27th Parliament · 2nd Session
The PRESIDENT /Senator the Hon. Sir Alister McMullin) took the chair at 10 a.m., and read prayers.
– I give notice that on the next day of sitting I shall move:
That the following Standing Committees shall be appointed, to be known, unless the Senate otherwise orders, as -
– Is leave granted? There being no objection, leave is granted.
– I have given notice of a motion which is important to the Senate. The categories of the committees as I have suggested them are not put forward to the Senate in a dogmatic way. I would be very happy to accept suggestions as to modifications of those categories or as to any other proposal before the matter comes on for consideration. I felt that it was important in the interests of the Parliament that a specific proposal be put immediately before the Senate. With that in mind I have brought the matter forward.
– I ask for leave to make a short statement on this matter.
– Is leave granted? There being no objection, leave is granted.
- Senator Murphy has given notice of a motion in relation to standing committees. I remind honourable senators of item 15 on the business paper, which relates to a report concerning standing committees which has been tabled in the Parliament. I think it is proper for me to say that the Government Parties have considered the proposal for the establishment of standing committees. When the matter comes on for debate it may be that views will be expressed by honourable senators on this side of the chamber in relation to what form, if any, the standing committees may take in the Parliament in future. It would be quite improper for me to speculate on the views that will be expressed in the debate, but I want to make it abundantly clear that while Senator Murphy has given notice of a motion and has expressed in it views as to the form he considers the standing committees may take, when the debate takes place - and we expect that it will take place before we rise - views will be. put from this side of the Senate as to the form of the standing committees. It is also my understanding that the Standing Orders Committee will be given an opportunity to consider item 15 on the business paper and any cognate matters arising out of it.
– I give notice that on 18th June next I shall move:
That the amendments of the Public Service Regulations as contained in Statutory Rules 1970, No. 42 and made under the Public Service Act 1922-1968 be disallowed.
That the amendments of the Military Financial Regulations as contained in Statutory Rules 1970 No. 46 and made under the Defence Act 1903- 1966 be disallowed.
I ask for leave to make a statement concerning the notices of motion I have just given.
– Is leave granted? There being no objection, leave is granted.
- Mr President, I have given notice of motion today relating to Statutory Rules 1970, Nos. 42 and 46. The provisions of these regulations are under active consideration at the moment by the Senate Standing Committee on Regulations and Ordinances and, as today is the last day for giving a notice of motion for their disallowance, I have given this notice in order that the Committee may have time to pursue its investigations further.
– I ask the Leader of the Government in the Senate: Is there any truth in the statement reported in today’s news that an executive of an Australian oil company has claimed that if oil refineries were stopped from exporting millions of gallons of petrol from Australia to avoid taxation in this country, motorists would pay less for petrol? In view of that reported statement, will the Government investigate this matter of taxation evasion and the possibility of providing lower priced petrol to Australian motorists?
– The honourable senator has asked me whether there is any truth in a statement made by an official of an oil company. Until I see the statement and evaluate it I would not presume to say whether it is true or false, or whether it is a wrong appreciation. As the question is framed I do not think it is suitable for question time. Obviously an official of an oil company has expressed a view. I would be perfectly happy to study the view he has expressed and to consider it, but it would not be proper for me to make a categorical statement on whether such a statement is true or false.
– You will look up the statement?
– Yes, I will.
– I ask the Minister representing the Minister for Primary Industry a question. I refer to the recent announcement that some Australian meat export plants had had their licences to export meat to the United States of America cancelled. 1 now ask the Minister whether any of those licences have been restored.
– The answer is no. As I told the Senate earlier in the week, the Meat Industry Advisory Committee last week set up a sub-committee to look at all immediate problems in regard to the mutton ban. The sub-committee will meet in Sydney on Friday and will report to the Meat Industry Advisory Committee next Monday. It is hoped that some of the works will be restored to the United States list fairly quickly, but at this stage it is not possible to forecast the exact time when that will happen. In order to be restored to the list the works, first of all, must be inspected by inspectors from the Department of Primary Industry who must then certify to the inspectors from the United States Department of Agriculture that the works are up to a certain standard. Then, should the works pass those inspectors, they are put up for relisting.
SenatorMcMANUS - My question, which is directed to the Minister representing the Minister for Primary Industry, refers to the statement that the governments of New South Wales and Queensland, and possibly of other States, are seeking discussions with the Commonwealth Government before the legislation introduced in the House of Representatives last week to give effect to the marginal dairy farms reconstruction scheme is advanced a further stage. In view of the vital necessity of a co-operative attitude from the States can the Minister give any indication whether the Commonwealth will agree to the requests of the States for the Commonwealth to meet them for discussions on this matter?
-BROCKM AN- Discussions on the scheme to which the honourable senator has referred have been going on for a great length of time. The Minister for Primary Industry has met representatives from the Stales on many occasions in an endeavour to reach some finality on this scheme. So far the only State that has indicated that it is at all willing to go on with the scheme is Western Australia.I am quite sure that the Minister would be willing to meet representatives from Queensland and New South Wales. I know that he has already met New South Wales Ministers on a number of occasions. But I shall take the matter up with him and try to obtain some information for the honourable senator.
– Has the Minister representing the Minister for Primary Industry seen reports in yesterday’s Press of a nationwide campaign to eradicate bovine brucellosis and tuberculosis? Can he say what part the Commonwealth Government is playing in this campaign and how much money, if any, it is contributing to the campaign?
– I did see this report from Perth. It arose out of a statement made by the Minister for Primary Industry last year in which he indicated the Commonwealth’s interest in this matter. I had a talk with the Minister this morning and he informed me that following a series of discussions with the Australian Agricultural Council the Commonwealth Government has agreed to support State efforts in the eradication of these diseases to the extent of$4.lm for the 3 years beginning on 1st January last. The Commonwealth will match the combined expenditure of the mainland States for this purpose. Tasmania receives special consideration because the 2 diseases virtually have been eradicated there. All States have indicated their acceptance of this arrangement.
The national brucellosis and tuberculosis committee, which is heading the nationwide campaign, will recommend the amounts to be allocated to each State out of the Commonwealth’s matching fund. These will be approved by the Standing Committee on Agriculture. The amount approved for the period from 1st January last to 30th June is $1.1m. The method of Commonwealth distribution is that the States will first spend out of their own resources what they are obliged to spend under the programme. Close to the time of a State’s money running out the Commonwealth will make available the full approved amount for that State for the periods mentioned. Funds already have been provided for Western Australia and South Australia.
– Has the Minister for Air received any reports from the team of specialists and other officers presently in the United States of America investigating the proposal relating to Phantom aircraft and the failures of the F111 aricraft? Have they resolved in part any of the issues which remain between the Australian and United States Governments including the. question of storage charges for the F111 aircraft? If not, when does the Government expect these reports to be made available to it?
– We have not received any reports yet from the evaluation team, if you like to call it that, which has gone to the United States. I do not expect to receive any reports until the team returns to Australia and makes a full report to myself and the Minister for Defence who then will take it to Cabinet. After Cabinet has discussed the matter a report no doubt will be made to the Parliament.
– How long will that be?
– I could not indicate that at this stage.
– Has the Minister representing the Postmaster-General seen a statement in today’s ‘Australian’ to the effect that the Postmaster-General has plans for Australian communications up to and beyond the year 2000? Can the Minister assure the Senate that top priority in those plans will be given to eliminating all those telephone exchanges which have restricted hours of service certainly not later than the mid-1970s, thus placing every Australian telephone user on the same basis of a 24 hours a day 7 days a week service?
– I can inform the honourable senator that the policy of the Post Office is to convert completely the Australian telephone service to the automatic system. I shall obtain detailed information for the honourable senator on the other matter he has raised.
– My question is directed to the Minister for Civil Aviation, ls it a fact that Qantas Airways Limited is experiencing difficulty in obtaining finance on the world loan market to confirm its options on 2 additional Boeing 747 aircraft? Is it a fact that Qantas may have to pay up to 12% for the necessary finance and, in addition, allow overseas airlines certain reciprocal entry rights into Australia? Oan the Minister advise the Senate Of the current position?
– None of the propositions which have been advanced by the honourable senator is factual, although he suggests that they might be. The matters which he has raised in his question are Serious and quite important. Therefore they heed to be studied very carefully. World interest rates are at a fairly high level at the moment. It would be undesirable for
Qantas to commit itself to a loan programme at interest rates which might make its business much less attractive. So Qantas is being careful about its borrowing programme and the rates it may be called upon to pay.
I have no information which would lead me to believe that a particular lender is trying to tie his loan money to reciprocal flying rights. One would regard it as being fairly reprehensible if a lender were to seek to do so. I am content at present to leave the judgment in relation to these matters in the hands of the board of management of Qantas, which is composed of extremely competent people. The Chairman of Qantas left Australia for overseas on Friday. One of the things he will be doing while he is away is examining the world position. As far as I am able to determine with my limited knowledge it would appear that there has been a tendency lately for some of the very high interest rates which are charged throughout the world to begin to come down. If I receive any further information at a later stage I shall inform the honourable senator accordingly. The honourable senator’s question is a serious one and I accept it accordingly.
– My question is directed to the Minister representing the Minister for Health. Do the Commonwealth Serum Laboratories intend to produce and market the recently announced vaccine which controls foot rot in sheep? If so, is it known when supplies of the vaccine will be available? Further, in view of the reported criticism by Dr Vernon Pleuckhahn, who is a pathologist at the Geelong Hospital, of the use of multi-dose hypodermic syringes as a result of 2 deaths in 1969 following injections of people with Hong Kong influenza vaccine, I ask: Have the Commonwealth Serum Laboratories taken any action to pack such vaccines in single dose disposable syringes?
– The honourable senator’s question raises a very important matter indeed. In order that I will be able to obtain a very detailed reply for him I ask the honourable senator to place his question on the notice paper.
– My question is directed to the Minister representing the Minister for Labour and National Service and arises from a reply he gave on Tuesday to a question asked by Senator Fitzgerald. The Minister stated that a persistent fallacy pervades the industrial movement that wage fixing tribunal assessments should be supported by some form of price control. He said that such a suggestion is idle because tribunals fix only minimum wage rates and these rates are weighted with millions of dollars in over-award payments. I ask the Minister whether, in view of his beliefs, he condemns any employer, including Commonwealth and State government departments and instrumentalities, who persists in regarding the minimum wage as being the maximum wage.
– Condemnation on my part of such an attitude would be completely inappropriate. The tribunal has fixed the minimum wage which is payable according to the economic circumstances of the day, which means that the law leaves it to the employer and his employees to decide at what wage the employment will be provided. I should think that it would be completely inappropriate for me to base any comment upon a general question which relates to a matter for their decision.
– My question is directed to the Minister representing the Prime Minister. As the General Assembly of the United Nations has designated 1971 as the International Year for Action to Combat Racism and Racial Discrimination will the Government make an early statement on whether it will actively support this decision, which would be in line with Australia’s subscription to the Universal Declaration of Human Rights?
– This question obviously should be addressed to the Minister for External Affairs. As the honourable senator would appreciate, Australia is a member of the United Nations and by virtue of that membership is a party to the principles and doctrines of the United Nations. However, I think the question should properly be answered by the Minister for External Affairs.
– I direct a question to you, Mr President. On arrival at Parliament House this morning I found myself faced, at the Senate entrance to the House, by a man wearing a uniform which I was unable to identify but which I took to be that of a private security service. He was carrying a rifle which appeared to be at the ready and which was pointed at me. This man was standing on the footpath alongside the door at the Senate entrance. In view of criticisms by responsible police officers regarding the activities of certain private security services and the carrying of arms by officers of those services, do you feel it is proper that private citizens should be allowed, in the precincts of Parliament House at entrances used by members of Parliament and others, to carry loaded firearms? By what authority are they there and what precautions are taken to see that persons entering Parliament. House do not become involved in some fracas which could be dangerous to them?
– It is not news to me that there is an armed guard at the Senate entrance to Parliament House when payroll money is being brought into the House. It is a well established practice for us to employ this security service. I think a question was asked last week either here or in another place about this matter. If the man offended the honourable senator by thinking he was a dangerous looking person I am sorry. ButI can assure the honourable senator that the armed guard is there with my full authority. He is there to protect the Commonwealth’s money when it is brought here to pay the staff.I see nothing wrong in that.
– Can the Acting
Minister for Immigration indicate what action has been taken to accelerate the processing of applications from Australian wives of non-Australian husbands who desire their offspring to be registered as Australian citizens under clause 7 of the Citizenship Act 1969?
– Yesterday Senator Mulvihill asked me a question concerning this, with special regard to the Sydney office. I had inquiries made and I wish to inform him that there is no backlog in the Sydney office of the Department of Immigration of applications from Australian mothers for registration of their children as Australian citizens. In regard to a particular case which I believe is of particular interest to the honourable senator, the position is that registration will be effected as soon as a further document has been lodged with the Sydney office of the Department. Action is being taken to assist the mother concerned in lodging this document.
– My question is directed to the Minister representing the Minister-in-Charge of Aboriginal Affairs. Is he aware that the Queensland Government is calling tenders for the mining of wolfram on Banks Island and that the island people are likely to receive a return of less than 50% of net profits? Will the Minister take appropriate action to ensure either that the islanders are able to mine the deposits through a locally formed cooperative or that they will be guaranteed not less than 90% of the net profit if the mining field is exploited by a private company?
