best medical and hospital attention, irrespective of his means or position. No matter whether a person is very rich or very poor he must be looked after from the health angle. This is most necessary, and in fact in the long run it will prove the most economical policy.
This Government’s scheme will never achieve the required purpose. From the time the scheme commenced in 1953 it was quite clear that it was not introduced to achieve the results that I have suggested arc necessary. It was apparent that its purpose was not to build up a population of healthy people. Nor was it supposed to assist those who might be unfortunate enough to suffer illness. Its main purpose - in fact perhaps its only purpose - was to assist the members of the medical fraternity to obtain their fees. Today, as a result of increased charges and the failure of the Government to measure up to its responsibilities, the stage has been reached at which many people will be forced either to risk having to bear the entire cost of hospitalisation or, at best, cover themselves and their families for much lesser amounts of benefit than will actually be required. The cost of taking out sufficient cover to meet increased hospital charges will be simply beyond the capacity of ma.ny people in the lower income brackets. Because of this and because of the high costs of medical and hospital treatment, many people will refrain from consulting a doctor or going to a hospital in the early stage of sickness and will become major hospital cases.
Last week the Liberal Government in Western Australia announced that hospital charges, which were increased last year, will be considerably increased again as from 1st November. This will mean, of course, that the hospital and medical funds will be obliged in turn to increase their contribution charges- and increase them quite considerably - because hospital bed charges are to rise by as much as 56 per cent. I would like to give an illustration of what the increases will mean to one fund and its contributors. Hospital bed charges will be increased from S7 to $10 a day for a public ward containing 10 beds. The bed charge in a two bed ward will be increased from $9 to $13.50 a day, and the single room charge from $11.50 to $18 a day. The charge in a two bed ward after 1st November will be $2 a day more than the charge in a private ward at the present time, and public ward beds will cost $1 a day more than a bed in a two bed ward costs at the present time.
As the National Health Act stands, the Commonwealth pays only $2 a day irrespective of the charge for the bed. This will leave an amount of S8 for a public ward. $11.50 for a two bed ward and $16 a day for a private ward, and these amounts must be found by either the fund alone or the fund and the contributor together. While the fund at present can provide coverage for existing charges under certain of its tables at the present rates of contribution, it is quite obvious that contributions will have to be increased quite considerably to meet the increased bed charges.
At this stage Iel me point out that in 1955, when the public ward bed charge in Western Australia was 36s. a day, the Commonwealth paid 12s. a day to a person who was a member of a registered hospital fund. If he was not a member, of course, the Commonwealth contribution was only 8s. In other words the Commonwealth paid 331 per cent, of the charge. With the existing public ward charge of $7 a day the Commonwealth pays $2, which is about 29 per cent, of the total charge. So even at the present time there has been a decline in the proportion paid by the Commonwealth. Unless the Commonwealth contribution of $2 a day is increased before the end of next month the Commonwealth will then be paying only 20 per cent, of the public ward bed charge, or only slightly more than half the proportion that it was paying in 1955. This would be a scandalous slate of affairs, but if the statement of the Minister for Health (Dr. Forbes) which was reported in the “ Financial Review “ of 6th September 1966 is in line with Government thinking this will actually be the position. The Minister was reported as having said -
No immediate increase in the Commonwealth contribution to hospital benefit funds would be made . . .
No doubt the funds will be giving consideration to introducing tables to cover the increased private ward charges.
By this latter statement he meant, of course: “ Let the contributors carry the whole of the burden “. The Minister’s reference to new tables to cover increased private ward charges could be taken to mean that for other than private wards, such as public wards or those with two beds or four beds, the contributor would not be obliged to pay more, but this of course is not the case. The facts are that the funds have several tables - perhaps seven or eight of them - each providing different amounts of cover depending on the amount of benefit that the contributor wishes to obtain. As a result, of the increased hospital charges a contributor now covered fully for a public ward under Table 5 may be obliged to make the extra contribution under Table 8. In fact I understand that this actually will be so in the case of the Goldfields Medical and Hospital Fund of which I had the privilege of being a committee member before I came to this place. It is a fund which I would be prepared to say is as good as, if not better than, any other fund that I know of.
Before quoting the increased contributions that members of funds will have to pay to meet increased hospital charges, I want to point out that in 1955 a contributor who paid contributions at the rate of 3s. 6d. a week was fully covered for medical and hospital costs up to public ward level. Today he would have to pay 14s. 6d. a week for the same level of coverage. Yet this Government claims that it is keeping up to the field in health services. With existing hospital charges, a contributor, to cover himself for a bed in a public ward, must pay contributions at the rate of 50c a week under Table 4. As I said earlier, after 1st November he will have to pay $1.05, or 10s. 6d., a week under Table 8. That is purely for hospital benefits alone. It does not include coverage for medical costs. A person who prefers a private ward or who, because of the nature of his illness, must be in a single bed ward will be obliged to pay a great deal more. At the existing charges, he can obtain full medical and hospital benefits coverage for SI. 45. As a result of the increase in charges, he will be obliged after 1st November to pay S2.35 - an increase of 90c a week or almost half the recent increase in the Federal basic wage and half as much again as the recent increase in the State basic wage in Western Australia.
It is quite certain that people on normal wages cannot afford contributions of anything like $2.35 a week to cover them for medical and hospital benefits. In fact, as I said at the outset, a very large number of people will not be able to afford even the weekly contribution of $1.05 for medical and hospital treatment at the public ward level. So it becomes obvious that many either will have to remain in the same benefits table as at present and be prepared to meet the additional treatment charges out of their own pockets or will have to give away altogether the advantage of belonging to a fund. The increased contributions may not mean very much to people who are on high incomes and who pay income tax at the rate of 8s. or 10s. in the £1. The cost to people in that category paying the top rate of contribution of $2.35 a week, after receiving the benefit of the tax deduction in respect of the contributions paid, will not be greater and indeed may even be less than the cost to a person on a much lower income who pays contribution at the rate appropriate to coverage at the public ward level.
So, under our national health scheme, the position is pretty much the same as in so many other fields under the administration of the present Government, which imposes the greatest burden on the person with the smallest income. I can see developing a position in which only very few people will be able to cover themselves at private ward level. The trend at present seems to be to provide an increasing number of private wards, and we shall find that people who are covered perhaps only at the four bed ward level will be obliged to go into single bed wards and will have to pay the difference in cost out of their own pockets. I suggest that the Government should be taking action now to increase the Commonwealth benefit to at least the same percentage of public ward charges as applied in 1955. At that time, in Western Australia at least, the Commonwealth benefit represented 331 per cent, of the public ward charge. I cannot say what the percentage was in the other States. But let us take Western Australia as a yardstick. To raise the Commonwealth benefit to 331 per cent, of the public ward charge in Western Australia, the Government would have to increase it after 1st November from $2 to at least S3. 30 a day. Even this would not be anything like sufficient to make our health scheme a decent one and to provide the coverage that is required if we are to have a really healthy nation. But it would certainly be a step along the right road and would allow medical and hospital benefit funds to keep their contributions to a much lower level.
I appreciate the difficulties in which any government could find itself in a situation in which it has no say in what hospital charges will be in the various States. Looking at this question, one is bound to wonder whether it would not be much better if the Commonwealth had complete control of all medical and hospital affairs throughout Australia. I notice that my time is almost up. There is no doubt that some funds could go out of existence unless the Government immediately gives them some idea where they stand. They must determine what their contributions are to bc in the future, and they have to get the approval of the Minister for Health before they can increase contribution rates. So I ask the Minister to treat this matter as very urgent and to give medical and hospital benefit funds an opportunity to put themselves on a sound basis.
.- Mr. Deputy Chairman, I propose to use the short period of 15 minutes that is available to me in discussing the problems of the aged sick and the chronically ill. 1 have given a great deal of thought over the years to these problems. According to the best information that I have been able to get, it costs the community about $100 a week to maintain a patient in a public hospital, about $60 a week at the minimum to maintain a patient in a private hospital and about $30 a week to maintain a person in a nursing home. These respective costs are borne by the citizens of Australia as a whole. It costs the taxpayers more than three times as much to maintain a patient in a public hospital as it does to maintain one in a nursing home. It costs the community twice as much to maintain a patient in a private hospital as it does to maintain one in a nursing home. In view of the wide disparity in costs, honorable members will see how important it is to ensure that those who can be treated in nursing homes are treated in such places. In some instances, the sick person himself pays the cost, In others, it is paid partly by him and partly by the benefit fund to which he has contributed as an insurance. In some instances, the entire cost is paid by the taxpayers through the medium of general revenue. In any event, the cost has to be met and it is borne by the people of Australia.
In the past there has been great waste because many patients who could be adequately treated in nursing homes, and who would be much better treated in such places than in either public or private hospitals, because they arc aged or chronically ill people, often have had to be placed in a public or private hospital as there was no other institution to which they could go. This means that they are treated in a place that is expensive to run rather than in a nursing home, which is much less costly to conduct. In 1954 I had the great pleasure in this chamber of congratulating the Government on being the first in the world to bring in legislation to provide government assistance for homes for the aged. It gives me the greatest delight to extend to the Government my congratulations on amending the Aged Persons Homes Act to enable churches and charitable organisations to set up nursing homes for the aged sick and to receive the Commonwealth subsidy of $14 a week in respect of persons in those homes.
The people in whom I am particularly interested are those in receipt of the age pension or whose income is little higher than the age pension. I mentioned earlier that the minimum cost of maintaining a person in a nursing home is about S30 a week. After the passing of the amendments to the Social Services Act. the age pension will be S13 a week. A pensioner who has no income apart from pension will receive supplementary assistance of $2 a week. The subsidy paid to the nursing home is $14 a week. So a nursing home will have available $29 a week in respect of each patient. My investigations show that this sum approaches the cost of maintaining a patient in a nursing home, provided there are no charges on capital cost to be made. The figures of operating costs of nursing homes vary considerably, but from my appreciation of the position I think an efficiently run nursing home can be maintained at a cost of about $34 a week per patient. But that includes a certain amount for interest and depreciation on capital cost. Proprietors of efficiently run private nursing homes have told me that they estimate that if there were no interest to be provided on capital cost, the nursing homes could be run at a cost of about $30 a week per patient.
If the churches and charitable organisations accept the Government’s generous offer of a subsidy of $2 for $1 in respect of nursing homes for the aged, we should be able to have nursing homes erected and operated by churches and charitable organisations, which should be able to break even with the $29 a week they will receive for the pensioners in their homes. Some aged persons will have income additional to the pension and some will not be in receipt of pension at all. No doubt the churches and charitable organisations will be able to charge those people more than is obtained from a pensioner and this will better enable them to break even. Being non-profit-making organisations, the churches and charitable organisations will have only one objective - to provide the best possible nursing home care for those who are in their homes. No element of profit comes into the picture. The difficulty in the past has been that even if a church or charitable organisation decided to build a home for the aged sick or chronic sick, the amount that could be collected from a pensioner did not cover the cost of maintaining him in the home. Now, with buildings specially designed for the purpose and designed with all the proper facilities to cut maintenance to the barest minimum, I believe that the churches and charitable organisations will be able to meet this very great need.
Nobody in his wildest dreams would have imagined in 1954, when the Aged Persons Homes Act was passed, that within a little more than 10 years $100 million would have been spent on building homes for the aged and that of that sum the
Commonwealth would have provided $60 million by way of subsidy. The Act has been of tremendous benefit to the aged, lt has been acclaimed throughout the world as the finest piece of legislation ever passed by any Government. I think we can produce facts, figures and buildings to prove that this is so. I hope that the extension of the subsidy of $2 for $1 for nursing homes, as announced by the Treasurer (Mr. McMahon) in his Budget, will be as beneficial as have been the other provisions of the Aged Persons Homes Act.
In the past, there has been a terrible gap in the care of the aged. The public hospitals have been unwilling to accept as patients the chronic sick. Their attitude is understandable. It costs them about $100 a week per patient. The hospitals say that their function is to give curative treatment on a short term basis - to cure people and send them out into the community. This is why they are unwilling to take the chronic sick. The nursing homes, which in the past have had to buy old buildings and spend a lot of money on repairs, have adopted the attitude that they could not take all pensioners because the pension, plus the subsidy paid to nursing homes, was insufficient to cover working costs. With the hospitals not taking these patients and the private nursing homes not wanting them, a terrible gap existed. We all know that, as a result, some of these people were placed in mental homes, although they were not mental. This should never have happened. I want to make it clear that, in the main, our nursing homes have been managed by most dedicated matrons, who work long hours trying to run the homes on the pension payment plus the Commonwealth’s subsidy. But now a challenge has been issued to the churches and charitable organisations. I am confident that they will enter the field of caring for the aged sick and the chronic sick just as they entered the field in earlier days of providing homes for the aged.
I also express my appreciation to the Government for increasing the benefits payable to national health organisations in relation to the chronic sick. In earlier years the mutual health organisations were unwilling to insure the chronic sick. They had a pre-existing ailment and therefore they were bad risks which could not be accepted by the health organisations. The Government then, by means of what was known as the special account, provided a guarantee of any losses sustained by the funds which insured the chronic sick. It is pleasing to note that this guarantee is to be increased from S3. 60 a day to $5 a day, which will enable our chronic sick to be looked after in hospitals when they are insured. I express my appreciation to the Government for the two excellent reforms for the aged and chronic sick.
.- In the time at my disposal I desire to address a few remarks to the 1965-66 annual report of the Commonwealth Director-General of Health, with particular reference to a section dealing with those people he calls “ detailers “. At the outset let me say that I think the report, whilst we may not agree with it all in substance, is an excellently produced document which contains valuable information about the health services. In that respect I commend the Department of Health for having made this document so interesting and for compiling and producing it so efficiently. I should like to direct my remarks particularly to pharmaceutical benefits and to refer to the comments of the Director-General of Health. This matter received passing reference in the Press and a question was directed to the Minister for Health (Dr. Forbes) during question time today. 1 do not think we should let the matter pa«s unnoticed. The increasing cost of prescriptions is evidently disturbing the Government and the Director-General, and probably many other people. In his report the Director-General states -
The cost to the Commonwealth of pharmaceutical benefits in 1965-66 was S91.8 million: an increase of S9.6 million. As I have stated previously there are three main aspects to the cost of the Scheme; firstly, the level of prescribing by medical practitioners; secondly, the prices of drugs which are arrived at by negotiation between my Department and representatives of the drug companies and thirdly, the remuneration to chemists for dispensing these benefits.
I quote the following extract from the report because the figures are interesting -
The number of pharmaceutical benefit prescriptions continued to increase.
That, by the way, happened despite the 5s. charge that was imposed and which the Government insisted was introduced, among other things, to reduce the number of prescriptions. The report continues -
The number of prescriptions in 1965-66 was 50 million compared with 47.6 million in 1964-65. an increase of 5.1 per cent. The increase in 1964-65 over 1963-64 was 7.2 per cent. The number of prescriptions per head of population was 4.36 in 1965-66 as against 4.23 in 1964-65, an increase of 3.1 per cent. The increase in tho number per head of population in 1964-65 over 1963-64 was 5.2 per cent.
I mention these particulars because they are important. The Director-General went on to say -
In relation to drug company negotiations, my Department has continued to be most active and, in the year just concluded, negotiations with manufacturers resulted in reductions which will save the Pharmaceutical Benefits Scheme $4.8 million in a lull year at the present rate of prescribing. My Department will continue its determined efforts with the drug companies and 1 am hopeful that further successes will be achieved.
I think I should mention at this stage that it was not until the honorable member for Hughes (Mr. L. R. Johnson) a few years ago in this Parliament raised the question of the cost of drugs that certain refunds, amounting to a considerable number of dollars, were made by the drug houses of Australia. Undoubtedly the Minister and the Department will have to continue to make determined efforts, because the drug houses are by no means benevolent societies and they will exact, as has been proved in debates in this Parliament, the fullest possible measure of profit from the dispensing of drugs. All kinds of excuses will be given about the costs involved in research, and (his will probably be accepted as correct: but a study of the profits of the drug companies, the returns to their shareholders and the profit margin shows that the drug companies certainly are not in the habit of giving things away. If the national health scheme has proved one thing, it has proved to be a bonanza for the drug houses of this country. Later I will indicate how this is exemplified by the Director-General in his report. In his report he states -
An aspect of some importance in the Pharmaceutical Benefits Scheme is the place of the medical representative or “detailer”. In discussions with doctors in private practice it has often been said to me that they find it difficult and sometimes impossible to grant time from their very busy practices to interview all the medical representatives who call on them. I understand that there are about 1,200 medical representatives employed by drug companies in Australia.
That is a fantastic number. The report continues -
If this figure is correct this means one representative is employed for every five or six general practitioners in practice.
What company could afford to employ so many salesmen and have a reasonable margin of profit? What company could afford to have one salesman for every five or six customers? What company selling farm implements, for instance, could limit its salesmen to five or six farmers each? The wealthiest company in the world could not afford this in the normal run of business. This shows that there must be a great margin of profit and a considerable amount of exploitation of the people who find the money - the taxpayers of Australia. The Director-General continues -
These medical representatives are the salesmen of the drug companies who promote the use of their particular products. This indirect and discreet selling is directed to the person who is in the position to increase sales of a drug by writing prescriptions for it. In contrast to the usual situation in the selling process, the person who is the target of this salesmanship is not faced with meeting the cost of these prescriptions from his own pocket; nor, except for the first 50 cents, is the cost met directly by his patients. It is the taxpayer who pays the pharmaceutical benefits bill.
What the Director-General is saying, in effect, is that the salesman is selling the doctor something that the taxpayer must pay for, and there is no obligation on the doctor to find any of the money for the product he is going to buy. On that basis, if the doctor were one who did not care much, undoubtedly the system could stimulate a buying spree for drugs, with consequent benefit to the drug houses, though not so much to the population. There would be a tremendous drain on the taxpayers of this country in meeting the cost of prescriptions without much benefit to the public. The Director-General, 1 think charitably, says -
I do not question that there is a place for a reasonable number of medical representatives as part of the drug distribution and information process. I believe, however, it is open to question whether the employment of one medical representative to every five or six general practitioners greatly enhances the value of information and assistance provided to doctors for the treatment of their patients. ] think that the Director-General was doing something quite natural in his line of duty - and quite commendable - in bringing this matter to the light of day and in drawing it to the attention of the Parliament. At the same time, he might well have gone further. Instead of merely mentioning it he might have told us what steps his Department has taken to cut down on the number of medical representatives which must, as the Minister said in reply to a question today, undoubtedly add to the cost of prescriptions. lt would be interesting to know whether any direct approaches have been made by the Government or the Department to the drug houses to see what saving could be had if action were taken along that line. This matter should be taken further. I have in my possession a list of the cost of drugs. This was presented to this Parliament. I have not been able to bring it right up to date, but I think, broadly speaking, the information would still be a fair guide. I mention this to show that the drug houses are not, by any stretch of the imagination, benevolent institutions. They will eke out to the limit what money this Government and the taxpayers can find for drugs. I have before me a chart showing United Kingdom and Australian manufacturers’ drug prices. Admittedly they are the figures as at April 1964, but I do not think the percentages will have changed substantially. This chart presents a comparison of manufacturers’ prices for the 35 top selling national health scheme prescription drugs. The prices quoted arc the manufacturers’ net selling prices. In approximate terms, the manufacturers’ prices represent 45 per cent, of the Australian national health scheme dispensed prescription costs and 65 per cent, of the United Kingdom dispensed prescription costs. I do not propose to go right through the list. I shall just analyse it in the time at my disposal.
As I have stated, this list includes 35 of the top selling drugs. On checking them I find that the United Kingdom manufacturers’ price for no less than 23 of the 35 drugs is as much as 40 per cent, lower than the average price being charged to Australian purchasers. For example, the United Kingdom manufacturers’ price for one particular drug is the equivalent of £5 17s. 9d. Australian while the Australian manufacturers’ price is £7 14s. Id. Australian, or 31 per cent. more. The Australian prices range up to as much as 41 per cent, more than the United Kingdom manufacturers’ prices for 23 out of the 35 drugs mentioned, lt is true that the Australian manufacturers’ prices for 12 out of those 35 drugs are lower than the United Kingdom manufacturers’ prices, but the difference is only fractional, being as little as only 1 per cent, in some cases. In broad terms, two-thirds of the drugs mentioned on the list are up to 40 per cent, dearer here than in the United Kingdom and I should say that on the average the Australian people are paying from 20 per cent, to 25 per cent, more than is being charged in the United Kingdom. It has been stated in this House that Indonesia and other countries are getting some of these drugs cheaper than we in Australia are.
