25th Parliament · 1st Session
The PRESIDENT (Senator the Hon. Sir Alister McMullin) took the chair at 3.30 p.m., and read prayers.
– I desire to ask a question of the Minister for Customs and Excise. Does the Government contemplate changing the personnel of the Commonwealth Literature Censorship Board? What method is used in the selection of members of the Commonwealth Literature Censorship Board and the Appeal Censorship Board? By what method are the Chairman and Deputy Chairman of the Commonwealth Literature Censorship Board appointed, and by what method is the Chairman of the Appeal Censorship Board appointed?
– No, it is not contemplated that there will be any change in the personnel of the Commonwealth Literature Censorship Board in the foreseeable future. In the selection of members, it is normal for the Minister and the officers of his Department to have regard to the views of the Chairman of the Commonwealth Literature Censorship Board or those of the Chairman of the Appeal Censorship Board; to the background of the persons proposed to be appointed; to their literary associations; to their station in life and to their contemporary approach to life. In fact, all normal factors are taken into account. Appointments are made by the Governor-General in Council.
– I direct a question to the Minister for Civil Aviation. Can the Minister advise what progress has been made in providing an aerodrome and air services for the town and district of Gympie in Queensland? Will Gympie airport development be included in the aerodrome local ownership plan? When will work on the aerodrome commence? What type of aircraft will service Gympie?
– For some time we have been giving consideration to the request for an aerodrome to be built at Gympie in Queensland. We are taking steps to have the local ownership plan developed in the area. The site of the aerodrome is at Kybong, which is eight miles” from Gympie. It will be developed at an initial cost of £66,000. Under the local ownership plan the local council will assist in the development of the aerodrome, and I think that is a healthy sign. The work should be completed by late 1965. The present design provides for the aerodrome to take Piaggio type aircraft, but if the traffic develops as it is anticipated it will develop, the aerodrome may have to be enlarged to take aircraft of the Fokker Friendship type.
– I ask the Minister for Civil Aviation whether either of the two major civil airline organisations is being handicapped in respect of the delivery of the new Boeing 727 jet airliners to Australia. When are the aircraft due in Australia? On what date is it expected that the airlines will put them into service? Does Government policy still aim at maintaining two civil airlines in Australia? Do those travelling by air with Commonwealth Government vouchers still have the right to name the airline on which they wish to travel?
– Neither of the airlines concerned is at any disadvantage. When the airlines were assessing the type of aircraft they wanted, the Government made it quite plain that they could choose whatever type they wanted. Both of them chose the Boeing 727. The first two of these aircraft will arrive on 16th October, the airlines themselves having agreed that both should arrive on the same date. They tossed to see which would hit the ground in Australia first. I understand that Ansett-A.N.A. won the toss and that its aircraft will land first. These airliners will be flying in commercial service on 2nd November. As to the issue of travel vouchers, I point out that both airlines have equal access to government business .Neither airline is under any handicap in this respect. The recipients of vouchers may nominate the airline with which they wish to travel and the vouchers are made out accordingly.
– Has the
Minister for Civil Aviation seen a statement that in the last financial year Ansett Transport Industries Ltd. had a record profit of £1,567,644 and that the growth of air passenger and freight traffic continued throughout the year? Bearing in mind tha record profit enjoyed also by TransAustralia Airlines, Qantas Empire Airways Ltd. and Tasman Empire Airways Ltd., what justification was there for the recent announcement by the air companies of an increase of 6 per cent, in passenger fares?
– Yes, I have noted with pleasure the profit of the various airlines. It is not a big profit really, when one thinks of the amount of capital that is invested in the industry. The figure quoted is indicative of the position throughout the world. I repeat that when one considers the tremendous amount of capital that is invested in these undertakings throughout the world, airlines generally do not constitute a particularly profitable venture. However, last year was a better year for the airlines mentioned by Senator McClelland.
The honorable senator asked me what was the justification for the increase of 6 per cent, in air fares. All I can say in reply is that the additional expenses which have had to bc met by one airline alone - I do not think it would be fair to mention the name, although 1 would do so if the honorable senator wished me to - would have more than wiped out that company’s profit if no increase had been granted. I believe that no airline should be asked to live with that state of affairs. Therefore, after a close examination of the facts we believed that the increase of 6 per cent, was fully justified.
– My question is addressed to the Minister for Civil Aviation. Having just stated that the new Boeing 727 interstate aircraft will operate as from 2nd November, can the Minister state on what passenger routes they will fly? Can he state whether he has been successful in persuading or in directing the operators, namely Trans-Australia Airlines and Ansett- A.N.A., to formulate programmes of operations which would ensure that the jet aircraft of each operator would not leave for the same destination at or about the same time?
– I have not yet been advised of the routes on which the Boeing 727 aircraft will travel initially. The first services will start on 2nd November. For air safety reasons the times of departure of Boeing 727 aircraft will be staggered, but I have made no progress in getting the two major airlines to agree to a further staggering of flight departure times. I am still pressing, in the hope that this will be done.
– I direct a question to the Minister representing the Minister for Immigration. Is a group of 12 Russian tourists, including members of the Russian Communist Party, now in Australia? Were these tourists granted visitors’ visas? If so, why are members of the Russian Communist Party granted visas to tour Australia while an ex-member of the Communist Party of Germany is refused a visa to visit his children and grandchildren? Is membership of the Communist Party of one country more desirable than membership of the same party in another country, or is tourism more desirable than family reunion?
– The honorable senator has raised this particular case in a question upon notice and, indeed, on a motion for the adjournment of the Senate. He now links it to another alleged set of circumstances. I do not propose to give him an answer, but if he will place the question on the notice-paper I shall have it referred to the Minister for Immigration.
– I direct a question to the Minister for Health. Sir Ernest Marsden, the noted New Zealand nuclear physicist, who has just returned from an overseas study of cancer, is reported to have stated, inter alia -
We can reduce lung cancer by one-third very easily now … the causes of lung cancer had been discovered - certain tobaccos and high ash coals and, to a lesser extent, the effluent from motor vehicles.
If Sir Ernest Marsden said “ certain tobaccos “, as reported, does this imply that some tobaccos are now believed not to be causative factors in lung cancer?
– Senator Morris sought some information yesterday on this subject and, because of its great public interest, I took the opportunity of discussing the report with officers of my Department. I am now in a position to say that the report of the Advisory Committee to the SurgeonGeneral of the Public Health Service of the United States indicates that seven components of tobacco smoke are capable of inducing cancer. These components are referred to as polycyclic compounds and vary in their carcinogenicity. The most important and most carcinogenic of this group are benzo(a)pyrene and dibenzo(a,i)pyrene. The composition of tobacco is variable and depends upon the variety of tobacco plant, the locality and soil conditions of growth, the mode and time of harvesting and the various processes of curing and aging employed. It is thought that the concentrations of the polycyclic hydrocarbons can be affected by the method of curing and aging, for example, by fire curing, which involves hanging the leaves in closed barns where they are exposed to wood smoke for a long period. Although it is possible that certain tobaccos may be less carcinogenic than others because of the factors mentioned above, namely, components in the plant and soil and methods of curing and aging, no tobacco is known to me which does not possess significant quantities of carcinogenic agents. Therefore, at the present state of our knowledge, I know of no tobacco in which there could be considered to be an absence of the causative factors in relation to lung cancer.
– I direct a question to the Minister representing the Minister for Shipping and Transport arising from statements made by the Chairman of the Australian Coastal Shipping Commission, Captain J. P. Williams, in the report of the Commission. I preface my question by pointing out that these comments have caused considerable concern in Tasmania. In view of the report made by Captain Williams and the importance of shipping services and freight rates to Tasmania, will the Minister make a statement to the Senate as early as practicable on the likelihood of increased freights on goods and increased passenger charges for transport to and from Tasmania on the “ Princess of Tasmania “ and, shortly, on the “ Empress of Australia “?
– I shall refer the honorable senator’s request to the Minister for Shipping and Transport at the first opportunity. I think it fair to say that Captain Williams, as Chairman of the Australian Coastal Shipping Commission, merely took the opportunity to remark in the Commission’s report that the Commission was now feeling very greatly the effects of increased costs. These, in the main, have resulted from higher margins and basic wage increases. Of course, this is just another example of the cycle of rising costs going faster and faster and becoming more drastic in its effects. I am sure the honorable senator, knowing the record of service given by the Australian Coastal Shipping Commission, will appreciate that an increase in freights would not be even contemplated unless it were absolutely necessary.
– I direct a question to the Leader of the Government in the Senate. In view of reports that the copper shortage in Australia is critical and that availability and prices of copper are affecting the Australian economy and defence projects, will the Minister investigate the prospects of a resumption of copper mining in those areas of South Australia where production ceased during periods of depressed prices as one measure to meet this shortage?
– It is true that world prices of copper have increased quite dramatically recently. It is also true that this Government subsidises copper in order to keep the cost of copper in Australia to what is regarded as a reasonable level. I believe my colleague, the Minister for Customs and Excise, will be presenting to the Senate shortly a bill to renew the copper subsidy which, I repeat, is designed to keep copper prices in Australia within reasonable limits.
– I direct a question to the Minister for Civil Aviation. In view of the Government’s subsidisation and support of the airlines operations of Ansett Transport Industries Ltd. will the Minister make available to the Parliament the profit and loss accounts of the company in respect of those operations as distinct from other activities of the company?
– The balance sheets of Ansett Transport Industries Ltd. are published and are available to the public. The company is privately owned and I have no intention of interfering in the normal procedures relating to the publication of the balance sheets of such organisations in the present circumstances.
– I direct my question to the Minister for Customs and Excise. Is it a fact that for tariff purposes cricket bats are classified as toys and, as such, have a most favoured nation protective duty of only 45 per cent, whereas other sporting equipment such as hockey sticks have a most favoured nation protective duty of 55 per cent, plus 5 per cent, primage?
– Cricket bats are classified as cricket bats under item 310(a)(1) of the tariff. Prior to 1947 cricket bats were linked with other sporting equipment, including hockey sticks, and at that time carried duties of 221/2 per cent. British preferential tariff and 55 per cent, most favoured nation tariff plus 5 per cent, primage, as the honorable senator has indicated. In 1947 a trade agreement was negotiated between Australia and India. In that agreement cricket bats were classified and, being classified, the duty was reduced to 221 per cent. British preference and 45 per cent, most favoured nation. Despite the publicity to the contrary, cricket bats are classified as cricket bats and, in accordance with the trade agreement with India, carry the duty that I have mentioned.
(Question No. 244.)
asked the Minister representing the Minister for Labour and National Service, upon notice -
– The Minister for Labour and National Service has furnished the following answer - 1 and 2. The practice of married women being employed on a part-time basis is by no means uncommon and is doubtless extending under the pressure of a tightening labour market. Subject to industrial legislation and award provisions, conditions of employment are a matter for agreement between employers and employees and their organisations. Provisions relating to part-time employment appear in a number of Federal and State awards. Some of these awards cover industries in which large numbers of women are employed, for example, the clothing and retail trades. Under these awards there are appropriate provisions for paid sick and holiday leave for part-time workers.
(Question No. 250.)
asked the Minister for Health, upon notice -
– The answers to the honorable senator’s questions are as follows-:-
Details of the treatment have been made available by Dr. Moller at the request of my Department. They have been referred to, and studied by, the Royal Australasian College of Physicians. The report of the College has just reached me, and may be summarised as follows -
(Question No. 265.)
asked the Minister representing the Minister for Trade and Industry, upon notice -
– The Minister for Trade and Industry has supplied the following answers -
The Australian wheat acreage in the 1961-62 season - the season in which sales to Mainland China began - was 13.4 million acres. The acreage for 1963-64 was 16.4 million acres. No-one has ever suggested to wheat growers that they should produce wheat for the Mainland Chinese market. Growers no doubt have increased their plantings having regard to -
Motion (by Senator Paltridge) proposed -
That the Senate will resolve itself forthwith into a Committee of the Whole for the purpose of considering the Particulars of Proposed Expenditure for the Ordinary Annual Services of the Government in respect of the year ending 30th June 1965, and the Particulars of Proposed Expenditure for other than the Ordinary Annual Services of the Government in respect of the year ending 30th June 1965.
.- I wish to take the opportunity to record the view I have on the form in which the particulars of proposed expenditure are to be presented to the Committee. I remind honorable senators that the Constitution divides appropriations into those which concern the ordinary annual services of the Government which are not amendable by the Senate, and those for services other than ordinary annual services of the Government, which are entirely subject to amendment by the Senate. 1 remind the Senate that this subject was debated in this chamber on a recent occasion and for myself 1 regret that the papers now to be considered by the Senate have not been revised. They are still in the form in which they appeared when the matter was discussed in the Senate. In ordinary circumstances I would not accept papers in this form as being in accordance with the requirements of the Constitution, having regard to the respect that should be paid to the powers, and therefore the responsibilities, of this chamber.
I refrain from making any move to divide the Senate to reject the papers in their present form, only because the Treasurer (Mr. Harold Holt) indicated in the course of one of his speeches in the other place - a statement in similar terms was made by Senator Henty, the Minister representing the Treasurer in this chamber - that reconsideration of this form of presentation is continuing and that a decision upon the matter will be made by the Government in the following few months. I simply register my opinion that the papers to be presented to us are in a form contrary to the requirements of the Constitution inasmuch as this chamber has a responsibility, if it so decides, to amend proposed expenditure other than expenditure for the ordinary annual services of the Government.
I await the Government’s deliberations in the hope that next year thepa pers will be presented in a form which will give proper recognition of the Senate’s rights. Then the matter will be finally determined, I hope, by the two Houses of the Parliament.
– As I announced when tabling the papers we are now discussing, consideration is still being given by the Government to the matter which the honorable senator has raised. He will recall that this matter was the subject of considerable debate in this chamber prior to the end of the last financial year. Since that debate, the Treasury and the Government have been examining the position, and as 1 said, the matter will continue to be examined. 1 hope we will be in a position to announce a decision before these papers come before the Senate next year.
.-I should like to make an observation on a remark made by the Minister for Civil Aviation (Senator Henty) arising from something that was said by Senator Wright about the form of presentation of the papersnow under discussion. The expression “ ordinary annual services of the Government “ seems, by the form in which the papers have been presented, to be almost totally inhibited. I direct the attention of the Senate to a phrase used by the Minister in replying to Senator Wright. He conveyed to me the impression - I hope it is an incorrect impression - that the reclassification of these papers is a matter for decision by the Government. I wish to remind the Senate that in the final analysis the reclassification of these papers is a matter for decision by the Parliament, and in relation to the presentation of the papers in the Senate, it is a matter for decision by the Senate. I will say no more at this stage.
Question resolved in the affirmative.
– I move -
That, unless otherwise ordered, the particulars of proposed expenditure be considered in the following order -
Department of Health, £5,441,000
Department of Health, £417,400
Department of Works, £24,622,000
Department of Customs and Excise, £6,771,000
Department of Civil Aviation, £20,071,000
Commonwealth Scientific and Industrial
Research Organisation, £14,135,000
Attorney-General’s Department, £3,523,000
Department of External Affairs, £15,433,000
Economic and Defence Support Assistance to
Members of SEATO and Protocol States, £1,000,000.
Aid to India, £48,000
Department of Labour and National Service, £3,423,000
Post Discharge Re-settlement Training, £1,000.
Department of Territories, £827,000
Christmas Island, £100
Cocos (Keeling) Islands, £63,500
Norfolk Islands, £38,400
Northern Territory, £18,888,700
Papua and New Guinea, £28,496,000
Department of Social Services, £9,087,000
Department of Social Services, £11,500
Repatriation Department, £120,678,000
Department of immigration, £16,795,000.
Department of Supply, £33,044,000
Department of Primary Industry, £17,616,000
Department of Primary Industry, £637,100
Department of the Interior, £11,108,000.
Civil Defence, £330,000
Australian Capital Territory, £27,826,300
Department of Air, £90,015,000
Postmaster-General’s Department, £203,976,000
Broadcasting and Television Services, £22,338,000
Department of Trade and Industry, £5,531,000
Department of the Treasury, £88,258,000.
Advance to the Treasurer, £1,190,000.
Advance to the Treasurer, £16,000,000.
Department of the Navy, £69,212,000.
Department of the Army, £94,185,000.
Department of Defence, £5,279,000
*Prime Minister’s Department, £21,566,000.
Prime Minister’s Department, £30,000
Department of Shipping and Transport, £24,596,000
Department of Shipping and Transport, £82,000
Commonwealth Railways, £9,908,000
Department of National Development, £25,699,000
Department of Housing, £36,806,000
Mr. Chairman, the Senate dealt with the papers in this form for the first time last year. They are referred to in the list that has been circulated to honorable senators as document A and document B. Document A is an extract from the schedule to the Appropriation Bill 1964-65. Document B is an extract from the schedule of the Appropriation (Special Expenditure) Bill 1964-65. The page numbers on these papers correspond with those on the relevant bills.
Question resolved in the affirmative.
Motion (by Senator Paltridge) agreed to -
That, in relation to each division in the Particulars of Proposed Expenditure, the Chairman shall put the question - “ That the Committee takes note of the proposed expenditure “.
Department of Health
Proposed (expenditure, £5,441,000.
– First ofall,I wish to discuss DivisionNo. 250 - Administrative. There was a question asked in the Senate recently regarding research into the reasons why nurses leave their employment. It would be a complete waste of time if the Government or the Minister gave any further thought to this matter because every hospital board in this country has tabulated the number of nurses who leave their employment during the course of training. That would answer straight away the question asked by the honorable senator. We all know of the wastage of nurses due to certain fixed causes, and those causes are practically standardised throughout Australia. The main one, of course, is that almost 50 per cent, of nurses get married during their training. That is the greatest cause of wastage. Other nurses leave through illness and for other reasons. I feel it would be a complete waste of money to have any research into this aspect of nursing.
I want to refer particularly to Administration Expenses, item 05 - Health conferences. When I attended a health conference under the auspices of the National Health and Medical Research Council, and suggested that an item concerning smoking bc placed an the agenda I was horrified when I was told that no such item would be allowed. It was particularly horrifying to me to think that any Minister or any Director-General of Health could have issued instructions to his officers to debar discussion of smoking. Whether or not we believe in the health reports on the dangers of smoking - and I firmly believe in them - there is no doubt that we must do something about the matter. Yet when this matter of smoking was raised at a meeting to discuss preventive medicine, where the prevention of lung diseases - not just cancer - is one of the main subjects discussed - we were refused permission to talk about it.
– What was the nature of the conference?
– The conference was held under the auspices of the National Health and Medical Research Council. It was a meeting of the Committee in Preventive Medicine in General Practice. I happen to be the Tasmanian representative on the Committee.
– Generally, who are the representatives?
– There is one from each State, and the Commonwealth Director of Public Health is the Chairman.
– Who appoints the representatives - the profession or the Government?