– The honourable senator has made some very detailed inquiries. I would like to take this matter up with the Minister-in-Charge of Aboriginal Affairs and I will obtain an answer as soon as I can.
– My question is directed to the Minister representing the Minister for Primary Industry and it flows from a question I asked the Minister some few days ago concerning the existence of a professional meat lobby in the United States of America. I ask: Has the Minister anything further to report concerning, firstly, the existence of a paid meat lobby in the United States which is paid, as I understand it, from the resources of the Australian Meat Board, and secondly, is the Minister able to indicate whether any reports have been provided by this meat lobby concerning the present difficulties which have arisen over the ban on mutton Imports into the United States?
– I understand that (he Australian Meat Board does employ the legal firm of Clifford, Warnke, Glass, Mcllwain and Finney, which was appointed by the Board as legal representative and adviser to ensure that the Board and the Australian meat industry are kept fully informed of all legislation brought before the United States Congress, and to put the industry’s view before the United States representatives. I understand also that this legal firm does not concern itself with hygiene and inspection matters which are of concern at the present time. It is there purely as the legal representative and adviser of the Meat Board.
– My question is directed to the Minister representing the Treasurer. I ask: Is it a fact that the tax committee of inquiry known as the Hulme Committee recommended that for calculation of income for tax purposes depreciation claims should be allowed in respect of income producing buildings? From his own business knowledge does the Minister feel that there is sound reason to suggest that where commercial buildings are used for the purpose of producing assessable income depreciation must be calculated for business purposes and depreciation should be allowed as a deduction when calculating income tax? As at present this provision is not applicable to income tax paying companies, can the Minister give the reasons, and will the Minister give serious consideration to advocating such a provision for future income tax years?
– The first point that has to be considered in any reflection upon income tax, depreciation allowances or any other allowances is the revenue itself. Every government has to make up its mind as to the type of revenue it requires and the means by which it will get that revenue. In that context, therefore, any concessional allowances that may be given across the board have to be regarded, first as to the merit of the proposals and secondly as to the gathering of the revenue. It is true, as I understand it, that there has always been an argument in relation to the merit of the case for depreciation allowances not only in relation to buildings used for commercial purposes but also in many other fields. The question arises as to the time of depreciation. What would be fair depreciation in relation to a monumental building which will be there for 100 years, and in relation to a short term building? These are very complex matters. All 1 can give is the answer 1 have given so many times in the past, that is, that the question of tax allowances and concessions is dealt with annually at Budget time and I have no doubt that the Treasurer, having a look at his responsibilities and his requirements for governmental purposes, will consider all manner of possible allowances that have been put to him by way of representation in the Senate or in other places. I can only add that I will draw to the Treasurer’s attention the point of view expressed by the honourable senator.
– I direct a further question to you, Mr President, following my previous question. In your answer, part of which 1 take it you intended to be humorous, you said that the armed guard to whom I referred may have taken me to be a suspicious looking person. Do you think it appropriate that an armed guard of a private security service should judge whether members of this Parliament are suspicious looking persons or otherwise? Can you inform the Senate of the instructions that are given to these persons as to the occasions on which they may use the firearms which they carry in their hands? In what circumstances may the firearms be used and what precautions have to be taken if the armed guards decide to use the firearms? As this is the national Parliament, do you not consider that there is something to be said for an officer of either the Commonwealth Police or the Australian Capital Territory Police, whichever is appropriate, and not a member of a private organisation, mounting guard on the national Parliament?
– If my reference to the honourable senator offended him in any way f apologise to him for that. I had no intention of reflecting on him. I want to tell him quite firmly that the procedure here also is adopted by other government departments, lt is the responsibility of the authorities here to ensure that (he money is transported from the bank to Parliament House and that it is in safe custody while it is in transport. In view of the number of robberies that have taken place I think it is a reasonable precaution to have an armed guard. That is the reason why he is there. It is a custom that has been introduced in the last few years because of the outbreak of offences of this type. I have no intention of departing from the present policy of having an armed guard present while money is being brought into Parliament House. Again 1 say that if I offended the honourable senator I am sorry.
– I ask the Minister for Civil Aviation what is the present position of the tribunal under, I believe. Professor Isaac which the Parliament set up a year or two ago to deal with industrial issues affecting airline pilots. Can the Minister say whether it now appears that the pilots fight major industrial disputes by going on strike or threatening to go on strike because they realise the industrial power that they possess by virtue of the immense cost to the airlines of a lay-off? Is this method to be accepted as the normal method by which pilots achieve their aims?
– It will be apparent to honourable senators that later this morning a statutory rule which provides for payment to Professor Isaac will be debated. This matter properly comes within the ambit of the Department of Labour and National Service and will, be handled by my colleague. Senator Wright. Nonetheless, 1 may be able to help concerning some of the points contained in the honourable senator’s question. Professor Isaac acts as an arbitrator when the employer and the employee are unable to reach agreement on rates of pay and conditions. He has so acted in the past with, I think, very useful results, lt will be equally apparent that the technical aircrews of Qantas Airways Ltd from time to time have threatened strikes to pull the airline out of business. The honourable senator will understand that, as the responsible Minister, this has caused me quite a lot of concern. I have done what I can to be helpful to both sides, to both employees and employers, without in any way delimiting the ability of the normal arbitrator to act if the dispute is one concerning rates of pay. I suggest to the honourable senator that the matter should be left at its present stage of explanation. Industrial disputes are not necessarily helped at critical stages by a great deal being said about them, and I assure the honourable senator that to the extent that I am able to help I will try to do so.
– My question, which is directed to the Minister for Civil Aviation, follows upon the question asked by Senator McManus. I ask: Is it a fact that the current dispute has arisen because at the present time many pilots are working minimal hours while Qantas Airways Ltd is recruiting actively for more pilots7 Is it a fact that the real issue in the dispute is the question of maintaining some sort of stability for Qantas pilots in the future? Did I understand the Minister to say that he intends to help to resolve the dispute?
– A lot of what has been said by Senator McManus and some of the things that have been said by Senator Bishop have a great deal of application to the present dispute. But these kinds of problems are very complex. There are points on both sides to be considered, and at this stage I do not wish to go beyond that.
– My question, which is directed to the Minister representing the Minister for Health, refers to the Therapeutic Goods Act 1966, Act No. 29 of 1966, which I understand has not yet been proclaimed. Can the Minister inform the Senate why the Act has not yet been proclaimed and whether it is intended that it shall be proclaimed?
– The honourable senator is quite correct in saying that the Therapeutic Goods Act 1966 has not been proclaimed, because regulations which are to be made under that Act before it is implemented have not been finalised. That is the reason why the Act has not been proclaimed. But I would inform the Senate that the first proof of the regulations has been received from the Parliamentary Draftsman and some small amendments have been necessary. These amendments have been conveyed to the
Parliamentary Draftsman and it is expected that the regulations will be available during the next session of the Parliament.
– I ask the Minister for Civil Aviation a question. Has the Government given consideration to selling the service known as Qantas Airways Ltd in view of the fact that it has become a most uncertain service in its aircraft departures because of the rebellious attitude of its pilots and personnel, and also in view of the fact that these continual delays and disturbances to Qantas, which is an international operator, are giving Australia a very bad name with the international travelling public?
– The question really revolves around the proposition: Is the Government giving consideration to selling Qantas Airways Ltd? No, it is not. But I think 1 should add one or two other comments because obviously this matter is of great interest to the honourable senator. Qantas, as shown from its last published balance sheet, had, as at 31st March 1969, a total asset structure of approximately $240m, on what, I believe, were conservative valuations. The contribution to the share capital of that company made by the Australian Government on behalf of the Australian community was $40m. That means that approximately 16% of the company’s growth has come out of other than its own innate abilities, energies and drive and its use of borrowed money and the accumulation of reserves. In 50 years Qantas has built up to an international air carrier which ranks ninth in the world. It carries the Australian flag. It generates $67m a year of revenue to help the Austraiian foreign exchange position. It adds to the tourist capacity of Australia, lt is an important arm of Australia abroad.
Having said that, honourable senators will understand that for my part, and I hope with the co-operation and help of honourable senators, 1 am most anxious to see that the reputation of Qantas and its ability to perform are maintained at the highest possible level. That is why I do what I can at any level to try to see that the problems are overcome, lt is no part of a proposition of mine at any stage to back out of an Australian enterprise of which I am fundamentally extremely proud.
(Questran No. 86)
asked the Minister representing the Minister for Health, upon notice:
– The Minister for Health has provided the following answer to the honourable senator’s question:
- Senator Devitt asked me a question last Tuesday seeking information from the Minister for Primary Industry in regard to the ban on mutton exports to the United States. I have obtained the following information from the Minister:
All 76 meat works licensed by the Australian Government to export mutton to the United States were forbidden to export mutton to America from 14th May last.
It is hoped that some works wilt be restored to the United Stales list fairly quickly, but it is not possible to forecast exactly when this will happen.
The works must first be inspected by inspectors from the Department of Primary Industry who then make a recommendation to the U.S.A. inspectors, who then inspect the works before relisting them for participation in export to the American market.
The ban has been imposed due to impurities which have been detected in the mutton going to the United States. These impurities have included such things as wool, hair and similar foreign . matter as well as organisms which the Americans object to, but which are harmless to humans. These organisms are caseus lymph adenitis and cysticercus ovis. For short, they can be called C.I..A. and C-ovis.
– On 5th March, 1 970 Senator Fitzgerald asked me, as Minister representing the Minister for Education and Science, the following question:
Can the Minister representing the Minister for Education and Science inform the Senate, or obtain for the Senate, the number of Colombo Plan and private overseas students in Australia’.’ Can he tell us also what justifies the Austraiian Government’s bringing private students to this country when both universities and the governments in Singapore and Malaysia, whilst in support of Colombo Plan students, arc nol in support of the policy of private wealthy students coming here? Will the Government took further at this policy when so many thousands of our own students who hold the necessary qualifications are being refused entry to the universities, which have not the accommodation to admit them?
The Minister has now provided the following answer:
There were 10.029 private overseas students in Australia as at 30th April, 1968 from all overseas countries. This is the latest figure available. Statistics for 1969 are expected to be released by the Commonwealth Statistician shortly. There were also 1,534 Colombo Plan students in Australia as at 30lb April, 1968 and 1,478 as at 30ih June 1969. Private overseas students are admitted to Australia to assist their own countries by increasing their numbers of qualified people in areas of special need, as a contribution to the economic development, social progress and political stability especially of the region of which Australia is a part, indirectly the programme helps also to build good relations between their countries and Australia and to extend Australian students’ understanding of other peoples and cultures.
Normally students are only approved for admission to Australia to study where it is assessed that the proposal courses they wish to follow will lead to qualifications of definite value in their own countries.
So far as the Government of Malaysia is concerned, close consultations take place in respect of applications for entry from potential students in Australia and that Government is aware of each individual student application.
Close consultations also take place with the Singapore authorities in respect of applications for entry from that country.
Any opposition which might exist on the part of universities in Malaysia and Singapore to the training which is undertaken by private students in Australiahas not been made known to Australian Departments concerned.
A careful review of student policy was made by the Government in 1966 and since that time the number of private overseas students in Australian universities has remained comparatively stable, the figure for 1966 being 3,211 and in 1968 3,076. In fact in relation to the increasing Australian student population, this represents a proportionate decrease.
(Question No. 10)
asked the Minister representing the Minister for Shipping and Transport, upon notice:
– the Minister for Shipping and Transport has provided the following answer to the honourable senator’s question:
The final list of those who travelled is not an accurate reflection of those who were invited. Unfortunately a high proportion of those invited were unable to attend.
Neither a list of those who travelled nor those invited can be released without the express agreement of the State Governments concerned.
(Question No. 205)
asked the Minister representing the Minister for the Interior, upon notice:
– the Minister for the Interior has provided the following answer to the honourable senator’s question:
At about 8.30 p.m.on 18.2.69 when a small group of us were about to commence a barbecue and continue talking shop (having ceased duty at about 7.00 p.m. after attending a meeting requested by a group of Aboriginals) afight commenced in the camp. Within a few minutes the nursing sister in our company was called to the hospital to patch up the almost severed nose of a small child accidentally injured by a boomerang during the fight.
On the previous night she had been called out at 2.00 a.m. to an Aboriginal child, who was suffering from a painful ant bite (nothing more serious) and whose mother was worried sick because the child had screamed for some time before dropping into a sobbing sleep. You will be aware that this is not an unusual occurrence on settlements and missions and yet this sister was one of the persons of whom a well known Aboriginal leader recently said They are doing nothing. You might as well get rid of the lot’.
He belongs to a group of people who are becoming known as ‘Knockers’. Generally speaking they come from all walks of life. They are prevalent in the universities, the pulpit and in Federal and State Parliaments on both sides of the House and in the front and back benches. Their main habitat is the big city, not too far away from the comforts of air-conditioning, the theatre, television, pubs and night clubs, but they occasionally make fleeting visits to remote areas. You rarely find them in a remote settlement and never attempting to quieten a mob of skirmishing Aboriginals, stitching a broken head at midnight, or up to their elbows in a stinking epidemic of infantile diarrhoea. Despite their comments about Aboriginal housing and education, you won’t find them engaged in the difficult task of trying to educate these children who live in an environment not conducive to rapid eduction, or attemtping the frustrating task of training Aboriginals to occupy accommodation quite foreign to them, in fact their habitat is not the habitat and their endeavours not the endeavours of the people whom they ‘rubbish’ despite the inference that they have the answers to all these problems. In the field of Aboriginal welfare, they are particularly generous with hot air but conservative of elbow grease.