I mention these matters to show that it is no wonder that the drug houses can employ almost one salesman to every customer. They can do this because, in the first place, their profits are unrestricted. Also, they have an open cheque to fix charges because the people to whom they are selling are not required to meet the costs. In my view, the Director-General of Health might well have used a little stronger language when referring to the practices of these people. I think he could quite safely have said that their charges were scandalous and that in fixing them the drug houses were blatantly misusing their selling opportunities.
Let me quote what was said by the honorable member for Hughes (Mr. L. R. Johnson) in August 1963 about the practices of drug houses. I might add that he substantiated what he said and fully established the Labour Party’s claim that there should be a complete national inquiry into all the ramifications of the drug industry in order to reveal how the drug houses were exploiting the Australian national health scheme. This is what the honorable member for Hughes said on 29th August 1963, and what he said then is supported by the Director-General for Health in his report for the year just ended -
So great are the margins of profit in sections of the industry that manufacturers, retailers and travellers often provide discounts, bonuses or rebates, as they are usually called in fact, which go as high as 25 per cent. That indicates the profit margin which enables those people to play around with prices so generously. Very big money is involved here, and the Australian taxpayers have to carry the burden.
He then went on to outline the margins of profit these people were enjoying and suggested that what is being done is made possible because of the great profits being made by the drug houses. The honorable member for Hughes also said -
Balance-sheets for a number of our leading drug houses have been published recently which reveal dividends of 16 per cent, and 17 per cent. There is nothing unusual about this. Many drug houses make these profits after diverting large sums of money into new capital investment for expansion. One group is said to be showing a return of 66 per cent, on paid up capital.
The point I am making is that these people could not afford to employ almost one salesman to each customer, nor would they have been able to give back the great amount of money that they have refunded - approximately $4 million over the period - had action been taken when the Labour Opposition pointed out to this Parliament how the national health scheme was being exploited. I can well understand the concern of the Director-General of Health at this state of affairs. The cost will become enormous if the present practice is allowed to continue, and there is cause for grave concern when we remember that, with a view to keeping down both the number of prescriptions dispensed and the cost of the scheme, the poor old sick person is called upon to pay 5s. for each prescription. The position becomes all the more alarming when we note that the number of prescriptions dispensed is increasing and that the drug houses are employing the huge numbers of detailers mentioned by the Director-General of Health. Honorable members will be interested to know that the 5s. prescription dispensing fee was abolished in England a long time ago because it was looked upon there as only a further imposition on the man who is already paying tax for social services. The fact that the national health scheme is being exploited by the drug houses who are making such huge profits is clear evidence that all is not as well as it might be. As I stated earlier, the national health scheme has proved to be a bonanza for the drug houses and others concerned with the distribution of drugs. I point out, too, that the manufacturers are well paid for not only the ingredients but also the containers used in connection with the manufacture and sale of drugs. The cost of drugs this year alone will be just over S57 million, and S37 million will go to the chemists. The total cost of the scheme will be S94 million. The drug industry is a very profitable one, especially when we remember that §57 million of the taxpayers money will go into it in one year. Instead of searching constantly for some way of reducing costs to the taxpayer, these drug houses are employing more and more staff in order to boost the amount they can get from the scheme.
I am pleased that the Director-General of Health has brought this matter to the attention of the Parliament. I am only sorry that he did not apply the one word that should have been applied when describing the practices of these people. He should have said that their attitude was scandalous. I hope that the Minister will be able to tell us what effective steps the Government has in mind to curb the type of selling now being engaged in by the drug houses. This Government has certain powers to discipline doctors and chemists who infringe the law. There should be a law giving it power to deal wilh those who exploit the national health scheme in the way in which the Director-General of Health has outlined.
.- The honorable member for Grayndler (Mr. Daly) has raised several points which I would like to answer. But first let me say that I agree with what he said about the manner in which the Director-General of Health has compiled the report published for this year. It contains some very interesting facts and figures. My only regret is that it was nol available for us earlier in this Budget session. If it had been we could have used it to much more advantage. But I think it is appreciated by all that to collect and compile the statistics contained in the report is a most difficult task. The Department of Health is a most complex organisation. It covers a terrific number of activities.
The honorable member for Grayndler has suggested that the statement made by the Director-General of Health in his report about the number of detailers, or manufacturers’ representatives, has caused a great deal of controversy in the community. I think the Director-General of Health has portrayed the position to the community in the wrong light. In answering a question this afternoon the Minister for Health (Dr. Forbes) did say that the number of detailers employed by the drug houses was a factor which contributed to the cost of our health scheme. I agree that it is a contributing factor, but I believe that it is a cost that cannot be avoided if this country is to keep abreast with the rest of the world in medical and pharmaceutical science and if the sick are to get the benefit of new cures.
Indeed, exchange of information between doctor and detailer about the peculiarities of certain drugs is a valuable exercise in getting the best curative effects from any new drug that comes on to the market. I submit that the suggestion that the drug manufacturer retains or employs - I think the word “ employs “ was used by the Director-General in his report - one representative just to see five general practitioners was rather an unfair one for the person who compiled this particular part of the report to make. I am sure that he has left a quite wrong impression in the minds of many people. These detailers or representatives, in addition to seeing the doctors, must see the pharmaceutical chemists, the public hospitals, the private hospitals, the veterinary surgeons and others who use drugs. The physical properties, the pharmaceutical properties and the therapeutic effects of drugs must all be known and understood by everyone concerned. The mere fact of a man calling on a doctor in those circumstances suggested by the Director-General creates quite a wrong impression.
One State President of the Australian Medical Association who came into this controversy in support of the claim that there were too many drug salesmen is alleged to have warned of the health danger from the increased use of drugs. It must be remembered that dangerous drugs can be obtained only by prescription originated by a medical practitioner. If there are dangers from the increased use of drugs - I am not questioning the validity of the argument - only one section of the community can stop that practice. I hope that I have left the impression with the Committee that what a representative or a detailer has to do has not been properly explained. There was one other remark made by the honorable member for Grayndler which I thought was most unfair. He said: “These drug houses never give anything away “. I am not here to represent them but I must say that the other day I received a communication from the Australian Pharmaceutical Manufacturers Association and I think justice may be done if I refer to the fact that last year the members of this organisation made a direct grant of $623,000 to Australian medical research, study and teaching activities. I am sure the medical, veterinary, scientific, pharmacology, pharmacy and hospital institutions which were the recipients of this financial assistance were very pleased to receive it. I believe it will help considerably to get the very best out of the scientific field of medicine.
I regret that I must restrict my remarks during this debate on the estimates for the Department of Health, because of the time limitation, to those activities which provide what one could describe as the more publicised benefits or services to the public. I realise that I. shall do less than justice to the Department of Health which has a very high degree of professional and managerial skill, perhaps more than most departments in the Commonwealth Public Service. Having said that, I now wish to pass to those subjects which come into the category of the more publicised services of which we hear so much today. I have in mind the national health scheme. This scheme has been in operation for about 15 years. The whole concept of the Government’s policy then, as it is today, was to regard those actively engaged in the scheme - doctors, chemists, hospitals - as partners and not as servants of the Crown as I know the Labour Opposition would like to make them. I believe this has been one of the fundamental reasons for the success of the scheme. When one reads of the dissatisfaction with which government health schemes in other parts of the world are viewed - I have particularly in mind the United Kingdom scheme - one can say that the Australian Government’s concept of a medical scheme was soundly based. It would have been much easier for this Government to have administered a nationalised health scheme, such as that which operates in the United Kingdom, in preference to the existing one but I am confident that such a scheme would not have been as successful as is the present one. The cost of providing an adequate modern service is colossal, as the figures contained in the Department’s annual report indicate. But a medical scheme of these dimensions does not remain static. I am quite sure that in the years to come the cost will be very much greater than it is at present. I know that the Minister appreciates that fact. I know that it is his desire that the present scheme should embrace services over and above those at present provided.
One question which exercises my mind, and has exercised my mind very often in the past in relation to our present national health scheme, is that we are not making full use of the ancillary services which have proved themselves so valuable in modern medical science. I recall to mind just a few of these such as dental, optometrical and physiotherapy services. I am sure there are others, but there are two basic principles to be observed in any national health service, particularly if it is to be successful. The first is that the cost of the scheme must be within the financial compass of both the individual citizen and the nation as a whole to administer. The second basic principle is that the scheme must be such as to guarantee the cooperation of doctors, chemists, hospital managements and all those bodies and groups of people who participate in a service of this kind. We can say without equivocation that the scheme operating in Australia today is operating in those circumstances.
Some time ago I said in the House in much greater detail than I am able to give at present - in fact, I have repeated it on many occasions - that I believe an independent inquiry into the national health service is necessary after it has been in operation for 15 years so that we can ascertain whether we are getting the most efficient and economic use from the services provided within the present scheme. I include in that the hospital and medical benefit funds. I believe there is a problem to be considered in the matter of the multiplicity of registered medical and hospital benefit organisations. This is a subject to which I know my colleague, the honorable member for McMillan (Mr. Buchanan), has referred on previous occasions. There are 80 medical benefit organisations and 112 hospital benefit organisations at present participating in the scheme. I have been informed by some of the directors of these organisations that the large number of funds creates administrative problems which are costly. Were the number of organisations reduced, the cost to members of hospital and medical benefits would be less than it is. It is obvious that the big organisations can operate more economically than can the smaller ones, but in order to keep the smaller organisations in business the larger ones must standardise their schedule of fees to the level of the smaller funds.
The position at present is that six major funds cover over 60 per cent, of the insured persons enrolled in hospital and medical benefit funds. It follows, therefore, that some 106 organisations cover less than 40 per cent, of the insured persons. It is obvious from these figures that the time has arrived when we must appreciate that there is a good deal of unnecessary duplication of administration which is quite uneconomical. I think that an inquiry such as I have suggested would reveal anomalies of this kind in these aspects of our health scheme. And of course, I have mentioned only one aspect. An independent inquiry would be able to investigate this problem as well as many other spheres of the services now being provided, and to make the necessary recommendations to the Government. 1 am sure that the Government would accept and implement those recommendations.
The following interesting statement appears on page 6 of the annual report to which I have previously referred -
Following an application by the Federated Pharmaceutical Service Guild of Australia for an increase in the rates of remuneration paid for the dispensing of pharmaceutical benefits, a firm of independent management consultants was commissioned to conduct a survey into earnings, costs and profits in pharmacy, the cost of $37,780 to be shared equally by the Commonwealth and the Guild. The survey has been made possible by the co-operation of a number of chemists who have agreed to participate in the obtaining of the necessary detailed information.
This subject is one on which I can speak without inhibitions because I no longer have any connection with the pharmaceutical profession. Many criticisms have been made of this arm of the medical service by the honorable member for Grayndler, who has just referred to it, and by people who have no knowledge of the cost associated with the most simple pharmaceutical benefit. The cost of the work performed by specialised staff employed in chemist shops in order to attend to returns demanded by the Government is no small part of the pharmaceutical benefit. 1 believe it is much to the credit of the Pharmaceutical Guild that it is prepared to share the cost of a survey into the earnings, costs and profits of pharmacies so that people will know exactly what the position is. This will answer criticisms such as those raised by the honorable member for Grayndler. The action of the Guild is possibly a good example to others associated with the national health scheme who may wish to do the same. If an independent survey of the whole of the national health scheme were conducted I believe that individual surveys such as I have referred to would be unnecessary. I regret that I have not time to pursue this subject further. I support the appropriation.
The DEPUTY CHAIRMAN (Mr. Mackinnon). - Order! The honorable member’s time has expired.
.- I was delighted to hear the honorable member for Isaacs (Mr. Haworth) agree with the honorable member for Grayndler (Mr. Daly) that there should be an investigation into our health services. 1 assure honorable members that such an investigation is long overdue. Although SI 1.5 million is to be spent under Division 250 of the Estimates by the Department of Health this year for administration, the papers show that the Department’s total estimated expenditure under the special appropriations for the year ended 30th June, .1967, is expected to reach $265,718,000, which is something less than 4 per cent, of the total budgetary expenditure of $5,930 million. The expenditure this year will be about $15.75 million more than last year. I admit that this would not be bad in normal circumstances. However, because this is an election year, I suppose it is only natural that the Government would want to make it appear to the general public that it is a generous sort of government and one which is worthy of being returned to office at the election in November. Perhaps that was the principal reason for the Government easing the hospital and medical benefits means test at the beginning of this year. It was at that time that all pensioners became eligible to receive free medical benefits.
If honorable members read the current annual report of the Director-General of Health they will see that it appears that the Government already regrets having extended the medical benefits means test. In his introductory remarks the Director-General had some very pertinent things to say when referring to pharmaceutical benefits. I believe the honorable members for Grayndler and Isaacs have already referred to the report. However, 1 think the Directors remarks are worth repeating. He said -
The cost to the Commonwealth of pharmaceutical benefits in 1965-66 was $91.8 million; an increase of S9.6 million. As I have stated previously there are three main aspects to the cost of the Scheme; firstly, the level of prescribing by medical practitioners; secondly, the classes of drugs which are arrived at by negotiation between my Department and representatives of the drug companies; and thirdly, the remuneration to chemists for dispensing these benefits.
The Director-General then pointed out that the cost of dispensing prescriptions continued to rise and that the Department had been most active in negotiating price reductions to drug companies for the purchase of drugs. He said that last year the pharmaceutical benefits scheme had been able to save $4.8 million in a full year on the purchase price of drugs.
The report also contained a complaint about the activities of the representatives of drug companies who, apparently, are conducting a campaign of high pressure salesmanship among members of the medical profession. The honorable member for Grayndler repeatedly referred to the fact that this was very disturbing when it had been contended that there were about 1,200 of these representatives. There is one representative for every five or six medical practitioners throughout Australia. After hearing those remarks is there any wonder that the cost of the national health scheme is getting out of hand? Yet at the same time many pensioners are being deprived of benefits under the scheme. The truth of the matter is that things are not normal. Costs are skyrocketing in every direction and people are often unable to consult doctors or obtain proper medicines which they require because they are far too dear. Many drugs have been removed from the list of life saving drugs for reasons best known to the Government. However, I believe that the reason is contained in the report of the DirectorGeneral of Health.
On the one hand medical science prolongs life, yet on the other hand this Liberal and Country Party Government denies to the ill and infirm the adequate use of proper medical facilities and the care and treatment that people are entitled to receive. In my opinion the financial responsibility for the health and welfare of the Australian people rests fairly and squarely on the central Government which is responsible for the fiscal and monetary policy of the nation. In every facet of the welfare State there has never been so much hardship or so much political skulduggery as we see today, especially in the fields of health, social services and housing, embracing, as they do, hospitalisation, the aged and infirm, medical benefits, convalescent homes, mental institutions and nursing homes. In my view people whose health and economic needs compel th*m to seek Government aid either for medical treatment or institutional nursing will receive justice only when we have elected a Federal Government which will provide ample finance to allow the authorities to build enough institutions to accommodate or to provide residence for the aged and the infirm. As it is, public hospitals everywhere are head over heels in debt and State Governments are starved of sufficient finance with which to carry out their administration of public hospitals and welfare institutions. Yet many private nursing homes are being allowed to get away with anything and to charge what they like.
I believe that all people living in retirement should be entitled to live as well as when they were at business or in industry. But for tens of thousands of them that is not the case. The Government is responsible for this situation because of its failure to control the adverse elements of age and infirmity. The Government’s national health scheme is one big racket from start to finish with the general public being the pawns in the whole unsavoury game. Some people are making big money from the scheme while others are paying through the neck for their services or are getting nothing at all. Generally speaking members of the public today are contributing, through hospital and medical benefit societies, tens of millions of dollars towards their own health service, yet when they are sick they are stung with additional crippling costs for doctors and pharmaceutical charges. That state of affairs could never have occurred under a Labour administration. Although the Government boasts of its free medical pensioner service, thousands of pensioners are today being denied that service simply because the Minister for Health, through the Pharmaceutical Benefits Advisory Committee, withdraws at will drugs and pharmaceutical formulae from the free list of life saving drugs. Apparently this happens when the costs to the Government begin to rise or when it is necessary to reduce or keep down Government expenditure.
The inequalities and inadequacies of the public health system throughout Australia today present a challenge to our thinking and to our ability to rectify them at some time or other. I hope a Labour government will do just that as soon as it can after it takes office. Any administration that allows its public institutions to run head over heels in debt, wi:h their trades people and contractors waiting for months and months to be paid, is not entitled to remain in office. Recently, the New South Wales Government had to find millions of dollars to liquidate some of the debts of its public hospitals, and many hospitals are still badly in debt. What can we expect when we live in a system that fosters an accumulation of debt on a government level? An honorable member on the Government side, when speaking about the abolition of the means test a fortnight ago, referred to “ mad arithmetic “. If he had referred to the mad fiscal and monetary policy of the Liberal-Country Party Governments, he would have been much nearer the mark.
How does the Government think that the basic wage earner or the near basic wage earner can get the $50 or $60 a year to pay the contributions to medical benefit funds? How can the unemployed or the unemployable folk in the community meet the contributions to the funds when they have practically no income? I suppose that section of the community represents a million people or more; but when these people become ill and need hospital attention, who is expected to meet the cost of their treatment? Only the State Labour Governments, and they must do so from the funds that this Government doles out to them. For an uninsured person to be expected to pay more than $57 a week for a bed in a public ward of a hospital is simply ludicrous. The Government’s proposal to pay inmates of mental hospitals the value of three months pension on discharge is belated but welcome. Through the years, those of us on this side of the chamber who have battled to have pensions paid to inmates of mental hospitals in the way that was done by the Chifley Government have always been rebuffed and told that the State Governments have the responsibility of looking after patients in mental hospitals. However, as I see the proposal, more repercussions will come as time goes by.
For some years now, the Government has been encouraging the mushroom growth of slum types of nursing homes, convalescent homes, private hospitals and the like. It is, therefore, responsible for much that is happening now. Some of these homes have tremendously high tariffs and the ordinary pensioners and sick people cannot meet them. But these establishments give families the opportunity to unload their elderly parents and relatives, regardless of the financial position of the patient, or whether he or she is a pensioner. The point I make is that the Government, in addition to the pension, provides $2 a day or $14 a week towards the board or lodging of a number of privileged people while denying to many pensioners the right to have free medical benefits. 1 have here details of the case of a lady named Mrs. Arthur. Her doctor, Dr. 0’Donohue has reported -
Mrs. E. M. Arthur … is allergic to sodium salicylate and phenylbutazone. She has to take Betnelan for treatment of her crippling arthritis.
The Minister has been telling me for months that the drug she requires cannot be provided for this old lady. Now she must pay up to £3 14s. a hundred to obtain Betnelan tablets, although the drug included in the pharmaceutical benefits list costs 27s. a hundred, in another case, the doctor reported -
Mrs. had her left breast removed about three years ago for carcinoma. She has been receiving Durabolin injections for the last twelve months wilh excellent results. ( recommend that these injections be continued if possible.
The Minister and his Committee have refused to make the drug available. la another case, Dr. Marshall has written -
As requested I am writing to acquaint you of the situation in this man’s (Mr. William Cain) case.
Rheumatoid arthritis with the usual wasting and weight loss, which had been replaced on Primobolan therapy. Since this item has been removed from N.H.S. and the patient has been unable to afford them, he has again regressed to his previous state, i.e. loss of weight, weakness, more myalgia, more ostalgia(?).
Because this man cannot afford to pay for the drug he needs, he must continue to waste away and he will die. Dr. Marshall has reported on another case. He wrote to a member of the State Parliament and said -
The enclosed letter, from the Commonwealth Director of, Health, is a refusal for the supply of the drug Durabolin for Mr. John Armstrong, who is suffering from leukaemia.
I feel that regulations could be bent a little bit in his case as his life expectancy is very limited.
I would be grateful if you could help me in this matter.