– I assume they are appointed by the Government. Actually, I am not sure whether they are appointed through the National Health and Medical Research Council or by the Government. The Committee is allied to the Committee of Preventive Medicine of the Australian College of General Practitioners. In fact, the members of that Committee of the Australian College of General Practitioners are exactly the same as those of the Committee of the National Health and Medical Research Council. For a meeting of the subcommittee of Preventive Medicine in General Practice to be told that it cannot discuss smoking just staggers me. I think it was a terrible thing for anyone in authority in the Department of Health - I do not know who was responsible - to issue an order that we could not discuss preventive conditions associated with smoking. I do not want to say more on that subject, because it is a matter that the Minister himself will have to investigate. There is to be another meeting of the Committee within a few days, but unfortunately I shall not be able to attend. I would have brought up the matter again if I had had an opportunity.
I now wish to relate my remarks to Division No. 254 - Health Services, and to refer to the subject of compound tablets. The Minister has answered - to my mind unsatisfactorily - several questions on this subject asked in this place. I am quite certain that most people have accepted his statements, one of them being in reply to a question asked by Senator Ormonde. This state of affairs has lasted for over a year. Last year we got into a little tiff with the Minister because he thought we were talking on behalf of the drug houses. That was not so. But this year apparently the same thing is going on.
Before the war most prescriptions took the form of mixtures which contained one, two, three or four ingredients. In other words, they were compound mixtures. Even today the Department of Health has a standard list of prescriptions which includes mixtures that contain compound drugs. However, for some unknown reason, the Pharmaceutical Benefits Advisory Committee was horrified at the thought that anybody should put more than one drug into a tablet. As 1 said earlier, this state of affairs has been going on for years and it has been accepted by the profession.
– As applied to asthma?
– I shall come to the specific subject of asthma.
– They now accept some compounds, but they will not accept one with the three constituents.
– I am coming to that. Let us deal with the one that has been mentioned by Senator Ormonde and Senator Dittmer. I refer to the preparation called Amesec which is a favorite with doctors for the treatment of asthma, even though not all doctors order it. It was removed from the list because some members of the Pharmaceutical Benefits Advisory Committee did not like compound tablets. All that we have been told by the Minister is that this Committee is not obliged to tell anybody why it takes such action. That is quite wrong. Surely if the Committee is to act as arbitrarily as that it should give reasons for its action. This Committee consists of five or seven doctors. They may have their reasons for so acting, but there are approximately 12,000 other doctors who have their reasons for prescribing certain preparations. To be told that the members of this Committee are the best professional people in the Commonwealth does not altogether hold.
Amesec is a useful tablet. If members of the Committee had cancelled its use on the ground of expense, I would not have argued with them. If they think a drug is too expensive, they have every right to remove it from the list. But they did not remove it for that reason. They said it was removed solely because they did not like compound drugs. But what did they do then? They placed on the list a preparation called Tedral, which is exactly the same. Is that not plain stupid? One can raise this matter with Ministers and talk about it, but nobody takes any notice.
– What is the standing of this Committee? Are its members professional men?
– Yes. Can anybody imagine a committee removing from the list one capsule and replacing it with another one which is exactly the same? Perhaps it is slightly different in terms of the amounts of the ingredients, but that does not matter. The point is that it is a triple compound drug.
– Is it sold under a trade name?
– I am using the trade names. Tedral is a trade name, and so is Amesec. For a moment let us forget about Amesec and Tedral as related to asthma. There are other compound tablets which are approved by the Department. I am not blaming the Minister - we cannot expect the Minister to know - but I am blaming his Department. Ephedrobarbital is a combination of ephedrine and phenobarbitone. It is a very useful drug and we all approve of it. It is still on the list, and there are others. Pensioners are allowed triple compound drugs. These drugs apparently do not harm them; they harm only non-pensioners. I do not say that Amesec is allowed to pensioners; I say that other triple compound drugs are allowed to them.
The Minister, in reply to Senator Ormonde, said that these compound drugs were not suitable and that therefore they should not be used. If they are suitable for 60 to 80 per cent, of the people, why can they not be used for those 60 to 80 per cent.? The doctors can write out prescriptions for the other 40 to 20 per cent, for whom they are not suitable. In the old days a patient used to get 100 Amesecs for 5s. The Minister said that a doctor could order each ingredient. If he orders each ingredient, he must order three ingredients and the cost of each is 5s. He has to authorise repeats because in some instances a patient is not allowed more than 25 or 50. Instead of paying 5s., the patient has to pay nearly £2 to get the same quantity. The Minister told us, on advice from his Department, that these ingredients could be ordered separately and the doctor could put on the prescription the words “fiat capsule “, that is, make a capsule, in which case it would be allowed. The poor chemist has to deceive the Government, because no chemist will, for the sake of the Government, make up a capsule of three ingredients, which are already in a capsule. If the doctor wrote down the three separate ingredients and stated that they should be made into a capsule, this would cost a patient only 5s., but one is allowed only a limited number of capsules. There have to be certain repeats. The patient would have to go back to the doctor to get repeats to make up the 100 capsules he could have got under the old scheme. Surely most doctors have enough commonsense to be able to decide what they want for their patients. If they do not want the triple compound Amesec, let them order something else.
I understand - I may be corrected if I am wrong - that another drug, Mysteclin V, is about to be taken off the list. It is a combination of tetracycline with an anti.monilial type drug, lt has been on the list ever since the list has been operating. Sir Derrick Dunlop, one of the greatest therapeutic physicians iri the world, who visited Australia recently, has just completed a new text book on medicine, in which he states quite emphatically that in certain cases we should use this compound tetracycline rather than a single tetracycline, because it would be more advantageous to the patient. That is only Sir Derrick Dunlop saying that. I do not know the reasons why the local committee recommended that this drug be removed from the list. We are not told the reasons. It is essential that the committee be made to give its reasons, especially to the medical profession. The reasons should at least be published in the “Australian Medical Journal “. I understand that the committee is taking the drug off the list because it is a compound drug. Surely we are getting into the realm of stupidity rather than the realm of science.
If compound drugs are to be wiped off, wipe them all off. If the theory of the wallahs on the committee is that compound drugs are harmful, wipe the lot off. They should not try to say that one is harmful and another is not. Doctors must be allowed some decision in regard to what we use. This brings me to my final point - the big brother attitude that the Department is now adopting. The cost of drugs was getting so high, the Department said, that it was going to do something. It virtually hinted that this was the fault of the doctors. Let me say that it is the fault of the Government for opening up the scheme in the way that it has done. When you provide something free, everyone wants it. It does not matter how much the Government tells doctors that they must restrict the use of the drug. The patient knows it is on the free list and he says: “Why cannot I have it? Give it to me “.
This Government made provision for lifesaving drugs to be free but suddenly, for political purposes, it threw the list wide open and now the Government is horrified because the cost of drugs to it is mounting year by year. The costs will continue to mount whatever else the Government might do. If it provides a free service, it must expect the worst. This suggestion by the Government that doctors must be careful in dispensing drugs reflects a very poor attitude, in my opinion. The Government should not blame the doctors for its own mistakes. If the Government had not extended the free list, we would not have all the trouble we are having today.
I still maintain that the list should have been limited to lifesaving drugs as it was originally. Instead, the Government has put tetracycline and all the other expensive drugs on the list and then has said to the doctors, in effect: “ You must not use them.” I do not want to put a halo on my head but, personally, I prefer to use sulphadiazine instead of tetracycline. However, thereare other doctors who prescribe these drugs and it is not their fault. If you send a patient to a consultant, he must show his worth and so he orders the most expensive drug. Having that example before them, general practitioners order the expensive drug first instead of the ordinary sulphadiazine tablet which is cheap and effective in most cases. So there is no-one to blame but the Department of Health itself. I object to this big brother attitude which implies: “If you don’t look out, we will investigate you.”
Order! The honorable senator’s time has expired.
– I direct attention to Division No. 250 - Administrative, and the item “ Sirex wasp control and eradication (for payment to the credit of the National Fund Trust Account) £100,000”. I commend the Government for the interest it is taking in sirex wasp control. I alerted the Government to this matter early in 1952 when I was appalled after seeing the effects of infestation by the sirex wasp in the pine forests near the Llanherne airport serving Hobart. The softwoods timber industry is important to South Australia and I am grateful to the Minister for Health (Senator Wade) for his energy in prosecuting control for the sirex wasp.
I note that £100,000 is to be provided this year compared with an appropriation of £90,000 last year and I should like to know why the additional amount of £10,000 is being provided. I approve fully of the expenditure because if the sirex wasp got control in the forests of southern Australia the losses could be of the order of tens or even hundreds of millions of pounds. In addition, the nation would suffer because that much softwood timber would not be available.
Will the Minister state how much the States are providing to this National Sirex Fund? Do they match exactly in total the amount that is provided by the Commonwealth Government? Will the Minister state how much is provided by each State? I should like to know also in what way the money is being used. Will the Minister state whether sirex wasp infestation is being discovered now or whether it is a matter of preparing against future outbreaks? What method is being used to destroy the trees that have been attacked by the wasp? Is the fund being assisted by the work of the Commonwealth Scientific and Industrial Research Organisation and the Waite Institute in South Australia?
When I first became interested in this matter I went to the Waite Institute near Adelaide to see the work being done there by some of the officers employed by the State Government and by the University of Adelaide. Is some assistance and direction still coming from that source?
I pass now to Division No. 253 - Administrative Expenses - item .05, which relates lo payments to the States and medical practitioners for services rendered. I do not know the precise item under which the home nursing subsidy falls but I am assuming that this item covers it. I learned of this subsidy when reading the annual report of the Commonwealth DirectorGeneral of Health who, on page 69, refers to the scheme in this way -
The home nursing subsidy scheme, which came into operation on 1st January 1957, was designed to assist in the extension of home nursing activities, either by the expansion of existing home nursing organisations or the formation of new ones. To be eligible for a subsidy, an organisation must provide a home nursing service, be a non-profit making organisation, employ registered nurses and bc in receipt of assistance from a State Government.
I am not aware of the way in which this scheme operates in South Australia. I should like the Minister to state the extent to which it operates in that State, the amount that the Commonwealth pays to the State and the assistance that the State Government gives to the scheme to enable it to become eligible for a Commonwealth grant. To me the scheme appears to be an excellent one.
I refer now to Division No. 254 - Administrative Expenses - item .09, which relates to payments to the States for capital and incidental expenditure in relation to the provision of milk for school children. I note that £12,500 is being devoted to the scheme for this financial year. I invite the Minister’s attention to some observations that I made after visiting independent schools in the Adelaide area some months ago to see their science teaching facilities. I had discussions with principals and headmasters. I learned that the boys at one school were not availing themselves of the milk that was being supplied by the Department either because they had lost the zest for it or because they did not like it. A good number of the bottles of milk that the school was receiving were not being used. The thought has occurred to me that the Government could well consider changing the drink that is supplied. On page 70 of the report of the Director-General of Health to which I have already referred the following appears -
An innovation in the free milk scheme was the introduction, without any rise in price, of flavoured and homogenised milk into schools in the northern part of Tasmania. This resulted in a 15 per cent, increase in consumption in that area and it is proposed to introduce this milk into the southern section in September 1964.
After searching for ways of encouraging school children to use the milk that is supplied, the Department decided to flavour it. I commend the Department for that but I wonder whether it is not desirable at this time to consider supplying an entirely different drink to assist in the growth of our school children. Perhaps it could be something in the nature of a fruit juice. Whether ii be pineapple or citrus juice is something that the Department could consider. I do not think the Department should be entirely wedded to the provision of ordinary milk. As I have mentioned, the Department in Tasmania is now supplying flavoured milk. From my observations the plain milk is not being used to the extent that it could be and I think it would be a good idea if the Department considered providing some other health giving drink.
I recall the observation along these lines made by Mr. J. A. Ferguson, Chairman of the New South Wales Milk Board, which was publicised about six or eight months ago. He spoke from the very forceful level of his position and I consider that his remarks are entitled to very close examination by the Government. I should like to hear from the Minister whether his Department is carrying out any research into the question of a substitute for milk or into the question of serving milk in a different way.
, - I have been asked a series of questions and I think I should endeavour to cope with them now before they reach really major proportions. Senator Turnbull, in his opening remarks, advised the Government to reject the submission made to it that it should assist in a programme of research that has been undertaken into the interests of nursing in the various States. He said categorically that about 50 per cent, of the wastage - I think that was the word he used - was the result of marriage. That fact is incontrovertible. In fact, when addressing a public gathering recently I said in a rather facetious manner that if I were ever the dictator of this country I would prohibit the marriage of nurses. I have never lived that down. In reply to a question the other day I said that this matter was before the Prime Minister (Sir Robert Menzies) as it came within his province. I indicated then that the States had undertaken this investigation and it could well be that they would be approached again by the research group to support the programme further. That is purely speculation, but that is the position as I see it.
The honorable senator also commented on compound drugs. I think he rather erroneously stated that the advisory committee had said that it did not like compound drugs or, in other words, mass medication. As far as I know, the committee has never given any reason why it has recommended the removal of Amesec, a compound drug. The honorable senator was quite correct - the committee does not state reasons. He suggested that it should give reasons for its decisions. I think that I can put to the Senate very valid reasons why the committee should not bc called upon to do as the honorable senator has suggested.
– I should like to hear them.
– You will hear them. Whether you will be convinced is another matter but having heard you voice opinions on many occasions, I think you will support the points that I make when I state the principles involved in this matter.
– That depends upon their validity.
– They will be valid when they come from me. The whole concept of this section of the legislation is that there should be set up an advisory body that is completely free from pressures and influences. It should make its recommendations based wholly and solely on the therapeutic values of the drugs concerned. Cost is not taken into account by the committee. There is no Ministerial interference or direction. It happens that I know the chairman, but I could not name one member of the committee. That is the way it should be. It is the committee’s responsibility to come to a skilled and academic decision after consideration in a highly specialised field. That is the first point I wish to make.
In order to achieve the composition of such a committee we asked the British Medical Association - as it then was - to nominate some of the most highly skilled men in’ the profession to form a committee. That has been done. When replacements have been necessary the Australian Medical Association has forwarded its nominations. So far as I can sec, that affirms the complete independence of the committee and vouches for the skill and standing in the profession of its members. I could not think of a more competent body of men to advise in this field.
It has been suggested that the committee give reasons for its decisions. Senator Turnbull said that there are 12,000 doctors in Australia who could give reasons. That is very true, but with the greatest respect to the 12,000 doctors, it might well be that none of them would agree with the reasons advanced by the committee. You appoint to the committee the best men you can find in the land to advise you on technical matters; not on matters of policy or politics. To adopt the suggestion that the committee be called upon to give reasons for its decisions would be to place it in an untenable position. The committee members have no interest at all - other than their professional interest - in making recommendations to the Government. If the recommendations have to be recorded in reasoned words of explanation as to why they have been made, they can be openly challenged by 12,000 people, perhaps all of them with different approaches and experience. The time would come when you could not get a committee to advise you.
I would not like to see the day arrive when you could not get an independent body of skilled people to advise on this subject and it would be necessary to throw the responsibility for decisions on to departmental officers, good as they are. In almost every case their decisions would be influenced by government policy and thinking, by matters of cost, and so on. I suggest to the honorable senator that until someone can produce a better system - and I have not heard of one - the present system is the most satisfactory one.
Senator Turnbull suggested that the committee does not like compound drugs. So far as I know the committee has never stated that it does not like compounds. In trying to assist in a discussion on a previous occasion, I suggested that might be so. As a layman I find it difficult to put these points as they should be put. My departmental officers and medical men to whom I have spoken on the subject have said that you rarely find two patients who require exactly the same quantity of a compound drug. I think there is some merit in their argument that each individual should have a prescription written to cover his specific needs. There may be room for argument, but I think there is a good deal of merit in that point of view.
asked for information concerning the sirex wasp campaign. He said that lastyear the expenditure in this field was £100,000 and this year it is £90,000. The Government’s allocation of funds for the campaign has not been reduced. The difference in expenditure is accounted for by different accounting methods. I think that in the previous 12 months it was necessary to make an additional appropriation to complete the first year’s programme and that accounts for the difference of £10,000. There has been no relenting in the Government’s attitude to the campaign.
– But this year the expenditure is higher.
– Well, the converse is true. For each of the last two years the Government has made £100,000 available for the campaign. There have been no new outbreaks of infestation by the wasp. 1 am sure that Senator Laught will be interested to learn that an intensive campaign has been undertaken in South Australia and, to a lesser degree, in the other States. The conclusions reached indicate that Victoria and, of course, Tasmania, which has had the sirex wasp for some years, are the only two infested States. The Sirex Wasp Committee, which controls the operations, is using the resources of the Victoria Forests Commission as the machinery to fight the campaign. The Victoria Forests Commission has pursued the campaign very vigorously. I have in my possession some photographs which indicate where the sirex wasp has been found in Victoria, the areas in which it has been eliminated and the areas to which it has been confined. I think it has been confined to two or three areas. I shall be pleased to show the photographs to the honorable senator if he would like to see them.
Our last conference with State Ministers, officers of the Commonwealth Scientific and Industrial Research Organisation and representatives of other interested bodies was greatly heartened by a report of the Sirex Wasp Committee, because it gave us hope that the eradication of the wasp is not impossible. The C.S.I.R.O. is playing a very valuable part in this field and is responsible for the research side of the campaign. I wish that Senator Gorton, who is in charge of Commonwealth research activities, were here, because he is better informed on the subject that I am. I believe that the C.S.I.R.O. is pursuing a vigorous research policy. In the long run, its findings may be of greater benefit to Tasmania than to Victoria, because the wasp has been firmly entrenched in Tasmania for so long that its eradication there presents a much greater problem than it does in Victoria. It is the policy in Victoria that trees attacked by the sirex wasp must be removed and burned. That could not be done in Tasmania and scientific methods must be used to combat the wasp there.
Senator Laught also referred to milk for school children and pointed out that he had found in some independent schools that milk was not being consumed by the children although it was delivered. I must confess that this information disturbs me to some extent. The Slate Departments of Education are responsible for the implementation of the free milk scheme. The Commonwealth reimburses them for their costs. I would not like to think that the practice to which the honorable senator has referred is widespread, because that would involve waste which we could not condone. As the matter has been brought to my notice I will make inquiries to see that there is not widespread waste. The honorable senator went further and suggested that the time might be ripe to consider the replacement of milk by fruit juice. I am not qualified to debate the virtues of milk against fruit juices except to say this: The officers of my Department are convinced that there is no substitute for milk and for that reason I cannot anticipate any change in this field. The honorable senator asked for information concerning home nursing. I will give him that information the next time I reply, after 1 do some research.
– As a preliminary, may I congratulate the Minister for Health (Senator Wade) and the Director-General of Health and his staff on the early release of the report of the Director-General and the early release of the report of the Commonwealth Serum Laboratories Commission. It is only since Senator Wade became the Minister and Dr. Refshauge the Director-General that there has been an early release of the report of the Director-General. As honorable senators will recall, they were biennial reports delivered months after the close of the second year, making them ineffective in actual practice from the point of view of rendering assistance to the government of the day - which is the approach of the Australian Labour Party - and in no small measure preventing criticism, or preventing effective criticism. But I do again tender my congratulations. Early release of the reports makes information so much more readily available to everyone and makes discussions so much more constructive as distinct from destructive.