Unfortunately they deal in the sensational and in this capacity easily command the ear of press, radio and television. It is this rubbish which is read in newspapers by our staff and by their friends and relations. Their side of the story is rarely told in this medium and, therefore, rarely finds its way to the public as the medium in which it is told (the Annual Report) is rarely read by the bulk of the public. 1 believe our public relations is situated too far away from the source of information and more frequent bold denials of false statements should be printed but above all I believe that the morale of staff (settlement and mission) in remote areas could be greatly lifted by periodic reassurance to the public by our policy makers in Parliament, that they are not ashamed of us and’ that what we are doing is, in the eyes of Government, worthwhile and what is intended. This would help our staff bear ‘the stings and arrows …’ to which they are frequently subject’.
(Question No. 290)
asked the Minister representing the Prime Minister, upon notice:
Will the Prime Minister have tabled in the Senate any documents purporting to represent a request from the South Vietnamese Government, in 1965, for military assistance from the Australian Government.
– The Prime Minister has provided the following answer to the honourable senator’s question:
I refer the Honourable Senator to the answer given to a question without notice on 7 April 1970 (Hansard (Senate) page 549) and to the reply given on 27 October 1966 in the House of Representatives by the then Prime Minister to a question without notice (Hansard page 2257).
(Question No. 140)
asked the Minister representing the Minister for Health, upon notice:
With reference to the entry in the Hospitals Contribution Fund of Australia Report and balance sheet which shows an item of $500,000 - Public Hospital Loans, what are the details of these loan transactions and what is the rate of interest prevailing.
– The Minister for Health has provided the following answer to the honourable senator’s question:
The Hospitals Contribution Fund of Australia has furnished the following details of the Public Hospital Loans of $500,000 shown in the balance sheet for the year ended 30th June 1969:
The loans are in accordance with section 37 of the New South Wales Public Hospitals Act 1929, as amended, and are for a period of 15 years from 8th January 1969. They are repayable by equal instalments of principal and interest on a half-yearly basis. The interest rate is 5% per annum.
– Are Notices of Motion Nos 1, 2 and 3, Business of the Senate, formal or not formal?
– Not formal.
– In connection with Notice of Motion No. 1, Government Business, I move:
Question resolved in the affirmative.
– Having had discussions with the Leaders of the other Parties and without in any way reflecting on the blanket resolution, I now move:
That Government Business take precedence over General Business this day.
It is applicable only to today.
Question resolved in the affirmative.
– I ask for leave to make a statement relating to Notices of Motion Nos 2 and 3, Business of the Senate.
– ls leave granted? There being no objection, leave is granted.
– Mr President, on 21st April last I gave Notices of Motion Nos 2 and 3, Business of the Senate, standing in my name on today’s notice paper. At the time of giving these notices of motion, I. pointed out to the Senate that I was doing so in order that the rights of the Senate Standing Committee on Regulations and Ordinances to consider further the Regulations and Ordinances concerned bc preserved. Your Committee is actively considering these ordinances and regulations and in relation to the Australian Capital Territory ordinances Nos 7 to 13 has received a suggestion from the Minister that certain amendments could be made which would overcome the Committee’s objections. I propose asking the Senate to postpone the consideration of the motion for the disallowance of these Ordinances to enable the Minister to prepare these amendments.
In relation to the notice of motion for the disallowance of the Customs (Prohibited Imports) Regulations, the Committee is in the process of drafting a report to the Senate for its consideration and I will ask for a postponement of this matter to allow the Senate time to consider this report. Accordingly, I move:
Question resolved in the affirmative.
– In relation to Notice of Motion No. 1 standing in my name on today’s notice paper, there ls before the Senate the Thirty-first Report of the Standing Committee on Regulations and Ordinances, which recommends the disallowance of these regulations. The report pointed out that the regulations provided payment of salary and allowance for the person constituting the Flight Crew Officers Industrial Tribunal, and that these payments were to be retrospective over a period of almost 3 years. As the report stated, the Regulations and Ordinances Committee has always maintained that retrospective payments of this kind deny to the Parliament the right to approve or disapprove of expenditure when that expenditure is made. In its Twenty-fifth Report, tabled in November 1968, the Committee stated that regulations providing for retrospective payments would attract close scrutiny by the Committee and that retrospectivity extending beyond 2 years, unless quite exceptional circumstances are established to the Committee’s satisfaction, would be the subject of a recommendation for disallowance. Since the Thirty-first Report was tabled, the Committee has discovered that these regulations are objectionable on grounds other than retrospectivity of the payments alone. The regulations did not come into effect until January 1970, by which time, on the Ministers authorisation, over §8,000 had already been paid in anticipation of the regulations. These payments were made without any legal authority whatsoever.
The Senate will appreciate that the principle of parliamentary control of expenditure is violated by these regulations in a much more fundamental way than was set out in the Committee’s Thirty-first Report. Not. only has the Parliament been denied the right to approve or disapprove of expenditure but public moneys have been expended by the Minister without any authority, either explicit or implicit.
Such an issue has been before the Senate previously. In October 1960 the Committee pointed out, in connection with certain defence forces regulations, that over $100m had been expended without legal authority in anticipation of the regulations. The Senate on that occasion quite properly took the view that the regulations were objectionable, that they undermined parliamentary control of expenditure and that, therefore, they ought to be disallowed.
The same priniciple, though a lesser amount of money, is involved in these regulations. Whatever difficulties may have led to the delay in promulgating these regulations, the Senate ought not to countenance such a fundamental denial of the powers of the Parliament as is embodied in these regulations. The Senate ought not to countenance the expenditure of public moneys by the Executive without any authority given by Parliament, either direct or indirect. I trust that, for these reasons, the Senate will disallow the regulations. Accordingly, I move:
That the amendments of the Conciliation and Arbitration Regulations, as contained in Statutory Rules 1970 No. 1 and made under the Conciliation and Arbitration Act 1904-1969, be disallowed.
The DEPUTY PRESIDENT (Senator Bull) - ls the motion seconded?
– Yes, I second the motion. This has caused the Regulations and Ordinances Committee grave concern. Apparently, this is not the first occasion on which this sort df thing has happened. Nor has the Committee taken action, on the basis of retrospectivity, without previous warning. As Senator Wood, the Chairman of the Committee has just reported, our Twenty-fifth Report referred to our scrutiny of retrospective payments and the authorisation of payments after they had been made. On this occasion we found that payments were made without any authorisation at all.
As Senator Wood has pointed out, this point was debated somewhat fully on 4th October. In that case a huge amount of money was involved and legislation was introduced for the purpose of authorising payments that had been made without previous authorisation. I recollect from party discussions that the other chamber has before it at present a Bill that seeks to validate payments made to members of the defence forces since 1961. The Committee is somewhat concerned that it seems to be i habit for some executive authority to decide upon a payment or a salary, to pay it and to seek approval afterwards. The approval is not sought beforehand. It would appear that the Minister concerned accepts some executive body as a greater authority than the Parliament in deciding the amount of payment or salary.
The Committee sought an explanation from the Minister concerned. The Committee fust took objection to these regulations because they were simply submitted to it without any explanation or justification al all. They make provision for the Flight Crew Officers Industrial Tribunal to be paid $75 for each day of sitting in his home State and $100 for each day of sitting away from his home State. Notification of these regulations appeared in the Government Gazette’ on 15th January 1970. However, we find that appointment and payment have occurred since December 1967 but there was not an attempt to get Parliament’s approval of the payment by regulation until January this year. The effect of the regulation is that it seeks retrospectivity to 13th December 1967, the date of the appointment to authorise payment from that date.
We have gathered information to the effect that the Minister was in somewhat of a quandary at that time. There was turmoil in the airline industry when the Parliament agreed to legislation to set up a Flight Crew Officers Industrial Tribunal in October 1967. It was necessary, therefore, to find the correct man to act as chairman of the tribunal who would seek to iron out disputes in the industry. Professor Isaac was selected but before the appointment could be finalised Professor Isaac, or whoever we were seeking, would want to know the remuneration for the appointment. The Minister for Labour and National Service (Mr Snedden) has informed us as follows:
My predecessor, Mr Bury, had approved certain proposals for the remuneration and travelling allowance of the Tribunal and ad hoc Tribunals and these had been pui to the Secretary of the Prime Minister’s Department, Sir John Bunting (as a member of the Permanent Heads Committee which deals with such matters) by the then Secretary of my Department, Sir Henry Bland. Before it had been practicable to finalise these mailers it was necessary to appoint an ad hoc Tribunal to deal with a threatened strike between Christinas 1967 and the New Year. This was done and the strike was averted.
The whole procedure and the matter of salary seem to. have been referred to the Permanent Heads Committee, not the Parliament for decision.
In further explanation we received a minute from the Minister showing that for the period from 2nd February .1968 to 30th June 1968 payment amounted to $2,625, the first payment being made on 14th May 1969. The Department gives as its reason:
As previously explained, because of the acute industrial situation it was necessary to appoint the Flight Crew Officers Industrial Tribunal, Professor Isaac, before the Higher Salaries Committee of Cabinet had the opportunity of considering the fees recommended by the Minister for Labour a’nd National Service.
The first consideration of payment of a fee would appear to be consideration by the
Higher Salaries Committee of Cabinet on the recommendation of the Minister. The Department’s information continues:
In fact the Tribunal had been required to handle a considerable number of matters.
There is another point whichI, in association with employees in industry, do not quite understand. We were then advised as follows:
Further industrial trouble was being threatened by the Flight Crew Associations because they had become aware that Professor Isaac was not being remunerated for his services.
It seems so unusual to me that an association of employees is concerned that the adjudicator is not being paid a sufficient amount.
– What is the date of the communication to which you are referring?
-It is 20th May 1970.
– Are you referring to current concern or concern at some time in the past?
-I am referring to the occasion when the Minister made the first payment without authority. He justified it by saying that a payment had to be made then because the Higher Salaries Committee of Cabinet had not had time to consider the matter and it was urgent because further industrial trouble was being threatened by the Flight Crew Asociations following their becoming aware that Professor Isaac was not being remunerated for his services. In my association with the Australian Council of Trade Unions and various trade unions I cannot remember an occasion when a union has threatened industrial trouble because it was dissatisfied with the salary being paid to Mr Justice Kirby or Mr Justice Dunphy. But the flight crew apparently threatened industrial trouble because the person adjudicating upon their wage claims was not being paid for his services. I do not know whether Professor Isaac joined the Flight Crew Association and it was therefore responsible for the protection of his status or his remuneration. However, the threatened stoppage was one of the considerations which forced the Minister to act on that occasion.
– I think the honourable senator is doing an injustice to the
Association. I think that there was quite genuine concern.
– But it is unusual for working men to be so concerned about such a matter, regardless of whether they are flight officers. I suppose one of the things which caused the Minister grave concern was that industrial trouble had been threatened, because the Minister produced regulations which would permit the payment of a remuneration to Professor Isaac. Questions were asked earlier concerning Qantas Airways Ltd. It has been necessary for this section of the community - the Flight Crew Association - to take drastic action to protect the position of the appointee of the Minister because the Minister has not made any provisions for the payment of his salary.
– Perhaps the Government is paying him by results.
– If Senator
McManus is of the opinion that Professor Isaac will be paid by results he should support the disallowance of the regulation which is before the Senate, because there would then be no authority to pay him. The whole question revolves around the fact that a payment has been made without authority. This is not the first occasion on which payments have been made without authority. The Minister has failed to accept the advice of the Regulations and Ordinances Committee in its report that there should be close scrutiny and he has simply gone ahead and made such a payment. The Regulations and Ordinance Committee has said that the question of the payment of officials in higher positions is a matter which should come before the Parliament in the form of legislation. The amount was apparently decided on the recommendation of a committee which reports to the Cabinet on the salaries of officials in higher positions. In my opinion this is a matter for the Parliament to decide. 1 do not wish to express an opinion on whether the Regulations and Ordinances Committee is of the opinion that there is justification for the payment of this amount. However, I believe that legislation should be introduced in the Parliament concerning these payments so that the full facts are brought out. For far too long payments have been made by Ministers without any authority. At some stage the Parliament will have to take a definite stand. The Parliament is supreme over any committee. A frightening thought is that the Minister who decided to make this payment without any authority has since been appointed Treasurer. If he wishes to proceed to hand out money without authority I should imagine that in this position he would be better able to do so because he has greater access to the taxpayers’ money.
I am seriously concerned about payments which are made by the Commonwealth without authority. Secondly, I am concerned about the manner in which existing executive appointments are being made retrospective, which is in complete defiance of and contrary to the wishes of the Parliament. The Regulations and Ordinances Committee has discussed this matter of whether retrospective payments should be made. Such a payment can be made despite the fact that the Committee may recommend and the Senate may subsequently accept disallowance of the regulation. Let us have a look at what the Acts Interpretations Act 1901-1966 has to say about the control of regulations. Section 48.(1.) states:
Where an Act confers power to make regulations, then, unless the contrary intention appears, all regulations made accordingly -
shall be notified in the Gazette;
shall, subject to this section, take effect from the dale of notification or, where another date is specified in the regulations, from the date specified and
shall be laid before each House of the Parliament within 15 sitting days of that House after the making of the regulations.