Dr. Bassett has provided the following certificate
This certifies that Mr. J. Naughton, aged 73 years, is suffering from chronic bronchitis, emphysema and continual asthma. Experience over a five year period of treating this patient has proved that .he is only able to get about and stay out of bed as a result of talcing continual corticosteroid therapy. In other words without corticosteroids he is in continual severe respiratory distress which is not relieved by any other available drug.
I appeal to the Minister to help these people. If he cannot provide the drugs they need, he should give these old people an amount equivalent to the cost of the drug that is provided by his Committee. These people are almost starving. Old Mrs. Arthur must pay her rates and taxes and her insurance out of ?6 a week. But the Minister and his Committee, who are supposed to be reviewing some of these cases, have had them for month after month and nothing has been done. How can anyone subscribe to the belief that we have a free pensioner medical service when cases of this sort arise constantly?
The DEPUTY CHAIRMAN- Order! The honorable members time has expired.
.- The honorable member for Shortland (Mr. Griffiths) has referred to some drugs that are not available currently on the national health service list. I think the Committee is well aware that the honorable member is genuinely concerned about this matter.
But I would point out to him that the inclusion of drugs on the list is not under political control and it is not a matter for political control. The decision as to the drugs that are to be made available is made by an expert medical committee. I do not think there should be government interference in the activities of such a committee. I know that I personally disagree with some of its decisions, but the fact remains that it has been appointed to make these decisions.
The honorable member for Shortland mentioned the drug Betnelan, which was prescribed for an arthritic condition. A great deal of research has been done on this subject and it has been shown that, although there is a temporary benefit from the use of the cortico-steroid type drugs, in the long run the results are no better than simply taking aspirin alone. There is an extraordinary relapse rate, the drugs are exceedingly expensive and they are most dangerous. I completely subscribe to the decision of the expert committee not to make such drugs as Betnelan freely available for conditions such as rheumatism. Incidentally, a new drug is available on the list. I do not intend to give it a plug, but it is very good as an anti-arthritic drug. It is available on the national health service list in capsule form. Tn common with all these powerful drugs, it has certain dangers. In some cases, it has proved to be extremely valuable, and I hope that the patient mentioned by the honorable member is allowed to try it. It has been most beneficial in a number of cases.
– I will tell Dr. O’Donohue what the honorable member has said about it.
– Good. I hope he will try it. There may be certain cases in which, in very exceptional circumstances, one of the corticoid drugs is indicated but is not available because of the decision of the expert committee. Perhaps we should have some expert tribunal to determine whether, in individual cases, hardship is being caused by the decision not to make the drug available. I hold this view, notwithstanding my reitereation of my belief that the case cited by the honorable member, though I know he is genuinely concerned, does not fall into the categeory I have in mind.
Much has been said about the profits made by drug companies and some retailers. I do not think I should engage in a detailed discussion of this subject. But 1 would say that this has been put in a rather misleading light. The honorable member for Isaacs (Mr. Haworth) mentioned that the work of a detailer involves far more than just having a chat with medical practitioners. He has to see many other people, and his work involves a great number of other things. One of the very misleading aspects of the statistics on this subject is that a detailer does not handle the work of all the drug firms. There are literally dozens of drug firms in Australia and detailers simply handle only the products of the manufacturers they represent. It is a pity that these statistics have been given so much publicity, because I do not really believe there is a great deal of substance in them.
The problem of the pricing of drugs is a very real one and exercises the government of every country in the world. It is a continuing problem and will have to be dealt with firmly, but there are many difficulties in the way. However, I will not have a chance to discuss the problem in the 12 minutes remaining to me, so I will move on to a rather broader aspect of the whole thing. We should not lose sight of the wood for certain individual trees. The fundamental question at stake is: What is our health scheme like? Is it a good health scheme or not? There is only one possible answer. I say quite categorically, having made a considerable and continuing study of health schemes throughout the world, that the Australian national health scheme is undoubtedly the best. This should not be lost sight of. Although it is the best in the world this does not mean that problems do not arise. Very big and serious problems do arise. Undoubtedly the scheme can be improved, but the difficulties are enormous. In striking a happy mean between the various problems, and in steering through the very shoaly waters of national health, this Government has achieved a remarkable result. The fact that there is a constant stream of medical practitioners coming to Australia from Great Britain amply bears witness to this. The comments of some of these people in the Press recently, when controversy arose, speak for themselves.
In Australia there is a good degree of rapport between doctor and patient, which we all know is very essential. It is also apparent between doctor and government, which is equally important, because there is nothing which can suffer more quickly than exacting work calling for a sense of vocation, such as medical work, when the Government begins to frustrate the person concerned. One only has to look to other countries to see the problems that are arising. There have been repeated strikes by doctors. Normally it is unthinkable for a doctor to strike. I can assure honorable members that a doctor strikes only when he really believes that he is at the end of his tether. The fact that doctors have been so restrained in Great Britain is a fair indication of this. But there have been repeated strikes in many countries because doctors found that their working conditions were intolerable and very often their remuneration was inadequate. A recent Press report tells of a doctor in Great Britain who went to work in his father’s butcher shop because he could not make ends meet working as a hospital doctor. This is the -sort of thing that can happen because salaries for hospital doctors in Great Britain are very poor. In fact, not a very high proportion of British doctors work in hospitals. If it were not for people going to Great Britain in order to get postgraduate experience - very often they are from India, Pakistan and places like that - and staffing these hospitals, the British hospital system would collapse.
The staffing and operation of hospitals is probably one of the largest problems confronting national health in Australia today. There are some tremendous problems involved. We have seen a lot of criticism, especially by State authorities. It is easy to criticise. The States are sovereign and control their own hospital systems. State authorities are making a great deal of noise and I think they are unfairly criticising the Federal Government in regard to this matter. I am not minimising the problems, because costs are mounting, as they are in every country, Running a hospital is a labour-intensive activity, and that must mean mounting expenses these days, especially when one considers that there is a very high proportion of highly trained and expert people working in hospitals. Nurses need good salaries, and 1 believe that today their salaries are barely adequate. They need a great sense of vocation to stick to their jobs because of the barely adequate salaries. For a hospital to operate happily and efficiently all staff members must be adequately remunerated, ami this, of course, is one of the things adding to the costs of running a hospital. There are a lot of others. Capital costs are not the least.
The time is coming in Australia when a very considerable capital expenditure on hospitals will be necessary. 1 think people have to ask themselves where the money for this capital expenditure is to come from, lt takes a lot of money to build a hospital, so I believe that the time has come when the Commonwealth Government must consider what its position is to be in relation to the State hospital systems. If the Commonwealth Government is to bc asked to provide money for building new hospitals, to run hospitals and to provide all the help that the States are asking for, then it is entitled to some say as to how this money is to be spent. Rising costs - and I believe they will continue to rise - can be arrested by a careful consideration of the problems.
First, let us consider building. I believe that buildings could be rationalised if there were a standard design for an ideal hospital - if such could be formulated, and I am sure it could be. Individual requirements as between the various States are not so different that there could not be formulated a standard design for a hospital, say on a modular system, with larger and smaller units joined together, so that the various sizes of hospitals could be achieved with economy of scale. This is one point which must be looked at. Moreover, the siting of hospitals is important. We can no longer afford to have redundant hospitals. The needs of an area must be considered. A hospital should not be planked down willy-nilly in an area because there has been one there since the year dot. They must be located according to need so that adequate services will be available to all and so that no redundant services are provided.
I also believe that many of the services provided by hospitals can be strictly rationalised, as they have been overseas. A few stumbling steps have been taken towards achieving this Things like central services must be considered as soon as possible. There could be a central sterilising service in the middle of a city to provide for a very wide area services for sterilising equipment. A central service could be run far more economically, better and more safely than a number of little sterilising departments in each hospital could be run. The same can be said for a laundry service and a food service. Perhaps there could be central pathology and other services. I think the idea of central services must be pushed along as hard and as quickly as possible if we are to achieve economies.
In short, I believe there should be a national survey of hospital needs, not just Slate surveys. The needs of the future should be projected so that the whole question can be put on a rational basis and so that we can get down to tin tacks and deal with this problem in a scientific and orderly manner. There is one other point 1 would like to make here. I do not think we should be entirely preoccupied with having the State running hospital services. I believe that these services should be strictly co-ordinated, but the -State should not by any means have a monopoly of the running of hospital services. I.n Germany, for instance, various church organisations have been extremely helpful in sharing the load of providing hospital services, and the system i.n that country has proved quite effective. I believe that as far as possible private organisations which are able to do so - this would mean mainly church organisations, but it does not exclude other organisations - should be encouraged and helped to provide hospital services. I do not think I need to tell any honorable member that the atmosphere for patients in hospitals run by church organisations is magnificent, and more conducive, especially in difficult cases, to recovery than the atmosphere in an ordinary secular hospital. There are many virtues in having the churches participate in the provision of hospital services, although if we are to help them I think they must be strictly fitted in with the national survey so that hospitals provide services which are needed and are not redundant. If we adopt this system not the least of the benefits that will accrue, apart from the improvement in the health of the community, will be some savings in costs in a very difficult area.
– I appreciate the opportunity to make a contribution on behalf of the Opposition to this debate on the estimates for the Department of Health. I was somewhat disappointed with the remarks of the honorable member for Bowman (Dr. Gibbs), a medical practictioner by profession. In his opening remarks he said that in his opinion after making a deep and extensive study of the subject, our national health scheme is the best in the world. Does he suggest that it is better than the Swedish Government’s national health scheme?
– Of course. What do they pay for drugs in Sweden?
– I know what they pay for drugs in Australia, and I will be touching on that very soon. 1 would have expected strong condemnation of the national health scheme from the honorable member for Bowman because I have always accepted his sincerity although realising that he is politically misguided. I would have expected strong condemnation from a learned member of the medical profession of the exploitation by drug companies of the Australian national health scheme. But the honorable member was very kind to the drug companies. He actually apologised for them, or at least I interpreted his speech as an apology for the exploitation by the drug houses of this country of the Australian taxpayer.
The exploitation carried on by Australian drug companies has been pointed out by the honorable member for Grayndler (Mr. Daly) today, as it was some time ago by the honorable member for Hughes (Mr. L. R. Johnson) who, after conducting extensive research into the subject, made some disclosures which shocked this nation. It was pointed out by the honorable member for Hughes, and reiterated today by the honorable member for Grayndler, that the price of certain drugs in Australia is three times the price in the United Kingdom. It is a wicked thing to exploit a section of the community suffering from ill health. It is all against Christian principles to exploit people in indifferent health, and it is something that deserves the strongest condemnation by every member of this
Parliament, irrespective of the political flag that he carries. I think the most important point that has been made in this debate has been the exploitation engaged in by the drug companies.
When I was listening to the broadcast of the speech by the honorable member for Grayndler I was reminded of a statement made to me recently by a publican in Newcastle who had opened a chemist shop on the central coast at a place near Gosford. He had appointed a qualified chemist to run this shop and he said to me: “ Bert, it is a gold mine. I am making about £80 a week and I am not going near it.” That man may go to church every Sunday and pray for the poor, and yet he is exploiting many of them. He is a man who does not need to do this because his hotel business would probably be bringing him in well over £100 a week profit. Yet he is making another £80 a week in a chemist shop.
I think I am entitled to offer the strongest condemnation of the way in which the drug companies of this country are exploiting the Australian community. Every member of this Parliament should press for a full public inquiry into this exploitation. But it is something that I believe the honorable member for Mallee (Mr. Turnbull), for instance, would not subscribe to if he had made a study of the subject - and perhaps he has made a study of it. The Labour Party will not tolerate such exploitation when it comes to power. Whilst I am on drugs-
– Is the honorable member on drug houses or on chemist shops?
– Drugs and drug houses and racketeers connected with the drug industry - and I do not think the honorable member for Angas (Mr. Giles) is connected with it. I remember that about three years ago I ran across a publication in the Library which praised the efficiency of Sabin oral vaccine as opposed to Salk vaccine in the eradication of poliomyelitis. I was aware that Sabin was having marked success in eastern European countries, despite the fact that it was a United States discovery. But now I find that three years later the Department of Health in this country decides to change over from Salk vaccine to Sabin. The Sabin vaccine has totally eradicated poliomyelitis in East Germany. There was an epidemic raging in West Germany and the East German Government was kind to the West German Government - as it should have been - and provided the Sabin vaccine to eradicate the disease. But we find that in Australia it takes three years for the Government to decide to make the switch from one vaccine to the other. One may well ask why. 1 strongly suspect that it is because the drug houses have effective control of the drug industry and the Governments of this country and have said: “ Let us sell our stocks of Salk vaccine first. You cannot switch to Sabin because we will lose too much money “. Human lives mean nothing to the drug houses of Australia. This is the kind of price we pay for the system under which we are living. We see the exploitation of the community under the ruthless . capitalist system which so many Government members support.
The honorable member for Bowman said that United Kingdom medical practitioners are fleeing to Australia, and he implied that this was because of the great national health scheme that we have here. Let us get down to earth, Mr. Deputy Chairman; it is not because they are lovers of our national health scheme but because they are lovers of the attractive salary that comes from practising medicine in Australia. The journal of the Australian Medical Association pointed out some years ago that the average income of a medical practitioner is between 7,000 and 10,000 a year.
– Dollars or pounds?
– Pounds. I am grateful to the honorable member for Higinbotham for asking me to make it clear. This is not a bad salary. One never hears it mentioned by any of the Government members. Does not this salary in itself explain why so many medical practitioners are fleeing from Great Britain to Australia? They cannot earn that kind of money in Britain. They should bc adequately paid. I believe that there ure in the medical profession many decent and honorable men, but. there are also many scoundrels and villains who make the community suffer, just as many people in other fields make the community suffer.
– What does the honorable member think would be a reasonable income for medical practitioners?
– What is the honorable member, as an untrained man, getting?
– I receive my parliamentary salary and nothing else. 1 have no investments and I do not want any, because they might affect my political ideals.
The DEPUTY CHAIRMAN (Mr. Falkinder). - Order! The honorable member should address the Chair.
– Investments might affect my principles, and I do not want them warped, either while I am a member of this Parliament or afterwards. J think that the circumstance that I have mentioned explains why many medical practitioners are fleeing from Great Britain to Australia. As I said earlier, I do not agree with the submission by the honorable member for Bowman, who stated that our national health scheme is the best in the world. The estimates for the Department of Health provide for the expenditure of $11,509,000 this financial year. We on this side of the chamber consider that this sum is totally inadequate to meet the needs of the nation’s health today. Australia’s national health scheme has been described by many people in the community as neither socialistic nor capitalistic, lt is a hybrid kind of scheme that does not do justice to the genuinely and chronically ill. 1 believe that considerable attention should be given to the exorbitant cost of drugs. 1 emphasise the need for a full, open and public inquiry into this matter.
In the Hunter electorate, the hospital authorities at Cessnock and Kurri Kurri have stated that, as a result of the increased hospital charges proposed by the State Government because of the inadequate financial assistance forthcoming from the Commonwealth, private ward charges will be increased from $11-90 to SI 4.90 a day, intermediate ward rates from $9.10 to SI 1.70 a day and public ward charges from S6 to £8.20 a day. The hospital authorities consider that they will have to pass these increases on to patients and are quite certain that patients will be unable to pay them. I imagine that nothing is more distressing to a sick person, whether in or out of hospital, or militates more against his recovery than worry about paying the accumulating debt caused by illness. If this is constantly nagging at a person’s mind, his state of illness will be prolonged. The
Australian Labour Party, when it is elected to office, will overcome these problems.
There is another matter which is related to these estimates in my opinion and which I want to mention. I refer to the Government’s failure to amend the Aged Persons Homes Act so that better care and medical attention can be given to those who are chronically ill, particularly aged persons. There are many tragic cases in my electorate - I am sure that others are to be found throughout Australia - of one aged person in indifferent health looking after an aged partner who is chronically in an even worse state of health.
– And no special benefit of $14 a week is paid.
– No. There are not sufficient homes for aged persons and it is urgently necessary that the Government do something about the matter. Increasing numbers of sheltered workshops are being established to provide for the needs of mentally retarded and physically handicapped persons. These do much to help take the burden off the shoulders of parents with children who are mentally retarded or physically handicapped. These establishments enable the unfortunates who are afflicted in this way to be usefully and gainfully employed. A sheltered workshop has been established in the electorate of the honorable member for Newcastle (Mr. Jones) and another is now going up at Cessnock in the Hunter electorate. People who are so public spirited as to initiate the provision of sheltered workshops have to go about cadging by running raffles or conducting chocolate wheels in shopping centres on Saturday mornings trying to get from the community in general sufficient funds to establish sheltered workshops. Those who work for the care of aged persons have to do likewise. This is a shocking state of affairs. Many people in the community are exceedingly generous, but we have now reached saturation point with these cadging activities by public spirited people who are not given sufficient assistance by the Government.
We find that when the Government wants troops for Vietnam it does not hesitate to pay 17 and 18 year olds full adult rates of pay. Nor does it hesitate to spend $20 million on a rocket firing destroyer to be used at the behest or request of the
Government of the United States of America in any war in which that country is involved. In my view, these things represent just an extension of the United States military forces and Navy. And we pay for them while our aged and sick people are in need of proper accommodation and treatment. This attitude towards the community’s health needs is deserving of the strongest possible condemnation of the Prime Minister (Mr. Harold Holt) and this Government.
.- Mr. Deputy Chairman, my remarks in this debate will be directed to Division No. 250. which covers the funds necessary for the administration of the Department of Health. The proposed expenditure this financial year is §11.509,000. I stress to the Committee that the responsibilities of this Department embrace the expenditure of a very large proportion of the funds expended out of the National Welfare Fund. The expenditure by this Department is Jinked with the important matter of the health of the nation. Within the last few days, we all have been greatly impressed, I suggest, by the annual report of the Director-General of Health. This document is full of illuminating information and there is about the presentation of the latest report a freshness and originality in relation to many points on which, I believe, the Committee would commend the Minister for Health (Dr. Forbes), the Director-General and the staff of the Department. This originality appears in relation to a number of matters. It leads me to suggest that no critic of Commonwealth administration would claim that there is any fixed tradition on which the presentation of the facts in this report is based. Honorable members will be aware that at the back of this excellent report there are quite a number of tables from which we can extract vital information that assists us to assess the trends in health matters and the services provided by the Department, particularly with respect to hospital and medical benefits. It is little wonder, then, that the report, in the few days since it was presented, has attracted considerable attention in the Australian Press. Sections of the report have been discussed in detail in the newspapers for the benefit of the community. I believe that some of the matters dealt with in the report must be mentioned in this debate, as they have been this afternoon, and I am sure that repetition will not detract from the value of mentioning them.
In the few minutes that I have, I shall first of all examine the impact of pharmaceutical benefits on the taxpayers. The Director-General of Health has, quite fearlessly. I believe, pointed out that the cost of pharmaceutical benefits has increased at a rate greater than the rate of increase in the population. He has observed, as we should remind ourselves, that there are active in the community some 1,200 drug salesmen, or medical representatives or detailers, representing about one for every five or six medical practitioners. This was a most opportune comment. J am sure thai all honorable members hope that the closest possible scrutiny will at all times be given to claims for pharmaceutical benefits.
As 1 have visited constituents, particularly those who are elderly and confined to their homes due to sickness, 1 and others have observed with some concern the vast quantities of medications and drugs in their possession, lt would appear to many taxpayers who come in contact with this situation that the quantities supplied are far in excess of actual needs and that the continued rise in the cost of pharmaceutical benefits certainly calls for every care as far as departmental control is concerned. We all desire. I am sure, that this scheme, so well and adequately praised by the honorable member for Bowman (Dr. Gibbs), who is himself a professional man and therefore qualified to speak on these matters, should provide life saving drugs. We want to sec the scheme assist people who need assistance. We applaud all that has been done in the interests of the elderly citizens of our community. But surely we dare not tolerate any loose administration which might, not necessarily now but in the future, permit costs to go far beyond the basic intention.