I commend Senator Wright and Senator Cormack for drawing attention to the action of the Government in making available for discussion certain figures and then limiting in no small measure that discussion. They have been able to express a more authoritative an opinion that I in saying that the constitutional basis of procedure has been departed from. I hope that the Government will not accept as a practice the limitation of discussion by the elected representatives of the people.
As regards the discussion I propose to embark upon, I more particularly wish to refer to Division No. 250. I know that in this particular Division there are many features including telephone charges, office expenses, telegrams, postage, medical research, and sirex wasp investigation; but I think that if we tie our considerations down to the question of salaries we will be able to discuss everything and we can embark on a consideration of whether ‘.he Director-General and. his staff are entitled to the salaries paid them for their activities in the functioning of their Department. That will prevent any acrimonious discussion or disagreement as we proceed with this debate. If we limit our consideration to salaries we can then examine the effective functioning of the Department and the degree of efficiency of activities of the various departmental officers from the Director-General down. Those people have the administrative responsibility of tendering advice to the Minister. We know how sympathetic the Minister is in his endeavour to administer the Department and we know he would be responsive to suggestions.
The Minister, in his reply regarding Amesec was, I think, rather superficial. Apparently no reasons were tendered to him as to why it was taken off the free list and I suppose no reasons were ever tendered to him originally as to why it was put on the list. It would bc interesting to know why it was put on the list and then, after some time, when many medical practitioners had found it effective in the treatment of asthma - a disease not always amenable to particular treatment - the advisory committee saw fit to take it off.
It is all very well to speak in terms of the high credentials of the particular members of the committee and it is all very well to talk in terms of theoretical considerations, but asthma is a particularly difficult disease, as Senator Turnbull, and any practising doctor would know. Not everyone suffering from this particular disability responds in a similar fashion to a similar drug. It was the concensus of a large body of practitioners who were utilising the drug Amesec, or the equivalent composition or combination - term it what you like - that it was effective. I do not think - with all due deference to the Minister - that this answer was a satisfactory one. I think that in the responsible position that- the Minister occupies he should have a greater knowledge as to why drugs are put on and why drugs are taken off the pharmaceutical benefits list.
When you realise the tremendous amount of money involved, the great contribution that is made to the alleviation of suffering, the availability of drugs, the decrease in mortality, the decrease in disability and the early return of people to work which is associated with the increased productivity of this nation, 1 think the Minister has a greater responsibility than he, as a layman, just realises, lt is all very well to have committees appointed and to say: “I take their advice without reason.” But I think the Minister has a responsibility to himself and his senior staff to know why drugs are placed on the pharmaceutical benefits list and, particularly, why they are taken off. Even if these reasons arc not made available to the public in general or to medical practitioners the Minister and his staff should know them.
T wish to ask a question to which I know the Minister will be happy to supply the answer. Have departmental officers submitted to him any information as to the disbursement of money associated with hospital benefit schemes and as to whether there is the maximum efficiency associated with the administration of those benefits? May I put it simply in this way? As the Minister knows, there are 112 approved hospital benefit funds. Queensland represents one seventh of the population of Australia and near enough to a quarter of the area of Australia. Queensland has all the difficulties associated with the dispersal of people over large areas living, in many cases, in small communities, and yet it has only three registered hospital benefits funds out of a total of 1 12 in Australia.
Now, I ask the Minister to tell me why three societies or funds should be able to serve one seventh of the population of Australia and a quarter of the area of this nation whilst 109 other benefits funds are needed for the remainder of the area and the remaining percentage of the people of Australia. It does seem to me - at least on the surface, unless the Minister can supply a satisfactory answer - that there must be a measure of inefficiency in administration, associated perhaps with increased costs. It is visualised that the nation’s contribution to the funds in the coming year will be over £29 million. That is not the Government’s contribution, lt merely disburses the money provided by the people and it has a responsibility, being in control of the Treasury, to see that the money is disbursed efficiently and in the best interests of the people and of the nation. In the financial year 1963- 1964, the Government disbursed to hospital benefit funds £28,100,000, irrespective of what contribution was made for capital costs of hospitals treating mental disease, irrespective of the payments made to those suffering from tuberculosis and irrespective of other payments made to nursing services or anything else. I just wonder whether the Minister’s departmental officers have ever given consideration to the almost chaotic features of the scheme. Perhaps using the word “ chaotic “ is a minor exaggeration but sometimes the use of exaggeration draws attention to the existence of a particular set of features. The hospital system of Australia is almost chaotic. There is no integration or rationalisation. Do the officers of the Department of Health propose to continue the disbursement of tremendous sums of money year in and year out in the manner in which they have been disbursed in the past? I know that, almost automatically, the Minister will reply that hospital services are the responsibility of the States, but I remind the Senate that money is being provided by the Commonwealth, directly and through tax reimbursement grants. Millions of pounds arc being spent annually by the States on their hospital services. 1 do not think that it is good enough to say that hospital services are the responsibility of the States. If the States cannot provide other than a chaotic service, notwithstanding that the Commonwealth is providing millions of pounds, it is time that the Commonwealth Government entered the field, or at least determined the basis on which the money is disbursed by the State Governments.
There is no provision that I know of to preclude the Commonwealth Government from establishing hospitals. Nothing in section 96 of the Constitution would prohibit the Commonwealth from making a grant for a particular purpose, and laying down the conditions under which the money should be spent. I am not suggesting that the people concerned with administration are overpaid. Indeed, if they are accepting administrative responsibility and carrying out their work efficiently, perhaps the Director-General and other professional men in the Department are underpaid compared with doctors in outside practice. These officers have a responsibility to tender advice to the Minister. Whether he acts upon it is a matter for him and for the Government. I should like to know whether these officers have advised the Minister on the necessity for the integration and rationalisation of hospital services in this country.
The ideals I am expressing are not mine alone. Many people have given consideration to this matter for many years. Over recent months Dr. Selle, Chairman of the New South Wales Hospitals Commission, Dr. Thomson, the Superintendent of the Royal Prince Alfred Hospital, Professor Griffith, Professor of Hospital Administration in the University of New South Wales, Dr. Fulton, Chairman of the Institute of Hospital Administration, and many others have seen fit to be critical of the hospital services of Australia. I am not suggesting that the people serving in these hospitals, whether they be visiting staff, resident hospital specialists, nurses or other ancillary personnel are not doing the best they can within the limits imposed upon them, but what is being done is just not good enough.
There is duplication of some services and on the other hand inadequate or no provision for some essential services that are accepted overseas. .Some buildings are obsolete and should have been demolished years ago. Large wards are not consistent with modern hospital practice. Advanced nations today do not accept large wards, even in hospitals that we would classify as public hospitals. In some measure the Commonwealth Government is responsible for the great increase in road accidents by failing to meet its responsibility to provide sufficient funds for an integrated road programme in Australia, but the hospitals have not faced up to modern development in the treatment of accidents. I am not saying that every hospital should have an accident surgery unit, nor that every hospital should have an intercranial surgery unit, a cardiac surgery unit or a general thoracic surgical unit. However, there should be integration and rationalisation. In the process of time this would not only render a service to the people but also would prove to be financially justifiable.
For the sake of economics alone, and ignoring for the moment the humanitarian approach, there is ample justification for providing efficient hospital services. If we can return people to industry earlier than would otherwise be the case, we must make a real contribution to the economy.
– Order! The honorable senator’s time has expired.
– The total departmental expenditure last year for the Department of Health was £102 million. This included an expenditure of £95 million from the National Welfare Fund, and the balance came out of Consolidated Revenue for general administrative purposes.
With which item is the honorable senator dealing?
– I am dealing with Division No. 250 - Administrative. Provision has been made this financial year for an increase of 125 in the administrative staff. The main increases are in the administrative section itself which is to be increased by 58, and in the pharmaceutical services section which is to be increased by 50. The national health services section also is to be substantially increased.
Because of the immense importance of the Department of Health to the nation generally, and because of the vast expenditure involved, it is necessary to scrutinise the estimates for this Department with great particularity. At this stage I join with my colleague, Senator Dittmer, in congratulating the Director-General of Health upon the manner in which the departmental report has been presented to the Parliament. This is a highly technical and complicated field, and I think it is fair to say, after a perusal of the report, that plain and simple language has been used. The tables at the back of the report can be followed quite easily. Simplicity of language is the essence of the report. Many lay people in the community are vitally interested in the subject of national health and the annual report of the Department makes it reasonably easy for them to obtain a clear picture of the operations of the Department. As far as I can see no attempt has been made to hide anything in the report itself or in the tables presented at the back. The report is a type of document that could well be emulated by other departments that come under the attention of Parliament during the course of the Estimates debate.
Having made those remarks on administration generally, I turn now to Division No. 254 - Health Services. I refer particularly to the pharmaceutical benefits scheme. In this connection I should like to quote from page 16 of the annual report of the Commonwealth Director-General of Health. He refers to negotiations that have gone on between officers of the Department of Health and drug companies, and states -
The Department keeps drug prices under constant review and is continually engaged in price negotiations wilh drug manufacturers.
The report then goes on to state that in the last financial year a saving of approximately £2,700,000 was effected as the result of a reduction in the prices of drugs, and that most of the reduction applied to commonly used drugs such as antibiotics and non-mercurial diuretics. I suggest to the Minister that this amount of £2,700,000 is a mere drop in the bucket compared wilh the manner in which the expenditure in this regard has risen over recent years.
When we look at the tables at the back of the report we see that the expenditure by the Commonwealth on pharmaceutical benefits for the last financial year was £39,419,335, which was an actual increase of £964,256, or nearly £1,000,000, over the previous financial year. The report states that the expenditure on this item in the last three years has increased by £12 million. When we take into account the fact that the population of Australia in this period has increased by about 500,000, 1 suggest that this increase of £12 million in pharmaceutical benefits is rather large.
I turn now to table No. 22 on page 84 of the Director-General’s report. There we find that, whilst the average cost of a prescription has increased by 9d., the average cost per head of population has increased by 4d. We see that there were 44,357 prescriptions written out in the last financial year; that the average cost per prescription was 18s. 7d., and that the average cost per head of population was £3 15s. Id. This is an important matter because when one looks at the directory, which is put out by the “ Australian Financial Review “, of the top 800 companies operating in Australia, it is seen that of the 13 drug companies mentioned, 12 of them are completely owned by overseas interests. We find that there is only one company, Drug Houses of Australia Ltd.-
– And it is tying up with an overseas group now.
– Yes. I was about to say that that is the only company which has any Australian equity. I note that the company is tied up with Osmond & Sons Ltd., which has headquarters in the United Kingdom. Of the 13 companies listed under the heading “ pharmaceuticals” 12 have a 100 per cent, overseas equity. Because of the enormous amount of money that has been spent by the public on drugs, I suggest that careful consideration should be given to this matter.
We do not know, of course, all the ramifications of the operations of these drug companies in Australia because, so far as my knowledge is concerned, there has never been a public inquiry into their activities. The time has arrived when something of this nature should be embarked upon. Indeed, the fact that the Department iri its report says that the prices charged by the companies are continually being scrutinised and reviewed indicates that an inquiry conducted on behalf of the Government by departmental officers is necessary. Large amounts of money are spent on advertising in many forms. I think that Senator Dittmer, and probably Senator Turnbull, as well as other doctors in the community, would be able to illustrate to honorable senators and to the Minister some of the more ludicrous forms of advertising that are indulged in by these companies. 1 want to refer now to a document, which is an extract from the “ Washington Post “, containing a review of a book written by an American citizen who, I understand, was the secretary of the Estes Kefauver committee that was set up by the United States Senate to inquire into the drug industry in the United States of America. The name of the book is “The Real Voice” and it was written by Richard Harris. Without quoting in full the details that are set out in this document, 1 shall refer to one or two pasSages. The first is -
A drug company promoting a worthy but highly toxic antibiotic for a number of uses for which it is no better than other drugs and more likely than they to be lethal.
Then the name of the company is mentioned and the drug is referred to as Chloromycetin, Another passage is as follows -
A drug company covering up the results of research which show that its product, widely used to lower blood cholesterol, could cause eye cataracts and other major serious side effects. The company nevertheless promoted the product aggressively as a heart disease preventative even though scientists had not yet proved the cholesterol-heart disease link.
Then the name of the company is mentioned, and also the drug. A further passage relates to -
A drug company writing medical papers for doctors who subsequently published them under their own names in professional journals. Thus, the company succeeded in subverting the whole system of scientific search for and publication of the truth.
Then the name of th« company is set out.
– What proposition are you putting to us that this document supports?
– I am saying that this situation was found to exist in the United States of America, that there has been no inquiry conducted in Australia, and that because it existed in America it could well exist in Australia at the present time The document further goes on to state -
As Chairman of the Senate Sub-committee on Anti-trust and Monopoly, Estes Kefauver initiated the drug investigations to determine whether prices of the lifesaving compounds were rigged at unjustifiably high levels. After hearings spread over 26 months in which 12,885 pages of testimony were taken, the senator found that not only were prices high . . . but the products were not proven safe or effective. Nevertheless, even with the overwhelming burden of evidence favouring a drastic reform, the senator and his hardworking staff needed the impetus supplied by the thalidomide disaster to force passage of the bill.
I say to the Minister quite frankly that great concern exists in the minds of the ordinary man and woman in the community about the high expenditure on drugs which in actual fact, taking into account the amount spent on drugs by hospitals, as well as the amount contributed by the Commonwealth under the pharmaceutical benefits scheme, amounts to £48 million a year. I believe it is time that the activities of the drug houses in Australia were scrutinised publicly. I do not think it would do any harm if (he Government were to establish a royal commission, with suitable and adequate terms of reference to inquire into the ramifications of these companies, the main ones of which, of course, are completely owned by overseas interests. Such a commission of inquiry would unearth a wealth of material. I believe that the people of Australia could be saved, a lot more money than the £2,700,000 that is referred to in the report. Whilst- a greater saving could be effected, the companies would still be able to make quite a lucrative profit.
Another matter to which I wish to refer on this aspect is set out at page 23 of the Director-General’s report where, under the beading “ Adverse Drug Reactions “, it is stated -
Steps have been taken to establish machinery for the collation of reports of adverse drug reactions and the assessment and dissemination of information relating thereto.
The report continues -
This programme is being instituted by the Branch with the assistance of the Australian Medical Association, the Australian College of General Practitioners and the medical profession generally.
I think this is an important step that has been taken and one for which the department should be complimented, particularly having in mind the great thalidomide tragedy which swept the world two or three years ago. It is about time that the Government asked the drug companies to contribute to or to share in the cost of this work. I wish to refer now to the proposed contribution to the World Health. Organisation, which appears in Division No. 250.
– Order! The honorable senator’s time has expired.
.- I should like to express my interest in the contributions that have been made to this debate by honorable senators. I think everybody is interested* in the services of the Department of Health. In particular, I refer to the subject of lung cancer on which we have had some quite impressive expressions of opinion from professional sources throughout the world over the last five years. I have in mind the alleged connection between cigarette smoking and the incidence of lung cancer. I did not hear any reference in the reply of the Minister for Health (Senator Wade) to the statement of Senator Turnbull that a committee on preventive medicine which has governmental sanction was prohibited from discussing this subject. If such a prohibition were made, it calls for some debate. I hope that has not been the position. I ask the Minister to give us specific information about the matter. I hope that he will be able to refute the suggestion that a direction was issued, with governmental sanction, that this subject was not to be discussed. The Minister has assured us that this matter is of concern to his Department. I hope that the whole of the medical profession is being probed with a view to having all the energy and skill possible directed towards finding a cure for lung cancer.
I now direct my remarks to the provision for medical research in Division No. 250. Are we to understand that the sum of £400,000 is to be the total appropriation for medical research in this financial year? Without having more than a general interest in the subject, that would seem to me to be a diminutive sum to provide for such a purpose. I should like the Minister to tell us the scope of the research that is to be undertaken with that appropriation.
I now come to the provision for the control and eradication of the Sirex wasp, which was mentioned by my colleague Senator Laught. I should like to know whether the Tasmanian Government is making any contribution to the fund that has been established to deal with this pest and whether any of the research activities that were undertaken in Tasmania are still being carried on.
I turn now to a subject about which I asked, a question two or three weeks ago. I refer to the vexed provision in the medical benefits scheme whereby a higher benefit is payable for consultation with a specialist only if the patient has been referred to the specialist by a general practitioner. Patients are at a loss to know which members of the medical profession are recognised under the medical benefits scheme as being specialists or whether that status is accorded to practitioners by any body within the medical profession. Is there a continuing review of the economics of the requirement that, before a patient may obtain the higher benefit for consulting a specialist, he must be referred by a general practitioner? It seems to me from the experience of people who make representations to me on this matter in my public capacity that the consultation with the general practitioner is a mere formality and that in many cases the so-called specialist is not a person whom the public generally recognises as being a specialist or a person whose standing and accreditation have any official basis.
– They are self styled specialists.
– My colleague Senator Hannaford has used the term “self styled “. It puts my view quite well.
– In Queensland they are governed by law.
– I hasten to reply to Senator Wright’s comment about my omission to mention the subject of smoking and lung cancer, to which Senator Turnbull referred. Senator Turnbull may have given the impression, perhaps unwittingly, that the chairman of the committee in question prevented a debate on the subject for reasons about which we were left in some doubt. There was a very good reason for refusing debate on the subject at this point of time. At the last conference of Commonwealth and State Ministers for Health it was agreed that, as a joint undertaking, there should be an investigation of the best possible methods of informing the public about the dangers of smoking as related to lung cancer. The Governments of the Commonwealth and the States agreed to formulate a policy on the subject. That was the sole reason. The chairman suggested to the committee that at that point of time it would be inappropriate to intrude into a matter that was being discussed at a policy level.
– When was that conference?
– I am unable to be specific about the matter, but I should say it was about the middle of February. I assure Senator Wright that Tasmania is making a substantial contribution to the fund which was established for the control and eradication of the Sirex wasp. I understand that research is being undertaken in Tasmania on the original basis. 1 think that was the matter about which the honorable senator sought information.
– I understand the research is being conducted at Scottsdale.
– I cannot state the location, but I accept the honorable senator’s suggestion. Senator Wright referred also to the lower benefit that is payable to a patient when he consults a specialist without reference by a general practitioner. We make no apology for such a provision. We believe that the medical scheme should be built around the general practitioner. Of course, that docs not mean that the specialist is to be eliminated or that the general practitioner is the only person who can make a worthwhile contribution. We argue, I believe with justification, that the general practitioner knows more about the history of the patient than does the specialist. In so many instances, he has brought the patient into the world or has attended to his needs from a very tender age. We believe that the general practitioner has a personal knowledge of the patient which is invaluable to the patient’s welfare. If the patient without reference to his general practitioner who knows so much of the patient’s medical history, consults a specialist, both patient and specialist are at a very great disadvantage. That is why we have always done our utmost to persuade people to go to specialists per medium of general practitioners.