Then a regulation becomes a lawful document from the time of notification or publication in the Gazette, and if it empowers anyone to do anything, then what is done is quite legal. When a retrospective payment is involved k is quite legal after the publication in the Gazette. Section 48.(4.) of the Acts Interpretation Act says: (4.) If either House of the Parliament in pursuance of a motion of which notice has been given within 15 sitting days after any regulations have been laid before that House, passes a resolution disallowing any Of those regulations, any regulation so disallowed shall thereupon cease to have effect.
There is a period after notification, that is publication in the Gazette, within which a resolution may be passed by the Parliament and if such a resolution is passed within that period the regulation has no effect. As the regulation we are now considering had provisions for retrospectivity the question is whether that did not justify the payment. The question is whether the payment had the force of law and will cease to have the force of law only if the Senate today disallows the regulation.
We have to consider whether the Minister’s action was justified because of the fact that the regulation was gazetted. This is a legal question on which we would like some guidance, lt involves the possibility of the Minister doing as he likes in disregarding the will of the Parliament. Let us consider a regulation which provides for retrospectivity to the extent of 12 months, lt would come into operation after gazettal. The retrospective payment would be made and then it could be disallowed by this Parliament. After a lapse of 6 months other regulations could be made and notified by gazettal and include provisions for 12 months retrospectivity. So the will of the Parliament could, by regulation, be completely defeated.
If this is a correct interpretation it would seem that there is some necessity to look at the Acts Interpretation Act and that regulations should nol become effective unless the Parliament has some say in the making of the regulations. A regulation with which the Parliament disagrees should never have the force of law. 1 realise the difficulties involved. 1 realise the necessity for regulations when the Parliament is not sitting. But I suggest to the responsible Minister that serious consideration should be given to this Act. I therefore second the resolution for disallowance of this regulation. If there is justification for the payment to Professor Isaac then we should have a full debate on this question of justification for a payment which was made without any authorisation at all.
– I support this motion for disallowance. As honourable senators know, I am a member of the Regulations and Ordinances Committee which is appointed from both sides or this Parliament to scrutinise regulations and ordinances. If these are found wanting under any one of several headings in our terms of reference we have to draw the attention of the Senate to the matter and move for disallowance if we think this necessary. With regard to the timetable of this particular set-up, the legislation to set up the Flight Crew Officers Industrial Tribunal was introduced in October 1967 and, 1 presume, was passed shortly afterwards. Now, Professor Isaac was appointed on 9th February 1968. That is well over 2 years ago.
– lt was October 1967.
– That was the Tribunal. Professor Isaac was appointed on 9th February 1 968. There was some trouble about the fixing of fees. ] am just going through the timetable so honourable senators will understand the full set-up. The fees were finally agreed to in about April last year, I understand. Instructions were then given to the Parliamentary Draftsman to provide a regulation covering these fees, lt was suggested that this regulation should bc gazetted in the final Budget session of the last Parliament before it was dissolved but owing to drafting difficulties the regulation was unable to be provided and was finally gazetted on 8th January 1970. The point I want to stress is that somebody somewhere along the line authorised 2 payments to the Tribunal in May 1969 knowing full well - it must have been known - that no regulation had been gazetted and no regulation was in force. I want to separate the 2 payments made in May last year. They come to a total of $5,775. That was in the last financial year. I. am at a loss to understand why it has not been reported on by the Auditor-General, I just cannot understand that.
On 1st July 1969, the first day of this financial year, another $1,350 was paid by somebody knowing full well that no regulation had been drafted, let alone gazetted. On 10th October 1969 a further $ 1,200 was paid. I want to make it quite clear here that we are not questioning the payments. The Tribunal was entitled to them; I think that would be generally agreed. We are questioning the way it was done under the terms of reference of the Regulations and Ordinances Committee. The second of those 1 payments was made on 10th October 1969 and the regulation was gazetted on 8th January 1970. On 23rd January 1970 a further $1,425 was paid and on 17th April 1970 a further $1,500 was paid, making a total of $11,250. The last 2 do not come into question at all because the regulation had been gazetted. I would just like to establish a fine difference in relation to retrospective ordinances or regulations, lt is all right, I presume, to make a retrospective regulation and authorise payment for a reasonable time in retrospectivity provided no payment has been made up till that date, but I believe that if a payment has been made it has been made without authority. That is one of the reasons why 1 believe the Auditor-General should have reported on it. J just cannot understand that particular aspect. 1 suggest that the only way now out of this set-up that has arisen is for the Government to pass a validating Act authorising these payments - all of them if the regulation is disallowed, or those prior to 8th January 1970 if some other action is taken. 1 believe there is no other way out of this. The money has been paid. We are not questioning the entitlement of the Tribunal to receive this money; I am not, anyhow. The other points, to my way of thinking, do not arise at all - the question of the urgent necessity to have the tribunal appointed, the threatened industrial trouble or anything like this - because they do not come within the terms of reference of the Regulations and Ordinances Committee. For that reason I support the motion for disallowance of the regulation and I suggest that immediate validating legislation be introduced to overcome the difficulty.
- Mr Acting Deputy President-
The ACTING DEPUTY PRESIDENT (Senator Sir Magnus Cormack) - You are not closing the debate, are you?
– No. I am opening it for the Government. It was only in deference to the anxiety that Senator Lawrie showed on rising that I did not rise to compete with him. At the outset I would say that the whole Senate will know that we in this chamber appreciate the vigilance which is shown in these matters which are drawn to the chamber’s attention by the Regulations and Ordinances Committee. But it will be a sad day if, because a report has been brought into the chamber, the members of the Committee will not be open to persuasion in the chamber itself with regard to the judgment that should be exercised as to whether the appropriate course in any particular instance is to disallow a regulation. It is to that aspect that I wish to address myself.
I remind the Senate that it was in October 1967 that this special legislation was brought through the Parliament for the purpose of creating a special tribunal to deal with the particular industry. The circumstances that persuaded the Parliament to pass that legislation were that there was considerable turmoil in a most vital industry. In that respect 1 would ask Senator Lawrie in particular, in view of his last remarks, to listen to the point of view that once legislation is passed that approves the appointment of a special tribunal, it would be a matter of grave concern if anybody suggested the deferment of the exercise of that tribunal and its powers just because there had been an administrative hitch with regard to gazetting the remuneration. So I would wish the Senate to consider that the industrial circumstances of the time made it imperative that the Tribunal should begin to operate.
As I say, the Tribunal was authorised by legislation in October 1967. The preceding December had seen the end of the disastrous strike by Qantas pilots and negotiations for settlement of disputes were being conducted under the threat of strikes and walkouts by pilots’ representatives. Even while the legislation was being introduced the pilots of the domestic airlines were restricting their flying hours in support of claims. There were a number of important matters in dispute and the intransigence of the parties indicated that if something was not done urgently these disputes would not be settled without further crippling losses to the industry. Voluntary procedures had been unsuccessful and there were signs that the industry was approaching a chaotic condition, lt was obvious that a system of orderly settlement of disputes had to be provided quickly. Hence the legislation. A tribunal, as honourable senators know, is a person appointed to deal with a particular industrial question. If the person constituting the tribunal is unavailable or if the office is vacant, an ad hoc deputy or substitute may deal with the question; so it is not merely one designated officer.
When it came to fixing the remuneration of the Tribunal, a number of difficult problems were encountered. Firstly, the office is a fairly unique and a very important one, but it is a special office within the arbitral machinery and it requires a person of considerable talents and experience, lt is unique because it is a part time office requiring constant availability to confer, advise, mediate or arbitrate to keep peace in the industry. The remuneration had to be such as would attract the right man and involved sounding out those who were appropriately qualified. However, before even tentative approaches could be made to possible appointees, it was prudent to ascertain the likely reaction of parties. One of the main reasons for the pilots’ boycott of the Commonwealth Conciliation and Arbitration Commission was that they maintained that its personnel were not competent to deal with the problems of the airline industry. With these considerations in mind, the former Minister for Labour and National Service approved certain proposals for the remuneration and travelling allowance of the Tribunal and ad hoc tribunals and these were put to the then Secretary of the Prime Minister’s Department, who was a member of the Permanent Heads Committee which dealt with such matters, by the then Secretary of the Department of Labour and National Service.
Before it was practicable to finalise these matters it was necessary to appoint an ad hoc tribunal to deal with a threatened strike between Christmas 1967 and the New Year, so that the legislation that came into operation in October required an ad hoc appointment to deal with a threatened strike in the 1967 Christmas season. Would anybody really say that that appointment should have been deferred until the regulation had gone from the Permanent Heads Committee back to the Department, through the drafting department, then to the Governor-General and into the Commonwealth ‘Gazette’? Because of further threatened industrial action, it became necessary to proceed without delay to the appointment to the Tribunal of Professor Isaac. He was appointed on 2nd February 1968. There had been further discussions between the Department of Labour and National Service and the Secretary of the Prime Minister’s Department, but these could not be carried further at the time because of the uncertainty created by the death of Mr Harold Holt, the then Prime Minister, and by the re-arrangement of officers involving a change over in that the Secretary of the Prime Minister’s Department, Sir John Bunting, transferred to the Department of the Cabinet Office and the new Secretary of the Prime Ministers Department, Mr Hewitt, came into office.
In the meantime, the Tribunal proceeded with matters requiring its attention. The Secretary of the Department of Labour and National Service took up with the Permanent Heads Committee a proposal that had been approved by the previous Minister and an examination of what should be paid proved more difficult than had been anticipated. In the event, it was not until 1st April 1969 that, the previous Minister for Labour and National Service received from the Prime Minister (Mr Gorton) advice that, on behalf of the Higher Salaries Committee of Cabinet, he had approved the recommendation of the Permanent Heads Committee. Instructions were given in May 1969, with reminders going to the draftsmen in August and again in October - during, our Budget session, I remind honourable senator - and it proved impossible for the draftsmen to formulate the regulations before we rose last year, earlier than usual, for the election.
The draft regulations were produced to the Governor-General on 8th January 1970 and notified in the Commonwealth ‘Gazette’ of 15th January 1970. As honourable senators know, the regulations provide for a fee of $75 a day for a person constituting the Tribunal, $100 a day for persons appointed by the Minister to deal with a particular industrial question, and travelling allowance at the rate of $21 a day. Broadly speaking, these fees are payable in respect of a day on which the Tribunal or ad hoc tribunal, as the case may be, formally sits to deal wilh an industrial question. These fees and allowances are back dated to 13th December 1967 because of the appointment on that day of an ad hoc tribunal to deal with the threatened strike at the end of 1967, which I have mentioned already.
– Was the ad hoc tribunal to which you have referred Professor Isaac or somebody else?
– No. it was another person who dealt with the threatened dispute at Christmas 1967. In its consideration ) ask the Senate to bear in mind several factors. Firstly, this is not a case in which regulations impose liabilities either by way of taxation or of attempting to impose anything in the nature of a punitive liability or an adverse liability on citizens. In that regard I call to the minds of honourable senators the provisions of the Acts Interpretation Act. All honourable senators have a lot of regard for its provisions because they were handed down during a great constitutional crisis of previous days. 1 submit that broadly they indicate the substantial considerations that are relevant to a position such as this. if honourable senators consult section 48 of the Act they will see that regulations of a retrospective character cannot bc made. They are void if they attempt to impose a tax or penal liability retrospectively on the subject, but the Commonwealth is specifically exempted from any such invalidity because the Commonwealth, as a payee, expects not to be subject to merely legal obligations. But if the Commonwealth hud asked people to perform services for it before all the legal requirements have been complied with, the Parliament would expect the Commonwealth even by retrospective legislation, whether primary or subordinate, to honour that obligation. The first point is that no taxation or punitive liability is imposed on anybody. Secondly, the regula-Hons do not alter the Commonwealth’s commitment. When the legislation was enacted, it was quite obvious that persons appointed under the legislation had to be remunerated.
As previous speakers have said, the quantum of the fee is not in dispute today; it is only the principle upon which argument is being offered. Thirdly, if these regulations are disallowed it will be necessary to enact legislation to provide for past services in addition to making new regulations. Viewed against the many important matters with which Parliament has to deal, it is suggested that that procedure is not appropriate in this case. The reason why I put that to the Senate for ils consideration is that Senator Lawrie has pointed out that 2 of these payments were made in May 1969. They involved $5.600-odd. In the Appropriation Bill which we passed last year, at page 60. Division 30. subdivision 3, item 03- relating to the Flight Crew Officers Industrial Tribunal, we see that fees and expenses were appropriated by this Parliament to the extent of $10,000 - more than covering the payment that had been made to the officer during that time. In the Appropriation Act 1969-70, at page 60 referring to the Flight Crew Officers Industrial Tribunal we see that fees and expenses were appropriated to the extent of S7.000. 1 have no doubt that Parliament in dealing with a Bill would exercise its judgment as a Parliament, and the Senate, as one House of the Parliament, has already made its judgment upon the propriety of the appropriation of that amount of money. Hence, when we come to consider whether payment”! have been made without any legal authority, 1 point out that in April 1969 the Higher Salaries Committee approved of these fees and it was then necessary for them to take the form of regulations, the drafting of which resulted in a delay of several months. Then the Parliament in its full capacity - and the Senate no doubt discharging its duties in scrutinising the items that 1 have mentioned - has itself given, not a delegated judgment by any means, but a principal judgment by statute as to the propriety of the appropriation in this regard.