In the report, the emphasis on the pensioner medical service has caught the attention. I am sure, not only of myself but also other members of the Committee. When we turn to table 14 in the report we find there some most interesting information. 1 would underline the fact that now 8.8 per cent, of the Australian population is enrolled in the pensioner medical service. The table shows that in the last 12 months 157,000 people have been added to the number previously enrolled. It is estimated that about .120,000 of those gained entry only since 1st January last because of the Government’s amendments to the pensioner medical service - amendments which provided all full or part pensioners with the benefits of the scheme free of means test. To my mind this was a meritorious decision by the Government.
– Hear, hear!
– Naturally the honorable member would expect me to say that. It is good that we can applaud a government’s decision. I imagine that in this field the honorable member has to do the same. The service has proved to be of tremendous value to this wider group of pensioners. Naturally they have been pleased with the opportunity now presented to them to claim a service which they noticed other pensioners in earlier years had received. This was something which many of us had been advocating through the years. I want to place on record that, once again, the Government probably would have found it possible to introduce this as a desirable amendment some years earlier had the ready co-operation of the medical profession as a Whole been available. The full impact of this substantial increase will not, as far as costs are concerned, be apparent until a full financial year has passed.
The table at the back of the report provides valuable information about visits by doctors under the pensioner medical service. This information relates both to surgery visits and visits by doctors to private homes, classified as domiciliary calls. It is apparent that visits to doctors’ surgeries have increased substantially while the number of domiciliary visits has declined. The average number of services per enrolled person is down from 8.6 to 8.4 but this situation, of course, has no doubt been affected by the large increase in the number of persons involved in the service for only half of this last year.
I wonder whether there are some anomalies in respect of surgery and domiciliary visits as between the Stales that should be clarified. For example, in Western Australia the proportion of domiciliary calls on pensioners by doctors would appear from the table to be substantially below the proportion of domiciliary visits in the neighbouring State of South Australia. Referring to the table I find that in South Australia 389,000 surgery services were rendered and 317,000 visits of a domiciliary nature were made. But in Western Australia 379,000 visits were made to doctors’ surgeries and only 1 68,000 visits were made by doctors to the homes of pensioners. So I would hope that the Minister for Health (Dr. Forbes) might be able, at the conclusion of the debate, to pass some helpful comments on this aspect. It would be interesting to establish from the Minister’s reply, if that is possible, whether there is a satisfactory explanation for this variation as between two States. I am one who believes that elderly people are entitled, in many circumstances, to receive their medical calls in their own homes and I would hope that the relativity of services to which I have referred will attract the closest analysis by officers of the Department of Health. The tables and the records kept and surveyed by officers of the Department are vital in this field.
I am not one who would at any stage advocate that it should be easy for malpractices in claims upon the Commonwealth to occur, but some very dedicated practitioners have drawn my attention to the fact that an inhibition is placed upon them regarding their calls on elderly people because the Department applies a formula which could well be related to the average number of services per enrolled person, as set out in the table. I would hope that this being a common average for the whole of the nation for the period of 12 months, it would not be used in any rigid way, because we can appreciate that, the average being 8.4 for all persons so enrolled, if a person is very sick and has a stream of calls on a local doctor over a period of three, four or more weeks, the average could well be exceeded. I gather from medical practitioners who have mentioned this matter to me that there is a fairly arbitrary application of an average of this kind. So I would recommend to the Minister that this matter might be considered and checked so that any unfair inhibition of the kind to which I have referred might be removed.
Table 15 in the report indicates that last year the average number of services per enrolled person was 8.4. There is a variation as between the States. Some of these State variations again logically attract our attention and are worthy of notice by those who are interested. From the same report I suggest that we must note the average remuneration to doctors under the pensioner medical service. Last year it was $2,246 compared with $1,578 in the previous year. While this is an increase of 42.3 per cent., most of us would be satisfied that it is due to the approved increase in fees for doctors. Another 12 months of statistics will be required before we can adequately measure the trend.
I understand from the report that in New South Wales a medical councillor has been appointed to guide medical practitioners in respect of claims upon the Department of Health. This, I feel, will be a valuable and worthwhile experiment. I believe it will be of great protection to the medical practitioners in general, and we should look to it in future to see whether it warrants a further extension by way of appointments to the other States.
Finally, 1 want to touch on care of the aged and to suggest that the Commonwealth Department of Health might develop its contribution to the care of the aged for the reason that the Commonwealth is now experienced in housing the aged. It is now to provide a subsidy for hospital buildings as an extension of the service given by various churches and charitable bodies. The Commonwealth contributes $2 a patient a day and is at this stage inspecting nursing homes and hospitals, so 1 suggest that it might well supplement the excellent work of the State Governments in the field of geriatrics. I believe that specialist research and national leadership in the care for the aged would be applauded by State Governments. The Scandinavian countries rank high in world opinion for their humanity towards their elderly citizens. Perhaps Australia can benefit from a close study of the methods used in those countries. We should compare our legislation. We should check upon our ideas in respect of the independent living and also the institutional care that we give to our senior citizens. Geriatrics and care of the aged are well worthy of detailed research by the Commonwealth Department of Health.
.- Let me bc plain right from the start. In my opinion the Australian national health scheme is seriously sick. As a matter of fact 1 am beginning to wonder whether the people in my electorate of Barton are some peculiar kind of people. Some will assert that they must be to have elected me to the Parliament. Forgetting that kind of facetiousness though, the range of complaints that are made about the national health scheme by my constituents, and indeed by many other people in the community, would have me believe anything but the contention of the Government that we have the best national health scheme in the world. Let me in summary form refer to some of its obvious inadequacies.
First is its inadequate coverage for doctor and hospital services which now must be among the most expensive in the world. I mean inadequate in the sense of financial coverage. Secondly, there is no coverage whatsoever under our scheme for dental, optical, physiotherapy and a host of other services described as ancillary services. Thirdly, there is a serious weakness in support for medical research as reported by no less a person than Dr. Ronald Wells, the First Assistant Director-General of Health, who is Secretary of the National Health and Medical Research Council. Fourthly, there is no protection for families receiving sickness and unemployment benefits. We know that the emolument they receive is not altered by the Budget, yet they are expected somehow or other to keep up their fund contributions, during their period of illness, in order to protect themselves. There is the oft reported shortage of doctors, particularly in country districts. Various country towns are offering homes free of cost and sometimes they are even guaranteeing to provide practices for doctors, but there are no takers. Then again there is the grave difficulty of not only pensioners but of ordinary citizens in getting beds in public hospitals. These days they are admitted only in many cases when they have acute illnesses and everything possible is done to -get them out of the hospital at the earliest opportunity.
Great difficulties are reported today in various sections of our public hospitals. One of the great public hospitals of Sydney, a teaching hospital, reports deplorable conditions in its casualty section. Other hospitals are reporting difficulties in other sections of their activities. There is the uneconomic multiplicity of private hospital and medical benefit organisations. 1 have not by any means exhausted all the criticisms that are made of our national health scheme. The “ Australian “ reported on Saturday, 13th August, under the heading “ Hospitals Face Financial Crisis “ that doctors are working a 90 hour week. The article quotes Professor John Griffiths, Professor of Hospital Administration at the University of New South Wales, as saying that not one in four Australian public, general and private hospitals could meet the standards of the United States of America and Canada. As a matter of fact, so confident was he of that proposition that he offered to pay §200 to charity if a random sample disproved his claim. The “ Australian “ sent out its own investigation team to see whether there were any truth in What Professor Griffiths had to say. After interviewing doctors, nurses, politicians, hospital administrators and patients it produced these claims - and I quote now from the “ Australian “ -
Resident doctors at some hospitals arc working 90 to ]00 hours a week.
Many nurses spend much of their time on menial chores at the expense of patient care.
Medical records are largely non-existent or hopelessly inadequate.
Empire-building and lack of co-operation in hospitals is causing needless waste of money.
Doctors and hospitals are writing off at least $10 million a year in bad debts.
The imbalance between country and major metropolitan hospitals is growing.
The article then refers to a number of other matters. Another authority, Douglas Gordon, Professor of Social and Preventive Medicine of the University of Queensland Medical School, when talking about the need for a total review of our national health scheme, said -
Mow often do patients stay longer in hospital because there are not enough typists to keep up with the paper work? How often are delays caused by lost records?
Answers to such questions are not lacking; but. when they are analysed, it can be seen clearly that for the most pari they are really opinions based on fragmentary facts which no business organisation could tolerate if it were to remain solvent.
In other words, he is saying that our hospital administration is woefully inadequate. I have some sympathy for the States in their dilemma at the present time. For once I agree with Sir Henry Bolte, and I must agree with the Liberal Premier of New South Wales, Mr. Askin, in his comments on the bad deal the States get from the Commonwealth as a result of Commonwealth and State financial relations. Why should they not complain? Let us look at the figures in terms of national debt, nowadays referred to as securities on issue. In the last 16 years, between 1950 and 1966, the Commonwealth Government has been able to reduce its share of the national debt by $587 million, but on the other hand the States have had to increase their share of the national debt - have had to go into the red - by more than threefold. They have had to increase their share of the national debt by no less than $5,127 million. No wonder the States are in great trouble in trying to maintain their public functions and their public utilities, whether in respect of education, hospitals, health generally, housing, transport, police administration or anything else. In a community near mine a house or two goes off - as the saying is - every night. Burglary is rife.
– It is a national sport.
– Yes, it is a national sport. There is also the whole situation of local government, with extremely high and increasing rates of various kinds. All of this breaking down of State services derives from the very inadequate and unjust Commonwealth and State financial relations. I do not pay much credit to Mr. Askin, though, for drawing attention to this problem, because when he was in Opposition and the Renshaw Labour Government was making the same complaint he was saying: “ But the States are getting record amounts of money. The Commonwealth is giving you more money than you know what to do with.” It is funny how these fellows get a new sense of responsibility and a new sense of perception once they get into government and have to balance a Budget. Now we find Mr. Askin proposing further substantial increases in hospital charges in his pursuit of a “ sock the sick “ campaign in
New South Wales. In that State, the cost of accommodation in a public ward is to be increased from $42 to $57.40 a week, or in the old currency which many people still understand better, from £2! to £28 14s. a week. This is an increase of 37 per cent. Here, of course, the means test is applied and only the relatively poor members of the community will be admitted to public wards. If a person wants to insure to cover the public ward charge he will be required to pay S3 1.20 or £15 12s. a year. The figures 1 am now giving relate to charges for family cover. In Victoria, hospital charges are to be even higher than in New South Wales. The cost of accommodation in an intermediate ward in New South Wales is to be jacked up to $81.90, or £40 19s. a week. One would think the accommodation was being provided in the Waldorf - Astoria or some similar luxurious hotel. The cost of £40 19s. a week represents an increase of 28 per cent, in the intermediate ward charge. The cost of insurance to cover treatment in an intermediate ward is to be $41.60 or £20 16s. a year. I remind honorable members that this is for hospital accommodation only. It does not include the cost of the doctor. No doubt the contribution to cover medical fees will be a like figure. In addition a patient has to meet dental, optical, physiotherapy and other ancillary charges. I remind those who may have to go into intermediate wards that they will be required to meet not only the ward charges but also the cost of other services such as injections and the various medicines which are not provided for under the national health scheme.
If a person wants cover for his family to meet the cost of accommodation in a private ward the expense will be enormous. The private ward charge is to be $104.30, or £52 3s. a week and the cost of insurance to cover that enormous charge will be $57.20 or £28 12s. a week. And all this in addition to the taxation one pays by way of income tax and social services contribution. If one happens to be a very unlucky person who is required to be in hospital for more than 91 days in a year, the fund payment is reduced to the standard rate despite the fact that insurance premiums to cover the higher rate have been paid. After 91 days in hospital, the fund benefit is reduced to $35 a week. This is all that a patient is paid to meet a weekly change of $57.40 for a public ward, S81.90 for an intermediate ward and S 104.30 for a private ward.
I come now to the pensioner medical scheme to which reference has been made in this debate. I suggest that it is nothing more than downright fraud and deceit for the Treasurer (Mr. McMahon) to say, as he did in his Budget speech and as has been said, in effect, on numerous other occasions -
Under existing arrangements pensioners and their dependants are entitled to free public ward accommodation and treatment in public hospitals.
The Treasurer must, know by now that the vast majority of pensioners cannot gain access to public wards and therefore cannot get the free treatment that has been promised to them. If they are long term patients as they most likely will be, they will not be received into the public ward of any hospital that I know of in New South Wales. Therefore, they have to go into private hospitals or convalescent hospitals.
Many people - one such case came under my notice yesterday - after contributing to a fund for perhaps 25 years to meet the cost of hospital treatment, cancel their membership upon receipt of the pensioner medical card, believing that they are entitled to free hospitalisation under our pensioner medical scheme. They find, however, that they will not be admitted to public hospitals and are up for a cost of at least £25 a week in some private hospital. They receive no fund benefit and only 8s. a day in Commonwealth benefit. If they go into a convalescent home as distinct from a private hospital, they will get £7 or Si 4 a week without having to belong to any fund. In any case, apart from the pensioners, long term hospital patients are reduced to the standard fund rate of only S35 a week after 91 days in hospital.
Rather interestingly, it is proposed in the Budget that recipients of repatriation service pensions who become mental patients shall receive up to 12 weeks arrears of service pension upon being discharged after treatment in a mental hospital. 1 am quite happy that some improvement is being made there. Goodness knows why the so called national health scheme does not completely cover the civilian pensioner mental patient. The service pensioner is to be given some cover under the provisions of the Repatriation Act, but what about the vast majority of pensioners who receive their pensions from the Department of Social Services? Why is not something comparable being done for them? As soon as they go in: 0 a mental institution, their pensions are cancelled. I. hope that honorable members will appreciate from what 1 have been able to say in the short time at my disposal that there are grave deficiencies in our national health scheme. These deficiencies cause grave misery and misgivings to many people. They cause great distress to elderly people who become worried at the prospect of having to go into hospital, even before they are sick.
The DEPUTY CHAIRMAN (Mr. Stewart). - Order! The honorable member’s time has expired.
– Mention has been made of the pensioner medical service card. I should like to place on record the fact that entitlement to this concession, which was extended to all pensioners by a Labour Government, was severely restricted by the present Administration and only recently has been liberalised slightly. There are certain people in the community whose capacity to earn is no greater than that of the age pensioner yet they cannot get a medical entitlement card. I refer in particular to one class of pensioner in whom my colleague the honorable member for Hunter (Mr. James) would be interested. I speak of those who have contributed to a retirement fund in the mining industry. These men who spend their working lives in the bowels of the earth make contributions, together with their employers, to a fund from which they are paid a pension on retirement.
In Queensland, coal miners are compulsorily retired at 60 years of age. They draw a pension of about £24 a week. If a miner pensioner is married and has a wife 60 years of age, then, subject to the means test, she becomes eligible for an age pension and a medical entitlement card. I understand that this card entitles her to free medical treatment. Her retired miner husband, however, is not entitled to such treatment, nor are any dependent children under 16 years of age or any student children. In my view, this is an anomaly.
Further, if a miner’s wife becomes widowed and therefore entitled to a pension from the retirement fund to which her husband had contributed while working, she is asked to give up her age pension and transfer to the miner’s retirement fund. If she does this, she loses her medical entitlement card. She was deprived of the entitlement. In Queensland the number of superannuated people will increase because under an Act of the State Parliament passed last year all local government authorities are obliged to establish superannuation schemes and it is compulsory for all employees of such authorities to contribute. The only employees exempt are those who will be retiring within a year or two. All these contributors will, on retirement, join the great number of public servants and others who, because they receive superannuation payments, are not entitled to even a part pension and, therefore, to a medical entitlement card.
The other matter I wish to mention is the increase in the allocation to the National Fitness Council. A step has been taken in the right direction. I know that the State National Fitness Councils have pressed continually for additional funds to enable them to carry on their work. I have the honour or being a vice-president of the Wide Bay area committee of the National Fitness Council in Queensland. I know the work that the Council does. We have engaged a fulltime organiser to establish national fitness clubs. We have only to look at the number of volunteers for the Services who have been rejected on medical grounds to realise that much is to be desired in the fitness of the youth of this country. This was one of the prime reasons for commencing the national fitness movement. It seems to me that the work of the Council needs assistance now more than ever before.
I commend the Government for making available a subsidy for capital works carried out over a period of three years by the National Fitness Council, but I believe that a greater degree of co-operation should be shown between the Council and the Taxation Branch in the matter of exempting from sales tax all equipment purchased for national fitness purposes. I do not refer to expendable materials such as basketballs and the like but to other items such as row ing shells and trampolines. Trampolines cost about £120. In recent months we have established national fitness trampoline clubs in the Wide Bay area and we have been able to raise the necessary funds to provide equipment. For example, because the secretary of the local national fitness club was an employee of a certain bank, the bank advanced a loan to that club to purchase a trampoline. The additional £30 or £40 sales tax on such an item does not seem much but the point is that this equipment remains the property of the National Fitness Council. If a club becomes defunct, the area committee representing the State National Fitness Council can take over the equipment and either retain it until such time as the club is reformed or give it to another club to assist that club to carry on its work. A greater degree of co-operation than is at present apparent should exist between the Taxation Branch and the National Fitness Council. 1 wish to refer also to the discrimination against optometrists in the national health scheme and in the field of repatriation. I know that a number of honorable members on both sides of the House have raised this subject. The Australian Optometrical Association has made numerous representations and has been told that optometry in isolation cannot be brought within the ambit of the national health scheme. I do not wish to discuss in detail this aspect of the repatriation service but I shall mention it in passing.
Sitting suspended from 6 to 8 p.m.
– Prior to the suspension of the sitting I was speaking of the attitude towards optometrists which now prevails under the National Health Act. I was pointing out that in claims under the Act optometrists are lumped together with ancillary services, such as nursing and physiotherapy. Both these services are subservient to the medical profession and are largely dependent on it for their fees. On the other hand, optometry is a fulltime profession, the training for which is at fulltime courses at the University of Melbourne and the University of New South Wales. Like dentistry, optometry is independent of the medical profession, although optometrists work with medicine to a certain extent. The Australian Optometrical Association now wants to have its sphere of activity defined. It claims that this is in the public interest.
The A.O.A. claims that many approved benefit organisations extend fund benefits for both eye examinations and spectacles to all their contributors, but that the medically controlled Blue Cross funds are allowed to discriminate in favour of the medical profession by refusing to pay a fund benefit to those contributors who prefer to go to an optometrist. I understand that the procedure is that the person first consults a general practitioner who refers him to a specialist who then undertakes the work of refraction, which is normally carried out by the optometrists, and the prescribing of glasses. The patient then claims for the examination and for the prescribing by the specialist. It is felt by the Optometrical Association that this is a restricted practice in favour of the medical profession. The optometrists realise that the medical profession has the ear of the Government and that, quite rightly in many instances, the Government feels that it should listen to the medical profession on health matters.
Optometrists are required to undertake special courses and their specialist training is not always undertaken by eye specialists who, because of the nature of their work, have a shorter contracted course on optometry. The Australian Optometrical Association has never claimed that it is qualified to deal with eye diseases, but it does claim that because of the nature of the work and the experience gained optometrists are able in many cases to identify diseases of the eye. In all cases, because of their professional responsibility, they have referred persons to doctors, who in turn have referred them to qualified specialists. It is apparent that many people have eye diseases but are not aware of their condition. I refer to a recent test conducted in Queensland by the service organisation known as Lions International which sponsored a glaucoma clinic where inspections were carried out in various centres right throughout the State. On that occasion a professional man made himself available voluntarily and he recommended to people whether they should seek further attention for their eyes.
The optometrists protest at their treatment. They point out that although the Go vernment says it has no jurisdiction over fund benefits which are paid, unless they exceed 5 per cent, of the total contribution to the fund concerned, when the Hospitals Contribution Fund of New South Wales sought permission to include a spectacle benefit to all its contributors, whether patients of optometrists or eye surgeons, permission was refused. Optometrists contend that the rectification of this glaring anomaly would entail no additional expense to the Government; it would simply require a ruling or regulation that any fund that wished to pay a fund benefit for eye examinations - not for diseases of the eye - and the provision of spectacles must be fair to all its contributors and be required to make the payment whether the examination was conducted by an optometrist or an eye surgeon.