– The patient can do it the other way if he wants to.
– Yes, there is no compulsion; but the patient docs not get the same benefit if he does that. Senator Wright asked what constituted a recognised specialist. I confirm what Senator
Dittmer has already said by way of interjection. Queensland is the only State which has a system of registering specialists. This is a subject on which I am not very competent to talk. The States are the authorities to make decisions in these matters, but I believe that the State Governments and the medical profession concede that the time may well be overdue when there should be some uniformity throughout Australia in the recognition of specialists. I should like the honorable senator to know that thinking in this field has broadened and a good deal of work is being done towards this objective, which has the support of the Commonwealth Government.
– Does a man get a reputation before he is considered to be a specialist?
– There are several ways. Some men have very high academic attainments and may well claim to have become specialists. Others have made reputations in practice in various communities which place them in the public mind as leaders of their profession.
– People in Sydney think that everybody in Macquarie Street is a specialist.
– That could bc so. There arc perhaps, more specialists in Macquarie Street. Sydney, per head of population than in any other country. I do not say that in a critical manner. It may well be argued that there is a tendency for people to specialise, and I suppose that they cannot be criticised for that. I hope that the day never comes when we will be dependent wholly and solely on specialists for medical attention. I repeat that the general practitioner is the cornerstone of the national health scheme.
Senator McClelland had a good deal to say about the cost of drugs. His figures were factual and a good deal of what he Said was unchallengeable. He rather belittled the saving of £2.7 million we made last year. He would like to see much more dramatic results. He would like to see us adopt a more dogmatic and arbitrary approach. The result we have had over the past 1 2 months in saving £2.7 million encourages us to pursue our policy. I am hopeful that after the next 12 months we will have a record that will bear comparison with that of other countries. That is really what we have to do. We must make our system comparable in cost and service with the systems of other countries and we are very close to that objective at this point. Senator Dittmer expressed some criticism concerning hospitals. He said that conditions were chaotic. 1 will not debate that now.
– I used the word simply to draw attention to the matter.
– That is so. The honorable senator conceded that it was perhaps an extravagant word; he wanted to highlight some of the matters. He criticised hospitals generally. I am not particularly competent to discuss the field of hospitalisation, but I do know that people who return from overseas say that we have a system of hospitalisation that is second to none. He spoke about the financial problems of hospitals. These vary from State to State. In my own neck of the woods in Victoria there is a big base hospital which, year after year for several years, has returned a surplus. It is giving a service that cannot be bettered in any large provincial city. This indicates that with prudent management the problems that concern hospitals from time to time can be overcome. I do not accept the contention that hospitalisation in this country is not at least comparable with hospitalisation in other countries. Senator Dittmer asked why, when there are only three hospital benefit organisations in Queensland, there were 109 throughout Australia.
– There are 112 in Australia - 109 in the other States.
– I accept the correction. He asked why Queensland should be able to give service with three funds whilst the rest of the Commonwealth was dependent on 109. I think his suggestion was that overheads were multiplied and that a much costlier system was involved than if there were only a few organisations, as in Queensland. That is fair enough. It is an approach that could be made without a good look at what would be involved in reducing the number of hospital benefit organisations. I ask the honorable senator which of the funds which have been functioning for years and years in New South Wales would be eliminated. Some of these were functioning long before the national health scheme was brought into being, and the Government had to decide whether it would eliminate them when they were giving such a splendid service to their members or whether it would integrate them into the scheme. I remind the honorable senator that very many of these funds are being managed adequately and efficiently by people who give their services year in year out in an honorary capacity. 1 take my hat off to them. I hope that the day never comes when this country will decide to have a compulsory scheme that will completely eliminate organisations conducted by people who are prepared to work day in day out in a voluntary capacity for the benefit of their fellow men. Would the honorable senator eliminate the New South Wales Railway, Tramway, Motor Omnibus and Road Transport Employees Hospital Fund, the Commonwealth Benefit Health Society, Sydney, or the fund of the Australasian Holy Catholic Guild of St. Mary and St. Joseph.
– That is sectarian.
– I proceed a little further down the list. Would the honorable senator eliminate the fund conducted by the Protestant Alliance Friendly Society of Australasia Grand Council of New South Wales? Would the honorable senator eliminate these organisations from the scheme? No. He propounds a policy that has some attraction until the facts of the case are examined. Looking at the overall composition of the scheme, one has to concede that many organisations in the 112 are giving splendid service. I do not think that any Government would remove them from the Scheme.
– Will the Minister for Health (Senator Wade) give some information about Division No. 254, sub-division 3, “ Commonwealth Serum Laboratories Commission - Additional capital, £300,000 “? I notice that no appropriation on this account was made last year. Will the Minister inform the Committee what is included in this amount and also why it appears under “proposed expenditure for the ordinary annual services of the Government “? I should imagine that as this proposed provision is for additional capital for the Commission, it could hardly find its place properly under the heading “ ordinary annual services of the Government”.
– When my time expired earlier, I was discussing hospitals and hospital systems. I want to conclude my reference to these matters because I have other contributions to make to the debate and I want to deal with the Minister for Health (Senator Wade). Speaking of hospitals, I said that there was a measure of inefficiency and overlapping, a lack of particular services and some duplication of services. Honorable senators need not take my word for this. Irrespective of what the Minister might say on this subject, he- has been modest enough to concede that he is a layman. The Minister said that we have a hospital system second to none. I do not know what other hospital system he was comparing with ours.
– I said “ the standard of hospitalisation “.
– I remind the Minister, who is interjecting, that I was very tolerant when he was bashing me down. Let us consider the opinions of the four men I cited earlier. They are experts in the field of hospital services. That has been virtually their- sole occupation throughout their professional lives. Dr. Selle is Chairman of the Hospitals Commission of New South Wales. Dr. E. Thomson is Superintendent of the Royal Prince Alfred Hospital. Professor Griffith is Professor of Hospital Administration at the University of New South Wales. Dr. J. C. Fulton is not working full time on this task but he is Chairman of the Institute of Hospital Administration. In their opinion, our hospital system calls for rationalisation and integration.
I shall be quite frank with the committee. Dr. Selle has said that the hospital system does not necessarily call for nationalisation but I do not know what he had in mind when he used that term. I do not know whether he meant, that all the hospitals in Australia should be owned by the nation, whether they should be controlled by the nation, whether there should be proportionate ownership by the nation or a proportionate measure of control by the nation. Only Dr. Selle can clarify his meaning.
I have known supporters of this Government to indulge in vituperation in an endeavour to confuse the people, particularly before elections, as to the meaning of socialisation and nationalisation. They use both words indiscriminately and make no effort to define the difference between them. The Australian Labour Party is quite clear about what the words mean and this is stated quite clearly in the platform and policy of the Party. The significance of the two words is written there in simple terms.
Suggestions have been made by Senator Wright for a register of specialists and I am pleased to learn from the Minister that consideration is being given to the establishment of such a register in association with the States. It is important to realise that powers have been conferred on the Commonwealth Government by referendum in relation to health, dental and similar services as distinct from the conscription of civil personnel. We know the limitation that has been imposed. I am pleased at Senator Wright’s suggestion because for many years I have suggested the registration of specialists. This is specifically laid down by Act of Parliament in Queensland which determined some years ago the basis of registration. This is based on postgraduate training, hospital appointments and so on. I believe Senator Ormonde asked by way of interjection whether all the doctors in Macquarie Street were specialists. So far as I know, all of them are specialists.
Sitting suspended from 5.45 to 8 p.m.
– Before the suspension of the sitting I was speaking of the rationalisation of hospitals and the integration of hospital services. The Minister saw fit to challenge my statement in relation to hospital benefit funds. I had mentioned that there are 112 registered hospital benefit funds in Australia. Queensland, which has approximately 14 per cent, of our population and covers roughly one-quarter of our area, has only three registered hospital benefit funds. Clearly there must be administrative difficulties in the sparsely settled areas of that State.
The Minister then saw fit to mention some of the 33 registered funds in New South Wales and he asked me which of those I would abolish. He mentioned the Railway and Tramway Hospital Fund, Catholic organisations and others, but he did not mention the Medical Benefits Fund of Australia or the Hospitals Contribution Fund of New South Wales. They are powerful organisations and would be the last, I would think, that the Government - not particularly the Minister - would think of integrating with other funds. It is interesting to note that Victoria which is a much smaller State than is New South Wales, both in relation to area and population, and which could operate efficient services much more readily, has 44 registered funds whereas, as I have already mentioned, New South Wales has only 33. The Minister did not ask which of the Victorian funds I thought could be abolished. But it is not my responsibility to advocate the abolition of any particular fund. I am pleading with those who control the finances of this Commonwealth to approach this matter from the point of view of integrating the funds. Irrespective of what Senator Ormonde said about competition being desirable, you cannot convince me that 112 separate organisations are necessary to serve a nation of approximately 11 million people. There is no real competition in this field of service.
The Minister said that these funds have managed their affairs competently and efficiently. I am not quite certain whether those were his exact words but that was the significance of his remarks. Let us see just how competently and efficiently they were managed. Many of them survived only because they were fortunate enough not to be caught up with epidemics in the early stages of their existence. As a result they had a surplus of premiums over payments to contributors and were able to build up enormous reserves which are represented today in cash and in substantial real estate. The Government has seen lit not to be particularly parsimonious by fixing administrative costs at not more than 15 per cent, of contributions received. I know that the 15 per cent, must be divided in cases where hospital and medical benefit funds are associated. These associated funds serve two purposes. On the whole, the administrative costs of medical benefit organisations are higher than those of hospital benefit funds. J suppose that the Minister is much more familiar with the actual financial details of these funds than I am.
– I would hope so.
– Leaving aside that rude and completely ignorant interruption which shows that the honorable senator has no realisation of the true facts, I shall proceed on my own way. The Minister should be in possession of more information on these funds than I am because he has access to documents and has a comparatively large staff to make the information available to him. He should know that when many of these hospital and medical benefit funds were inaugurated they were actuarily unsound. The actuaries of the day did not hesitate to say so. The funds survived, as I have said, because there were no epidemics and because the premiums collected were surplus to rebates to contributors. But for those circumstances, the funds would have gone down. Possibly only one group - the friendly societies - could have survived had the scheme run into rough financial weather, because they had other assets in real estate, reserves and so on. State legislation may have been necessary to permit the friendly societies to utilise their reserves to back the payments to subscribers. What should have happened at that time - I know that Labour governments as well as anti-Labour governments fell down on this job, and at the time I said so - was that the State Governments should have integrated the funds and backed them. Steps should have been taken to ensure that the funds would remain solvent and able to meet the legitimate demands of contributors.
As the Minister and many honorable senators on both sides of the chamber well know, many funds got into difficulties, lt is to the Government’s credit that it saw fit to ensure that those funds did not survive because they were taking premiums and making no real endeavour to meet the legitimate demands of the contributors. Their administrative expenses were extraordinarily high and, in the process of time, many of them were debarred from Commonwealth benefits. By and large, the existing funds are financially strong, but it seems extraordinary that we should have such a large number of funds to service such a comparatively small number of people. T do not know the exact number of shops that Woolworths Ltd. and G. J. Coles and Co. Ltd. have but. for the sake of argument, let us assume that (hey each have 1,000 shops. They do not have 100 head offices; they have one head office. The administrative current and the company policy flow from that one head office.
Surely the field of hospital and medical benefits is not dissimilar. For that reason 1 claim that the Minister is not answering the question that I posed by challenging me to say which fund or funds in New South Wales I would abolish. I have already mentioned the Minister’s own State of Victoria which has 44 funds whereas New South Wales, which is much larger in area and in population than is Victoria, has only 33 funds. I did think that his staff, in the light of the advice that has been tendered constantly by hospital experts, should take a substantial interest in the matter,
Order! The honorable senator’s time has expired.
.- I would like to make a few comments on and ask a question in regard to Division No. 250. section 4.. item 01, World Health Organisation. I have read in the annual report of the Director-General of Health the section which deals with the World Health Organisation and sets out the most important work undertaken by the countries associated with the Organisation. The fact that the fourteenth session of the World Health Organisation Regional Committee for the Western Pacific was held at Port Moresby in September of last year is, I consider, a tribute to the splendid cooperation given to the Organisation by the Commonwealth’ Department of Health. The report refers to the technical discussions held by the Committee, under the heading “The Role of Local Health Services in Leprosy Control “.
I take this opportunity to pay a very high tribute to the work that is being carried out in Darwin at the leprosarium under the direction of Dr. Hargraves. I also pay a very sincere tribute to the religious order that is staffing the leprosarium. Dr. Hargraves has studied the treatment of leprosy in India and is doing most remarkable work. I felt it to be a great privilege indeed to be shown some of the work that is being undertaken at the leprosarium. Th- report refers to the dread disease of kuru which affects the people in the eastern highlands of New Guinea. Tt seems that invariably it is fatal. We arc told that it strikes children of both sexes and women of childbearing agc. I ask the Minister for Health (Senator Wade) whether provision for research into this disease h:ss been included in the grant for the ensuing year. The report also mentions the suggestion that a world health research centre should be established through which members of the World Health Organisation could co-operate and by means of coordination and acceleration of programmes facilitate much progress on urgent health problems.. I ask the Minister whether Australia has indicated that it is willing to be a member of a world health research centre, if it is established.
I turn now to Division No. 250, section 4, item 02, which relates to medical research, and to the section in the DirectorGeneral’s report which deals with the National Health and Medical Research Council. It is a matter for gratification that the estimate has been increased from £318,500 to £400,000. Undoubtedly the work carried on by the Council plays a very important part in protecting the health of the people of the Commonwealth. 1 am particularly interested in the section headed “ Maternity and Child Health “. The report contains the recommendation that after childbirth mothers should be accommodated in the same room as their babies. The Council considered that rooming in should be routine with all first born children, unless there are exceptional circumstances, and should also be adopted with subsequent children, if possible. On the face of it, that recommendation may not seem to be very important. However, I read quite recently of the disturbing increase in the number of school children who are emotionally disturbed. One is forced to agree with the contention of all authorities that the emotional security of the child is absolutely basic to his or her wellbeing. I suggest that a child’s emotional security should begin at birth. Therefore, the recommendation that a mother and her child should be kept together from the day of the birth and through the hospitalisation period is a very important one. This point of view is held by many of the experts with whom I have discussed this matter in Victoria. I ask the Minister whether there is any means of informing the medical profession or the hospitals that contain maternity sections of the importance of this recommendation, other than by publishing the information in the “Austraiian Medical Journal “.
I am also extremely interested in the section of the report dealing with traffic injuries. A recommendation is made that the importance of seat belts should again bc emphasised. It is also recommended that members of the medical profession should set an example to the public by installing safety belts in their cars, and wearing them. There is very real concern throughout Australia at the increasing and tragic road toll. Last weekend a number of deaths and injuries occurred on Victorian roads. I ask the Minister whether publicity is given to this recommendation in the DirectorGeneral’s annual report. 1 turn now to Division No. 254, section 4, item 01, Child Health Centres. The estimate is increased from f 5.1, 450 to £58,350. The child health centres referred to are the Lady Gowrie Centres which, ever since their establishment with the assistance of the Commonwealth Government, have done a remarkably fine job in training children, and also in training mothers in the care of their children. They have been teaching at demonstration centres, as well as attending to the wants of families and children in the areas in which they are situated. It was a very great blow when the Lady Gowrie Centre in Melbourne burned down. However, we are extremely thankful that on 17th October the Minister is to open a new centre. It has come to my notice that the Lady Gowrie Centre in Melbourne is engaged in providing accommodation and care for mothers from country areas who must bring their children to Melbourne for specialist or rehabilitation treatment. I am sure that the Lady Gowrie Centres in the other States are doing equally important work. I congratulate the Minister on increasing the grant for this very worthwhile project. I would like to congratulate not only the Minister, but also the DirectorGeneral and the officers of the Department of Health on producing for us a very fine record of the work conducted in the important field of health.
Senator WADE (Victoria - Minister for Health) 18.20]. - Prior to the dinner adjournment 1 promised Senator Laught that I would make reference to a question he asked concerning the nursing service in South Australia. I am now in a position to tell him that there is one organisation in South Australia, the District and Bush Nursing Society of South Australia Incorporated, approved for Commonwealth subsidy under the home nursing subsidy scheme. The Commonwealth subsidy for 1963-64 was £16,340 which, together with the State contribution of £22,000, made possible the employment of some 38 to 40 nurses in this service. Anyone who has observed such services in the various States will, I am sure, agree that they do a magnificent job because as someone said earlier in the evening they provide a service where it is most needed and appreciated - in the homes. That is a far greater asset for the public than merely rendering a medical service because these people fulfil a need and a purpose that only they can fill in that role. 1 am certain that that service is appreciated.
asked for information concerning the £300,000 that has been set aside for the Commonwealth Scrum Laboratories Commission for this year. This item provides for an advance to be made to the Commonwealth Serum Laboratories Commission to form part of the capital for the Commission pursuant to the Commonwealth Serum Laboratories Act 1961. The current year’s provision of £300,000 is required to finance the Commission’s new building programme and to meet the estimated cost of the transfer of the Commission’s activities from Broadmeadow to Parkville and Woodville. This is a large term project that will have many advantages to the Commission, cutting down its overheads and running costs and consolidating it in one particular area for the service it is performing in that sphere. Senator Dittmer again referred to the integration of funds and I can only judge from his remarks that he would argue that, because Queensland has three funds, that number would be sufficient and adequate for all other States. He somewhat resented my suggestions-
– Will all due respect, you are not entitled to draw that inference at all.
– You have not made your point clear.
– I stated my case on a percentage basis and an area basis. Do not be tough because things have been pretty gentle between us all afternoon.
– That is the way T would like to keep it. But we must be truthful just the same. Senator Dittmer went to some pains to eulogise Queensland for having only three funds. I am not challenging that statement at all. I take it that the basis of his argument was that because Queensland had only three funds, the overhead expenses and running costs of those three funds were, per head of population, much less than similar costs in any other State. That could well be the interpretation of his argument. Senator Dittmer took me to task for citing some funds in New South Wales. He suggested that I had chosen New South Wales to make comparison for a particular reason. Well, I hold the old-fashioned idea that in this chamber the Estimates debate is an opportunity provided for honorable senators to make their submissions to the Minister and that he should be as brief as he possibly can in answering the questions. That is what we always try to do.
Since Senator Dittmer has suggested that I concentrated on New South Wales and has asked me to have a look at the Victorian situation, I invite him to look at some of the 44 societies and funds that are registered in Victoria. The first one that comes to my mind that is on the list is the Protestant Alliance Friendly Society of Australia, Grand Council of Victoria. The next one I come to is the R. S. and S. Mills Employees’ Hospital Fund, Geelong, which was founded by the Returned Servicemen’s League of Australia. It is a very successful undertaking, too. Would the honorable senator suggest that this organisation should be deprived of a fund that has been of inestimable value to the employees concerned for many years? He does not really mean that as a proposition, does he? Would he suggest that the Hibernian-Australasian Catholic Benefit Society, Victoria District, No. 1 Melbourne, should be eliminated? Does he suggest that the Australian Natives’ Association, Melbourne, should be asked to forgo its registration and its participation in this national health scheme? I remind him, again, that these are the people who for generations have rendered, in a voluntary capacity, a service of tremendous value to their members. This Government, which has always sponsored free enterprise, said right at the inception of the scheme that these were the types of people we wanted in the scheme-people who were prepared to give a service for the welfare of their fellow man. We have integrated them and they are giving a magnificent service at a nominal cost. I suggest that to stand up and advocate the integration of. all these schemes, with their diversified interests, would just bring chaos to a large body of people whose contribution in this field cannot be challenged.