– Is not the Senate entitled to assume that regulations have been properly made authorising these payments?
– I am not imputing any assumption that any of us is entitled to make. I should think that the propriety of our judgment on the appropriation would bc little influenced by whether or not the regulations had been made. I should think that here on the floor of the Senate we would all take the point of view: Here is an appropriation of $10,000 and $7,000 for this special statutory arbitral tribunal.’ I should think that it is a matter of judgment on the substance of the question that we bear in mind. Then the very next thing to be considered is whether or not it is appropriate now to disallow a regulation which was made in January of this year authorising the payments as from October 1967.
– With respect, only a legal mind could put it that way so well.
– Senator Webster, I would not consider justified any imputation adverse to the legal mind. It is known that the legal mind can be used for improper purposes, but I am sure that Senator Webster is not suggesting that. All I am saying is that when the jury has spoken - when the whole Senate has spoken - I should think that the preliminaries of the magistrate would be of little account. However, the Senate has been very patient in hearing me, and that is the only thing I expect. Having heard me, it is for the Senate to judge the appropriateness of the course suggested by my friend and colleague Senator Wood this morning. In a matter like this where the regulation does not adversely affect the rights of parties but merely implements the right of the tribunal, because the Commonwealth is honour bound lo pay the officer I should think that the only purpose of the Regulations and Ordinances Committee in bringing the matter before us is to note that there were deficiencies of an administrative nature in the preliminary procedures and to call our attention, quite properly, to the requirement that these administrative procedures ought to be dealt with more punctiliously and punctually. But having done that, do we just disallow a regulation that will give a basis of invalidity for the payment that has been made for services rendered by a tribunal of high responsibility, whose authority should not be questioned or brought into discussion of an industrial matter, anyway, if it can be avoided?
– Does your proposition involve that if the Senate disallowed this regulation today there would be validity for these payments in what appeared in last year’s appropriation?
– 1 have not considered that matter to the full. The validity of the appropriation would be unquestioned. If this regulation is disallowed, the administrative document to authorise the payment pursuant lo the appropriation would be disallowed as from today. So 1 find myself up against the complex question whether that carries invalidity back to payments that have been made by the application of the regulation even -though at the time it had not been gazetted. I think I have said sufficient to excuse me from giving a direct answer. I am not clear iri my own mind as to what the effect of it would be on a purely legal basis. But assuming in favour of the view that disallowance would invalidate the payment, which 1 would gather is the view of those honourable senators who have spoken in the debate up to date, I suggest that it is completely unjust to the tribunal that thay should be so, as to the past. As to the future, as honourable senators know the legislation now provides that these expenses must be prescribed. As honourable senators know, the Acts Interpretation Act provides that if this regulation is disallowed, no regulation which is the same in substance can be submitted again as a regulation unless this chamber rescinds the resolution.
I do not refer to the subsequent paragraph because I think it is inactive. If it is a case where disallowance has taken place because of expiration, then we have specifically to approve of it. What 1 am saying is that if the disallowance is made today, there will be a 6 months hiatus from now until the time when these travelling expenses and fees could be provided as required by statute.
– How long does it take to bring in a Bill?
– If that is thought appropriate, I do not contest that a Bil! can be brought in. I point out that the legislation of this Parliament at present provides that the remuneration shall be as prescribed. I am suggesting that judgment would dictate the acceptance of the view that having brought a matter before the Senate with criticism, the tone, the sting and the force of which have, not failed to penetrate even me, the purpose of the Committee has been fulfilled. I would urge upon the Senate’s judgment that great discretion which should pervade anybody possessed of power. Power sometimes is used more nobly in the restraint of its exercise than in its exercise.
– The Democratic Labor Party will support the motion far the disallowance of the regulation. We will do so as much as anything because of the very welcome assurance that we have been given by the Minister for Works (Senator Wright) that if the regulation is disallowed legislation to cover the matter will be necessary. I would hope that when the legislation is being considered the opportunity will be taken to examine the operations of the Flight Crew Officers industrial Tribunal. 1 am one of a number of people who have very grave doubts as to its efficacy. J think that without doubt it was conceived in a moment of panic. I question also whether in the appointment of the arbitrator the Government acted wisely. I do not question the efficiency, the ability or the integrity of Professor Isaac, but I question his experience in the handling and determination of disputes such as this. I feel that the Government would have been much better advised to have sought an arbitrator from the ranks of those people who are available in the community and who have had experience in the handling of industrial disputes such as this.
I am one of a number of people in the community who are disturbed at the fact that an industry which is of vital importance to Australia appears to be in a situation where, when the employees’ side desires certain action, it is becoming par for the course for it to say ‘We threaten to go on strike’, or to go on strike with the full realisation that the immense losses involved in every day of strike can enable them to force capitulation .There must be a point to which their demands are justified, but the feeling in the community at the moment is that they have now reached a situation where, like Alexander, they are looking around for fresh worlds to conquer, trying to think out new demands to make and to enforce because they have a stranglehold on the community.
I do not know if I read rightly in the Press, but the other day I saw a statement to the effect that a strike was being threatened because 2 pilots were going to be superannuated at the age of 55 years. I understood that considerable sums were given to pilots in superannuation for the reason that, as they claimed, by virtue of their onerous occupation they could become burnt out at an early stage of their careers. Having obtained astronomical sums in superannuation on the ground that they are burnt out at an early period of their lives, they then turn round and threaten to go on strike because 2 men may be superannuated as air pilots at the age of 55 years. I think we have reached the stage when we have to consider whether the community can stand by while an essential service is treated in this way. 1 had much sympathy with the pilots in the early stages because
I believed that they had a very difficult and onerous task. But. as 1 said before, I believe that there is a point of justice. I believe that they are destroying the sympathy of the community for their cause by the manner in which they are ali the time standing over the community and saying: You do this, or else.’ We have reached the stage when the motto of the Australian Federation of Air Pilots could be taken from that well known entertainer, Liberace: They cried all the way lo the bank.
– I identify myself with the motion moved by Senator Wood for the disallowance of this regulation. I support the motion which has been put to the chamber. As a member of the Standing Committee on Regulations and Ordinances I feel that I should make one or two brief observations on what has been said so far on this matter. I refer first to comments just made by Senator McManus. 1 believe that they might properly have been made on another occasion rather than at a time when we are dealing with a specific matter such as this where we are concerned with the appropriateness of making by regulation a retrospective payment. 1 do not dispute the right to raise questions of this nature, but I think we should deal with the specific question before the Senate in the particular circumstances that have come before us today.
The ACTING DEPUTY PRESIDENT (Senator Sir Magnus Cormack) - I would deprecate any further pursuit of argument as advanced by Senator McManus, but he was within his rights because we are dealing with the whole of the regulation.
– I am not disputing that; T am saying that there does appear to be a better time to raise a question which is so wide when we are dealing with a specific thing, that is, the retrospective payment. Senator Wright made some reference during the debate on the Appropriation Bills to a sum of $10,000 being provided and, on a subsequent occasion, a sum of $7,000 being provided for the specific purpose of funding the Flight Crew Officers Industrial Tribunal. I am not disputing what he said, but I suggest to the Senate that notwithstanding this appropriation it does not require that the expenditure of the money should be authorised by regulation. So far as I am aware there is nothing that would prevent the expenditure being given effect by legislation as has been suggested by the motion proposed by Senator Wood. lt should be made clear that at no stage is there any dispute or argument about the correctness of the procedure that has been followed by the Government in setting up the Tribunal. I believe that the circumstances were such as to require rather urgent action to resolve this industrial difficulty. I believe that the action which was taken was in ail the circumstances the appropriate action to be taken at the time. There is no dispute with that. Bearing in mind that it was necessary to get someone of wide knowledge and experience and an availability of time to fulfil this particular role, again there is no dispute at the decision taken being the proper decision. But we are concerned that a regulation has been introduced to give effect to the payment of salary and allowances. In the circumstances as we see them, surely no honourable senator would argue that where final arrangements for the payment of remuneration and allowances were made in April 1969, it should have taken until 8th January 1970 to produce a regulation to give effect to this decision.
What we are dealing with is not the establishment of the tribunal. There is no argument against the person appointed to the job. A.s a matter of fact, it is somewhat embarrassing to find ourselves in the situation in which the Government has placed us of having to argue the question of the way the salary of this person is to be paid. Administrative default having occurred on the part of the Government, the line has to be drawn somewhere. I believe that the decision of the Regulations and Ordinances Committee to disallow the regulations is the proper decision to be made. I think that the Government has to stand up to its own inefficiency in this matter, or the fact that it has not performed administratively as it ought to have done. It should accept the odium it has attracted. 1 think that the proper thing to do in the circumstances is to introduce legislation authorising retrospective payment.
– 1 will be as brief as possible. I have entered the debate not to argue the rights or wrongs of the case or its legalities, but just to mention to my honourable colleagues certain facts as I understand them and certain operating problems with which we must properly concern ourselves. The Flight Crew Officers Industrial Tribunal, as I understand this matter, deals with general air crew problems, domestic as well as those experienced by Qantas Airways Ltd in the international field. It is a labour and national service activity and not a civil aviation activity. Nevertheless, I hope you will welcome my intrusion into this matter. My study of the files shows that the Tribunal was appointed urgently at a rather critical time. The office was used in various disputes in order to try to resolve them. 1 have a history of the disputes which may assist honourable senators. 1 will give it as quickly as I can. In August 1969 Qantas received a log of claims from the Australian Federation of Air Pilots. In the log the pilots asked for very substantial salary increases of the order of 60%, which if granted would have cost Qantas about $.3m a year. They also wanted a number of changes in conditions of employment which would have involved the employment of about ISO extra pilots, representing a 20% increase in establishment, at an estimated cost of $3. 8m a year. There were a number of miscellaneous claims estimated to cost about $200,000 a year. After receipt of the log of claims Qantas proceeded to make a detailed study of it in the 30-day period allowed by the Conciliation and Arbitration Act for that purpose. It then held several conferences with the pilots, but these were disturbed in October and November by industrial troubles with the pilots concerning, firstly, the use of a steward on freighter aircraft and also on normal passenger carrying aircraft being moved without passengers for positioning purposes and, secondly, the matter of instant captains.
During this period of industrial unrest with the pilots Qantas did not proceed with negotiation of a contract. There was therefore a fairly long period - about 6 to 8 weeks - in which no negotiations took place. The conference with the pilots resumed in November 1969 which was coincidental with the time at which I took over my portfolio. Qantas then informed the Flight Crew Officers Industrial Tribunal - Professor Isaac at that time - that there was a great differential between the demands of the pilots and what Qantas would be prepared to offer.
Concurrently with the negotiations between Qantas and the Australian Federation of Air Pilots negotiations were proceeding between Ansett Transport Industries Limited and Trans-Australia Airlines, the domestic operators and the AFAP on a new contract covering salaries and conditions of service for pilots in the domestic field. I am giving this history because we are involved in operating difficulties, both past and future. I feel 1 am entitled to present them for the consideration of honourable senators. I will resume my general comments on the history of this matter. Although the general managers of Qantas, Ansett Transport Industries Ltd and TAA had met and agreed on an offer being made to the pilots by the airlines for a 10% increase in the first year, to be followed by ari increase of 4% in each of the 2 succeeding years, the AFAP called a 24-hour strike of Ansett and TAA pilots.
That was done precipitately, without notice, and consequently many people were left stranded. At the same time there was a threat that the strike would be extended. As a result the Federation of Air Pilots obtained from the domestic airlines settlement of a .19% increase in the first year, followed by increases of 3% in each of the 2 succeeding years. This settlement by the domestic airlines placed Qantas in a very difficult situation. Qantas asked the Flight Crew Officers Industrial Tribunal to assume control of negotiations between it and the pilots. Professor Isaac agreed to do so and proceedings commenced before him about mid-December and continued through January. They were completed on 10th February 1970. The proceedings concerned the issues of salaries, and the Utilisation Committee set up separately dealt with the various operating conditions. That Committee was established to consider the various claims made by the AFAP concerning hours of duty and so on.
The final argument was settled before Professor Isaac on the same basis as the domestic airline settlement took place. I have gone to the trouble of reciting that history because I believe that the Senate is entitled to have it. Any Minister is helped in the process of trying to do his job by the considered wisdom of his colleagues. It is obvious to all honourable senators that we are by no means through the period of industrial difficulty with the technical air crew of the airlines, and this situation persists. Naturally 1 am concerned about it. The Tribunal has in the past, no matter what may be said about it, been effective in bringing about a settlement. Perhaps it was thought that the settlement was too generous to the pilots or that the airlines did very well out of it. There are always 2 views of these things. Irrespective of that, settlement of a very expensive industrial dispute has taken place. I understand from my study that the previous dispute between the technical air crew and Qantas, which took a long time to settle, cost in revenue about $14m. So one does not treat these industrial disputes lightly.
I have taken a very careful note of what has been said by my colleagues, some of whom have had wide industrial experience. lt could well be that the services of the Tribunal will be necessary at any point of time to help in difficulties which al present confront us.
– What has that got to do with-
– With respect, Senator Cavanagh, it has something to do with the fact that the job of a government is lo be concerned with actions, with getting things done, as well as with points of law. I would nol wish lo be placed in a position, it’ it can be- avoided, in which the services of the Tribunal would be denied to the Australian community to help to settle an industrial dispute in the airline industry - a position which could be brought about by the Senate in its own wisdom, which I fully accept, setting the regulations to one side. Does this mean that the process available would not then be available? That is the point that I raise.