The Association feels that unless something is done along these lines it will be plain that the medical profession is exercising a very tight control over the national health scheme. The Association points out that optometrists, although not claiming that they are qualified to treat any eye disease, claim that they have the ability, because of their experience in the examination of eyes and their work with eyes, to be able to identify eye diseases in their early stages and in many cases have been able to save an individual’s sight. I hope that the Minister will be able to give further consideration to this request by a worthy organisation.
.- I support most heartily the remarks of the honorable member for Wide Bay (Mr. Hansen) in relation to optometrists, the national health scheme and the Government. For 15 years the Australian Optometrical Association has patiently tried to get justice under the National Health Act which at this moment denies it justice. The Australian Medical Association, with the connivance of the Australian Government through the National Health Act, has been discriminating against optometrists in Australia with a very effective economic stranglehold on these trained people. The economic stranglehold which has been applied to optometrists has been carried out by a combination of the National Health Act, the Commonwealth Government and the Australian Medical Association. Those three are the guilty parties in this unjust treatment. For several years the 800 professional men who are members of the Australian Optometrical Association have found that the National Health Act restricts their work. Prior to 1951 when the Act was introduced by Sir Earle Page, doctors or optometrists could send their patients direct to specialists for the treatment of eye troubles, but since the National Health Act was brought in by this Government every optometrist’s patient who has a suspected disease of the eye has had to go to a doctor who has then referred him to a specialist or an ophthalmologist. The patient pays the doctor in the first place and then pays the specialist, and the Commonwealth Government is involved in a double payment.
The optometrists are being economically strangled by four methods. First is the practice which has grown up under the National Health Act of forcing optometrists to refer eye cases to medical men instead of direct to specialists. In other words, the intermediary has come into this scheme. As honorable members know, the doctors are on a very good wicket today; they benefit both coming and going. With so many new methods of treatment which doctors have installed a patient is on a real roundabout to get treatment. The doctor is a lucky man because he benefits both coming and going. The case of the optometrists is one instance of this. The second method is in the refusal by the Medical Benefits Fund of Australia Limited, which is run by the doctors and the chemists, to pay for glasses unless they are prescribed by a medical practitioner or an ophthalmologist. In other words, there is no benefit from this fund if the glasses have been prescribed by an optometrist. The third method is the threat of gradual reduction in the number of university undergraduates taking the optometry course. The fourth method is the operation of Optical Prescriptions Spectacle Makers Pty. Ltd. Through television and newspaper advertisements, this company is advising people to see doctors and not optometrists when they have their eyes examined. The organisation is operating in 80 to 100 places in Australia. Last year, a friend of mine in this city rang the organisation and asked whether it could help her with her eyes - whether it would test them. These people said: “ No, but we can recommend two doctors who will “. She was given the names of two Canberra doctors and she was told that consulting a doctor was an excellent proposition because she would then have $4 taken off the cost of spectacles prescribed by the doctor.
– But doctors can only count eyes, can they not?
– Probably, but this is an interesting demonstration of the way they work. The organisation did not refer her to an optometrist, but to two doctors. This is the intermediary again. Spectacles prescribed by a doctor attract a refund of $4. The optometrists are being bypassed in the workings of this unfair provision in the National Health Act. The medical practitioners arc engaging in direct competition with optometrists. A medical practitioner deals with eye diseases only as a sideline whereas the optometrist makes work associated with the eye his entire career. He trains in eye conditions for five years at a university and sets up as a man qualified to care for the eyes. In my opinion, that, is a scandalous state of affairs and we on this side of the Committee will continue to do all we can to correct it.
– Honorable members on the other side should, too.
– The other side has been looking at this for years, but has refused to do anything about it. And we know why. It is because the National Health Act is really the A.M. A. act. That is the association that approved of the Act and all along the line the Government must pander to it. lt must approve an amendment before it is passed. The Government is not running the Act; the A.M. A. is running it.
– Dr. Forbes is.
– He is a mouthpiece. The optometrists are being bypassed through the deliberate connivance between the A.M.A. and the Government, with the assistance of the Act that was brought in many years ago and has not been amended on this point. This looks like a deliberate long term plan to restrict the optometrists in their life’s work and to channel the treatment of eye conditions to doctors instead. About 15 months ago, the Australian Optometrical Association, to show its good faith, inaugurated a scheme of scholarships, which are available in al!
States. Optometry is a full time course at the University of Melbourne and the University of New South Wales. The scholarships were introduced to ensure that students of the highest standard were attracted. Thus, optometry, which has always been held in high esteem in Australia, is giving practical recognition to the need for a five-year course. The Australian Optometrical Association provides four scholarships a year. They involve a payment of $2,500 annually. So, in five years the optometrists are paying more than $.12,000 out of their own pockets to carry out a scholarship scheme designed to encourage young men to engage in this worthy profession, which is being strangled, as it were, by the discriminatory provisions of the National Health Act.
The Medical Benefits Fund of Australia pays $4 towards the cost of spectacles, provided they have been prescribed by a specialist, a doctor or an ophthalmologist, but not if they are prescribed by an optometrist. In the past few years, the number of optometrists has increased by only 2 per cent. But the number of ophthalmologists has increased by 40 per cent. No wonder, when we have an act of Parliament that obviously is deliberately designed to encourage the ophthalmologists at the expense of the optometrists. This is a national Act and it should be a fair and just Act. The Parliament should always act fairly and should not discriminate against one section of the community. I condemn the discrimination in the National Health Act with all the force at my command. Other Opposition members have done so over the years. The honorable members for Bass (Mr. Barnard), Wide Bay and Barton (Mr. Reynolds) have spoken on this subject and so have I. I will outline the procedure that is followed. When a patient with eye trouble visits an optometrist and the optometrist considers that the eye may be diseased, he refers the patient to an ophthalmologist. If as a result of testing the ophthalmologist establishes that there is disease, the patient is treated by the eye specialist, but if he does not find that the eye is diseased he has the right to refer the patient back to the optometrist from whom he came. Under this vicious Act, he does not do that. He keeps the patient, who has been stolen from the optometrist. In some instances, the patient is sent to Optical
Prescriptions Spectable Makers Pty. Ltd. for his glasses.
– Who owns that organisation? The doctors, I suppose.
– I imagine they could get some kind of commission out of this for referring their patients to the organisation. The optometrist therefore loses the patient who came to him in the first place and who was sent in good faith to the ophthalmologist in the belief that he had an eye disease. If he did not have a disease, he should have been sent back to the optometrist. But he is not sent back; he is kept by the ophthalmologist and sent to this organisation of spectacle makers for his glasses. I regard this as most serious and I hope that the Minister, even at this late stage in the history of the Act, will give the requests of the Australian Optometrical Association consideration with a view to including optometrists in the provisions of the Act.
I want to refer to another matter in the time left at my disposal. I note from the excellent report of the Commonwealth Department of Health that discrimination still exists between people in an approved medical benefits society and people who are not. Of course, this is one of the worst discriminations in Australia. We are told that 78 per cent, of Australians are now insured in more than 80 medical benefit funds, which have grown like mushrooms since the Act was passed. In other words, 8,915,000 people are now insured. But this is interesting. The Government will pay $2 a day to people who are not pensioners in a hospital if they happen to be in a medical benefit fund. If they are not, they receive 80c a day. This is a wicked discrimination. People are being forced to join medical benefit funds so that they will receive the extra $1.20. That is the extra amount that is paid by the Government to insured persons. Why should there be such discrimination by the Commonwealth Government in the matter of sickness? Two people with similar ailments may be in adjoining beds in a hospital. One will get 80c a day from the Government because he is not insured; the other will get $2 a day because he is a member of a medical benefit fund. This is deliberately forcing people into this empire of insurance that has been built up all over Australia since 1951. This is becoming a great colossus, a kind of Frankenstein in our economy.
Honorable members on the other side have been boasting about the abolition of the means test within the means test for the pensioner medical service. In 1956, the Government abolished the free medical service lor pensioners. But it then brought in a means test within a means test, wiping out over 100,000 pensioners from entitlement to a medical card because they had more than £202 in a bank or other institution. Then, after nearly 10 years of that inequity and injustice, the Government suddenly announced last year that it was going to wipe out this discrimination which existed by its own act. It is good that the Australian people should realise this.
Finally, in the section of the report of the Director-General of Health for 1965-66 dealing with pharmaceutical benefits we find that benefit prescriptions totalled 49 millionodd last year. This was an increase of 1.370,122, or 4.1 per cent., in the number of prescriptions written. The population of Australia has increased by only 2 per cent, in that time but those prescriptions have increased by 4.1 per cent. Why? Have people suddenly become ill more often or has sickness increased in the last 12 months? Why was there not parity between population growth and the increase in the number of prescriptions? I think there must be over-prescribing, and that that is why this great increase has taken place.
.- I would like to thank honorable members who have taken part in this debate on the estimates for the Department of Health for the tributes they have paid to the report of the DirectorGeneral of Health, for the way in which it was produced and for the information contained in it. I. will be glad to pass those comments on. I would now like to say something about matters which have been raised by honorable members in the course of this debate. I have been rather distressed to find an atmosphere of hostility to the medical profession in Australia in most of the speeches made in this debate by members of the Opposition. This was clear in the speech of the honorable member for Wilmot (Mr. Duthie) and in the remarks of a number of other speakers from the Opposition side.
– -It is just that the Government is discriminating against other professions.
– The honorable member for Barton, who interjects, has raised one particular matter mentioned by the honorable member for Wilmot. But 1 am talking about this in a more general sense now. Speaker after speaker on the Opposition side chose to be extremely critical in one way or another of the medical profession in Australia. 1 refer honorable members to “ Hansard “ if they do not believe this. In order to redress the balance somewhat I point out that, as the honorable member for Bowman (Dr. Gibbs) said, we have developed in Australia since 1952, when it was introduced, what I believe is the finest national health scheme in the world. J know few people of experience who have not testified to this - that we have instituted a scheme which produces a balance between the finest medical and hospital care being available to all and the private responsibility of members of the community to do something about helping with the provision of their own medical and hospital needs. At the same time we have created a scheme in which the medical profession finds that it is able to co-operate while working productively in order to meet with the ever increasing demands made on it if it is to keep abreast of advanced modern techniques. One thing that distresses me about the attitude of many members of the Opposition is the complete lack of realisation of the tremendous pressures and responsibilities that rest on members of the medical profession if they are to discharge their duties properly and efficiently in a situation of tremendous technical advances.
Honorable members opposite have indicated that they believe our national health scheme should be replaced with a different one. They point to the health scheme in the United Kingdom as their talisman. But as the honorable member for Bowman pointed out - and we have had plenty of evidence of it recently - to a large extent the British scheme is breaking down. One of the reasons for this is that it does not provide an atmosphere in which the medical profession considers that it can work productively and give the type of service it thinks should be given. I am aware that one or two Opposition members said that the only reason why British doctors were fleeing to Australia or the United States of America, but particularly to Australia, was that they would get more money here. That seems to me to be a highly over-simplified view. Honorable members opposite do not seem able to comprehend the vital importance of having an atmosphere, an environment, in which you can work harmoniously and productively when you are doing this type of work, on this level, and under the strain involved. Despite its defects, and despite the criticisms that people have made of it, the Government has provided a scheme in Australia which enables the medical profession to do this.
– The medical profession should be pulled into line like the wharf labourers were.
– The honorable member for Kingsford Smith, by his interjection, demonstrates completely and explicitly the point I am trying to make, so I think I need say no more on it.
Another general theme in the contributions by honorable members was the question of hospital charges. This has been highlighted by recent increases in some States. Some honorable members attempted to link this with the national health scheme and held that in some way this was a Commonwealth responsibility. The allegation was made that the Australian hospital system was breaking down and that this was the fault of the Commonwealth. I want to make it perfectly clear that hospital services, hospital administration and hospital policy in Australia are the responsibility of State Governments. What those Governments do in relation to hospital charges and hospital revenues is completely their own affair. I just point out in passing that although there have been increases in hospital charges, those charges vary widely as between the different States. In Queensland, for instance, public ward treatment is provided completely free, while in Victoria the charge for public ward treatment has recently been increased to $10 a day. This on the one hand emphasises my point that the provision and administration of hospitals and the charges for hospital treatment arc matters purely for the States. On the other hand it emphasises the difficulty in relation to that aspect of the matter for which the Commonwealth has accepted responsibility through the national health scheme, that is the provision of benefits to individuals to assist them to meet the cost of hospital care. These variations to which I have referred point up the difficulty of devising a scheme to cover a situation in which there ave six different hospital administrations, wide variations in charges and in policy and so on. The remarkable thing is that in this situation the hospital benefits scheme is successful and effective. We have created a scheme which provides substantial benefits to assist individuals to receive hospital care, even within the framework that I have just described. The scheme is flexible enough to meet the situation.
The other point 1 want to make is that although the Commonwealth has, under the national health scheme, provided assistance to individuals to cover a substantial proportion of their hospital costs, it has never accepted the responsibility for any particular proportion of those hospital costs. The Commonwealth benefit that we provide is an incentive. It is an incentive to people to insure voluntarily; an incentive to them to make their own provision for hospital treatment, so that they will be able to meet the charges which the Slate authorities, in their wisdom and having this responsibility, levy on them. And it works, if I may say so, quite effectively, despite the criticism we have heard about the level of Commonwealth benefit. It works so effectively that Commonwealth benefits have increased by 300 per cent, in ten years, as honorable members will see if they look at the Director-General’s report.
As I have said, the Commonwealth does not accept responsibility to provide a specific proportion of hospital costs at any particular time. How could it do so in face of the variations in charges in the different States and of the various elements in the cost situations in the different States? What the Commonwealth has done is from time to rime to review the national health scheme and to provide improvements, to make additions, and to increase benefits where this seems desirable in the light of the requirements of the times and of the budgetary situation. Although it is true that the Commonwealth Government has not for some little time increased the Commonwealth benefit element of the hospital benefits scheme, it has made considerable improvements and additions in respect of other elements of the scheme, and the Government will continue to review the national health scheme year by year in the light of its budgetary situation and make improvements where they seem to be desirable.
I may remind the Committee that in this years Budget the Government has increased payments to hospitals for pensioners who receive free treatment from S3. 60 to §5 a day. This will mean that in a full year more than S6 million will flow directly into the States’ hospital systems. The Government also increased the guaranteed minimum benefit, the standard rate benefit, for hospital patients who are insured from $3.60 to $5 a day. These are the people in the community most in need. From 1st January 1965 - honorable members opposite have tended to criticise this - the Government increased Commonwealth medical benefits by one-third, and more in the case of some benefits. From 1st January 1963 the Commonwealth introduced nursing home benefits of $2 a day without any insurance requirement. All these measures strengthened the ability of people to receive proper treatment without financial hardship, and they strengthened the position in areas where assistance was required most urgently and was most necessary.
The other general matter that was touched on by quite a number of speakers in this debate was the pharmaceutical benefits scheme. Reference was made to the statement in the report of the Director-General that the pharmaceutical companies employ a very large number of detailers or sales men. He mentioned a figure of one to every five or six doctors in Australia. As I said in answer to a question today, this is the Director-General’s opinion arrived at after a very careful investigation of the situation and much experience. I am inclined to agree with him. I feel quite certain that the activities of the salesmen for the drug companies have played a part in increasing the cost of the pharmaceutical benefits scheme. The honorable member for Grayndler (Mr.
Daly), having highlighted this point during his speech in this debate, asked what we were going to do about it. I do not quite know what he means by that, but if he is asking whether we intend to restrict the number of salesmen the drug companies may employ, the answer is that we do not.
I want to make the point that the very fact that the Director-General of Health has chosen to publicise this matter in his report will, I believe, have considerable influence on the situation. I think it not only will have some influence on the pharmaceutical companies, which on the whole are responsible organisations, but also will constitute a warning to the members of the medical profession and others at whom the activities of these people are directed. In these days of subtle salesmanship and techniques, the effect is not always obvious even to the object of the activities. I believe that the highlighting of this matter by the Director-General in his report and the publicity that it has been given both in the Press and in this Parliament will have salutary effects. I have no doubt that that was the principal reason why the Director-General chose to highlight the matter in his report.
The honorable member for Grayndler implied that the Department’s negotiations with the drug companies for price reductions for pharmaceutical benefits that have resulted in considerable savings to the taxpayers arose from some comments that the honorable member for Hughes (Mr. L. R. Johnson) had made in this chamber a number of years ago. I point out that officers of my Department have been actively engaged in these price negotiations ever since the pharmaceutical benefits scheme began in 1950 and that the object of the negotiations at all times has been to arrive at fair and reasonable prices for drugs prescribed under the scheme. This Government does not believe in the arbitrary fixing of prices for drugs. But it does believe in fair and reasonable prices freely negotiated between the parties. The honorable member for Grayndler compared the prices paid for drugs under the pharmaceutical benefits scheme in Australia unfavorably with the prices paid under the United Kingdom scheme. Taking into account all things, including the size of the market in the United Kingdom, the volume of prescribing there and the difference between the sources of raw materials, I believe that prices in Australia are not markedly out of line with the prices paid in the United Kingdom for pharmaceutical benefits.
In this debate, reference has been made to excessive prescribing. Health authorities in all countries that provide assistance to their people in obtaining drugs - not only in Australia - have the duty to keep before the community the problems associated with the unnecessary prescribing of drugs. Unnecessary prescribing has adverse effects medically in many instances. As we know, because of resulting increases in the cost of pharmaceutical benefits, it has adverse effects financially also. But many patients expect their doctors to write prescriptions, and the health authorities must help the medical profession to see that patients maintain a proper perspective concerning what drugs can do. Whenever opportunity offers, medical officers of my Department provide information to medical men in private practice regarding the value of particular drugs. In this respect, I would like to mention that the Department arranged with the United Kingdom authorities to distribute here what is known as the “ Prescriber’ Journal “, a publication issued quarterly, which gives doctors a balanced and authentic account of the use and value of the drugs that are available. Tt is believed that this has played a part in reducing excessive and unnecessary prescribing under the pharmaceutical benefits scheme.
Concerning this scheme, I would like to mention finally some remarks made by the honorable member for Shortland (Mr. Griffiths) about the way in which drugs arc placed on the pharmaceutical benefits list. As he knows, and as all honorable members know, neither I nor my Department decides what drugs shall be placed on the list. Under the provisions of the National Health Act, we have established the Pharmaceutical Benefits Advisory Committee, which is composed of some of the most eminent medical specialists and pharmacologists in Australia. This Committee makes the very difficult decisions that are involved in determining what drugs shall be placed on the list. It is the job of the Committee to advise me. I, as Minister for Health, am not permitted to place on the pharmaceutical benefits list a drug that is not recommended by the Committee. Its members give their time in an honorary capacity. They work tremendously hard and they bring some of the highest medical skills and experience in Australia to bear on this problem which affects the wellbeing of the whole community.
As the honorable member for Bowman pointed out from the standpoint of his own professional experience when referring to a particular case that was mentioned by the honorable member for Shortland, the members of this Committee have a very great responsibility not only in relation to the national health scheme but also in relation to the safety and health of the Australian people. To suggest that just because one doctor believes or two doctors believe that a particular drug should be placed on the pharmaceutical benefits list contrary to the advice of the Pharmaceutical Benefits Advisory Committee is to propose something that is not, I venture to say, in the interests of the health and wellbeing of the Australian people. The members of the Committee have a very difficult job to do. There is nothing to prevent any doctor from prescribing a drug that he wishes his patient to have even though, in the opinion of the very skilled men who give a tremendous amount of time and thought and the benefit of their experience to the task that they perform as members of the Committee, that drug should not bc on the pharmaceutical benefits list.
I want to make just one more point. The honorable member for Hunter (Mr. James) suggested that the only reason why a decision has been made in the Commonwealth Territories and in most of the States recently, rather than two or three years ago or even earlier, to change from Salk vaccine to Sabin vaccine for poliomyelitis immunisation is that the pharmaceutical companies put pressure on the Government to allow them first to exhaust their existing stocks of Salk vaccine. None of the pharmaceutical companies in Australia makes Salk vaccine. Most of the Salk vaccine required by the Commonwealth is made by the Commonwealth Serum Laboratories. The Government’s decision in relation to poliomyelitis vaccine will have no effect whatever on the profits of the pharmaceutical companies and certainly does not result in any way from pressures by them. As I said in a statement to the House recently, most of the Sabin vaccine will be imported from the Connaught Laboratories in Canada, which is at least a semi-government instrumentality.