– Of course, the Minister for Health (Senator Wade) was rather uncharitable in the way he paraphrased the views of Senator Dittmer about the various health and medical funds. Senator Dittmer was, I think, quite right in saying-
– I would ask the honorable senator to please state the Division to which he is referring.
– I am referring to Division No. 250 - Administrative. I thought that Senator Dittmer’s point was well made and I am going to talk about administration. Three weeks ago in the Senate I raised the question of compounded drugs. I had been approached by people - associates of mine and other friends and constituents - who were suffering from asthma. Those people had found that certain drugs that they used to get and which had been on the free list were no longer on that list as a compounded drug. That was a very serious matter to them - a matter of life and death. They had been supported in their views by their own doctors and chemists who were all in support of the patient. They considered the patients were carrying a burden that they should not have to bear. I asked the Minister a question on notice about this matter and the Minister very properly replied in his usual way, giving me all the information I wanted and he, as a layman, promised further to examine the matter. I gave him the correspondence from my constituents and he has those letters in his hands now and is having a look at them. I think he will do the right thing for them.
But I think that we in this Senate should be grateful that we have two doctors here - Senator Dittmer and Senator Turnbull - who stood up this afternoon and supported the case I put up, in a layman’s way a month ago. I think that the Minister ought to be very grateful that they are here also. I say that because I know the Minister would take their criticism in the right way because they are both learned men in their profession and the Minister tells us so often that he is a layman - which he is. Really, I am in favour of having laymen as Ministers and, in this case, having medical advisers. to assist them. Now, both Senator Dittmer and Senator Turnbull - both medical mcn - have supported the case I put up and I think that that fact ought to have some influence on the Minister.
I shall be a little ungentlemanly, now, to the Minister because I intend picking him up on something he might not exactly have meant to say this afternoon; but he said that he did not know the names of the medical men on the committee that made determinations regarding drugs on the free list
– He knew the chairman but did not know the others.
– He knew the chairman, but this committee looks like another group of faceless men springing up in the medical profession. I think it is a very serious situation when the medical men who make these vital decisions, which are life and death decisions, are not known. The Minister does not know them and the public does not know them. I think the public should know who they are. We all like to have supreme confidence in the medical profession. Most of us have. But its members are not foolproof. Medicine is not a private business today anyway. Public health is public health. In other words it is government business. We have large organisations like the Medical Benefits Fund of Australia Limited and the Hospitals Contribution Fund of New South Wales. These arc partly socialised, or community, organisations which are working in association with the Government. I think that it is absolutely wrong that the members of the committee which determines the drugs which go on, or are taken off, the free list, should not be known. They should be known to everybody.
– They should not be faceless men.
– I do not think they should be faceless men. I do not think the Minister meant what he said in that regard; he will probably have an explanation for it. 1 wish to raise another matter and here I am expressing a layman’s point of view. People have approached me about compounded drugs for the treatment of asthma being taken off the free list. This has had the effect of putting the cost of the treatment for ashma up to as much as £2 10s. a week. Sufferers have to pay this out of their own pockets in order to be free of asthma. Senators will remember that asthmatics at one time had to use a very awkward looking spraying instrument which caused them a great deal of embarrassment when they had to apply it in public. It was a sort of a pump which they pressed into their throats and operated by squeezing a bulb. This was most embarrassing for them. Certain manufacturers have now produced a small pressure pack which patients can apply to their mouths without being noticed. From my own personal inquiries in chemist shops I understand that the medical profession - and this committee of faceless men - do not like these pressure packs.
– Maybe they think they might blow up.
– I do not know what the reason is, but I understand that the medical profession is not very happy about them. The general practitioners in the surgeries are quite happy about them.
– Do not condemn the lot of them.
– I am not condemning the lot. I have just been praising you. I do not often do that, but I did tonight, notwithstanding that when you started your speech you wrongly accused me of believing in competition in medicine.
I should like the Minister to consider the point I have just raised because many people are interested in this debate and want these matters cleared up. I know that if the Minister had the power, every asthmatic would be given free treatment under the medical health scheme, because if ever there was an ailment that merited free treatment it is asthma.
I pass now to a matter which is probably more unpleasant from the Minister’s point of view. 1 hope he will forebear with me while I read from a publication entitled “ Your Guide to National Health
Benefits”. I direct the Minister’s attention to a passage at page 6 which, according to Mr. Sheahan, the Minister for Health in New South Wales, is wrong. The publication reads -
Pensioners who hold a Pensioner Medical Service Entitlement Card receive free public ward treatment in public hospitals under arrangements made between the Commonwealth Government and the hospitals.
Mr. Sheahan said that that was untrue and that he took exception to it. He said -
This is a complete distortion of the truth. No such arrangement was ever made. The free public ward treatment has been made available by the New South Wales Government whilst it has been in office and the Commonwealth has now provided it in this State.
Hospitalisation in New South Wales costs £5 17s 2d. per day. The Commonwealth Government pays only 36s. per day for a pensioner with an entitlement card.
For a non-insured patient the Commonwealth pays only 8s. per day. If someone opens a private nursing home, the Commonwealth will pay that hospital 20s. per day.
If a patient in the private hospital needs a serious operation and is transferred to a public hospital, the payment is reduced from 20s. to 8s. payable to the public hospital for a noninsured patient.
So the Commonwealth provides more for a patient who is in what we might call a second-rate private hospital than it provides for a patient who is taken to a public hospital and receives the best care and the most scientific treatment. I have read the views of the Minister for Health in New South Wales. I take it that he is a responsible Minister. He challenges the very important statement in this booklet published by the Commonwealth Minister. Possibly a mistake has been made and the Minister has nothing to do with it.
J now wish to deal . with the question of competition which was raised by Senator Dittmer tonight. I think that the Minister really misunderstood what Senator Dittmer was saying. The facts ar<; that in New South Wales there is very severe competition and I know that the Minister himself tried to eliminate it. At one period he took action to stop the heavy spate of advertising being indulged in by the competing funds. That, in some way. proves Dr. Dittmer’s case because the Government did take action. The result was that the advertising campaign was considerably reduced. It was a type of competition that the Government did not want. However, competition is still being indulged in. If you happened to be a member of the Medical Benefits Fund of Australia Limited and of the Hospitals Contribution Fund of New South Wales when those funds were linked, but you remained with the Hospitals Contribution Fund, after the separation, the Medical Benefits Fund kept pestering you in an endeavour to get you to join that fund. By virtually dishonest advertising it tried to create the impression in your mind that you still belonged to it. People are being confused by the competition between the two funds. This competition should not exist in matters of public health. People in these funds ought to be given every assistance and there should not be this violent type of competitive advertising.
Senator Wade tried to be broad in his remarks by referring to funds operated by the Hibernians and the Protestant Federation. But these are small funds. The whole point I am making is that most people are in one of the two major funds. The competition between these two was so violent at one stage that the Minister, in answer to a question put to him, said that the Government intended to see that the funds did not use for the purpose of advertising, moneys that should be used to provide benefits to the community. The matters raised by Senator Dittmer are of great public moment and I hope that the Minister will be able to clear them up.
I should like the Minister also to promise me that he will consider the matterof pressure packs. I ask him to find out whether there is opposition on the part of the medical profession to this new type of instrument. It is absolutely new and to my mind much superior to the oldfashioned method of applying drugs in the case of asthma. I can assure the Minister that if he can break down the opposition to these pressure packs he will be doing a great deal for the people who suffer from this disease.
Before I call the next speaker I would like to point out that we are considering proposed expenditure for 1964-65. I should like honorable senators to confine themselves as much as possible to the’ subject before the Committee and not to make what I consider to be second reading speeches. I believe I must direct attention to this matter because it is essential that the Committee should consider the Estimates in a thorough manner.
.- 1 refer to Division No. 253- Quarantine. I desire to ask the Minister for Health (Senator Wade) some questions regarding quarantine, particularly animal quarantine. Like a number of other honorable senators in this chamber, I am deeply concerned at the possible introduction of foot and mouth disease into Australia and its Territories. As honorable senators realise, if foot and mouth disease were to get a hold here, it would mean great economic loss to the primary industries of this country. As I see the position, foot and mouth disease could spread from the arrival of a ship or an aircraft, and also it could spread overland from West Irian to Papua and New Guinea and then, by a reasonably simple process, to the Australian mainland. Can the Minister give details of how foot and mouth disease could spreadfrom the arrival of a contaminated person or article of clothing on a plane or a ship? Can he say how it could spread across a. land boundary, such as the boundary between Papua and New Guinea and West Irian? How do the officers of his Department act to detect this disease in either of the two instances that I have mentioned?
I was interested to read in the annual report of the Commonwealth DirectorGeneral of Health for 1963-64 this comment at page 25 -
The task of the Animal Quarantine Service is a complex one. Despite advances in scientific knowledge, particularly in the field of virology, tests have not yet been devised to enable the presence of diseases in live animals to be detected wilh certainty and this influences quarantine requirements. 1 appreciate the problems that confront the officers of the Department, but I am encouraged, on reading that paragraph, to make that observation. Also at page 27 of the report I was interested to read that the Government appears to be making quite an attack on this problem. I understand that in August 1963, the Director of Veterinary Hygiene visited Indonesia to confer wilh the governmental authorities onproblems of animal health and quarantine, and that he was accompanied by officers of the Administration of the Territory of Papua and New Guinea. Can the Minister inform me of the result of this visit because, as I see it, it was of great importance?
Australia is in a somewhat difficult position regarding the detection of these diseases because we have not had them in this country, and our veterinary officers, who have been educated here, have not had first hand experience of them. I ask the Minister: What steps do the officers of his Department propose to take regarding the education of our veterinary officers in relation to these diseases? I refer particularly to foot and mouth disease which could have such devastating results if, through carelessness on the part of the officers of his Department, or through subterfuge on the part of people entering this country, it were to establish itself here.
– If I am to do justice to the questions which have been raised, I had better try to keep up with the field as best I can. I was charmed with the tribute paid by Senator Ormonde to the two medical men in the Senate, Senator Dittmer and Senator Turnbull. I do not challenge for one moment the statement he made that both of these gentlemen have been of great value to the Senate and that on many occasions they have been good enough to go out of their way to give us technical advice and information. Having said that, I was pained to think that Senator Ormonde had not been impressed with what Senator Turnbull said earlier in the afternoon. Senator Ormonde, with some eloquence, went to great pains to point out to honorable senators the sad state of affairs that had arisen since Amesec, a compound drug, had been taken off the free list. He argued that there was no substitute provided on the free list, that people were called upon to pay for this drug out of their own pockets, and that great hardship resulted.
Less than two hours previously Senator Turnbull stood in his place and criticised the Government for the removal of Amesec from the free list and for leaving Ted rat on the list. He declared that they are both exactly the same. Are they the honorable senator’s words?
– 1 say to Senator Ormonde that he could not have been listening to the speeches of our medical friends. I do not like being criticised for having removed Amesec from the list, the inference being that there was no substitute provided on the list, when a distinguished doctor in the Senate stands in his place and says that Tedral is exactly the same. I say to him and Senator Ormonde, if they do not already know it, that Tedral is on the free list. Just in passing, I am informed by the officers of my Department that there is a slight difference between the compounds Tedral and Amesec, but they both serve the same purpose.
– They serve the same purpose completely.
– That strengthens my case. I thought that in all honesty I should indicate that there was a slight difference in the compounds, but my distinguished friend, Senator Turnbull, says that there is no difference. So I refer Senator Ormonde to Senator Turnbull when he criticises the Government for the removal of Amesec from the free list. Tedral is on the free list, and Senator Turnbull says that it is identical with Amesec.
Senator Ormonde also criticised me for saying that I did not know the personnel of the Pharmaceutical Benefits Advisory Committee, with the exception of the Chairman. There are two reasons for that. They were appointed by my predecessor, and they have given excellent service. Senator Ormonde suggested that these people should bc well known to the Parliament. In the world in which we live today, if they were known their position would be completely intolerable. The drug industry is a highly organised and efficient industry which exerts tremendous sales pressure in every avenue that it can explore. I do not criticise it for that. We all would do likewise if we were engaged in the same kind of work. 1 think that on a moment’s reflection Senator Ormonde will agree that to place the members of the Committee in a position where they would be subject to the pressures of the manufacturers would create an intolerable situation. He is not so naive as to suggest that, if the manufacturers and the wholesalers knew who were to decide whether their drugs would be added to the list, the manufacturers would not subject these men to some pretty powerful sales talk, at least. For that reason, if for no other, I think it is wise and proper that we accept the fact that these men are nominated by their profession and are leaders in their profession.
Senator Ormonde also referred to the health booklet. Again without any intent on our part, 1 am afraid that the booklet has caused the New South Wales Minister for Health to exhibit more concern than I expected anybody to exhibit. I am not going to take it back. I am not going to review it. I am not going to take one word from it. I repeat what I said on a previous occasion, that the booklet entitled “Your Guide to National Health Benefits” sets out in precis form the benefits that are available under the Commonwealth’s national health scheme. It made no reference at all to State participation in any contribution to the health of the community. I went so far as to say that we do not claim the sole right to provide benefits. What I said was strictly true from the point of view of the Commonwealth, and that was the only story that we were telling. With great respect to Mr. Sheahan, he is at perfect liberty to tell the people of New South Wales what the State Government is providing, and knowing him as I do I do not think he would be backward in that respect. Reference was made to the use of pressure pack sprays for asthmatics. All I can say about that matter is that I shall discuss it with my officers.
asked why the grant to (he National Health and Medical Research Council had been increased from £318,500 to £400.000. That is a result of an increase in the salaries of academic staff who are engaged in research work. An added reason was the requirements of the Monash University, which has come into the field of research in recent times. The sum of £400,000 was required to permit the completion of research projects at present being undertaken. Reference was made to seat belts. The National Health and Medical Research Council has recommended that seat belts be fitted to motor cars, and that recommendation has been conveyed to the State Governments. The Commonwealth can only advise and inform, and it is pleased to do that. The honorable senator asked why there is to be an increase in the grant to child health centres. The reasons are very similar to those for which we increased the grant to the National Health and Medical Research Council - that is, salaries and costs have risen. The child health centres faced financial difficulties in continuing what I believe is a model work and one which is of great value to the mothers of Australia. The Government believed that it had an obligation to help them to meet their growing financial needs.
I was asked whether provision had been made in the contribution of £256,000 to the World Health Organisation for research into kuru. That is a matter for the Minister for Territories (Mr. Barnes). The national institutes of health in the United States of America have been assisting in this field. The honorable senator also asked whether Australia is willing to become a member of a World Health Organisation researchcentre if one is established. The answer is straightforward and simple: This matter will be considered when further information is available from the World Health Organisation. As honorable senators know, Australia is playing an ever increasing role in the activities of the World Health Organisation and quite properly is being recognised as a nation that has something to deliver in this field.
asked me about quarantine precautions and the incidence of foot and mouth disease. I am afraid I would take up a great deal of time if I were to go into the detail that the honorable senator would like. Suffice it to say that in the last two years, particularly in the light of recent events to our north, we have felt that we must be equipped as adequately as possible to meet the threat. For that reason for the last two years we have sent to the United States of America two of our leading veterinary officers for a course in the prevention and detection of foot and mouth disease. We believe that the entry of foot and mouth disease into Australia if not detected immediately could have devastating effects on our livestock population. We believe we have an obligation to the nation to have at hand trained men who can recognise the disease at first sight. It was for that reason that for the last two years we have sent men overseas. We will continue to do that until we have built up a team of qualified officers who are highly skilled in this field.
I was asked what was the result of the visit to Indonesia of our chief veterinary officer. He went to Indonesia to place before the Indonesians the Government’s views on the prevention of the introduction of foot and mouth disease and other exotic diseases into the western areas of Papua and New Guinea. I am loath to make any comment about the attitude of other countries to foot and mouth disease and similar diseases. May I say that in some countries people have learned to live with this disease over the centuries. We in Australia cannot afford to do so. The attitude of people who have been living with this sort of thing is quite different from ours. The purpose of this visit to Indonesia was to let these people know how seriously we viewed the possible introduction of the disease into our Territories. It is to be said to the credit of the Indonesians that they listened and that they undertook to co-operate with us in every possible way. But lest I be accused of expressing a pious hope, let me emphasise that, whilst we appreciate the attitude of the Indonesians, we arc determined to take every possible precaution to prevent the spread of the disease into the islands to our north, which are very close to Australia.
.- I wish to refer to Division No. 250, section 4, item 02 - Medical research (for payment to the credit of the Medical Research Endowment Fund), lt will be noted that in the last financial year the appropriation was £318,500, of which every penny was spent. This year the Government is asking for a sum of £400,000. The Minister for Health (Senator Wade) has demonstrated that he has a very retentive memory. I propose to put it to the test. About two years ago, according to my recollection, the Minister supplied information about a project that was commenced in a certain department at the Brisbane General Hospital. I made a note of what the Minister said. He said that the project was commenced to study the incidence of head injuries including the proportion due to road accidents of various types and the proportions due to other accidents including those of a sporting, industrial or domestic nature. It was also proposed to investigate the relation of head injuries to other injuries sustained in road accidents.
Another field of study embraced patients who died before reaching hospital or before any emergency or definite treatment could bc offered in hospital, lt was proposed to study the incidence of patients dying at an interval during which treatment could have been or was offered. Another study was the incidence, daily clinical course and degree of efficiency and success of the treatment offered within hospitals for various specific lesions in survivors from head injury. Another field of study was the clinical course of the patient in the early period after discharge from hospital, including the period away from usual employment or occupation, morbidity, employability in relation to employment found, and medico-social problems. 1 should like to know whether the project has been continued, whether it has operated in the past two years, and what has been the result of the study. Has the study been worth, while to the victims of accidents? Is the information that has been ascertained beneficial to the rest of the people in the Commonwealth who meet with road accidents, the number of whom is increasing daily? Will the Minister state what is the situation in 1964? Has the money been well spent?
Senator Dame ANNABELLE RANKIN (Queensland) [9.0]. - I should like to ask the Minister for Health (Senator Wade) a question in connection with Division No. 254, sub-division 2, item 07, “ Publicity - Pamphlets, £20,000”. I notice that last year the appropriation was £30,000 and the expenditure was £26,906. which was quite considerably less than the appropriation. This year the proposed appropriation is still further reduced. I should like some details about these pamphlets, because it would seem to me that a very great service could be rendered to the community in the provision of valuable pamphlets concerning health, which could be in the form of education for those who are concerned about certain illnesses and health problems in the community.