– 1 am afraid it is a case of pay up and smile.
– 1 do not put it that way. I entered this debate in the hope thai honourble senators would give some consideration to the problem, irrespective of whether they believe the Tribunal is efficient and irrespective of whether they quarrel with the person concerned and how he was paid. The fact is that in the past he has been very helpful. If you throw out these regulations or these rules will he no longer be able to act?
Senator GREENWOOD (Victoria) 112.3J 1 support the motion for the disallowance of these regulations. The Regulations and Ordinances Committee in recommending the disallowance of these regulations submitted its reasons in the Thirty-first Report of lb/; Committee, which has been tabled. That report drew attention to certain aspects of retrospectivity, lt referred to what had been said by the Committee in its Twenty-fifth Report. lt concluded by saying that in view of its Twenty-fifth Report and the fact that no explanation had been given of the high degree of retrospectivity of these regulations, the Committee had no alternative but to recommend disallowance of the relevant statutory rules, which are now before us. 1 believe that it is relevant - all the more so in the light of what Senator Wright has said this morning - to refer to the Twentyfifth Report and to some of the principles which consequentially must flow from acceptance of the principles set out in that report. I appreciate that much has already been said in the Senate this morning on the question of whether these regulations should be disallowed. Some of it bus been relevant; some of it has not been relevant. But I believe that, if only to emphasise a point and to indicate what I think should be the strongest possible objection to the course that has been followed, as solid an expression of opinion as the Senate is capable of making should be made on (his occasion.
The Twenty-fifth Report was tabled in the Senate on 28th November 1968. In that report these words appear:
For many years the Committee has kept a close scrutiny on delays which occur in the promulgation of regulations, and the consequent retrospective operation necessitated in some cases, wilh a view to minimising the incidence of retrospectivity in regulations, particularly those involving the payment of moneys.
Delay in the promulgation of regulations providing for the payment of moneys denies to either Mouse of the Parliament the right to approve or disapprove of the expenditure at the time of expenditure and, under these circumstances, the Committee is of the opinion that such provisions should, more properly, be embodied in substantive legislation.
The Committee then explained that it had been conducting inquiries over a long period and endeavouring to ascertain why these delays were occurring and why so many regulations with retrospective operation were being put forward. The Committee then said:
This report lias expressed the view of the Committee that delay in promulgation of regulations denies to Parliament the right to approve or disapprove of expenditure at the time of expenditure. It is for this reason that the Committee has, over a long period, scrutinised regulations involving payment of moneys which have a retrospective operation. In the 19th Report of the Committee, the principle was enunciated that, based on a desire to avoid any possibility of adversely affecting the rights of servicemen serving in overseas areas, a maximum period of two years retrospectivity could be accepted for exceptional cases, but that two years should not be taken in any way as a criterion for retrospectivity. ‘On the contrary, the Committee believes that retrospectivity beyond a few months is objectionable, and will continue its scrutiny on this basis’. Hie Committee now reaffirms the principles set out in the 19th Report.
The Committee then indicated guidelines which it said it would observe in its examination of such regulations. These guidelines, which were set out again in the Thirty-first Report, were as follows:
The Committee continued:
The Committee will continue, to scrutinise all regulations for payment of moneys which contain retrospective provisions extending beyond a few months, and will regard the retrospective aspect of such regulations as warranting some explanation.
That report was tabled in the Senate in November 1968. It has since been printed. Although no debate has occurred on it it has been quite apparent to the Committee in its subsequent consideration of regulations that the contents of that report are known in many places.
– But did the Committee at any time express the view that the consequence should be disallowance in each case?
– No, it did not presume to say what the Senate should do. lt certainly said that, unless an explanation were forthcoming to it, in the cases that were indicated in the guidelines, a recommendation for disallowance would be made to the Senate. But I am stressing that when these regulations were gazetted and circulated to members of the Parliament together with a so-called explanatory note there was no explanation whatsoever of why this retrospectivity was involved. lt was for that reason - the retrospective operation coming clearly within the guidelines which the Committee had set out in its Twenty-fifth Report and on which it was operating - that the Committee had no alternative, in the light of what it had said earlier, but to recommend the disallowance of these regulations. Let me say in passing that if there is point in having explanatory notes accompany regulations that are tabled in the Parliament those explanatory notes should explain what the regulations are about and, where there is an area that is so clearly a matter of concern, there should be some explanation of the reason for the retrospective operation. One sees far too frequently in these socalled explanatory notes a mass of words which give no explanation whatsoever.
But, having said that, I point out that the reason for the retrospective operation of these regulations was subsequently given to the Committee in a letter that it received from the present Minister for Labour and National Service (Mr Snedden). The circumstances explaining the retrospectivity have been referred to by honourable senators who have preceded me in this debate, and in particular by Senator Wright I for my part would believe that if that was all that was involved there would have been a case for the Committee accepting that explanation as being sufficient in all the circumstances. I express a purely personal view in that regard.
However, the very important fact that has arisen is that which arose as a result of an examination of the Minister’s letter to the Committee. It appears that, notwithstanding the absence of regulations, there have been paid to the person constituting the Flight Crew Officers Industrial Tribunal moneys which as a matter of law he should not have been paid. I sense the difficulty in which Senator Wright found himself in endeavouring to present to the Senate any justification for that course. I well appreciate the considerations that he has urged upon the Senate. But I believe that questions of expediency, which the adoption of his approach would involve, ought not to prevail over questions of whether lawful requirements laid down by the Parliament have been observed.
The basic reason why retrospectivity of any sort is bad where the payment of money is involved is. as the Committee said, that the Parliament is denied the opportunity lo disapprove of expenditure at the time it. is incurred. Naturally the payment of all moneys must ultimately have parliamentary authority either by an Act of Parliament or hy virtue of a regulation or executive authority made or granted with parliamentary sanction. Parliament may approve of past payments. It may approve of future payments. In every area Parliament has unquestioned authority. Likewise it may permit by regulation payments which have retrospective operation. It may also permit in appropriate language, an executive action that permits payments which have retrospective operation. But in all cases I believe that it must be for the Parliament to decide whether it will sanction payments for services rendered in the past or whether it will allow regulations or administrative procedures to sanction such past payments.
When one considers the Conciliation and Arbitration Act under which these payments were made it is interesting to reflect that there is no authority whatsoever, in my view, for a regulation of this character which sanctions payment in the past. The amendment of 1967 to the Conciliation and Arbitration Act which established the Flight Crew Officers Industrial Tribunal provided for the Governor-General to appoint a person to constitute the Tribunal. By section 88l of the Act it was provided:
The person constituting the Tribunal shall be paid -
such remuneration, whether by way of fees or otherwise- as is prescribed, and -
such allowances in respect of expenses- as are prescribed. 1 submit to the Senate thai the purport of that regulation and of any other regulation expressed in similar form is to envisage in the future what is to be paid by way of remuneration and allowances as laid down in the regulations. There is. I feel, a very strong argument to be raised that a regulation which purports to grant remuneration to a person for services which he has rendered before those regulations came into force has no power whatsoever. In this particular case payments were made from December 1967 until April this year and only payments made subsequent lo January this year, which were made after the regulation authorising those payments, had legal effect.
The Minister has failed to explain - this should be a matter of concern not only to the Parliament but also to the Government itself - why it takes 15 or 16 months to determine what amount the one person constituting this Tribunal is to be paid. As I understand the position, the officer was appointed in February 1968 yet it was not until April 1969 that there was a final decision upon which the draftsman could proceed to drafting as to what payments were to be made. Apparently from April 1969 until January 1970 it was impossible to have the regulation made which has come before us in the form of 3i pages of typescript. One would suppose that on reasonable application, if the Draftsman had the time it could be done with reasonable expedition. This is the area in which I appreciate the Minister finds difficulty in providing an answer. I am sure the Senate sympathises with him. However I feel it is equally proper for the Senate to indicate that this kind of situation warrants its objection and that such objection should be expressed.
There is one other aspect to which I wish to reply. The Minister sought to say that there is a validity in some way attaching to the payment which has been made - I hope that by using that expression I am not elevating his argument beyond the point to which he would want to take it himself - because in the Appropriation Act of 1970, as in the Appropriation Act of 1969, moneys have been appropriated for the Flight Crew Officers Industrial Tribunal. The Minister pointed to Division 370 sub-division 3, item 03, in the particulars of expenditure for the
Department of Labour and National Service where it is shown that in 196S-69 there was appropriated a sum of §10,000, and in 1969-70 a sum of $7,000. If an amount is appropriated in this form I fail to see how that represents in any way an authority for money to be paid contrary to the procedures for payment which the Parliament lays down. After all, the Appropriation Act is an Act In which the operative section is contained in clauses 3 and 4. Clause 3 of the Appropriation Act enables the Treasurer to issue out of the Consolidated Revenue Fund and apply for the services specified in the Schedule a total sum. Clause 4 provides that the sums authorised by the earlier Supply Act and by the last preceding section of the Appropriation Act which are to be issued out of the Consolidated Revenue Fund amounting to the appropriate sum shall be deemed to have been appropriated. Appropriation is simply the taking out of a mass of money amounts earmarked for particular objectives. That is done because the Constitution of the Commonwealth requires that there should be such an appropriation. Section 81 of the Constitution provides:
All revenues or moneys raised or received by the Executive Government of the Commonwealth shall form one Consolidated Revenue Fund, to be appropriated for the purposes of the Commonwealth in the manner and subject to the charges and liabilities imposed by this Constitution.
Section 83 of the Constitution then provides:
No money shall be drawn from the Treasury of the Commonwealth except under appropriation made by law. . .
The amounts referred to in the Appropriation Act are appropriated from the Consolidated Revenue Fund for specific purposes, but there is no law involved in the Appropriation Act which enables any part of those moneys to be paid out for any object. The mere fact that the Appropriation Act also provides that the Treasurer may issue out of the Consolidated Revenue Fund a total amount of money is, in itself, no law as to the purpose for which that money is to be applied. For the Flight Crew Officers Industrial Tribunal, as for the salaries of various other officers, as for many of the purposes which are established by statute, some parliamentary enactment is required constituting the law for which the moneys are appropriated.
I have said that under the Conciliation and Arbitration Act the Flight Crew Officers Industrial Tribunal is to be paid such remuneration and allowances as are prescribed. The Committee has directed the attention of the Senate to the fact that such prescription, such regulation, was not made until January of this year and that moneys paid prior to that date were paid contrary to law and without any statutory authority. Whatever appears in the Appropriation Act can have no validity to make valid that which is unlawful. It was for matters such as this that the Senate, 1 am sure, set up the Regulations and Ordinances Committee some 40 years ago to investigate and report on. In this particular case, because the Committee has recognised a problem of retrospectivity it has opened another area which T suggest should leave no question in the mind of the Senate but that it should object to the practice and require that a Bill be introduced to validate these payments. Not only is it right and proper as a matter of law that it should be done, but also there is nothing like one occasion such as this to ensure that in the future these practices, which may have administrative expediency to justify them - and very properly to justify them if you look at the objective to be achieved - should not be pursued when they are contrary to law.
The ACTING DEPUTY PRESIDENT (Senator Sir Magnus Cormack) - Order! I think that the Senate is tending to stray from the central point, that is inherent in Senator Wood’s motion. Senator Greenwood was within bis rights when he addressed himself to the proposition of the disallowance of the entire regulation. Senator Cotton, as the Minister concerned, replied. I call Senator Bishop and in doing so I rule thai any further discussion on this context will be out of order after Senator Bishop has concluded.
– 1 support the members of the Regulations and Ordinances Committee. Primarily I think it is clear that what they propose is correct. The regulations should be disallowed. The situation which has developed during the debate and which has been widened to some extent by what Senator McManus has said highlights the irresponsibility of the Government in advancing an amendment to the Commonwealth Conciliation and Arbitration Act to provide for the Flight Crew Officers Industrial Tribunal without taking proper procedures to ensure that the Chairman of the tribunal and others associated with it would be properly paid for their services. As Senator Greenwood has correctly pointed out. the amendments were made in 1967. Surely the Government is aware that since 1967 there have been a number of debates in the Senate concerning the principle of the Parliament having the right to ensure that moneys are correctly paid. I believe that it should be the responsibility of an officer appointed by the responsible Minister to ensure that a similar position does not occur again.
It is unfortunate that the issues involved in the dispute between the pilots, Qantas Airways Ltd and the Government have been raised in this debate. The first thing 1 want to say about this is that the setting up of the Flight Crew Officers Tribunal was a recourse by the Government to settle the disputations which had occurred prior to 1967 between the Australian Federation of Airline Pilots and the Government. At that time the Government threatened the pilots that it would bring them under the penal provisions of the Conciliation and Arbitration Act. Recourse was had to the Flight Crew Officers Tribunal because it was thought that it would prove to be a conciliatory body. I understand that by agreement between the Department of Labour and National Service, which is - or should be - a specialist in the industrial field, the air pilots and the Government it was agreed to appoint Professor Isaac as the Tribunal. I think it is unfortunate that Senator McManus saw fit to attack Professor Isaac this morning without having substantive evidence to. the effect that Professor Isaac has not performed his duties. Senator McManus said that the Tribunal and the industry might be better served if a decision were taken to appoint to the Tribunal one of the conciliators now employed by the Commonwealth Conciliation and Arbitration Commission. The only way in which this proposition could be proved would be to test whether one of the experienced conciliators would do a better job than Professor Isaac.