The honorable member for Swan (Mr. Cleaver) asked specifically that 1 refer to some statistics relating to the pensioner medical service which appeared in the report of the Director-General of Health. The honorable member drew attention to the difference in the proportion of domiciliary visits and surgery visits under the scheme as between Western Australia and South Australia. I am afraid I am not in a position to give an answer to his specific query. The trend in Western Australia is part of a world wide trend. It is a trend away from domiciliary visits to surgery visits. It may well be that there is a difference in the approach of the medical profession in Victoria and South Australia on the one hand and in Western Australia on the other. I will certainly see whether it is possbile to provide a full answer on this matter. It may be necessary to approach the Australian Medical Association to see what it has to say on the subject.
The honorable member referred also to over visiting by doctors under the pensioner medical service and suggested that the average number of visits in a State might be taken as an arbitrary figure in deciding whether a doctor was fulfilling his responsibilities under the pensioner medical service. I assure the honorable member that there is nothing arbitrary about the use of the averages. To come under the notice of the Department, a doctor must, in the first instance, be considerably above the State average in the services he provides. Even then the system provides for a committee to examine in detail the activities of the doctor in relation to his particular patients. The committee comprises five doctors, one of whom is the Commonwealth Director of Health for the State and the other four of whom are fellow general practitioners with experience of the pensioner medical service, nominated by the Australian Medical Association. So to come under the notice of the Department a doctor must be considerably above the average in his number of services. Even then he has an opportunity to place the facts before people experienced in this matter and to justify his number of services. Even if, as the honorable member suggested, particular circumstances may lead a doctor to see a particular patient on a large number of occasions, it should not be difficult for the doctor to satisfy his colleagues that his services were necessary.
The honorable member for Swan referred also to the care of the aged in nursing homes and to the benefit provided by the Commonwealth in respect of these people. He referred, also, to the co-operation in this matter between the States and the Commonwealth. I am proud of what has been achieved in this field by the Commonwealth’s decision a few years ago to introduce the nursing homes benefit. Not only has it directly provided a very large increase in the number of nursing home beds available in Australia and. therefore, taken considerable pressure off the State hospital systems but I am sure that it also has played an extremely valuable part in raising the standards of nursing homes and nursing home care throughout Australia.
One further comment I would like to make is in relation to a point made by .he honorable member for Barton. He spoke of defects in medical research in Australia. To support his case he referred to an article written by an officer of my Department, Dr. Ronald Wells. I assume that the honorable member has not read Dr. Wells’ paper published in the “ Australian Medical Journal “ but a report of it published in the “Australian”. Like most reports by that newspaper, this one highlights and over emphasises a number of points in Dr. Wells’ paper and, by taking them out of context, implies criticism of our arrangements for the support of medical research. In fact, Dr. Wells makes it clear in his paper that an increase in expenditure on medical research of 10 per cent, to 15 per cent, per annum seems a reasonable objective in this country, having regard to our resources and the present state of medical research here. The point I make is that this objective is being attained, due in part to increases in the Commonwealth’s contribution to the Medical Research Endowment Fund. Over the last four years those increases have averaged 15 per cent, per annum - the upper figure suggested by Dr. Wells - including an increase of 25 per cent, in this year’s Budget.
– I do not intend to delay the Committee unduly, but I cannot let pass the remarks of the Minister for Health (Dr. Forbes) about the Australian Labour Party’s attitude towards doctors. My colleagues and 1 have great respect for the services rendered by the medical fraternity in the community. We feel that most doctors deserve every penny they receive. They work long hours and give dedicated service in the vast majority of cases. 1 hear very few complaints about the services of doctors. But. as with any group of citizens in the community - any profession or trade - there are from time to time complaints about individuals. Generally I have no qualms about doctors. What the Labour Party is concerned about though - and it is not directing its attack at the doctors but at the Government - is the way the Government discriminates against other professions associated with the disposition of health services. I could be just as generous in talking about the services of dentists and how equally vital they arc to the health of the community.
Every now and again statistics arc produced showing the decline in the state of dental health in Australia. The supreme irony of the position is that while ill health stays in a person’s mouth in the form of dental decay the Commonwealth Government will do nothing about it. but if the decay is permitted to reach the stage where it prejudices a person’s general health the Commonwealth Government will then go some way to help him, through hospital and medical benefit schemes. Can dentists be blamed for thinking that the national health scheme is heavily prejudiced in favour of the doctors, that it is influenced by doctors, that it is dominated by doctors? This is the kind of thinking that is in the minds of dentists. What opportunities are tthere for dental research at our universities as compared with medical research?
The Minister for Health look me up on this question of research in Australia. I am not in a position at this moment to confront him with what his departmental officer said. I have not read the original material that his officer prepared and I must confess that I took my evidence from a newspaper report of what the officer said. Having conceded that much, however, I know on the testimony of the Dental Association that it gets very little help in developing dental research in Australia. If it is true (hat doctors arc leaving England to come to Australia because they prefer to work under our national health scheme it is equally true that dentists are leaving Australia to serve under the British health scheme. I do not have to reiterate the eloquent testimony of my colleague, the honorable member for Wilmot (Mr. Duthie), and others about objections that another professional group associated with community health have against the national health scheme. I am referring to optometrists who. in New South Wales, do a science degree course at the University of New South Wales. As far as I know, and I speak from recollection, they do a five year learner course at university level in New South Wales. Then there is a whole range of paramedical courses that are not recognised under our national health scheme. Physiotherapists and a whole range of people like that receive no recognition and no assistance in developing their activities under the national health scheme.
The Minister said that it is not the business of the Commonwealth Government to look after the hospitals of the States. This was said, of course, about our schools. lt was said before, in days gone by, about our universities. It is said about our technical colleges. But even with a Liberal Government in power sometimes enlightenment starts to percolate through, and now we get the Prime Minister (Mr. Harold Holt), and we have had the former Prime Minister, Sir Robert Menzies, and others congratulating themselves on the Commonwealth money that is being made directly available for educational institutions either affiliated with the States or run directly by the States. The Government takes the philosophy mainly that it will give aid to the patient rather than to the institution. It has a funny, mixed up philosophy. It criticised the Labour Party when it had this type of philosophy in respect of education and asserted that it was much more responsible to give the money direct to the institution. Be that as it may, the fact is that the system is not working well, lt is true that the Commonwealth did increase its contribution to medical benefits; but what happened? Within a .matter of months doctors’ fees were increased - possibly legitimately - and all the advantage of the increased Commonwealth contribution was lost and the patient was just as far behind as he ever was. This is a continuing story. I am sure that honorable members opposite would not like to quote what the “ Daily Telegraph “ has had to say. They would not suggest that the “Daily Telegraph” would be unduly critical of the Government. Somebody once called it the “ Menzies’ Daily “. There is evidence all over the place that while this system continues the patient will be left behind.
It is all right to be very solicitous of doctors, as the Government pretends to be now, on the eve of an election when it wants to curry favour with doctors and wants to attract, maybe, election funds from the doctors. What we are principally concerned about in the Labour Party is the welfare of the patients - the vast majority of people in Australia. How are they getting on under this scheme? I want to see doctors get a fair go: I want to see dentists get a fair go: I want to see optometrists get a fair go. Ophthalmologists, who are medical specialists, attract benefits. These are the things we are concerned about. I want to draw attention to the philosophy the Labour Party has in respect of a few of these matters. The Labour Party’s policy lays down, in respect of general practitioner services that it intends to provide a general practitioner medical service staffed by salaried medical practitioners willing to join, and available without charge and without means test to persons who choose to use such a service. In other words, when somebody who gets unemployed or who has a family and cannot meet the insurance costs is not going to be prejudiced in health; such people will still have a service available to them under a Labour Government. They will be able to go along to the local general hospital and receive full general practitioner and specialist services from resident salaried doctors attached to the regional hospitals. We think this is a far better scheme, a far more stable scheme and a far more equitable scheme than the scheme the Government uses which involves in the long run, a regressive form of taxation which falls heaviest on those least able to bear it. The family with the small income pays the same fund con tribution rates as does the wealthy person to get the same kind of hospitalisation.
Under a Labour Government the payment of Commonwealth benefits to all patients who choose to use private services, irrespective of their membership of voluntary insurance organisations, will be allowed to continue. We recognise that this is a system that has been established. We do not want to create fear and anxiety in anybody’s mind. If people want to use voluntary insurance and want to go on using a private practitioner service, under Labour’s programme they will certainly be able to do so. We intend to set up a national hospital service involving hospitalisation, without charge and without means test, in public wards of public hospitals, and with appropriate financial provision for approved private beds. There will be subsidies for those who choose to use intermediate and private wards, but public wards will be free. Of course, we will be asked: How can people get anything free? It will have to be provided by way of taxation. Of course it will, and no-one is dishonest enough to suggest otherwise. But it will be through direct taxation. We think this is a more equitable burden upon the public at large.
– Will Labour increase taxation to pay for it?
– If it is a substitution of taxation for the kind of thing that is going on under the Askin Government in New South Wales I will be all for it, and I think the public will be all for it. I emphasise “ if it is a substitution “. I ask the honorable member not to take my words out of context. If instead of paying into private funds over which the Government, the Opposition and no-one else has control we substitute parliamentary control over the running of hospitals then I am all for it and I think honorable members will find that the general public will be all for it. We do not deny people the right to have the services of private practitioners or private hospitals if they can pay for them or are willing to insure for them. We want a dual system to operate. We want to give people the complete right of choice. We do not want a continuance of this business of the dog chasing its tail; this system under which increases in fund benefits are immediately followed by increases in the cost of hospital accommodation and doctors’ services with the result that, after having contributed to a medical benefits fund, after having contributed to a hospital benefits fund and after having contributed by way of income tax and social services contribution, people still have to put their hands into their pockets to make up the leeway. We think a lot better system than that can be devised. We are thinking of something in the nature of a compromise between the British system and the Australian system.
I do not think I need say much more except to highlight this business of the dog chasing its tail; this system under which almost immediately after fund benefits are increased the doctors’ fees go up. In reply to a question on notice by the Deputy Leader of the Opposition (Mr. Whitlam), the Minister is recorded in “ Hansard “ of 13th September as having provided this information in relation to the percentage of cost of doctors’ services contributed by each party -
The percentage of the cost of services met by each party during 1965-66 was -
Fund . . . . . . 35.7 per cent.
Commonwealth . . 33.9 per cent.
Members .. .. 33.9 percent.
After having contributed to fund insurance, and after having paid his taxes to the Commonwealth, the patient still had to find 33.9 per cent., or well over one-third of his medical costs. Incidentally, I hope that the Minister is a better administrator of health schemes than he seems to be a mathematician. I point out for his benefit that his figures add up to 103.5 per cent. I think that would be an example of what the honorable member for Evans (Dr. Mackay) has called mad arithmetic. I do not want the Labour Party to be branded as being prejudiced against doctors. The Labour Party is interested in seeing that all parties to the provision of proper health in Australia get a fair go.
Motion (by Mr. Aston) put -
That the question be now put.
The Committee divided. (The Deputy Chairman - Hon. W. C. Haworth.)
Question so resolved in the affirmative.
Original question resolved in the affirmative.
Proposed expenditure agreed to.
Department of Housing.
Proposed expenditure, $4,457,000.
.- We are indebted to the Department of Housing for having placed before us statistics relating to applications made to the various authorities under the jurisdiction of the Minister for Housing. They cover applications made under the war service homes scheme, applications for homes savings grants, and applications made to the Housing Loans Insurance Corporation. The figures contained in the documents are very enlightening. For many years the housing industry has been subject to the winds of change and financial fluctuations. The availability of credit still exercises a great deal of influence on the construction and purchase of homes and, consequently, on a number of industries closely associated with housing, such as the furniture trade and so on. In recent years we have been indebted to numerous organisations - the housing industry authority and others - for particulars of trends in the industry. On the basis of this information the Government, in the early part of this year, made additional funds available at short notice for home building. Despite this, it is worth noting that, according to the latest figures available to me, an increase in home building was apparent in only two States.
The documents also reveal a trend in recent times away from the construction of homes. According to the report of the Department of Housing, a high percentage of people is purchasing existing homes. Of the total number of homes purchased with the assistance of the home savings grant, 52.7 per cent, are existing homes and 1 per cent, of these are flats or home units. This trend is having an effect on employment in the trades associated with housing, such as furniture making, brick manufacture and so on. It is worth pointing out also that in the period 22,953 homes were purchased on a first mortgage only whereas a first and second mortgage were taken in some 4,713 cases. The average first mortgage loan was $6,542 and the average second mortgage loan was $1,518. According to the Minister, the Government this year under the Commonwealth and State Housing Agreement has made a record allocation of funds to the States. This is true but, having regard to the increase in the cost of homes, particularly in Queensland where the maximum loan for State Housing Commission homes has been increased by $1,000 to $8,000, and having regard to the fact that each applicant will probably accept the maximum loan available to him, certainly fewer homes will be constructed in Queensland. Although an additional amount has been made available, the number of houses that will be constructed could quite easily be fewer than in the previous year.
The sixth All-Australia Timber Congress is being held this week at the Chevron Paradise Hotel at Surfers’ Paradise, Queensland. Numerous people associated with the timber industry have been invited to the Congress. Among them is Mr. F. Lowry Wyatt, Vice-President Manager of the American Weyerhauser Company’s wood products group. He believes that procedures for buying, financing and remodelling homes should be simplified. His comments are reported in today’s “ Courier Mail “ in this way -
Mr. Wyatt said a car could be bought in an afternoon and a trip to Europe could be arranged by telephone.
The prospective home buyer, on the other hand, found himself involved “in a complicated and expensive legal and financial maze “ which he seldom understood.
He usually had to call on an estate agent and a solicitor to guide him through it. Even then the process often took weeks, or even months.
Mr. Wyatt said procedures for extending or remodelling a home were almost as complicated.
I think that comment is true and I think it applies to Australia as well as to the United States.
In the short time remaining to me I want to comment on the Government’s failure, since the passage of the Home Savings Grant Act, to recognise savings in credit unions as savings for the purpose of attracting the grant. On a number of occasions the Australian Labour Party has proposed amendments to legislation requesting such recognition. The former Minister for Housing, Mr. Bury, when introducing the relevant Bill, said that it was designed to encourage young people to save for a home of their own. Credit unions rightly claim that they probably have a greater influence than any other section of the community on saving, particularly as it applies to young people. There is a trend amongst young people to live it up. I do not say that we were any different in our day. We did not accept too much responsibility and in many cases never thought of purchasing a home until it became almost a necessity. But the credit union movement, through its close association with and personal knowledge of people, particularly young people on the job, has encouraged young people to open a savings account as soon as they start work and to budget for their known expenditure throughout the year. This is a training in saving. The credit unions play a considerable part in encouraging savings.
The credit union movement is only new to Australia although it has been operating in other countries, particularly Canada and the United States, for many years, lt is worth while noting that credit union savings in Australia are currently estimated at §80 million. This is the amount lodged in some 500 credit unions. The movement made many approaches to the former Minister for Housing and later to the present Minister for Housing, Senator Dame Annabelle Rankin, lt has placed before her now a case which it feels justifies its claim to have all savings in credit unions recognised as savings for the purposes of the home savings grant. It is worth pointing out that the grant is a home savings grant, not a house savings grant. The former Minister for Housing challenged the people associated with the credit union movement and suggested that they were not making any worthwhile contribution to savings. He said they were more “interested in ordinary finance in competition with hire purchase companies. He made a further comment that the maximum that a credit union would lend was £1,000, which would now be $2,000, and that the maximum period of the Joan was five years. Credit unions have taken up this challenge. Over a number of years they have entered into the second mortgage field and have made money available at a reasonable rate of interest. They have not charged as much as 7J- per cent, interest which has been suggested as the maximum rate at which the Housing Loans Insurance Corporation will insure. But credit unions have taken the challenge even further and now a number of them, which are considerable in size, have been prepared to make available loans of up to $4,000 for a period as long as 10 years.
What is the investment in housing by the credit union movement? Figures which I have in my possession show thai four credit unions operating in New South Wales have made available a total of $674,674 for housing. Those credit unions have made a total of 4,398 loans, including loans o5 almost $700,000 for housing. This gives some idea of the extent to which the credit union movement can help people who want to purchase a home and can assist them to bridge the deposit gap, that elusive difference between the amount of deposit purchasers are able to arrange for themselves and the maximum amount of finance that is available to them through the various lending authorities. Although 33 per cent, of the allocation from the Commonwealth to the States for housing is made available to home building societies, the societies still face a serious shortage of funds. They depend not only on this source for their funds but also on savings blinks and insurance companies.
It is worth while pointing out that most building societies have a ceiling of $200,000 beyond which they will not lend money. Usually they operate at about this figure and, if more is required, another society is formed. Most permanent building society loans must be repaid within 15 to 20 years. Many of the societies depend on support from credit unions, one co-operative assisting the other. Credit unions lend a considerable amount to the permanent building societies. The report of the Housing Loans Insurance Corporation shows that credit unions had made 809 housing loans aggregating $6.3 million to permanent building societies by 30th June this year. I understand from statements made by the Minister in another place that this amount has increased by 50 per cent. 1 point out to honorable members that this is only the amount made available by approved lending societies for which insurance has been written by the Housing Loans Insurance Corporation. If credit unions are to be required to make bigger housing loans the result will be that funds available will be channelled to fewer people.
The DEPUTY CHAIRMAN (Mr. Peters). - Order! The honorable member’s time has expired.
.- The importance of housing in the Australian community is well known to all of us. The whole Australian way of life is hinged about the family unit. The Government from time to time has made certain moves in relation to the building of more homes. This is evident to anybody who moves about Australia. We find that houses have been built in huge quantities. However, there is one point which I wish to raise tonight. I wish I did not have to raise this matter. I refer to a problem which 1 have been endeavouring to solve for some considerable time. Although I have solved part of the problem, I have not been able to complete the solution. J feel that there should be no discrimination between individuals throughout Australia. If a person chooses to live in a free country and to take up a certain occupation he should be able to obtain benefits enjoyed by other members of the community who live in the cities and towns of this great country. We find that there is discrimination throughout Australia in the allocation of funds which are made available from lime 1o time from various sources to those wishing to build on long term housing finance. I refer tonight to the War Service Homes Act.
When 1 came into this place I found if a man was eligible for a loan under the Act he could obtain up to £3,500 for the purpose of building or buying a house, provided that he lived in a town or city. But if his occupation took him into country areas, such as in the farming and pastoral world, he was debarred from obtaining any money whatever from the War Service Homes Division. I took up this point with the then Minister for Housing. After 12 months I was able to obtain some remedy for those people who were farming and desired to take advantage of the War Service Homes Act. But that remedy was available only to persons who owned the freehold of their farm. Until now the Government has refused to move from this point. We are now in the position where men who have served overseas and are eligible under the War Services Homes Act to obtain a loan of £3,500. or part thereof, to purchase a home will be deprived of this benefit unless something is done about the situation. I have been trying for many months to do something about it. In my opinion the present situation is not good enough. I point out that the former Minister for Labour and National Service on 18th May 1965 when delivering his second reading speech on the Defence (Re-establishment) Bill said -
T have already explained in this House that national servicemen who serve in special areas will qualify, under the same conditions as those applying to regular soldiers, for repatriation and war service homes entitlement.
That is quite plain. The Government has said that a man serving in special areas should qualify. A man who returns to Australia after having done his duty overseas should not be discriminated against because he wants to go farming.
– The Minister should have said that it would apply according to the geographical situation.
– He should have. I agree. This is the situation in which we find ourselves today. I believe that no honorable member would say that an exserviceman is not entitled to the loan of £3,500, or whatever it may be, merely because of the location of his property, and especially if he, is farming. What is wrong with farming? Goodness me, it is the greatest industry in Australia. As I said, I have managed to make some progress in relation to second mortgages on freehold land.