As the Minister well knows, I have on more than one occasion in this chamber asked whether some special consideration could be given in relation to children who suffer from cystic fibrosis. Perhaps under this item it might be possible to distribute and make available to people in medical services and parents who care for children who suffer from cystic fibrosis a very valuable book which has been produced by the American National Cystic Fibrosis Research
Foundation, entitled “ Guide to Diagnosis and Management of Cystic Fibrosis “. A note on page ii of the book reads -
This syllabus may be reproduced in toto or in part without permission.
So it is produced with the idea of its being used for assistance in this very serious illness. As I think honorable senators will remember, on more than one occasion I have spoken of the very real problem faced by parents whose children suffer from this disease. As a result of investigation which has been carried out in America through the foundation, as stated in the foreword -
Cystic fibrosis has become a substantial part of medicine’s most pressing concern today - the care of the chronically ill and disabled.
Later, the foreword continues -
The purpose of this syllabus is to provide a practical summary of current knowledge and opinion relating to diagnosis and treatment of cystic fibrosis … ft reflects intensive experimental and clinical experience of several groups whose work in cystic fibrosis has been carried out under a variety of conditions and over an appreciable period of years. 1 believe that if this book could be made available through the publicity service, the Government would indeed be doing a very great service to the children who suffer from” this disease, and to their parents and others who are associated in caring for them. I should like to direct the attention of honorable senators to a paragraph which appears on page iv of the book. It reads -
Established in I9SS as a voluntary, non-profit organisation, the Foundation’s purposes are . . . to lead, co-ordinate and foster efforts seeking new knowledge concerning the cause, prevention, treatment and cure of cystic fibrosis … to stimulate the use of government, public and private resources in all areas bearing on the cystic fibrosis problem . . .
I suggest that under the item “ Publicity - Pamphlets “ some assistance could be given by the reproduction of this book to children suffering from this disease and to persons who are endeavouring to assist them.
. -I direct attention to Division No. 250 and to the reference to the Bureau of Dental Standards at page 172 of the schedule of salaries and allowances. I am rather disappointed to see that expenditure by the Commonwealth Government on this important section of health is so low. Both the
Opposition and the Government have expressed to the Australian people their concern about dental health.
– We are fluoridating the water here.
– That is true. The Opposition has promised to include in the national health scheme provision for dental care. The Government has conceded that there is a problem and has stated that it will give serious consideration to it, but in the Estimates all that 1 can find is provision for this very small Bureau of Dental Standards. Senator Laught, of South Australia, has said that Indonesians have learned to live with foot and mouth disease in animals. It is a shameful thing that the Australian people arc living with mouth disease in the juvenile section of our community which is not being nearly adequately treated. We have in Western Australia a dental hospital which only scrapes the surface of the needs in the community. Quite recently there was a dental congress in Perth which set out minimum charges for dental services. It suggested an examination fee in excess of what an examination by a doctor would cost in normal circumstances. It set minimum standards for first fillings of children’s teeth, and the cost mentioned was extortionately high.
Does the Government contemplate having an investigation at some stage of the cost of these services to the community, such as the investigation that was made into the British health scheme a couple of years ago? As a criticism of a national health scheme, that was very revealing. A comparison of dental charges disclosed in that inquiry with those in Australia shows a differentiation not of 20 per cent, but of several hundred per cent, higher in Australia than in the United Kingdom. I ask the Minister to consider very seriously the incorporation in the national health scheme of provision for the care and treatment of diseases of the mouth. I know that in Western Australia parents whose children have been ordered by a doctor to get dental care have been unable to afford it, and the care has not been available to them. Nobody can deny that a man on the basic wage, or on a wage reasonably in excess of it, cannot afford adequate dental care for three, four or five children. 1 have known children to be stood over without dental care for months, with the point being ultimately reached where it has been found necessary to extract the infected teeth or to provide more extensive treatment or hospitalisation. As Senator Cormack has interjected several times, fluoridation of the water supply in the Australian Capital Territory has been introduced. That is an experiment, anyhow. It is a type of mass treatment. It might do some good, but there is conjecture about it. I do not want to enter a controversy in relation to it now, when we are considering the Estimates.
I urge the Commonwealth Government to consider including dental treatment and diseases of the mouth in the national health scheme. What does the Bureau of Dental Standards do? Can it give a lead to the Australian people on what is necessary to meet this urgent demand for dental health? ls it able to nominate standards and state what are reasonable charges for dental treatment? There is no government control of charges for dental services through an agreement with practising dentists on an agreed formula. The dentists claim that they have to meet high rentals, provide individual surgeries with plant which is often duplicated and provide for modern advances in the science of dental treatment. These are their reasons for terrifically high prices which are beyond the capacity of the average person to pay.
Therefore, I ask the Minister for Health to ascertain whether the Government can see any possibility of relieving this burden on Australian families. Is there any possibility of providing for dental treatment for adults? Has the Bureau of Dental Standards any chance of investigating and recommending to the people standards of dentistry necessary for efficient treatment and the charges which should be made for these services? These things are outside any control at present. The States have not made any provision for dental treatment. The dental hospitals have many calls made upon them and their staffs are dedicated to the work but it is impossible for them to meet the demand completely. I ask the Minister to state what extra expense would be incurred by the Commonwealth Government if it introduced a dental health scheme.
Will the Minister state what are the activities of the Bureau of Dental Standards and whether its work can be extended? I think much more money should be devoted to it so that it can give a better service. It is very necessary that something should be done in that respect. Perhaps the Bureau could recommend assistance to the States. 1 ask for an assurance that the Government will consider including dental care in the national health scheme. The treatment of diseases of the mouth in Australian adults is more important than the treatment of mouth diseases in Indonesian animals - a subject which has been mentioned in this place.
– Senator Benn has strained my memory to breaking point. I remember giving some information in answer to a question about two years ago concerning a research project that had been allocated to the Brisbane General Hospital but I do not know what was the result of that project. I shall obtain the information for the honorable senator without delay.
Senator Dame Annabelle Rankin referred to the reduction in the proposed expenditure on publicity pamphlets. There is a very simple reason for this. In the last financial year we brought out the “ Your Guide to National Health Benefits “ which has raised the ire of one of my New South Wales colleagues. The reaction of the public has been so good, however, that we will not be obliged to repeat the publication this year. Therefore, there will be a reduction in cost on that production and other works of a less costly nature will be undertaken.
Senator Dame Annabelle Rankin also made a most eloquent plea for the reprint of a booklet entitled “ Guide to Diagnosis and Management of Cystic Fibrosis “. No one could remain unmoved by the logic of the honorable senator’s case and the way she presented it. I assure her that we will examine the submission and if it is possible to give a service in this field we shall be happy to do so.
Senator Cooke made a plea for a national dental health scheme. The logic of his argument somewhat fascinated me. He said the people of Australia were demanding this service and added that this had been part of the Australian Labour Party’s election policy for I don’t know how many years. The odd thing is that the Labour Party has been rejected every time it has gone to the polls for the last 15 years. The people have rejected Labour’s policies So I suggest to Senator Cooke that when he is pleading for a national dental health scheme, he should not try to support his argument by saying that this was part of Labour’s policy, because the people have rejected that policy.
Perhaps there are other very good reasons why a dental health scheme should be inaugurated but from my somewhat limited knowledge of the United Kingdom scheme I can say that so far as I am concerned! - and I would hope that this is the attitude of the Government I have the honour to represent in this chamber - there will not be any replica of that scheme in Australia for several reasons. I repeat that I do not like talking about and criticising in caustic terms other people’s affairs. But since Senator Cooke has raised the question of the national health scheme in the United Kingdom, I believe I am entitled to say that the consensus of opinion in that country is that the quality of the dental service, because of the very nature of the scheme, is getting worse and worse as time goes by.
– Why has the Tory Government kept on with it then?
– This is not a government matter at all. It is a matter of basic principles so far as the scheme is concerned. I do not say that nothing any good can come out of Nazareth so far as a national health scheme is concerned, but I do say that my reading and information at my disposal lead me to believe that this type of scheme could be bettered. Does anyone want to challenge that statement? If we do get to the stage - as I hope we will - when we can inaugurate a dental service in a national health scheme, it will be the best scheme in the world and not a second rate one.
– I wish to refer to Division No. 250 and the salaries and allowances which are set out in the schedule. I am curious to know what ministerial staff is filling unclassified positions. There is provision in the schedule for this staff. 1 will not comment further on that matter until I have a reply from the Minister for Health. There is also reference in the schedule to “ Officers, on unattached list pending suitable vacancies, £30,908 “. This is an increase on the appropriation for this item last year. Again, I am seeking information and will not comment further until I have an explanation. I am concerned as to whether officers are being paid until suitable vacancies arise and whether, thereby, the Government is depriving civilian occupations of man power in a time of shortage. 1 turn now to Division No. 250 - Other Services - Item 02 which relates to medical research. I again want to refer to the disease arteriosclerosis about which the Minister today answered a number of questions that I had placed on the notice paper. Some weeks ago I asked the Minister whether people who normally would be eligible for medical and hospital benefits would receive a rebate for medical and hospital fees incurred in receiving treatment outside Australia. The Minister replied that if the people are eligible and present a bona fide case to the effect that they received treatment and have paid their accounts, the Government will refund the amount to which they would be entitled if the treatment were received in Australia. In Germany, Dr. Moller is treating people suffering from arteriosclerosis with what he calls oxygen therapy. Do people who receive this treatment overseas become eligible for reimbursement by the Government upon their return to Australia? This disease causes undue pain, and some further investigation is necessary into the possibility of affording relief to the patients. The Minister stated today that there is no known cure for the disease and that amputations are sometimes performed for the purpose of relieving the pain. In my series of questions I took the unusual step of asking a busy Minister to read the speech of a member of the South Australian Parliament. I did that for the sole purpose of putting within the Minister’s knowledge a statement that was made by someone who has studied this subject.
– I read the speech.
– I realise that you read it, so you know that the member named a number of persons in Australia who had been diagnosed as incurable and told that the only possibility that they had of obtaining relief was by amputation. One woman sufferer was told that her only possibility of relief was by the amputation of both legs. She and others who were men tioned by the member for Adelaide in the South Australian House of Assembly went to Dr. Moller in Germany and received the oxygen therapy treatment. They have now returned to Australia apparently cured and not suffering any pain.
As the Minister has said, Dr. Moller himself does not claim that his treatment effects a permanent cure - he believes that it is necessary to have periodical oxygen therapy - but it does afford relief to patients who are virtual cripples and have no prospect of relief other than by amputation. Dr. Moller believes that subsequent treatment is necessary after five or perhaps ten years. If sufferers from this disease can enjoy a happy active life for the remainder of their days -on earth by undergoing this treatment periodically, this is all the more reason why we should seek to introduce it in Australia.
The Minister has said that a report will be received from an organisation to which Dr. Moller has submitted details of his treatment, but he is not keen that any further investigation be undertaken here because of a report that he has received from the Royal Australasian College of Physicians which has stated - I do not deny its capability to carry out an inquiry - that no really satisfactory evidence has been given of the value of Dr. Moller’s therapy. But I am asking the Department to see whether there is available any satisfactory evidence of cures effected by Dr. Mollers’ treatment. Although the speech of the member for Adelaide refers to a number of Australians who have been treated by Dr. Moller and have returned to Australia apparently cured, I suggest that we should interview the medical officer in South Australia whom the member for Adelaide said has details of those people who were given up in South Australia as incurable but who, after visiting Germany and undergoing Dr. Moller’s treatment, are now apparently cured of the disease.
The Minister has said that in view of the statement by the Royal Australasian College of Physicians he can see no good reason why he should even look at the list of persons concerned. I appeal to him, in a not unfriendly way, to reconsider his decision. I do not want to criticise the Department for something about which I know nothing, but it would appear that people are getting relief from this disease by paying their fare to
Germany and having Dr. Moller’s treatment. The evidence of the efficacy of the treatment is here in Australia in the person of those who apparently have been cured. Surely that is sufficient evidence to encourage the Government to take a further step in this matter. If the Minister puts this information before the Royal Australasian College of Physicians, which he accepts as an authority, perhaps the College will regard it as satisfactory evidence of the value of Dr. Moller’s therapy. Surely this would be the reply to the experts who ask: “What is the answer to this problem?” The Minister has never said that Dr. Moller’s treatment is not worthy of consideration, but while we are awaiting reports from various organisations people are suffering untold agony and are being incapacitated by this disease.
Surprisingly, it has been discovered after talks with the member for Adelaide and, 1 believe, from his speech, that there are two machines in Adelaide at present which could be used for the purposes of Dr. Moller’s treatment, so the question of the importation of machines does not arise. We should use them to see whether we can obtain any satisfactory proof that the treatment is beneficial. My submission is that the proof is available in Australia in the person of those who have received the treatment. They should be interviewed and a study made of the evidence relating to their condition before they went to Germany and their condition upon return after treatment so that we can decide whether to develop similar treatment in Australia.
The Minister agrees that Dr. Moller would be prepared to come to Australia to demonstrate or to explain his treatment. However, the Minister claims that he can see no good purpose in debating this suggestion in view of the report he has received from the Royal Australasian College of Physicians. Yet we have the outstanding evidence, which has not been denied, of the apparent cures that have been effected. Dr. Moller agrees that it is not a permanent cure but surely a temporary cure which, with periodical treatment, will enable people to live a happy and active life, rather than face the prospect of amputation, should receive further consideration. I appeal to the Minister to make a detailed examination of the cases that have been treated by Dr. Moller and to study the medical charts with a view to having Dr. Moller’s treatment introduced into Australia.
– I wish to ask the Minister a question which is related to Division No. 250. This section deals with the administration of the Department of Health and I think it is the only section under which I can ask my question. I have noticed in the report of the Director-General reference to four overseas migration posts to which medical mcn are attached. We are told that medical officers are employed in European migration missions in London, The Hague, Athens and Cologne. I ask the Minister for Health (Senator Wade) whether those are the only overseas migration missions at which Australian medical representatives are employed. I also ask whether our medical representatives, who are active in the choice of migrants to Australia, are men who are experienced not only in the study and treatment of physical illness, but also have some training in mental health. Over the years there have been cases - not a great many, I admit - where migrants who have been admitted to Australia have had histories of mental illness or of serious physical defects. Somehow they have been able to get through the medical examinations made in Europe. I wonder whether sufficient medical men are attached to our overseas migration missions.
I turn now to Division No. 250, section 4, item 03, which refers to the Commonwealth Council for National Fitness. This item refers to a very important section of the work of the Department of Health. In these days when there is so much talk of compulsory military training as an aid to disciplining our youth, as well as for defence purposes, a great deal of work is being done in each State on a very limited budget by the National Fitness Council. Can the Minister tell me whether there is any prospect of the amount allocated for national fitness work being increased in proportion to the excellent work being done by the National Fitness Council at present? It seems to me to be ridiculous to expect the Council to achieve the excellent results it does achieve when its budget is so low. I refer particularly to the grant in respect of universities and teachers training colleges, for assistance in the training of teachers in physical education. The amounts granted to the States vary from £500 for residential courses in New South Wales, to £300 in the smaller States such as Western Australia, Tasmania and South Australia. 1 appreciate that the grant is not meant to represent the total cost of training even one teacher in physical education, but is intended to give assistance to students who already have been selected for training in a general way. In a budget as large as that of the Department of Health I think a larger proportion could be spent on grants to our training colleges and universities. I maintain that one of the principal aims of the Department of Health is not so much to cure the sick as to keep healthy people well. I think that can be done in a great measure by encouraging physical fitness in our young people, which also encourages fitness of the mind. 1 express my deep gratitude to the officers of the National Fitness Council, to the very many voluntary organisations and to all those who have in any way helped to make this one of the fine spots in the Department of Health.
I turn my attention now to the Royal Flying Doctor Service which is covered by Division No. 254, section 4, item 02. This year the grant for the Service has not been : altered from last year’s grant. This vital work has aroused the admiration not only of Australians but of people in other parts of the world. It has been copied in parts of Africa. When I was in the United States of America last year, one of the facets of Australian life which I found to be of paramount importance to the many groups of people I addressed was the Flying Doctor Service. As a Western Australian I can appreciate how much it means in that State where there are so many big outback areas to which it is the lifeline. The term “ outback “ aroused great interest in America. Whenever I referred to the outback 1 immediately aroused interest. When I spoke of the Flying Doctor Service my remarks were received with a great deal of appreciation.
In Western Australia we also have a flying dental service and a flying native welfare sister service. If any savings could be effected in another branch of the Department, they could very well be spent on the very important Flying Doctor Service which is doing so much to bring a feeling of security to the women in outback areas. When these women realise that this excellent medical service can be brought very quickly to their aid it gives them a feeling of security. Because of this feeling of security they are better able to help in the development of the outback areas of this vast continent. I ask the Minister to inform us why the grant for the Flying Doctor Service has not been increased this year.
– I wish to direct a few comments to Division No. 254, section 4, item 06, which relates to thalidomide affected children. The grant is for the supply and repair of artificial aids for these children. I am a little hesitant in mentioning this subject as we have in the chamber two well-qualified medical men. However, the subject is of great interest to us all and bears very heavily, I think, on the conscience of our medical service. Recently on television I saw a film of some thalidomide affected children. It was a most moving sight. They seemed mentally to bc fully equipped, but physically were dreadfully afflicted. Their arms were shortened and some children virtually had no arms. One can appreciate the enormous problem with which their parents arc faced in endeavouring to provide something approaching a normal life. I am anxious to know whether the sum available - £900 for this year - is adequate to cater for the needs of these children.
I would also like to know whether the Minister can give any information as to the number of thalidomide affected children in Australia. The sum of £900 seems relatively small to cater for the needs of children who are so terribly afflicted and will be handicapped for the rest of their lives.
I refer now to drugs. We have seen a scientific development of drugs,, particularly in the last few years, some of which undoubtedly are of doubtful value. I think it is very imperative that, as an enlightened community, we should have something in the nature of a drug evaluation committee. I think there is some such committee within the Department of Health. I do not know the reason for its existence or the cause of its having been set up. The fact that it is a drug evaluation committee would, I think, have something to do with the evaluation of new drugs as they come on the market and are applied to remedy the ills of mankind. I would like to hear from the Minister just What the function of the drug evaluation committee is. As I said, I believe one does exist. As we all know there are lots and lots of drugs that have been brought very much to the. attention of the Australian public in recent years, particularly in the last twelve months.
I do not like touching on rather delicate subjects but one may as well be perfectly frank. We have what is termed a contraceptive pill . that has been introduced recently and is in widespread use. I believe that it is necessary to have a prescription from a medical officer in order to obtain it. As far as we can gather, it is an effective means of preventing a woman from having unwanted children, or unnecessary and numerous children, and enabling her to indulge in a little family planning. I would like to know whether this drug is one of the things that has had proper evaluation by an expert committee. Who is to know that this particular tablet could not have some adverse effect on a woman who at the behest of her medical adviser is taking these tablets and who may be doing untold harm to her future life when she comes to middle age?