I wish to make the point that this morning the Minister for Civil Aviation (Senator Cotton) would not answer questions asked by honourable senators on this side of the chamber, including myself, about this matter. He said that it is under consideration. 1 believe that it is improper to accuse Professor Isaac of not being able to perform his duties. To my knowledge - and I stand to be corrected by those people in the industry who have had more experience in negotiations with Professor Isaac than 1 have - he has done a good job taking into account that this is a unique industry. The aviation industry is a most unusual one, and I believe that whatever remuneration pilots receive they deserve. Let us face it, they have a great responsibility. If the conciliation and arbitration facilities which are available in Australia at present are not adequate to solve the disputes which are occurring in the industry these facilities should be improved. Any improvements would have to be considered by the people who are involved in the industry and not by this Parliament, except in retrospect in order to determine whether the improved facilities are performing efficiently. However, I think it is unfortunate that this matter has been debated in the Senate today.
The only other thing J want to say, without extending the argument, is that, as I understand the situation, the current dispute - about which the Minister said little this morning - is based on strong grounds. The Federation of Airline Pilots claims that although many of its members are working minimal hours Qantas intends to employ a number of British pilots to fly aircraft which will be chartered to perform a job which Qantas has to do for the Commonwealth Government.
– At the same time the pilots argue that they are working beyond certain hours and that that is a strain on them.
– I do not know about that. I have been a member of this chamber for some years. I have also been a member of the Regulations and Ordinances Committee, of which Senator Wood is Chairman. I have noticed that whenever the aviation industry is discussed Senator Wood is always prone to be critical of the pilots. I think he is adopting an attitude which is similar to the attitude adopted by people who always condemn strikers.
– That is a very unfair statement to make about Senator Wood.
– I may be wrong, but as far as I can remember Senator Wood has been consistently opposed to the Qantas pilots whenever the aviation industry has been debated in this chamber. That is my impression. I do not know whether I am being unfair to him. All 1 am saying is that the aviation industry is an industry which has a number of unusual characteristics. Pilots have great responsibilities. Therefore the industry feels that specialists should handle its industrial matters.
When the Senate discussed the pilots dispute in 1967 it became very evident at that time - 1 remember the arguments which were advanced because ] discussed the matter with the pilots and took part in the debate - that the management of Qantas which discussed these matters with the pilots failed to discharge its duties in relation to the normal settling of industrial disputes. I do not think that it is the right approach for anybody to stand up and say that the pilots are in the wrong because they are holding up an important industry. That is all I wish to say on this aspect. I have tried to state a case for Professor Isaac who, as far as 1 am aware, was selected with great care. I. believe that he has performed his duties as well as might be expected having regard to the circumstances of the industry.
I come back to the point I made earlier, and I hope that the Minister will take note of it, that on too many occasions we see important proposals introduced into the Parliament - in this case it was introduced to meet an industrial situation - in the hope that the proposals will correct the disruption in the industry to which the Minister for Civil Aviation has referred, and then for some reason the department which originates the proposals fails to carry on its interest in the mission by way of suggesting to the draftsman that legislation ought to follow up the proposals as soon as possible to ensure that the responsibility to the Parliament is properly met. I do not wish to say anything further, Mr Chairman. 1 hope that this debate does not turn into a debate on industrial relations.
– Once again the Senate is indebted to the Regulations and Ordinances Committee. The Committee is living proof that the Parliament can supervise, administer and protect the rights of the people, regardless of whether it is their civil rights as individuals or their collective rights, which we should protect as their representatives. The Committee has been described as the most effective body supervising delegated legislation in the Commonwealth of Nations. I believe that that is true. The reason for this is no doubt the dedication and application of the members of the Committee, under the chairmanship of our distinguished colleague, Senator Wood. lt is apparent in this instance that the regular procedures for the payment of moneys have been flouted and that the Constitution itself has been flouted. The Minister for Works (Senator Wright) has attempted to defend the indefensible. If the Senate disallows this regulation, as I think it should, my concern is that it may not bc necessary to introduce legislation to validate what has been done in the past, which raises some very serious questions, lt is clear that some legislation will be necessary to meet the procedures required under the Acts Interpretation Act in regard to future payments. But my concern is in regard to the breach in the past, ft may well be that some attention will have to be paid to the question adverted to by Senator Cavanagh of the possibility of the device of retrospective regulations being made to cover back payments or actions in the past. Even though the Senate may disallow a regulation, nevertheless it may leave intact what has been done under the regulation.
Apart from the central subject of this motion remarks have been made about the Qantas dispute and what ought to be done. I. do not want to enter deeply into that dispute, and certainly not into its merits. No doubt Professor Isaac has performed his duty as best he could. I think it is apparent to the Senate that the Government did not perform its duty. The legislation was clear. A prescription was to be made. It was not made. If the Senate were to allow this motion to pass without exercising such power as it has to disallow the regulation, this would only encourage further action of this kind. It amazes me that the Executive continues to persist with its defiance of statements which have been made by the Regulations and Ordinances Committee in reports which have been endorsed by the
Senate. The vigilance of the Committee ought to be confirmed by salutary action on the part of this Senate. The Senate should perhaps go further than merely disallowing these regulations. The Senate may have to pass a resolution of condemnation if there is any repetition of such procedure which amounts not merely to a defiance of the Senate in its clearly expressed wishes but also to a defiance of the Parliament and a defiance of the Constitution of Australia. 1 support the motion.
– As the mover of the motion and as I. am now closing the debate I would like to thank honourable senators for their contribution to the debate which ensued as a result of this motion for disallowance of a regulation. Many interesting facts have been brought out during the debate. I am very thankful to Senator Lawrie for the way in which he brought out the various dates, indicating the considerable period of time the Government had to rectify this situation. It could have been done quite a long time ago. I think the debate has fairly well covered the subject. This debate, as I mentioned before, recalls to my mind the debate of 4th October when a sum of money was involved. I think 1 might have mentioned during my speech when I moved the motion that the sum of money was $100m. At that period of time Australia was under the old currency system and the amount was £50m, which was a considerable sum of money. At that time the matter was brought to light by way of disallowing the regulations. I think the Executive should be more watchful over the payment of money. I think it is an important function as far as the Parliament is concerned to have the right to say how moneys will be spent. This is the core of the matter on this occasion. The Minister for Works (Senator Wright) has probably found difficulty in certain respects. Over a period of many years he gave great service of very high quality and integrity to the Committee. I do well to record his great service to the Committee. I know that at al! times the work of the Committee has his very earnest consideration.
The Committee has considered this matter, lt should be stressed that the Committee has a legal adviser who is engaged to advise the Committee on these various regulations. It also has the advantage of the senators’ own views. The Committee’s work flows from its attention being drawn to certain matters by the legal adviser and also by individual senators who may be well versed in particular matters. The Committee at no time moves without a deep sense of responsibility for what it is doing. After the debate which has taken place 1 still feel that the Committee is on the right lines. It is most unfortunate that a former member of the Committee, Senator Bishop, who also gave very fine service to the Committee should have clashed with me over the Qantas pilots dispute. I draw his attention to the fact that it was not I who introduced this question in this debate. I hope it can be fairly said that at all times when dealing with the Committee’s work and in introducing motions as Chairman I have always tried to confine myself to the essential points of the debate. With those few words I close this debate. I feel that under these circumstances the Committee’s action is one which is entitled to the consideration of the Senate.
Question resolved in the affirmative.
Debate resumed from 20 May (vide page 1652), on motion by Senator Dame Annabelle Rankin:
That the Bill be now read a second time.
Upon which Senator McClelland had moved by way of amendment:
That the following words be added: ‘but tha Senate is of the opinion that, while the Bill represents some improvement, a National Health Insurance Commission financed from graduated contributions would pay for medical and hospital services for all more equitably and economically’.
And upon which Senator McManus had moved as an amendment to Senator McClelland’s proposed amendment:
Leave out all words after ‘that’, insert- in view of the fact that:
it is desirable in the national interest that the National Health Bill find maximum possible acceptance from all interested parties;
negotiations within the Australian Medical Association between various groups in that body have not yet succeeded in reaching an agreement; and
for the purpose of endeavouring to reach such an agreement a meeting of the Association has been called for 2nd and 3rd June, at which the Federal Assembly nf the Association will make a final endeavour to arrive at a formula acceptable to all branches of the medical profession and which will not be contrary to the interests of those who will benefit from the Bill, further consideration of the Bill be postponed until the outcome of this meeting is made known to the Government’.
[12.44] - When the Senate rose last night 1 was replying during the second reading debate on this National Health Bill. 1 said the Government opposed the amendment which had been moved by the Australian Labor Party. I spoke to that amendment. I also said the Government opposed the amendment which had been moved by Senator McManus on behalf of the Australian Democratic Labor Party, that I had quite an amount of information to give regarding that amendment but that I would give it when the Senate met this morning. I refer to the points which were raised in that amendment. In his proposed amendment Senator McManus moved to delay the debate to enable further negotiation to take place with the medical profession. Senator McManus has specifically proposed deferment of debate until after the Australian Medical Association has met on the 1st, 2nd and 3rd of June. He said that deferment would allow the Australian Medical Association to present a more complete view of the profession’s attitude towards certain aspects of the Government’s proposals. This in turn would allow the Government to make a more thorough examination of the profession’s attitude. I point out that this meeting of the AMA is the usual annual meeting, ft is not a special meeting as was implied last night. The Bill has already been deferred twice because of the differences of opinion that have come forward from the medical profession.
As recently as 8th May 1970 the Minister for Heal th (Dr Forbes) met representatives of the Australian Medical Association, the
Royal Australian College of General Practitioners, the Australian Council of the Royal College of Obstetricians and Gynaecologists, the Royal Australasian College of Surgeons, the Royal Australasian College of Physicians and the Society of General Practitioners, in an endeavour to solve the conflicting opinions within the medical profession on aspects of the health benefits plan and explore the possibility of adjustment to the plan based on agreement between various sections of the medical profession. The Minister advised these representatives that the Government was prepared to consider adjustments to the health benefits plan and within a framework - I stress that - which preserved the full interests of patients and the intention of the plan to provide both general practitioner and specialist treatment according to medical needs on the basis of the most financial help to the patient when it was most needed. I think that has surely been the whole point in which we have been interested.
Let me refer to some notes which 1 have been given by the Minister concerning the Australian Medical Association. This Association comprises about 14,000 members and it is a body representative of the whole of the profession. Us constitution and procedures are framed in such a way as to ensure the broadest possible consensus within the profession as a basis of Association polciy. The policy making body is the Association’s assembly which meets at least annually, lt is the parliament of the profession and comprises representatives of al) State branches and affiliated bodies. The federal executive and the federal council are obliged to conduct the Association’s affairs within the policy laid down by me assembly. The federal council is empowered to conduct a plebiscite of members whenever it feels that a matter on which the assembly has passed a resolution ought to be referred to the members for confirmation or variation. From 1965 until April 1970 the Association’s policy was that the rebates for services carried out “ by specialists in the practice of their specialty should be higher than rebates for such services when provided by general practitioners. This is the policy incorporated in. the Bill as it now stands. The AMA says that the basic objective of the policy so far as it was concerned was to ensure wider contributor satisfaction with the voluntary insurance scheme so that voluntary insurance would have a better chance of surviving political demands for a compulsory scheme.
When differential specialist and general practitioner common fees were announced by the AMA on 5th February 1970, and the acceptance of the differential benefits plan was announced by the Government on 4th March 1970, there was such a strong reaction from general practitioner groups that the federal council arranged a special assembly on 11th April 1970 to re-examine the Association’s policy. The outcome of this assembly was that the policy was modified to the extent that the AM A now supports differential rebate only in relation to the services provided predominantly by specialists, and furthermore on the basis that, where there is a differential, the patient’s share of the fee should be higher in the case of specialist services than in the case of general practitioner services. The federal council decided that the altered policy determined at the April 1970 assembly should be put to the membership by plebiscite. Members were asked to vote yes or no or refrain from voting. They were asked to do this on 5 questions, the one most relevant to this discussion being:
A higher schedule of benefits for services to referred patients by registered specialists should be introduced, so far as it applies to consultations, and those services and procedures which are predominantly performed by a specialist in the practice of his specialty. 1 would like to give the Senate some very interesting figures on this because up until now over 50% of the membership of the AMA has voted with the following results:
1 think these are important figures which should be noted. Having regard to the steps taken within the Association to determine a new policy, the federal executive is bound to refuse to agree to propositions being urged by the Royal College of General Practitioners and the General Practitioners Society that the differential rebates be eliminated from the Bill altogether. In this situation it is clear that there is no value in delay to allow a new examination of policy by the AMA. These are important points which I make to the Senate in replying to the amendment which was moved last night and which the Government opposes. There were some other questions which were asked last night to which I would like to reply. Senator Mulvihill asked me a question, as did Senator Lillico. Senator Mulvihill referred to the excess reserves which were held by some organisations. I did asnwer one of his questions last night.
– You answered one about the loans.
– But this is another one that the honourable senator asked to which I would like to reply. I would like to refer to the Minister’s statement of 4th March when he said:
The contribution rales payable under the new scheme will be determined for each fund having regard to its particular financial position, and on the basis that the reserves which some funds hold in excess of their requirements for financial stability will be gradually absorbed. Thus all funds in a particular State will pay medical benefits at the same rate but contribution rales may vary between funds.