I will now refer to Western Australia, my own State, because I think that this is quite relevant to the situation I am discussing. In Western Australia, vast areas of land are available for the returned men to take up, if they want to do so. I have said here before that the State Government of Western Australia is releasing about I million acres a year. This presents an excellent opportunity for these chaps to pick a block and to be allocated a block, if they want one. But if they do so at the moment, they will not be able to take advantage of the War Service Homes Act as it now stands. When 1 first proposed that loans under this Act be made available to people on the land, considerable concern was expressed about security. I fail to follow this argument in the present conditions. Why does not a country property provide good security? Anybody who knows about these matters realises that once a good home is put on a farm, the increase in the value of the property exceeds the cost of the home.
The blocks of land in Western Australia that I have mentioned are allocated on what is known as conditional purchase. This is nothing new. It has existed for many years in Western Australia and is operating very well. But the Government does not think that this land is good security. If the Government chooses to make inquiries, it will find that it is excellent security. I suggest to the Commonwealth Government that it discuss this matter with the State Government to satisfy itself that this is good security. If the Government then is not satisfied on the point, I suggest it negotiate with the State Government for the addition of special conditions to the terms of conditional purchases made by returned men who are eligible for loans under the War Service Homes Act, who wish to take up a conditional purchase block and who wish to build a home on it. The State Government no doubt would consider any proposal made by the Commonwealth Government. Sales of these blocks of land are made conditional on the payment of so many shillings an acre for a number of years.
I have no doubt that the State Government would be willing to talk to the Commonwealth Government on this subject. But in any event, I think there is nothing wrong with the security being offered. All the evidence we have over many years of allocating land in Western Australia on this basis is that the land is not forfeited if anything goes wrong, as has been suggested by the Commonwealth Government, but is sold. Over the years we have found that the price received for the blocks that are sold far exceeds the capital investment. Therefore, if a loan of £3,500 is made to the returned serviceman who wants to build a home and if he has spent other capital moneys on improvements, as he would have done, more than the capital he has invested would be obtained if the property were ever sold. I do not suggest for a moment that the Government take my word; I suggest that it confer with the State Government. But above all, there should be no discrimination against any individual who returns from service overseas simply because he chooses to take up his occupation in a particular area. After all, the security is still good. If farming in Australia is not sound, the country has a very poor future. I fail to understand why the Government should say that a home on a country property is poor security for an advance of £3,500.
What will we say to these chaps when they come home and want to take up these blocks, as many thousands have done over the years, to start carving out an asset for themselves and for the country, and to start making a future for themselves and their families? Will we say to them: “You may be eligible for an advance of £3,500 under the War Service Homes Act, but you can go and live in a tent on the land, you can build a hut with gimlet sticks and line it with hessian”? I would like to know who in. this Parliament is willing to say to a returned man that he can live in a tent because he intends to take up farming. I am not prepared to do so. There is nothing wrong with the Government extending the war service homes scheme to conditional purchase blocks in Western Australia. Western Australian boys will not be the only ones who will want to take up these blocks. Boys from the eastern States also will want to do so when they come back from overseas. Their opportunity is probably to be found in Western Australia, and the West offers the opportunity to them on very good terms. This is the future for these chaps and they are entitled, just as any other man returning from the special areas overseas is, to have the benefits of the war service homes scheme.
I ask the Government to look seriously at this matter and not to hedge. There is nothing wrong with these blocks as security. I repeat that the Government should go to the State Government of Western Australia and ask for all the facts relating to the blocks. I am sure the Government will get a good hearing. I say again that I regret having to raise this matter tonight. But what I have said had to be said. The present interpretation of the word “ holding “ in, the Act enables the scheme to be applied to leasehold land in the Australian Capital Territory but not to conditional purchase land in Western Australia. This is just not good enough. I say again that the Government should examine the position so that, when these chaps come back, we can say to them: “ If it is your desire to take up a conditional purchase block in Western Australia or in any other place in Australia, you will be eligible for an advance of £3,500 under the war service homes scheme “.
.- I was most interested in the opening remarks of the honorable member for Canning (Mr. Hallett) who stressed that the housing situation was most important. He commended the Government on the contribution it had made to housing in general. He also said that houses have been built in huge quantities. I think the honorable member meant huge numbers. Nevertheless, it is quite apparent that he has not done his homework. If he had, he would never have made such a remark, because the statistics show that more people applied for homes in 1964-65 than in the previous year. In 1965-66, we h3d a still larger number of applicants than in the previous year. I hazard the guess that in the coming year even more people, including young people, will apply for homes than did in the previous four years. lt is remarkable that in the debate on the Budget and now in the debate on the Estimates, honorable members on the other side of the chamber have spent a considerable time in eulogising the work of various departments. It is an election year, and one can expect members on both sides of the House to utilise the opportunity to get the maximum political propaganda for a particular department; but it amazes me that anybody on the Government side would attempt to justify the national scandal which this Government has allowed the housing situation to become.
At the 1963 election the Government’s gimmick - I refer to the homes savings grant scheme - gained considerable support for it from the young people under 35 years of age. Incidentally, these people now comprise the majority of electors. This section of the community has now had the opportunity to assess how genuine was the promise of the Government that they would be able to own their own homes. Those fortunate young people who had specific savings and qualified for the grant now realise that the unchecked spiral of building costs has absorbed more than the Government’s grant, with the result that thousands of these young couples must continue to occupy substandard dwellings. This situation is partly explained in the Second Annual Report of the Secretary of the Department of Housing, that for the year 1965-1966. I quote from page 4 of the report where, under the heading “ Reasons for Rejection “, it states -
Of the 3.1.668 applications determined during the year. 4,021, or almost 12 per cent., had to be rejected because the applicants had not met the requirements of the Act. The two main reasons for rejection were the failure of the applicant to apply for a grant within twelve months of entering the contract to buy or build the home, and the inability of the applicant to show that savings had been held in an approved form throughout the required three-year period. These were the reasons for 55 per cent, of rejections during the year. Other significant reasons for rejection were that the applicant was not residentially qualified, and that the value of the home in respect of which a grant was sought exceeded the statutory limit of S14.000.
This is an usually large number of rejected applications - 4,021, or 12 per cent. - but it is understandable when we witness the tight-fisted attitude of the Minister for Housing (Senator Dame Annabelle Rankin) and her departmental officers in administering this legislation. 1 made representations for one of my constituents, a naturalised new Australian, who inadvertently signed a contract to build one month before her savings conformed to the basic requirement of the homes savings grant scheme. My constituent had unmistakable evidence to support her claim that during the period from June 1960 until April 1963, which commenced two months after she opened her first bank account, she was assisting her father in the reduction of his overdraft with the Commonwealth Bank. The departmental officer concerned rejected her application even though he accepted the fact that her savings were assisting in the reduction of her father’s business overdraft during this long period. Yet on the other hand this same department is accepting statutory declarations from applicants, stating that they have assisted relatives for business purposes by lending personal savings. This in no way has interfered with their applications being successful. The Homes Savings Grant Act of 1964 - which in reality added another £250 to the cost of purchasing their home - the Housing Loans Insurance Act and all the other measures which have ‘been put into operalion by this Government have failed by far to meet (he housing requirements of the people.
I now want to make some comment about the continued failure of the Government to grant the financial assistance so urgently required by State Governments for slum clearance and land development, In 1945, under Labour administration, the Commonwealth-State Housing Agreement Act provided that all States should have) adequate legislative powers to cover slum clearance, land development and other related matters to ensure that the future national problem of housing would be met in the only possible practical way - the Commonwealth providing the necessary funds to enable the State Governments to carry out the mammoth task of providing homes for the young servicemen at that lime defending Australia and for the thousands of migrants which the Labour Government expected to attract to this country. It is history that the expectation of the Labour Government of that year was a correct assessment of the future requirements of the people of Australia; yet successive Liberal Governments since 1949 have deliberately disregarded the importance of advances for slum clearance and land development with the result that the housing problem today has been accentuated by the continuing cost spiral. This attitude is typical of the present Government, which completely ignores what many countries have recognised for years - that an urgent programme is necessary to provide finance to rebuild the areas which original inefficient planning and time have decayed. Today in this country those areas represent a complete loss, both to the States and to the nation.
The present Minister in charge of this Department, in line with her predecessor, on a number of occasions has brushed aside this important aspect of national rehousing by saying that it is currently under examination by the Department. A Labour Government made legislative provision 21 years ago for machinery to examine this national problem and for the position to be rectified. Labour members of both Houses of Parliament repeatedly throughout the years have advocated the solution to this problem. The Constitutional Review Committee, whose report was tabled in this Parliament eight years ago, made specific recommendations concerning this national scandal in housing but the Government of the day shelved the report. Successive Liberal-Country Party Governments have continued to ignore the recommendations which were the unanimous view of the all party committee. So in the light of the years of investigation of this matter, the platitudes of the Minister that her Department is currently examining this particular aspect of housing will be of little solace to the State Governments which are continuously under attack by persons and organisations seeking to rectify this national scandal. State Governments have limited fields in which to raise finance to cope with the major reorganisation necessary to achieve slum clearance and the rehousing of their citizens. This is particularly aggravated by the fact that during the past few years the Commonwealth has conducted a housing policy which in no way provides the solution to this great national problem.
Finally, I was interested to see that at least one Government supporter, the honorable member for Canning, rook part in the debate on these estimates.
– There are more.
– I am pleased to hear that from the honorable member for Mallee, but my information from the previous Deputy Chairman was that no Government supporter was going to take part in the debate on the estimates of this Department. This did not come as any surprise. Even if no Government supporter were to take part in this debate it would not come as any surprise to honorable members on this side of the chamber because the Government has demonstrated, certainly to this particular section of the community, the young people, that it is incapable of correcting this housing scandal. I compliment the honorable member for Canning at least on being one Government supporter who has taken part in this debate.
.- The honorable member for Bonython (Mr. Nicholls) can be assured that we have a story that we are proud to tell with regard to housing. The honorable member is a very difficult man to satisfy. He talks of a housing scandal when even a man with only one eye could see that the housing situation in Australia has changed vastly and that we now have our people living in far better conditions than they have ever enjoyed before. The honorable member and some of his colleagues opposite have had a lot to say in recent months about what they have called deficiencies in the homes savings grants scheme. I have not heard very much criticism from them tonight in this debate. A few days ago we had placed in our hands the second annual report that has been made under the Home Savings
Grant Act, and I think that for the record we should put a few matters in the correct perspective so that our friends opposite will have a little less to say in the future. This report indicates that in the last 12 months no fewer than 29,023 applications were received, 29,647 applications were approved and the total amount of grants approved for the young people whom this legislation was designed to assist was SI 3.347,979. The average grant approved under this scheme to these young people has worked out at $450.
I emphasise that the homes savings grants scheme assists young married people to acquire a home of their own. When the scheme was announced in the Goverenment’s policy speech before the last election there was a great outcry from our friends opposite. They claimed that the scheme was being introduced simply to attract votes. Well, it certainly attracted the votes of a large proportion of the young married people of this country, and in the years that have passed since then it is obvious from these statistics that the scheme has proved very popular and that it has been substantially sound. It will prove to be more and more of an encouragement to these young people as the years go by. It has introduced some very necessary originality into this field. Our young people certainly needed an incentive to save, and this has been the first government to provide, not loans that must be repaid, but nonrepayable grants to encourage savings.
I want to point out that the scheme has been very sound fundamentally in directing the attention of young people to the correct channels through which their savings should pass. We members of the Committee all know that the Government has sought to increase the funds generally available for housing by channelling the savings of young people planning to qualify for the grant to institutions like building societies and savings banks so that these institutions can provide the bulk of the long-term finance made available for housing when applications for loans are made to them. The building societies and the banks have benefited considerably from the request made to young people to put their savings in accounts clearly earmarked for the homes savings grant. For the record I will say that the Commonwealth Department of Housing offers married persons under 36 years of age a grant of SI for every S3 saved towards the purchase of the first home they own after marriage. The maximum grant to a married couple, or to a husband or wife if only one member of the couple is eligible, is $500 on savings of $1,500 or more, and smaller grants are payable in respect of lesser amounts when saved.
This is only the second report, as I have said, but it contains some very interesting statistics. It is interesting to note the progress made in this section of the comparatively new Department of Housing. On 1st July of last year there were 8,095 undetermined applications on hand, but through careful administration and organisation that number had been reduced to 3,510 at 30th June last, notwithstanding the flow of new applications to which I have already referred. I move on quickly to point out that the Department is not administering only the homes savings grants scheme. It supervises the Commonwealth and State Housing Agreement and administers the War Service Homes Act. In the whole field of housing the Commonwealth Department of Housing is making a very significant contribution.
I note with some concern that even in my own State the cost of land upon which homes are built has risen substantially in recent years, and this represents a deterrent to young people. A few years ago my State was able to claim that the cost of land was lower there than anywhere else in Australia. This report of the Department of Housing indicates that a survey which the Department instituted not many months ago showed that in the metropolitan area in Western Australia the average cost of land is now $2,221 per housing block. In the non-metropolitan area it is $932, and the average throughout the State of Western Australia is $2,070. I find that this is substantially higher than in many other States. The only States in which these figures are exceeded are New South Wales and Victoria. This is a reminder to the people in my State that the old order can change and costs can rise. Nevertheless I want to put on record some most interesting achievements in the field of housing in Western Australia.
Before I leave the homes savings grants report I would like to direct the attention not only of this Committee but also of young people throughout the country to the fact that, notwithstanding the very wide publicity given to this excellent scheme and the many copies that have been issued by the Department of the little booklet “ A Grant for Your Home”, far too many young people have been disappointed when they have lodged their applications for grants to cover their savings. We cannot say enough about the importance of ‘the various agencies advising young people early in their savings experience to ensure that their accounts are opened as homes savings accounts, and not to delay lodging their application when they have acquired a home. There is, of course, a time limit within which application must be made.
I have reminded my friends of the Opposition that they have had a lot to say against the Government in the field of housing. Let me say to them again that our record does not warrant very much criticism at all, and if the Deputy Leader of the Opposition (Mr. Whitlam) can come into this debate after I conclude and bring to it any factual information which will leave the Committee convinced that this Government has been at fault I will be surprised indeed. The Commonwealth Minister for Housing (Senator Dame Annabelle Rankin) in another place recently released a report which indicated that because of the stimulus provided everywhere by an increased volume of loans for housing it was now estimated that in the current year there will be no fewer than 110,000 commencements of new houses and flats. I was interested in this because of certain factors that are evident in Western Australia with respect to building activities generally and also some difficulty in the availability of loan moneys to those who want to build. So I sought from the Minister for Housing details, if they were available, of the breakdown of this 110,000 and a general survey of what had happened in Western Australia.
I am keen to put these interesting and challenging figures on record in the few minutes that are left to me. The Minister told me that there has undoubtedly been a remarkable expansion in the home building industry in Western Australia since the end of World War II. In 1945, the Housing Commission in my State reported that there was an estimated shortage of 12,800 homes in Western Australia. The annual rate of construction of dwellings in the State rose from about 1,000 in 1946 to about 9,000 over the past few years. A record total of 9,286 new dwellings was completed in the financial year 1964-65. Over the seven years to 1965, the number of dwellings completed each year averaged 6 per cent, more than the total for the previous year. Between June 1961 and December 1965, 43 new homes were constructed in Western Australia for each 100 persons by which the population of the State increased. The number of new houses and flats approved, commenced and completed fell slightly in 1965-66 compared with the record breaking boom year of 1964-65. It is notable, however, that the number of cottages commenced rose. A fall in the number of flats commenced accounted for the decline. I suggest that this is not an unexpected development, as flat commencements rose from 493 in 1961-62 to 1,730 in 1964-65- an increase of no less than 350 per cent, in three years. The average monthly rate of advances available to Western Australia under the Commonwealth and State Housing Agreement during the 15 months from April 1966 to June of next year will be increased to 38 per cent, above the monthly rate during the first nine months of 1965- 66. This follows the decision of the Australian Loan Council in March last and again in June to increase the total loan programme and the amount allocated from it to housing.
Finally, I put on record the fact that the seasonally adjusted figures for dwelling commencements in Western Australia for the June quarter of this year reveal a continuing upward trend. The Minister has indicated that, although the present outlook is for a continuation of the upward trend of the past few months, the Commonwealth Department of Housing will continue to keep a close watch on developments. In other words, Mr. Deputy Chairman, this Government is dedicated to the task of maintaining the upward trend in the housing industry. We are not satisfied with the excellent results that have already been achieved. The application of administration of the highest quality and this Government’s wise policy will, I am sure, protect us from any cycle of boom followed by decline. It is our keen desire to maintain the building industry at a high peak. I am extremely pleased to put on record these interesting achievements in the field of the homes savings grants made available to young people by this progressive Government and its excellent record of achievement throughout Australia, particularly in my own State, Western Australia, as indicated by the facts and the figures that I have cited.
.- Mr. Deputy Chairman, I propose to discuss a field of housing in respect of which the homes savings grants legislation makes no provision and for which the Government, in the current Budget, is allocating a sum smaller than that allocated in recent years - namely war service homes. The previous nine Budgets allocated S70 million annually for war service homes. The current Budget allocates §58 million. The Treasurer (Mr. McMahon), in his Budget speech, explained the drop by saying -
In 1957-58, the first year for which $70 million was appropriated, the War Service Homes Division was able to provide 13,258 houses. Last financial year, with the same sum. it was able to provide 9,847 houses. lt is clear that the Division is providing for a smaller sector of the housing demand in Australia. One reason is that the maximum loan is now not adequate to meet the needs of an increasing number of otherwise eligible persons. The loan limit was last increased in 1962. The previous increase was made in 1951. The maximum limit of £2,750 fixed in 1951 exceeded by some hundreds of pounds the average cost of house and land. The maximum limit of £3,500 fixed in March 1962 now falls many hundreds of dollars short of the average cost of a dwelling house and land. The annual report of the Director of War Service Homes for 1965-66, which was presented today, shows that the .maximum loan falls short of the average cost of a dwelling house and land by $4,132 in New South Wales, $3,712 in Victoria, $2,926 in Queensland, $5,500 in South Australia, $2,658 in Western Australia and $3,259 in Tasmania. Unless a person who is eligible for a war service homes advance can find the balance, as shown by those figures, he is unable to obtain assistance from the Division. He can obtain no assistance under the provisions of the Homes Savings Grant Act because the benefits of that Act are denied to persons who apply for assistance under the War Service Homes Act.
– That is not so. Applicants under the War Service Homes Act are usually excluded by age from the benefits of the Homes Savings Grant Act.
– The Minister states quite rightly that if an applicant under the War Service Homes Act is under 35 he can obtain the benefits of the Homes Savings Grant Act. But very few returned servicemen are within the age group which is eligible for homes savings grants. Furthermore, those who are in the eligible age group have to contend with the fact that in the two years since the Homes Savings Grant Act came into operation the increase in housing costs has been much greater than the amount of the grant, which stands at a maximum of $500. In the last two financial years, the increase in the average cost of a dwelling house and land, as reported to us by the Director of the War Service Homes Division in the report which we received today, has been more than $500 in every State except Western Australia. In some instances, the increase has been nearly $2,000. Accordingly, eligible persons are being denied the benefits of the War Service Homes Act because the present maximum loan limit was fixed so long ago when the cost of house and land was so much less. There are few other government sources which keep the maximum loan at such a low figure. This figure does not apply to loans advanced by four of the State housing authorities. Only in Western Australia is there a smaller maximum limit. In that State, the maximum loan is $6,000. In Victoria there is a maximum of $10,000. In the other four States and in the Territories no maximum at all is fixed for housing commission or comparable finance. For this reason, among others, there is no longer a waiting list for war service homes. One would have thought that this was the proper opportunity to remove some of the rationing schemes which the Government has imposed in recent years, in fact, for the Minister for Housing (Senator Dame Annabelle Rankin) to apply more tolerantly the ban in the Act on a second loan, which only she can waive. The Minister has stated as recently as this year in correspondence to me that exceptions - that is, the grant of a second loan - are rarely approved and then only in circumstances of greatest emergency, such as where a widow or totally and permanently incapacitated exserviceman is experiencing serious difficulties.