At the other extreme, I read in a newspaper - today 1 think it was - that a fertility pill has been developed. I hope this is not embarrassing to our female senators but it is desirable to be perfectly frank on this matter. I saw that this particular fertility pill had been taken by a woman who, apparently, had been unable to conceive, and her first children were quadruplets. I would say that that particular fertility pill achieved results undreamed of by the person concerned. I think it would certainly be a shock to the poor old husband, anyway, for his wife to present him with quadruplets as a result of what is, after all, only a human desire to have a family. So I think that this is a matter of very great importance and I speak quite sincerely when I say that these matters should be given more attention by the Department of Health. We live in a scientific age and many of these things are coming on the market and have been accepted to a large degree by the medical profession. The case of the thalidomide children was nothing short of a tragedy and it could be repeated in other fields.
So I suggest to the Minister that this is an extremely serious matter and one that deserves the very closest consideration by his Department. I do not wish to say more. I just want to draw the attention of the Minister to these matters because they are quite serious and could have a tremendous impact on the general health of the community. I ask the Minister in particular to give me an idea of the number of thalidomide children in Australia. Fortunately we were able to discover the adverse effects of this particular drug at an early stage and I believe the number of children affected in Australia is not very great. But the sum of £900 which is provided seems a very small one indeed to assist these poor unfortunate children and their parents! I ask the Minister to give consideration to what I said in regard to my request for further information concerning a drug evaluation committee which will provide an expert opinion and will be able to advise the medical fraternity and the people at large on the value or otherwise of some of ‘these new drugs that have been introduced in the last few years.
– Let me attempt to answer what I would term the easier questions first because some of those down along the line will really tax the ability of a much more able person than I. Senator Cavanagh wanted to know whether payments made to Dr. Moller in Germany for treatment received would attract medical benefits for the patient concerned on return to Australia. The answer is “Yes, of course, if the person was a member of a medical scheme and kept up his payments while he was away.” I will refer again to Dr. Moller later. A question was asked concerning the additional cost of ministerial staff to fill unclassified positions. This is an increase of £3,357 over actual expenditure in 1963-64 and is mainly due to the employment of an additional officer. The remaining increase, some £497, relates to basic wage increases, salary increments, and provision to fill the positions during the year 1964-65.
Information was also sought concerning the provision for officers on the unattached list pending suitable vacancies amounting to £30,908. These are permanent officers occupying temporary positions. Action has been taken, or is being taken, to place these officers in permanent positions at the first opportunity. They comprise three medical officers including two who are at present filling the positions of Commonwealth Medical Officer, London, and Assistant to the Commonwealth Medical Officer, London. Officers are appointed to these posts for three-year terms, usually, and the provision includes six clerks, three clerical assistants, five typists and one accounting machine operator. I return very briefly to arteriosclerosis. Senator Cavanagh made a plea for further consideration of the treatment by Dr. Moller of people suffering from this com print. I think that the appropriate attitude that I should take in this matter would be to say to the honorable senator that I will read his speech. I will discuss the matter with the officers of my Department rather than attempt an off-the-cuff analysis of his speech at this time. I would much prefer to have the opportunity of studying the points he made and of making a considered decision on his submissions. - Senator Tangney asked me about the National Fitness Council. She questioned whether the provision made for this Council was adequate. 1 suppose it would be a pretty brave person who would estimate what sum could not be spent wisely in this field; but there is a history of the National Fitness Council that, I think, might interest the honorable senator. I say this advisedly. For some years the National Fitness Council failed to receive what I believe was the encouragement to which it was entitled for the work it was doing. It worked on a pretty tight budget for a number of years, and 1 can remember on many occasions honorable senators in this chamber making a plea for additional funds for the Council.
The present Director-General of Health has been always vitally interested in this scheme and he encouraged the Council to gird up its loins and renew its efforts. Only 12 months or so ago 1 was persuaded to make a submission to the Government to add £25,000 to the amount being provided for the Council. The Government agreed to do that. I am pleased to say that the result was instantaneous as far as the Council was concerned. The added assistance has really been what I would regard as a shot in the arm.
– Give it another one.
– The honorable senator says: “ Give it another one “. That may well be done.
– That amounts to only 6d. a person.
– There is much more involved than 6d. a person. That is taking it at its lowest level.
– 1 do not get down low in these matters.
– I said that that was writing it down to the lowest level. I made no reflection upon the honorable senator at all. The point I am trying to make is that the efforts of the National Fitness Council today might well prompt the Government, in the foreseeable future, to encourage it with greater financial assistance to pursue its activities. That is not a commitment or promise, but it might be a prophecy.
The honorable senator asks why there has been no increase in the grant to the Flying Doctor Service. This organisation provides a magnificent service to the outback of Australia, lt is one of the instrumentalities in which the Government is very interested and towards which it is most sympathetic. The service is an instrumentality that does not have to ask a second lime for financial assistance if it can justify the request which it makes. It was, I think, iwo years ago that the Service asked for additional finance, and it got it. That has enabled it to re-equip its fleet of aircraft, and I understand that at the present time it has no need for additional finance. The people in this Service are responsible people who do not make claims that are not justified. Because the Flying Doctor Service has not made a request for additional finance I have no doubt that it is not suffering, but is providing the benefits it set out to’ give.
The honorable senator referred to four overseas posts mentioned in the annual report of the Director-General of Health and asked whether those were the only posts manned by Commonwealth medical officers. The answer is: No. Medical officers are employed by the Department of Immigration at Cairo, Rome, Madrid, Stockholm and Vienna. More than one officer is located at a number of these centres. The number is considered adequate to meet the needs of the immigration programme.
Senator Hannaford queried the adequacy of the £900 that is being allocated to meet the needs of the thalidomide children in this country. He made his points quite logically. There are only 23 children in this category; but that is 23 too many. The Commonwealth Government’s contribution is a matching £1 for £1 contribution with the State Governments. That was the original proposition of the State Governments and it was gladly accepted. This, too, is a field in which there is no ceiling to the Commonwealth contribution. Our main objective is to give a service to these unfortunate little individuals. If further proof is wanted of what I say I can tell the Senate that only last year the Government brought to this country a person who undoubtedly is the greatest authority in the world on the fitting of artificial limbs to thalidomide babies. He visited every State and even discussed individual cases with the parents and the medical people who were endeavouring to meet the needs of these children.
– The cost of that would not be shown under this heading.
– It is not shown under this heading. This £900 is required for the next 12 months to meet the needs of these thalidomide children. As they grow there is a need for the artificial limbs to be changed.
A question was asked about the Drug Evaluation Committee. I take great pleasure and some pride in having had a hand in the formation of this Committee. I believe it is a Committee that can make a splendid contribution to our national health. There arc seven members of the Committee. The chairman is one of our most distinguished medical men. I do not think that statement will be challenged by my medical colleagues here because even tonight Senator Dittmer has made reference to him. He is Dr. Edgar Thomson of the Royal Prince Alfred Hospital in Sydney. He is the chairman of the Committee and he has six colleagues assisting him. They accept a fairly heavy re sponsibility in as much as they examine many drugs that the Department of Health recommends to them for analysis and for a recommendation as to their use. The Committee is obliged also to arbitrate between the Department of Health and manufacturers if, for argument’s sake, the Department of Health says that a certain drug produced by manufacturers is not up to the standard. If the manufacturers want to challenge the matter it is referred to the Drug Evaluation Committee. It is serving a very useful purpose.
Senator Hannaford referred to another matter on which I am not competent to enlarge, namely contraceptive pills. He spoke in rather vague terms as I would expect a non-medical man to speak. In point of fact one such pill was referred to the Drug Evaluation Committee and I understand that the Committee found that there would be no side effects. But that was only one pill and I do not want it to be taken as certain that there are no side effects because there could be a dozen such pills. The honorable senator opposite might put me right if I am wrong.
– 1 do not know them.
– I do not know to whom I am to turn in these troubled times to give me advice on important matters. The point I would make is that all the known information on this subject is available to the medical profession. If anybody wants to know what the effects of taking such a pill may be there is no one better equipped to advise than the medical practitioner.
– My remarks are directed to Division No. 250, and in particular to item 02. I wish to refer also to Division No. 254 - Health Services which deals with the question of cattle tick eradication and control in New South Wales. Senator Dittmer has raised a matter of major importance in suggesting that the Department of Health and the Minister have circumscribed the scope of the Commonwealth health activities. Senator Dittmer has, in effect, accused the Minister and the officers of his Department - and I think with some justification - of timidity. We have heard too often in this chamber that the Commonwealth has not done work in fields of public health because these are matters for the States, and that the Commonwealth
Parliament has no authority to legislate or to enter into those fields. That is just not right.
Senator Cooke raised the matter of dental services. 1 think that the right answer was given to his query in an interjection by Senator Hendrickson, to the effect, that in 1946 the people of Australia conveyed power to the Commonwealth to legislate in respect of dental and medical services. Even before that time, it was the opinion of the Chief Justice of Australia that, leaving aside the fields in which the Commonwealth had complete power, such as quarantine and matters affecting the Territories, the Commonwealth could authorise the expenditure of public money on inquiries, investigations, research and advocacy in relation to matters affecting public health. Even before the referendum was held and an alteration was made to the Constitution, that was the power of the Commonwealth generally in matters of public health. Yet, again and again we hear advanced in this chamber the argument that the Commonwealth cannot do anything because it is a matter for the States. That is plainly not true, and it has never been true.
Since 1946 the Commonwealth has certainly had the power to legislate in respect of dental and medical services, lt can move into these fields if it wants to do so. If the estimate for health services is so low, then it is because the Government wants it to bc that way, not because it has to be that way.
– What action did the Labour Government take between 1946 and 1949?
– One of the things that it did was to pass legislation relating to national fitness, which gave great power to the Commonwealth in relation to matters of physical fitness. Of course, the measure has been treated by this Government as if it simply dealt with matters of physical jerks, taking people for trips and giving them holidays. This was a matter of considerable amplitude. It is a tragedy that the Menzies Government has so reduced the concept of physical fitness under the legislation that it has not been given its full scope. We have not seen physical fitness extended to matters such as lung cancer and to all sorts of other matters which affect the physical fitness of this community. It is time that something was done in this regard. There ought to be far more than £100,000 spent on it. The Government ought to be spending far more money on more things than it is spending today.
The activities of the Menzies Government in this field might be summed up by saying that there has been too little spent and that it has been spent too slowly. The Government has had far more regard, in matters of public health, to cattle than it has had to human beings. If one looks at Document B one will find under the Department of the Health that there is provision of £206,900 for cattle tick eradication and control in New South Wales. I do not deny that that matter is extremely important. I am well aware of the importance of it. In some ways it is a pity that so little money is being spent on it. I understand that there has been a reduction in the amount over the years. But when one turns to the amount being spent on other matters, such as research into cancer and heart disease in human beings, one finds that there is lamentable provision being made.
From questions which I have asked previously, it appears that last year the amount spent in the whole of the Commonwealth by every agency, private, Commonwealth and State, in respect of research into the prevention and cure of heart disease, was only £250,000, of which the Commonwealth contributed directly only £27,000, or much less than was contributed by another great country, the United States of America. So less money is being spent by the Commonwealth of Austrafia, including the States and private persons, on research into the prevention and cure of heart disease than is being spent on cattle tick eradication.
When one turns to cancer one finds that the provision last year for the whole of Australia was £180,000. The Commonwealth was not prepared to say how much of that £180,000 was contributed by it. That was the total amount of money spent in the whole of Australia from every source on research into the prevention and cure of cancer. It seems clear that, in the eyes of the Commonwealth, these matters which affect every human being and every honorable senator in this chamber are not of great significance. I have learnt from one of the medical men in the Senate that if one looks at all the senators in this chamber one can say that roughly 10 of the 60 will at some time suffer from severe heart disease and another 10 from cancer. So that before our lives are finished each of those diseases will prove to be for some of us the most important matter in our lives. Yet an extremely inadequate provision is being made in the Budget of the Commonwealth of Australia, which runs into a couple of thousand million pounds. The gross national income is, of course, very much more than that amount.
– How much is spent on this in (he United States7
– A great deal more, but it is the duty of each country which has the ability and the facilities-
– Do you know how much is spent?
– No. I ask the
Minister whether he will supply the comparative figures on the expenditure in Australia and in the United States of America?
Another matter on which I would like to direct a question to the Minister is the matter of smoking. He indicated earlier this year that there would be a conference of Commonwealth and the State authorities to formulate a campaign to educate young people against smoking. The. conference was held in March of this year. I would like to know what has been done in the matter since then. It is the opinion of a number pf honorable senators in this chamber that the Department is running dead on this matter. I would like to know how much publicity has been directed to young people, where it has appeared, where provision is made for it in the estimates, and how much is to be spent in this financial year on the educational programme against smoking.
I take it that the Minister and his Department have formed the opinion that this campaign should be conducted because there is a link between lung cancer and smoking. It is not a matter for honorable senators to decide. I suppose that many of us smoke. I do not, but I have some intimate friends who do. We cannot be the judges of whether smoking is a beneficial or a deleterious habit. The Minister has, apparently, decided on the advice given to him that there is a link between lung cancer and smoking. Some action ought to be taken to educate young people against smoking. It is no use saying that things are going to be done and then just dillydallying with them. If smoking is as serious as is suggested, then action ought to have been taken a long time ago to educate the young people against smoking, and there ought to have been plenty of publicity given to this matter.
– Have the States cooperated?
– Whether or not the States have co-operated, the Commonwealth has ample power of advocacy and it has ample legislative power. It ought to do something in this regard.
.- I refer to Division No. 250 - Administrative. I wish to raise the very important subject of entitlement under the pensioner medical scheme, and to refer to the limited category of eligibility. I raised this matter last year when we were discussing the estimates for the Department of Health, but unfortunately the debate was gagged before my question was answered. I now raise the matter again, because I suggest to the Minister for Health (Senator Wade) that it is very important. It often comes as a surprise to the average citizen to learn that not every age, invalid or widow pensioner is entitled to benefit under the pensioner medical scheme. Indeed, many age, invalid and widow pensioners who receive a full pension are not entitled to benefit under the scheme. That arises from the different test that is applied for eligibility under the pensioner medical scheme to that which is applied with regard to eligibility for pensions.
A pensioner may be entitled to a full social service pension, which is now £6 a week, notwithstanding that he is earning a small income. Even though a person is earning £3 10s. a week perhaps from the letting of a room, which is not regarded as property for the purposes of the merged means test, he is entitled to a full pension. But when it comes to eligibility under the pensioner medical scheme, the permissible income is £2 a week. So we have the extraordinary situation that means which do not count as income under the social service legislation are regarded as being income for the purposes of the pensioner medical scheme. An income of more than £2 a week is now enough to disqualify a pensioner, not in part but altogether, from entitlement under the pensioner medical scheme. I am sorry that Senator Wright is not in the chamber, because when I raised this matter last year he expressed some surprise when he learned that this was the situation and he suggested that the two provisions ought to be brought into line.
This is not a matter of mere passing interest, Mr. Chairman. It is one of great importance, because many people who are subsisting on their pensions and are living on the edge of poverty, having a small income of only £2 a week from some other source, are excluded from benefit under the pensioner medical scheme. Some time ago I asked the Minister for information about the number of persons who might be excluded from this benefit because of the differential means test. He told mc, on 15lh May 1963, that 720,277 persons in receipt of age, invalid, widow and service pensions and tuberculosis allowances were enrolled in the pensioner medical service. 1 asked him how many persons were ineligible to receive this form of assistance because their income exceeded £2 a week. He told mc in his written reply that that information was not available. He added -
At 3 1st December 1962 there were 96,060 pensioners who were not enrolled in the pensioner medical service. This figure includes those pensioners who, although eligible, have not chosen to enrol in the service–
I suggest there must be very few of those - as well as those not eligible for enrolment.
In answer to a further question he told mc that the average annual cost of providing medical services and pharmaceutical benefits for pensioners and their dependants was £17 2s. 3d. per head. So we have 60mc idea of the cost in which the Government would be involved if it were persuaded to abolish this unnecessary, arbitrary, anomalous and restrictive provision.
– And inefficient.
– That ls a good adjective, but it is not one that I had intended to use just now. I make a plea to the
Minister to have a good look at this proposition. 1 suggest that only two arguments can be advanced against it. Firstly, the Minister may ask where the Government is to get the money. We have some idea of what it would cost, because approximately 96,000 pensioners were not enrolled in the pensioner medical service in 1962. Let us take 100,000 as a round figure and let us take £17 as being the cost per person. That sum would be rather exaggerated, because it includes the cost of pharmaceutical benefits. Even if we take a round figure of £20 per head, the total cost would be approximately £2 million a year. I hope the Minister has a more accurate figure than that.
– I think the cost would be £1.2 million.
– That suits my argument a lot better. Tonight we heard Senator McClelland comment favourably on that part of the Department’s report which deals with the saving of money on the cost of drugs because of the cutting of prices and agreements reached by the Government with the drug companies. Approximately £2.7 million was saved in a single year.
– That was only because of public criticism through the Press; It was not because of Government pressure.
– I do not need to argue about it. It is a good start and it is welcome. It is good to see that the Government is facing up to the problem of saving money on the drug racket, even though in a limited way. The point I am making is that with that sum of £2.7 million we could provide a medical service for double the number of pensioners who arc still not enrolled under the pensioner medical scheme. That is a challenge to the Government. It ought to take up the challenge. Any argument based on expense is fallacious.
The only other possibility is that the medical profession is unwilling to see the scheme extended beyond the present limited category of eligibility. The Minister might be able to help us on this point. Judging by what 1 have heard, the medical profession would not be unwilling to extend the service! but would support the removal of the limitation if they were able to obtain increased fees for the service generally. Whether that is the general view of the profession or whether it is held by the Australian Medical Association or any other representative body of doctors I do not know. I think that at the moment they arc getting 12s. for a surgery consultation and 14s. for a home visit. I do not know whether that is a proper fee; but surely these matters could be negotiated. It is a blot on our national approach to health and on our pensions system to have this restrictive anomaly. I appeal to the Minister to consider the matter this year and to have removed a distinction that has no justification in logic. The removal of this injustice would be an act of humanity and would give a lot of needed assistance to many people who are underprivileged. The fact is, as I said earlier, that an income of over £100 a year from some other source makes the pensioner ineligible to enrol under the pensioner medical service. If such a pensioner fell ill, it might cost him a great deal more than £100 in any one year for treatment. This is a critical matter for people who live on the edge of poverty. As far as they are concerned this disgraceful blemish on our national health scheme cannot be removed too soon.
– I realise that time is running out for me and that I shall probably have to speak somewhat briefly on a number of iteres. I should like to conclude my remarks On the hospital system. There is no need for me to enlarge on the callous disregard, by and large, of the Commonwealth Government of the plight of those who are afflicted by mental diseases. The Government has been effectively thrashed on many occasions on this question, but there is one aspect of the subject of hospitalisation that I should like to mention. The attitude of the Government is morally indefensible’, even though it may have established its right legislatively. About 74 per cent, of the people of Australia are provided for under hospital benefits funds, and they receive a substantial contribution. In respect of pensioners who are entitled to benefit under the pensioner medical scheme, a payment of 36s. a day is made to hospitals, if no charges are made. Certain other people are provided for under the repatriation scheme. This leaves between 12 and 15 per cent, of the people in respect of whom, when in hospital, the Government sees fit to pay only 8s. a day, in contrast with the payment of 20s. a day in respect of persons who receive an insurance benefit of 16s. or more a day. This is morally indefensible, and I cannot understand the Government’s attitude. We have made representations previously on this matter, but the Government seems to be adamant. I shall be pleased if the Minister will say why the Government is so determined to discriminate between citizens, all of whom appear to be Australians, under the law of this country.
It is estimated that this year payment of Commonwealth benefit under the medical benefit scheme will increase by £6 million from £12.4 million to £18.4 million. In addition, last year £4.8 million was paid in respect of the pensioner medical service. It is estimated that this year the payment on this account will be just over £5 million. In the light of the enormous sums paid to medical practitioners and the amounts paid under repatriation legislation, it can be seen that in no small measure the Government accepts responsibility for guaranteeing at least a portion of doctors* accounts. I should like to know just what activity the Department of Health is engaged in with a view to lightening the burden without decreasing the efficiency of the service. Is the Department considering the possibility of making extra payments to hospitals that will provide full time specialists, who will receive salaries without charges being made to patients?
Is the Government still adamant that the maximum amount must be extracted from the beneficiary? There is little doubt that since the late Sir Earle Page introduced the so-called voluntary insurance, it has become, in effect, a form of financial blackmail, and people have to join funds if they can possibly afford the money. It was intended that fund and Commonwealth benefit would meet 90 per cent, of the cost of medical attention, but at present this cost is being met to the extent of only 63 to 66 per cent. Recently the Government saw fit to increase the benefit in respect of general practitioners from 6s. to 8s. and in respect of specialists, when patients are referred by general practitioners, from £1 to 25s. On a percentage basis, that has lightened the burden somewhat, but that will remain so only so long as medical fees are not raised. I know that the Australian Medical Association, through its State constituent committees, has endeavoured to impress upon practitioners that there should not be a rise in fees, but it has no authority to compel them not to raise fees. It will be interesting to see what does happen in this regard.
Senator Cohen mentioned the disability suffered by pensioners who are not entitled to the pensioner medical service. As honorable senators know, subsequent to November 1955, anyone in receipt of an income in excess of £2 a week above the pension was not entitled to the pensioner medical service. Each year we have made representations to the Government to extend to these people the benefits that it has extended to approximately 800,000 people under the pensioner medical service. lt would be interesting if the Minister were to tell honorable senators when the last conference was held with representatives of the Australian Medical Association as to the possible inclusion of those who are now excluded from the pensioner medical service. Honorable senators, as members of the Parliament, have a responsibility to authorise the expenditure of public moneys, and they are entitled to know just what did transpire at the last conference between the Minister or his representatives and the representatives of the Australian Medical Association. We will be interested to know the date of the conference and what transpired at it.
It is estimated that in the current year payments under the pharmaceutical benefits scheme will be approximately £41 million. To this must be added something over £7 million which will be paid by persons receiving medicines. This represents a Midas cave from which treasure flows not only to pharmacists but also to drug houses. Some honorable senators have implied that it was Government pressure which resulted in a saving of about £2.7 a year on drugs such as erythromycin and diuretics, but this did just happen to coincide, by and large, with intense activity and criticism in the columns of the Press.
If honorable senators throw their minds back they will recall that these so called voluntary reductions by drug companies, said by some to be the result of Government pressure, were coincidental with but certainly not accidentally associated with an outburst in various editions of various newspapers. I understand that the Government has sold one of the two firms that were expropriated as enemy property on the declaration of hostilities and that it is proposing to sell the other, if it has not already done so. When the Government is engaged in such a big way in underwriting the purchase of drugs, one wonders why it saw fit to sell those enterprises which, I take it, were prosperous. I have not seen the balance sheets, but it would be unusual if the balance sheet of a manufacturing or wholesale drug firm were not favorable. Did the Government sell the enterprise as a matter of political philosophy or ideology or did it feel that it was not competent to run an enterprise of this type? Certainly it was an offspring of an overseas company, but I can see no reason why the parent company would not be prepared to negotiate on a royalty basis for the supply of its products.
Because the Government has sold this enterprise, it now has to buy from these companies drugs for which it must pay the maximum price. When we think of the niggardly approach of the Government to the Commonwealth Serum Laboratories we wonder whether the Government is sincere in trying to curtail the cost of pharmaceutical benefits and whether it is anxious to pare the profits of the wholesale druggists and the manufacturing companies. A review of the profits made by these companies in relation to capital invested is extraordinarily revealing. In many cases, the return is particularly high.
The drug manufacturers counter criticism by saying that they spend a tremendous amount on advertising. Certainly, they spend a large amount on advertising and on research but when you study the advertising, you appreciate the extraordinary cost that must be associated even with the class of paper that is used. You realise then that the cost is almost totally unjustified. I do not say that the drug manufacturers should send out the results of their research work to medical practitioners on the cheapest paper. On the other hand,
I can see no justification for using the most expensive type of paper for this purpose.
Over a recent period - I do not know whether this was the result of criticism emanating from certain quarters - there appears to have been a reduction in the number of samples that have been distributed. Some of these drug manufacturing firms must know that in a tremendous number of cases the only place for these samples is the wastepaper basket in the doctors’ consulting rooms. There is a tremendous wastage. AH this goes into the cost of the drugs. This, added to the excessive profits made by the drug houses, makes for extraordinarily high prices which the Government has to pay for drugs and which the people, through the Government, have to pay for benefits to which they are entitled.
I am not saying that samples should not be made available for clinical trial but at least the manufacturers should make them available to those who are interested and in an environment in which the value of these drugs can be capably assessed and represent a contribution to clinical medicine. Then we will get somewhere.
Senator Hannaford mentioned side effects of drugs. It has been proved overseas that some firms are somewhat casual in their assessment of the results of research. They are prepared to release drugs before their clinical value is really known in association with possible ill side effects. Senator Hannaford mentioned the oral contraceptive pill and the Minister for Health (Senator Wade) asked what were the names of these products. I do not know the names of them but I do know that many overseas authorities are interested in the possible side effects. I understand the best oral contraceptive is still: “ No “.
Let us consider how much this is going to cost the nation in relation to services rendered. What is the value received by the people?
– Order! The honorable senator’s time has expired.
– I associate myself with the statements made by Senator Murphy on the pensioners medical scheme. The case has been well expounded by honorable sena tors on the Opposition side but we did not get a satisfactory reply from the Minister for Health (Senator Wade) because of the gag. I wish to avoid that on this occasion.
I thank the Minister for the way in which he received my submission for a dental health scheme but he completely misunderstood what I had in mind. I did not suggest that the dental services provided under the United Kingdom health scheme should be incorporated in Australia’s national health scheme. I said that the health scheme should include some efficient dental attention. The Minister’s answer was completely negative.
I asked the Minister for information on the Bureau of Dental Standards. I asked him what was the actual work of this Bureau. I asked him to say whether it was possible for the Bureau to set dental standards and make them known throughout the Commonwealth so that the people would know what was a good basic standard for dental treatment and the treatment of mouth diseases and what was most required in such services. My questions were positive. I .wanted to know whether the Government’s expenditure on dental health was limited to the £15,500 which is provided for the Bureau of Dental Standards. I ask the Minister again to give me a positive answer. Is there any other expenditure through the Department of Health on dental health and care of the mouth? Senator Murphy showed clearly that the Commonwealth Government has power to legislate for medical and dental health. A service cao be operated. The power is there and there is no need for evasion. Will the Minister state whether it is possible for us to move in any way to get the Commonwealth Government to help the people in this way? The provision of a dental service affects 50 per cent, of the people, particularly the juvenile section. Can assistance be given towards the dental care of the people by Commonwealth Government activity or expenditure?
.- I am sorry that I did not answer Senator Cooke’s specific inquiry regarding the Bureau of Dental Standards. He asked what were the functions of the Bureau. The Bureau has four main functions in which it is engaged. These cover original research into dental equipment, materials, techniques and processes. That, of course, is most important because the Bureau is in a position to advise the dental profession and manufacturers, and all those who are interested in trading in dental equipment, on techniques and processes. There is great value in what the Bureau is doing in the processing field. The Bureau is established in Victoria and if any honorable senator would care to inspect it, he or she will get a welcome there. I am sure that any visitor will be impressed with the interest of the staff in their work and the quality of the work that is being done. It is difficult to describe this work because it is technical. I have been to the Bureau several times and extend an invitation to honorable senators to visit it.
– How are the results of the research work done by the Bureau passed on to the community?
– In consultation with a committee representative of the Department of Health, the Australian Dental Association and the Standards Association of Australia, developments and specifications for dental materials and equipment are made available. I think that answers the honorable senator’s question. Its objectives also are to carry out surveys of dental material on sale to the profession in Australia, to submit reports to recognised Australian scientific journals and to provide a consultative service and testing facilities for local manufacturers of dental materials. This is a service that is typically a Commonwealth service. Tt would be too much to expect a State instrumentality to set up such a bureau, and a good deal of overlapping would result if all States embarked upon the same project. As I have said, this is a. Commonwealth service that is rendered to the States and to individuals in the profession in the States. I am confident that the work being done by the Bureau is receiving great commendation from those who are benefiting from it.
Senator Murphy made a plea for some Government activity in the campaign to inform the younger generation of Australia of the hazards of smoking. He suggested that the Department was running dead. I would remind the honorable senator that in this particular field the Department does not enunciate or formulate policy. It carries out Government policy. Therefore, the charge cannot be laid against the Department, and I am sure that the senator will take great pleasure in shifting the charge to the Government. I remind him also, however, that the charge against the Government cannot be sustained for the very good reason that the last conference between Commonwealth and State Ministers for Health on this subject, held last February, decided unanimously that there would be a joint campaign by the Commonwealth and the States. A party to that agreement was the much quoted and highly respected New South Wales Minister for Health. The reason for a joint campaign is perfectly obvious because in some fields our powers in relation to publicity are limited and in other fields State powers are limited. It was agreed that there would be no compulsion. We agreed unanimously, I repeat, that a campaign would be undertaken jointly to inform the young people of the hazards of smoking.
– Well, what has been done?
– If you possess youseif in patience I will tell you what has been done. As recently as last Friday I had further discussions with a State Minister who was acting as the liaison between the Commonwealth and the States in this matter. We have tried, with some success, to determine spheres of influence. The planning is continuing. You may criticise the time lag. I do not deny you that.
– A lot of young people have started smoking since you said you would institute the campaign.
– That is true. Unfortunately, young people will start smoking regardless of what we do, but we will still make an attempt to inform them of what is involved if they smoke to excess in their youth. I do not deny you the right to criticise. Neither should you deny me the right to come up with an effective campaign, a well-considered campaign, a campaign that will meet the needs of the young people of Australia. For my part - I say this as kindly as I can - I will not be stampeded into going into this thing unless it will be effective.
Senator Cohen had something to say again this year about the pensioner medical scheme which, as he pointed out, has limitations inasmuch as those pensioners who have an income of £2 a week above the pension rate are not eligible for a medical entitlement card. I could say to the honorable senator that this is a matter of Government policy and not of administration, and therefore it could be argued that this is not a subject for discussion in the Estimates debate. But I do not adopt that attitude, and although what I am about to say has some limitations, I am certain that it will satisfy those honorable senators who have raised this matter. Senator Cohen has said - I emphasise that he has said this, not I - that there has been resistance from members of the medical profession who are not prepared to widen their service in this field because of the reduced fee that they receive compared to the fee received when attending ordinary patients.
– I asked whether that was a possible explanation. I do not think I made a direct allegation of resistance because I posed my statement in the form of two alternatives.
– I assure you that there is nothing sinister in my interpretation of what you said but I have never, in my capacity as Minister for Health, said that there was resistance. I am saying that you suggested that there has been resistance.
From that point I take you to a report in the Medical Journal of Australia “ which is not a public document but which is available for all who may be interested enough to read it. My understanding of an article published in the journal is that a committee was formed at the association’s last annual conference to investigate this problem. If, as you say, there has been some resistance, this could well mean a change of heart on this subject. The Government and my departmental officers have been doing some work on this for some time. As you know, the history of this means test is that the scheme was designed originally to provide a service for those who were in straitened circumstances. I believe that there are other factors today which demand that this policy be reviewed. I concede that. I know that I said that the amount involved was £1.2 million and that someone said that in a budget of £2,500 million this is just peanuts. But it is still £1 million. However, I assure the Committee that that is not the only factor that has been responsible for maintaining the present policy. All I want to say now is that this matter, has been exercising our minds for some time and the time may well come when it will be reviewed.
Senator Dittmer made some criticism of the fact that 14 per cent, or 15 per cent, of the people are not covered by hospital and medical benefit funds. I think the correct figure is 9 per cent, or 10 per cent, but do not let us argue over a mere 4 per cent, or 5 per cent. Be that as it may, the honorable senator asked in effect: “ Why do you not make provision for those people?” He criticised us because our contribution is only 8s. a day. To increase that amount to perhaps the £1 a day that we give to insured persons would weaken considerably the structure on which our voluntary health scheme is based. We have contended that the voluntary health scheme offers adequate cover for a very nominal sum. If we break down that principle and support people adequately - if that is the right word - who do not avail themselves of insurance, the time will come, perhaps overnight, when there will be no attraction left for people to insure themselves. Therefore, we say that there must be a very well defined line of demarcation between the service provided for those who insure themselves and that provided for those who will not do so. I make bold to say that when you refer to that 10 per cent, of the population, you should bear in mind that some people do not insure themselves because they have sufficient of this world’s goods to carry their own insurance. A balance remains, I know, but State Governments have responsibilities and accept them. I think it is pretty true to say that there is no real hardship involved. You may contend that the Commonwealth Government does not do enough in this field. I do not think anybody can criticise the State Governments in relation to this 7 per cent, or 8 per cent, of the population. I think honorable senators will concede that the Commonwealth Government makes a substantial contribution to the needs of the other 92 per cent, or 93 per cent. About 14 per cent, or 15 per cent, of pensioners are covered by the pensioner medical service, a percentage receives repatriation benefits, and the balance is included in the 72 per cent, who are insured for hospital and medical benefits.
– When speaking this afternoon I did not have sufficient time to refer to several matters in the Estimates that I shall refer to now. In Division No. 250, section 4, item 01, provision is made for a grant of £256,000 in respect of the World Health Organisation. The expenditure last year on this item was £227,000. It is apparent that the grant has been increased by about £30,000 this yean In this respect I refer the Minister to page 67 of the annual report of the Director-General of Health where reference is made to a proposed world health research centre to be established for the purpose of stimulating and accelerating research into major health problems. The report states that each country which becomes a member of the proposed centre will be asked to make a substantial annual contribution. I ask the Minister whether the increased grant of £30,000 this year is for the specific purpose of a contribution to the proposed research centre. If it is not, I ask what is meant by the Director-General when he uses the term “ substantial “ in his report. I believe that it is in the interest of Australia to belong to a body such as that proposed.
Earlier this evening Senator Murphy referred to the problems of cancer and heart disease. I understand that a recent World Health Organisation survey showed that Australia has about the third highest percentage of cancer and heart disease sufferers in the world. I think that only the United States of America and Scotland have higher percentages. Diseases other than cancer and heart diseases are referred to in the Director-General’s report; hepatitis, typhoid, smallpox and other infectious diseases could become of great importance to Australia in the future. If the increased expenditure in respect of the World Health Organisation envisaged in the Estimates is not for the purpose of contributing to the proposed world health research centre, I ask the Minister for what purpose it is intended. In any event, as the DirectorGeneral’s report states that a decision on Australia’s joining the proposed research centre will be taken later, I urge the Government to make a positive decision as early as possible. Many people, not only in Australia but throughout the world, could benefit from the scheme. We may all obtain benefits from the results achieved. In the interests of the Australian people I urge the Government to give favorable consideration to the proposal.
I refer now to smoking, which already has been adverted to by my colleague, Senator Murphy, and by the Minister. In this connection I refer to Division No 250, section 2, item 06. It is stated on page 21 of the Director-General’s report that specific powers are given to the DirectorGeneral of Health, or on appeal, to the Minister, in the field of broadcasting and television. I do not suggest that the powers set out in sections 100 and 122 relate to cigarette advertising, but I draw the Minister’s attention to a report in the “ Sydney Morning Herald “ on 9th June last that a Queensland cancer campaign organisation had approached cigarette companies in relation to the television advertising of their products. As a result, one major cigarette company agreed at the time to restrict its television advertising.
It was said that cigarette companies had been requested to restrict their television advertising to avoid influencing young people. The suggested restrictions were that advertising should be done at a time when it would generally be conceded that most young people would not be watching television and that no-one under the age of 25 years would be used as actors in the production of cigarette advertisements. I suggest to the Minister that it might be worthwhile for his Department to approach the cigarette companies on the same lines. I appreciate that the Minister has said that a joint campaign will be conducted by the Commonwealth and the States. I believe it is a very important matter and I urge the Minister to take it up with the States, the Postmaster-General (Mr. Hulme) and the cigarette companies to see whether an effective campaign can be launched along the lines I have described.
I now refer to Division No. 254, section 2, item 07, which relates to publicity and to pamphlets that have been prepared to explain to ‘ migrants the operations of the Australian national health scheme. I suggest that not only migrants but also many Australians are unaware of their entitlements from the Commonwealth in this respect or from the hospital and medical benefit fund organisations. I am aware that recently in a schedule to the Act the Commonwealth set out the benefits payable by the Commonwealth. I suggest to the Minister that his Department might give consideration to askingthe hospital and medical benefit fund organisations to set out details of the precise amounts contributors are entitled to receive from the funds in respect of medical or hospital expenses.
I refer now to Division No. 254, section 4, item 06, which relates to thalidomide affected children. Last year’s appropriation for this item was £1,500 and the actual expenditure was £897. An amount of £900 has been set aside this year as a contribution for the supply and repair of artificial limbs for these children. Recently in the “ Sydney Morning Herald “ there appeared a report that in London a team of surgeons and engineers–
The CHAIRMAN (Senator McKellar). Order! In conformity with the sessional order relating to the adjournment of the Senate, I formally put the question -
That the Chairman do now leave the Chair and report to the Senate.
Question resolved in the affirmative. (The Chairman having reported accordingly)
The PRESIDENT (Senator the Hon. Sir Alister McMullin). - Order! In conformity with the sessional order relating to the adjournment of the Senate, I formally put the question -
That the Senate do now adjourn.
Question resolved in the affirmative.
Senate adjourned at 11 p.m.
Cite as: Australia, Senate, Debates, 30 September 1964, viewed 22 October 2017, <http://historichansard.net/senate/1964/19640930_senate_25_s26/>.