The rationing schemes to which I refer are three: The first was introduced in 1951 when the Minister prohibited an advance being made by the Division to discharge an existing mortgage unless the Division’s approval had previously been given for that mortgage as an interim mortgage, subject to unlimited interest rates, as we know. The second form of rationing is where the Division has been precluded from allowing a person to transfer to a second house the balance of the loan which he still owed to the Division on a first house. The repayments - these premature repayments - have amounted to a very considerable sum. Last year they amounted to $16.5 million; the year before to $17.5 million, lt would seem a reasonable thing that a person paying off his war service home who, because of health or occupational reasons, has to move to another house, should at least have the benefit of the balance of the loan for the balance of its period. The third form of rationing is the ban on militia and women’s services and the fourth the ban on on loans for extensions.
Ministers have constantly said thatthere could be no relaxation of their rationing schemes because so many people were waiting for a first loan.It would be quite improper, it was said, to allow an eligible person to have a second loan - Mr. Roberton in his usual egregious style said a third, fourth or fifth loan - when other people were waiting for a first loan. There are now no persons waiting for first loans who are unable to receive them. Accordingly, it should now be possible to relax the rationing schemes and to allow people to have second loans; to allow them to at least have the balance of the loan which they will owe on an earlier house or to discharge an existing mortgage. Again, it would be possible to remove the ban on members of the C.M.F. and the women’s services who served in operational areas, such as Darwin, but not overseas. Instead of meeting these complaints, which have been put by the Returned Services League, by honorable members and by a great many ex-servicemen - by eligible persons for years past - the Government has reduced the total appropriation.
I have some examples of refusals which I might give to the Committee. One application was for a discharge of an existing mortgage. The applicant had enlisted in May 1940 when 18 years of age. He had been a prisoner of war for four years. He has a war pension. Because of a longstanding condition he had to enter hospital and be immobilised for at least six months and probably nine months. During the period of his reduced income, or for his dependants if he did not survive, he wanted the security of a war service loan to discharge an existing mortgage. His application was rejected.
I come to a case where a man had to transfer to a distant suburb in the course of his employment. He had eight children, all under eight years of age - two sets of twins I hasten to add. He applied for a second loan. His new place of employment to which his employer was sending him required that he travel 70 miles on 6 days a week. These were not sufficiently exceptional circumstances
Let me cite the case of a woman who had received a loan in her own right as a war widow. She was the mother of three returned sons. She was all alone in her house. She sold it and went to live with her daughter. One of the sons died. He had been a widower. His death was accepted as being due to war causes. He left a 17 years old son, who had to go to his grandmother. The grandmother then sought a second loan. The circumstances were not sufficiently exceptional, notwithstanding that she was a war widow, a mother of three returned men, looking after the orphaned child of a widower son whose death was accepted as due to war causes. She was denied a second loan.
I come to cases involving some serving men. First, the case of a warrant officer who served overseas with the Second A.I.F. from 1941 to 1945. In 1946 he obtained an advance to build in Tasmania. He rejoined the army and was promoted to a rank for which there was no establishment in Tasmania. He was posted to my electorate. There was no chance of his going back to Tasmania. He sold the house th;re. In October next year he will have served for 18 years. He will then be eligible for the maximum pension under the Defence Forces Retirement Benefits Act. It will not be possible for him to serve in his calling or to retain his married quarters beyond January 1972 when he becomes 55 years of age. He is unable to obtain a loan from private or institutional sources except on condition that he discharges it by the time he turns 60. It is impossible for him to obtain a loan with reasonable repayment terms. He is denied assistance from the War Service Homes Division.
My concluding example concerns a man who has served in the armed forces for 27 years. He had to leave his Adelaide war service home because he was promoted to my electorate. He will have to retire after 27 years service. His wife served in the Australian Women’s Army Service. He is unable to secure a second advance. These are merely illustrations of the circumstances which could have been met if the allocation in the last nine years for war service homes of $70 million had been continued this year. Instead of meeting its obligation to war widows, serving men and incapacitated men the Government has reduced the allocation for war service homes by S 12 million.
The DEPUTY CHAIRMAN (Mr. Peters). - Order! The honorable member’s time has expired.
.- I wish to devote my remarks this evening to that section of the Estimates dealing with the home savings grant. It is pleasing to note that since the scheme started 29,647 applications have been approved to a value of $13.3 million. There is no question that this has proved to be a magnificent scheme and of great assistance to many young people throughout Australia. The Government can feel satisfied that so many people have taken advantage of its scheme. However, my observations indicate one particularly unfortunate aspect of the scheme. Of course, it is understandable that any new scheme will reveal disabilities that seem almost inexplicable to those seek ing assistance. I refer to the rejection of about 1,200 applications because of lateness of application - the applications were not lodged within the time limit laid down in section 21 (I.) (c) of the Homes Savings Grant Act. Of a total of 4,021 applications rejected 1,200, or about 30 per cent., were rejected because of late application. I am surprised that other honorable members have not mentioned this aspect either privately to the Government, during this particular debate or in the House. It certainly has not been mentioned with any strength and surely other honorable members have had their attention drawn to this circumstance.
Five cases referred to me were of rejections because the applications were lodged too late, through no fault of the applicants. In each case the applicant was given incorrect information. Four were wrongly advised by bank managers and the fifth was advised by a regional housing director. I am sure that the regional housing director gave the right information and that it was misunderstood. Each of these cases involved a single person and each thought he had to be married before he could apply for the grant. They were all told they had to be married before they could apply for the home savings grant. These cases all occurred between July 1964 and February 1966 when what was known as the blue form was in use. The blue form was the application form for a home savings grant. It required the applicant to state the date and place of marriage. This implied, of course, that the applicant had to be married in order to be eligible for the grant. Of course, the bank managers and other agents who were handling these applications on behalf of the Commonwealth would have been misled by that requirement. Each of the cases referred to me occurred during the relevant period, and each applicant had a similar story to tell. Unfortunately, under the provisions of the Act the Minister has no discretionary powers, so he could not rectify the situation. I am going to ask that the Act be amended to give the Minister the necessary discretionary power. I am not unfamiliar with the difficulties of amending Acts of Parliament, but I feel this is an occasion when we should act sensibly and make the necessary amendments.
Obviously the Department is concerned with this aspect because in its latest report it states that it will give more publicity to the scheme because it is concerned that an increasing number of applicants have failed to lodge their applications within 12 months of acquiring their homes. When the form known as the brown form was introduced in February of this year, although the question concerning the date and place of marriage is included, the words “ If not married, then date of proposed marriage “ appear. This at least indicates that the applicant does not have to be married to apply for the grant. Another paragraph on the application form stresses that it must be lodged within 12 months of the conclusion of the savings period. The whole crux of the situation is that the Minister’s, hands are completely tied after the savings period has concluded. 1 have already suggested to the Department and the Minister that the booklet that the Department puts out regarding this scheme is quite confusing to the average person although it is suitable for people who are used to reading lengthy documents expressed in government language. I suggest that when this booklet is republished - and 1 understand it is to be republished in the near future - it should definitely be clearer and the emphasis should be placed on this question of late application. Young people are upset. Most of them have worked at weekends, and far into the night after they have finished their ordinary daily job. to get their homes before they marry. They have been under the impression that they have to be married before they can apply for the grant, and when they have sought to apply they have discovered they have been too late. This just does not add up at all. The Act should be more flexible than it is. These young people have nothing to gain by not applying within the stipulated period. They are not trying to fool anybody. They obviously want the grant and obviously they have misunderstood the situation or they have been misdirected by the agencies this Government appointed to look after the situation. I have no doubt that four of the people involved in the cases referred to me were told by their bank managers that they could not apply for the grant until they were married, and they took this advice and acted accordingly. I feel that the rejection of these applications has not been in accordance with the spirit, the objectives or the intention of the Act. I submit that the fundamental intention of the Act was to give an incentive to people to save, to encourage young people to build their own homes and to demonstrate that the Government is aware of the problems associated with home building and is prepared to help. We have upset not only the young people but also the parents as a result of the way in which the Act has been interpreted and administered.
I fully appreciate that the Minister has not the requisite power at the moment but 1 feel that he should be given power to exercise discretion in these matters. I hope that other honorable members on the Government side will strongly support my request. I certainly intend to press on with the proposal. I hope that other honorable members will see the wisdom of it and do all they can to support it. Clearly many young people are not acquainted with all the rules and regulations. The booklet that has been issued is very descriptive but 1 respectfully suggest that it is a bit disjointed. For example, the blue booklet states on page 6 that to be eligible for the grant a person must be married. It does not say that an applicant for a grant must be married, but it has been interpreted to mean that. Again, on page 15 the booklet states that the completed application form must be accompanied by the marriage certificate of the applicant. This, of course, cannot but give the young people the impression that in order to be eligible to apply they must be married.
I am making what I consider to be a constructive suggestion. There is no doubt that many young people have been dissatisfied and have felt that the Government has not been flexible enough in this matter. I urge the Minister to seek the necessary discretion and I urge the Government to grant it to him.
Mr. BARNARD (Bass) [10.431.- The appropriation for the Department of Housing this year is SI 1.750,000 less than it was for the financial year 1965-66. According to the Treasurer (Mr. McMahon) the reason for the reduced appropriation is that the allocation for war service homes will be $12 million less this year than it was last year. It is obvious that the proposed expenditure for housing this year will enable the building of fewer homes in 1966-67 than were constructed in the preceding financial year. And this, despite the substantial increases that took place last year, the year before, and the year before that in the cost of houses and land. Between 1961 and 1966, there has been an increase of 20 per cent, in the cost of houses and land. Therefore, the $120 million that is to be made available by the Commonwealth under the Housing Agreement Act 1966 will most certainly permit of the building of fewer houses in 1966-67 than $100 million did three or four years ago.
This has been the pattern in recent years. We are building fewer homes each year. In 1965-66, the number of new houses and flats under construction fell by 10,000. During the same period, the number of applications for assistance through the various State housing authorities increased considerably. It has always been difficult to assess the real demand for homes. The Government believes that our requirement is for between 80,000 and 85,000 new homes. But no doubt if we were able to ascertain accurately the number of people who desire better accommodation than they have at the moment, it would be necessary for the Government to review its assessment of the number of homes required annually. I submit that the figure would rise considerably if the means to obtain better homes were available to a great many of those people who are living in sub-standard accommodation today. The Government has made no attempt, nor does it intend to make any attempt, to evaluate the real position. Indeed, there has been no real assessment of the housing needs since 1957 - nine years ago - when the then Minister for National Development presented a report to this Parliament. That report contained the last accurate assessment to be placed before the Parliament.
The Director of War Service Homes reports to this Parliament annually. Now, in addition to that, we have a report from the Secretary of the Department of Housing relating to homes savings grants. If it is possible for a Minister to accept responsibility for housing, it ought also to be pos;.ible for the Department of Housing to submit to this Parliament a report concerning the housing requirements of the people. We should certainly be able to obtain a statement of the number of homes constructed and the number which the Government expects to be constructed in the years that lie ahead. Probably in no field is there a greater need for precise information relating to family needs than there is in this vital field of housing.
Even though statistics relating to housing requirements may not be available, at least the annual report of the War Service Homes Division confirms what has been said about the problem by honorable members on this side of the chamber in Estimates debates and in debates on allocations to the States under the Commonwealth and State Housing Agreement.
Honorable members on this side have referred frequently also to the deposit gap. It is obvious that the maximum advance today falls far short of the average wage earner’s requirements. In addition to the deposit gap problem, we have the difficulty referred to by the honorable member for Melbourne Ports (Mr. Crean) in his very thoughtful speech on the Commonwealth and State Housing Agreement Act 1966. On that occasion the honorable member spoke not only of the deposit gap but also of what is now commonly referred to as the economic circumstances gap. He pointed out that in addition to the problem of the margin of security required, home seekers, especially those with young families and those in receipt of low or moderate incomes, even though they may be able to find the required deposit, are not able, because of the inflated cost of houses and land, to meet the repayment commitments required of them. Secondly, there are those - I think this would be by far the larger group in Australia - who are unable to meet the repayments required of them and in addition, of course, are unable to provide the necessary margin of security.
In recent years the Government has not attempted to do anything about these problems so more and more young wage earners with families to support are being forced to turn to the State housing authorities for assistance. These are the only organisations which give them an opportunity to obtain a home under reasonable conditions. If we accept an annual increase of 5 per cent, in the cost of houses and land over the next five years, the position will be almost impossible for those in what is called the low income or average income group.
I now turn to war service homes. This matter has also been referred to by other honorable members on this side of the House. As the Deputy Leader of the Opposition has already pointed out, the appropriation this year will be Si 2 million less than it was in 1965-66. We are told that this reduction in the appropriation is due to a reduction in the number of new applications received. The amount allocated in 1965-66 was §70 million, lt will be $58 million for the current financial year. This is a substantial drop. According to the report of the Director of the War Service Homes Division, 10,930 new applications were received in 1965-66 whereas 12,478 new applications were received in the previous year 1964-65, so there was a fall in new applications in the last financial year. At the same time it must be borne in mind - surely the Minister would concede this - that in addition to the number of new applications received to the end of June 1966 there were 4,321 applications still awaiting settlement, lt is estimated that 800,000 exservicemen of the 1939-45 war are eligible for assistance through the War Service Homes Division but to the present only 23 per cent, of those eligible for assistance have received it.
No one doubts that the conditions under which loans are made by the War Service Homes Division are extremely good. They have the benefit of a reduced rate of interest of only 33- per cent., and all honorable members know that no other lending authority makes loans at such a rate of interest. The circumstances in which homes are made available by the Division are usually very satisfactory to the applicant. Because of these circumstances, and provided always that other circumstances are normal, the number of applicants for assistance should be substantially greater than 23 per cent, of those eligible to receive assistance. So there must be some very good reason for the reduction in the number of applications lodged with the Division during the last financial year. I say that the same situation applies in this Division as applies in most other organisations and companies which are prepared to make finance available to those who seek assistance to build.
May I again refer to the margin of security that is required. This matter, too. was referred to by the Deputy Leader of the Opposition. The last annual report of the Director of War Service Homes shows that in July 1962 the average cost of a house and land in New South Wales was $9,836. The maximum advance is $7,000; it has remained at that figure since 1962. In July 1965, that is, three years later, the average cost of a house and land in New South Wales had risen to $11,132, so that the deposit required was $4,132. According to the report, at the end of July 1965 the cost of a house only was $8,697. If we exclude the land, the deposit required for the house would be $1,697. So the situation is completely hopeless so far as the great majority of ex-servicemen are concerned. I point out again to the responsible Minister that in New South Wales the deposit required for the purchase of a house and land is no less than $4,132. If the ex-serviceman does not have this amount, his only alternative to gain the assistance that he is looking for is to raise a second mortgage at an interest rate of 10 per cent, or even higher. When this position is carefully considered it is found that the number of applications has declined not because ex-servicemen do not want to accept the benefit of a war service homes loan but because the deposit gap is so great that it is impossible for them to provide the amount required by the War Service Homes Division. I suggest in all sincerity to the Government that it would be impossible for the great majority of ex-servicemen to provide the security that is now required by the Division.
With easy assurance, the Treasurer tells the Parliament that the amount to be made available to the War Service Homes Division is to be reduced this year by $12 million. Instead of reducing the amount that is available to the Division, the Department should have considered increasing not only the overall allocation but also the maximum advance. If the maximum advance were fixed at $7,000 as far back as 1962 and if we take into consideration the 20 per cent, increase in the cost of house and land in the four year period, obviously the maximum advance in 1966 should be far greater than $7,000. If the Government had carefully considered this matter it would have found that large numbers of exservicenien desire to be assisted through the War Service Homes Division but are not in a position to obtain that assistance because the margin of security, or deposit required, is far greater than they are able io provide.
Bill returned from the Senate without amendment.
House adjourned at 11 p.m.
The following answers to questions upon notice were circulated -
m asked the Minister representing the Minister for Customs and Excise, upon notice -
At what ports and on what occasions have French ships called on their way to and fro;!i Tahiti and ils dependen ies in the last four years?
– The Minister for Customs and Excise has furnished the following answer to the honorable member’s question -
The records of ships’ movements maintained by the Department of Custom; and Excise show that the undermentioned French ships have called at Australian ports on their way to and from Tahiti and its dependencies since l«-t July 1962-
m asked the Minister for Territories, upon notice -
How many (a) Aboriginal and (b) other Australian children of school age live in the Northern Territory?
s. - The answers to the honorable member’s questions are as follows -
n asked the Minister representing the Acting Minister for Civil Aviation, upon notice -
– The Acting Minister for Civil Aviation has supplied the following information -
n asked the Minister representing the Acting Minister for Civil Aviation, upon notice -
– The Acting Minister for Civil Aviation has supplied the following information -
Shute Harbour Airstrip. (Question No. 1939.) lir. Patterson asked the Minister repressing the Acting Minister for Civil Aviation, upon notice -
n. - The Acting Minister for Civil Aviation has supplied the following information -
y asked the Minister for the Army, upon notice -
– The answers to the honorable member’s questions are as follows -
Armed Forces: Foreign Medals and Decorations. (Question No. 1995.)
m asked the Minister for
Defence, upon notice -
– The answers to the honorable member’s questions are as follows -
n asked the Minister for Territories, upon notice -
– The answers to the honorable member’s questions are as follows -
Details of Administrators and senior Government Representatives of the Northern Territory are - 25th March 1912 to 30th November 1919-
Dr. J. A. Gilruth, Administrator.
- 1st August 1919 to 30th November 1919- Mr. N. E. Carey, Director of the Northern Territory. 1st December 1919 to 15th January 1921- Hon. M. S. C. Smith, Acting Administrator. 17th January 1921 to 16th January 1926 - F. C. Urquhart, Esq., Administrator. 17th January 1926 to 28th February 1927- E. Copley Playford, Esq., Acting Administrator. 1st March 1927 to11th June 1931- Lieut. Col. R. H. Weddell, V.D., Government Resident. 12th June 1931 to 28th March 1937- Lieut. Col.
H. Weddell, V.D., Administrator. 29th March 1937 to 30lh June 1946- Hon. C. L. A. Abbott, Administrator. 1st July 1946 to 30th June 1951 - A. R. Driver. Esq., Administrator. 1st July 1951 to 30lh June 1956- Hon. F. J. S. Wise, Administrator. 1st July 1956 to 31st March 1961- J. C. Archer, Esq., O.B.E., Administrator. 1st April 1961 to 30th September 1964- Hon. R. B. Nott, Administrator. 1st October 1964 to date- R. L. Dean. Esq., Administrator.
- While Dr. Gilruth was still Administrator but absent from the Territory, Mr. H. E. Carey wason 1st August 1919- appointed Director of the Northern Territory and remained in that position until the appointment of Hon. M. S. C. Smith as Acting Administrator on 15th November 1919.
n asked the Minister for Territories, upon notice -
– The answer to the honorable members questions is as follows -
No arrangement exists between the Commonwealth and Vestey-controlled properties for erosion control in the Upper Ord Valley (Northern Territory section).
b asked the Minister for the Army, upon notice -
– The answer to the honorable member’s question is as follows -
The march was not, as implied by the honorable member, held for political reasons but to afford the citizens of Sydney the opportunity to welcome home members of the battalion which bus a traditional association with that city. The response shown by the community in its welcome to the troops speaks for itself.
All members were informed some three weeks before leaving Vietnam of the conditions which would apply regarding leave on return to Australia and the march through Sydney. The march was held on 8th June and local leave until 8 a.m. on that day was granted to all members who returned to Sydney up to 6th June. Servicemen ure not entitled to free travel for local leave and any member who travelled from Sydney during this period would have been responsible for his own fares. This local leave was, of course, additional to accumulated recreation leave and at the conclusion of the march all members of the Battalion then proceeded on recreation leave with free travel to which they were entitled for the purpose. Where a member had served for 12 months in Vietnam without recreation leave, his leave entitlement would be at least 30 days. Travelling lime was given to Western Australian members in accordance with standard practice, so that they were able to spend their full leave in their home Stale. lt will be apparent that far from losing any leave or travel privileges due to the march, members in fact received their full entitlement to leave and free travel, and in addition received local leave in Sydney prior to the march.
n asked the Minister for Primary Industry, upon notice -
– The answers to the honorable member’s questions are as follows -
Cite as: Australia, House of Representatives, Debates, 20 September 1966, viewed 22 October 2017, <http://historichansard.net/hofreps/1966/19660920_reps_25_hor52/>.