This was re-affirmed by the Minister’s second reading speech when he said:
Under the new plan, contribution rates may vary as between organisations. The contribution rale to be charged by a particular fund will depend on an assessment of its future financial experience and the level of its reserves. A policy will be applied under which larger funds ‘free’ reserves - that is, reserves in excess of amounts held against unpresented claims and contributions paid in advance - will generally be limited to the equivalent of 3 months contribution income.
This approach, 1 believe, is very much along the lines put forward by the Senate Select Committee on Medical and Hospital Costs in its report. Before getting on to the questions raised by Senator Lillico I would like to answer a question which was raised by Senator Turnbull.
– You found out how to interpret that clause?
– I have indeed, but 1 am sure that the honourable senator has interpreted it himself. He referred to clause 8(5.), which reads:
Where a medical service rendered to a person includes a medical procedure that would, but for this sub-section, itself be a medical service, that procedure shall, in respect of that person, be deemed not lo be a medical service.
If the honourable senator then turns to page 70 of the Bill I draw his attention to example item No. 5577 which includes a medical procedure that is itself covered by another item number, for example. 5573. If he looks at 5573 he will see that there are a number of matters attended to there whichI will not try to pronounce in front of such a knowledgable and learned person. The benefit payable in respect of item 5573 is included in the benefit paid for item 5577. The clause provides that where a patient receives the medical services covered by item 5577, the Commonwealth and fund benefits for that item are payable and item 5573 does not apply.
– That could be removed and the Bill would not be affected because a different item is mentioned.
– I think it is very necessary because there are 2 items and 2 benefits. It covers cases in which there is one service and also where there are a number of procedures included in the service. It is a very complex matter as one will see on looking at the details. Senator Dittmer said that the Government appeared to be giving little attention to hospital care or to the various ancillary services. This is not so. That is certainly not the position. The Nimmo report contained a number of recommendations directed to hospital services and hospital benefits. The States have significant responsibilities in the provision of hospital services. Accordingly, negotiations with the States arc being pursued actively. I am confident that the Government will be able to bring forward reforms in the area as significant and as far reaching as those that the Bill provides in respect of medical benefits. The Government is proceeding with an examination of arrangements for ancillary services within the framework of the overall scheme.
Senator Webster raised a point about examinations by general practitioners. In reply, I point out that it is a long standing practice in the medical profession that examination by a general practitioner should precede attention by a specialist. As every honourable senator will recognise, there are sound medical reasons for this. It is a sound medical practice. The referral conditions of the Bill will ensure its continuance. He also raised a point about separate registration of organisations in the various States in which organisations wish to operate. This is a new concept. During the course of my second reading speech I made a comment concerning this. It will enable the separate identification and assessment of an organisation’s experience in each State. I point out to honourable senators that all present organisations must apply for re-registration by 1st October this year if they wish to continue in the scheme. However, to clarify the point raised by Senator Webster, it is not intended that an organisation’s registration will be terminated abruptly. In fact, this Bill provides otherwise. I believe this is the relevant point: A particular fund will not be allowed to continue under the scheme if it cannot operate efficiently and economically. 1 think that comment would answer many questions raised by honourable senators on both sides at one time or another. Other points have been raised. I assure honourable senators who raised them that if I am unable to obtain replies for them during the Committee stage 1 shall endeavour to get them from the Minister and let them have them as soon as possible. Other points raised would be answered more correctly in the Committee stage. I thank honourable senators for the interest that they have taken in the debate. I repeat that the Government opposes both amendments. I urge that the remainder of the Bill be given as speedy a passage as possible. I believe it is imperative that the Bill be passed as soon as possible so that its benefits may be given to those Australians who I believe will benefit so greatly from it.
Sitting suspended from 1. to 2 p.m.
That the words proposed to be left out of Senator McClelland’s amendment (Senator McManus’s amendment) be left out.
The Senate divided. (The President - Senator Sir Alister McMullin)
Majority . . . . 42
Question so resolved in the negative.
That the words proposed to be added (Senator McClelland’s amendment) be added.
The Senate divided. (The President - Senator SirAlister McMullin)
Majority . . . . 2
Question so resolved in the negative.
Original question resolved in the affirmative.
Bill read a second time.
Clause 1 (Short title and citation).
– I am speaking to this clause because I want again to put before honourable senators the question of a postponement. The Minister for Housing (Senator Dame Annabelle Rankin), who represents the Minister for Health (Dr Forbes) in this place, has read out information about dissensions and has mentioned the results of plebiscites. She said that another assembly is coming and that it would not be a special one. it is a special one because normally we would have one assembly only each year. This is an additional one. If you do not call it special, at least it is extra. 1 am quite happy for the whole Bill to go through the Committee stage until we come to the Schedules. I do not mind which way it is done, but I think that when we reach the Schedules we should pause because this is one of the contentious parts of the measure. It is no good blaming the profession completely for the present situation. I admit that members of the profession are very dilatory, but nevertheless there is no dispute about a differential rebate. Everyone believes that there should be some increased fee for specialists, but it was not until the Prime Minister (Mr Gorton) announced the$5 maximum that a completely different perspective was put on the whole proceedings. As soon as we realised what was happening the question of differential rebates went by the board because we felt that it would do the greatest harm to general practice.
Do not let us get into the question of general practitioners being mercenary because the general practitioner will do quite well whatever happens. We arc trying to maintain the status of the general practitioner. That is why we want the question of differential rebates held over until such time as the new assembly can discuss the matter. If the assembly supports differential rebates I shall not say another word. If that is what the assembly wants let it have it. As a matter of fact I am not very interested in differential rebates, except from the point of view of the $5 which in the result would lower the status of general practitioners. I do not want to canvass the whole story of general practice, but I think all honourable senators would realise that there is a shortage of general practitioners. We do not want to do anything to denigrate the general practitioner any further. Consequently I suggest that we report progress and ask leave to sit again. Alternatively, if the Minister feels that we must get through most of the Bill 1 shall move for a postponement when we come to the First Schedule. Another point which was mentioned by Senator Byrne and Senator McManus is that we have not had dme to go through the amendments. I looked through them quickly this morning while listening to other debates. I hope that we were not expected to sit up last night and go through them.
– Senator Milliner and Senator Willesee did.
– But they are people of intelligence more able to cope than I am. So that the debate may be postponed i move:
That progress be reported.
– I do not intend to speak for long or to flog a dead horse-
– Order! There can be no debate on this question
– May 1 reply to Senator Turnbull?
Question resolved in the negative.
– 1 rise in order to get some guidance. 1 want to know, in the light of Senator Turnbull’s remarks, at what stage we will be dealing with the schedules to the Bill. I would like to know this because we may want to mention case histories in order to get clarification of what is meant by some items in the Schedules.
– The Schedules will be dealt with at. the end of our consideration of the Bill.
– In speaking to clause J I wish to raise a protest about the way in which the legislation has been brought before the Committee, lt is most difficult to understand a Bill of this size when it is brought in. Admittedly much of the document that we have before us is made up of schedules, but the Bill does contain 55 clauses which extend over 35 pages. We are supposed to be able to read these amendments into a roneoed consolidation of the National Health Act up to 1965 with 4 sets of amendments which have not been consolidated. These are 2 pages of Act No. 14 of 1967, 29 pages of Act No. 100 of 1967, 15 pages of Act No. 102 of 1969 and 33 pages of Act No. 44 of 1966. To complicate things a little further, we have a consolidation of the legislation which includes the amendments to the Act which are proposed by this Bill but which has no regard for the amendments that have been accepted in the other place. This is not the way that legislation should be presented and I think it is time that the Government studied this matter. 1 appreciate the difficulties involved in getting parliamentary draftsmen so that legislation can be consolidated, but 1 point out that in this instance, with an important Bill of this nature, the last consolidation was in 1965. 1 do not think it is good enough for the Government to present legislation in this way to the Senate and expect to get an intelligent debate upon it.
– I agree entirely with what Senator Cant has said. The manner in which this Bill has been presented to Parliament reflects no credit on the people associated with its presentation. It has been presented to us in a way which makes it almost impossible effectively to deal with it without an adjournment of at least a week to study its provisions. For some strange reason there is an urgent demand that this measure bc passed now. I do not know why there is such urgency, unless it is anticipated that there will be trouble at the coming meeting of the Australian Medical Association. I do not know why the Australian Labor Party is helping to push it through, particularly in view of what Senator Cant has said.
From what Senator Cant has just said one would hope that his Party would move for a week’s adjournment of this debate in order to give us time to study some of the problems which Senator Cant has said are almost impossible of solution. 1 have heard a suggestion that the ALP wishes this Bill to be passed at once in the hope of using it against the Liberal Party in the campaign for the Victorian elections. I do not know whether that is true. All I say is that the way we are obliged to deal with this legislation is most unfair. When the debate on this Bill opened yesterday afternoon we were handed a list of over 30 amendments to be moved by the ALP. What opportunity have we had to examine them and to discuss them with our Party? For most of yesterday afternoon we were engaged in discussions on the Bill. As the member of my Party who is handling the Bill I had to be present in the chamber. This morning at 8.30 I had to attend a meeting in connection with the Senate Select Committee on Drug Abuse and Drug Trafficking. At. 9 o’clock I had to attend a subcommittee meeting in connection with the South Pacific region. I have had to be present in the chamber today and yet I am supposed on behalf of my Party to deal with the proposed amendments. As yet I have not even been able to read a number of them.
All honourable senators realise that in normal circumstances this debate would have been adjourned for a week after the introduction of the Bill. It is scandalous that legislation as important as this should be treated as it has been treated. For some reason there is collusion to force the Bill through in circumstances which prevent its being properly debated. It is my task to act for my Party in handling this Bill, but I have not been given time to read the proposed amendments. If this is the way that Parliament is to be managed in future, all I can say is that the only result can be complete discrediting of the parliamentary processes. I want to register my protest at the cavalier manner in which the Minister for Health (Dr Forbes) has treated this Parliament.
– I think what should be paramount in our minds is that this is the Parliament of a democracy. The people who have the task of adjudicating on the merits of legislation should have sufficient time to read it. Senator McManus has pointed out that a sheaf of proposed amendments have been circulated and these require study, apart from the Bill. As he said, senators have been allowed little time to study those documents and to discuss them. I do not think that that reflects any credit on the Government. It is to the discredit of the Government that the legislation should be presented in this way. If we were on the Opposition benches and the present Opposition was in government, our people would be the loudest in their howls about such treatment.
At 9 o’clock this morning 1 was present at a meeting of the Regulations and Ordinances Committee. The Senate sat until late lust night. What time have we had to study this Bill? It is a very important measure. There are certain aspects of it that 1 do not like, particularly those which disparage general practitioners. 1 think we should have more time to study legislation of this character. The way that Ministers such as the Minister for Health (Dr Forbes) went to ride rough shod over Parliament is a disgrace to the Government.
[2.25] - I have noted all the points that honourable senators have made about the introduction of this legislation. I feel I must answer Senator Turnbull’s comments because he was answering me.I want to make it very clear that the point I made was that the meeting which is being held in June by the Australian Medical Association is not a special meeting. A special meeting was held in April. The meeting to be held in June will be the annual general meeting and the date for it was fixed last October. 1 think it is very important that the record be set right on that point.
Clause agreed to.
Clauses 2 to 4 agreed to.
Section 4 of the Principal Act is amended -
Senator MCCLELLAND (New South Wales) [2.26J- On behalf of the Opposition I move the following request for an amendment to clause 5:
At the end of the clause add the following paragraph:
by omitting from sub-section (4.) the words “, other than an attendance at which an examination of the patient’s eyes is made in consequence of which spectacle lenses are prescribed” ‘.
The purpose of the request for an amendment is to remove the existing discrimination against patients who use the services of ophthalmologists when those services require the use of or the prescription of spectacles. In this legislation the extraordinary situation arises that a patient may be referred by an optometrist to a specialist - that is an ophthalmologist - and if the ophthalmologist decides that part of the treatment to be provided is the prescribing of spectacles, no Commonwealth benefit will accrue to the patient. We believe that this is an absurd situation. A patient who in the first instance goes to a general practitioner and is referred by him to an eye specialist has to pay 51.50 for the referral. Where a patient is referred to an eye specialist and spectacles are prescribed as part of the consultation, the patient will then have to pay $5.75. A patient who goes to an eye specialist without being referred to him by a general practitioner will have to pay a total of $8.90,
– Are they schedule items?
– No. The situation is that if a patient is referred to an eye specialist by a general practitioner he is covered by the Schedule and if he goes direct to an eye specialist, assuming that spectacles are not prescribed, he is covered by the Schedule; but if the eye specialist prescribes spectacles no Commonwealth benefit is payable and indeed, 1 am given to understand, no fund benefit will be payable in the future.
We could have the somewhat ludicrous situation in which an eye specialist had to provide an artificial eye for some unfortunate person, who would receive the whole benefit at no greater cost to him than $5; but if the eye specialist prescribed spectacles the person would have to pay more than $5. The Australian College of Ophthalmologists has pointed out that the prescription of spectacles can be merely incidental to the medical examination. For instance, a full examination of the eye could be necessary and then the specialist, after having made that examination, could say to the patient: ‘You have to have spectacles’. Spectacles would then be prescribed, and in that event - that being the diagnosis by the eye specialist - no Commonwealth benefit whatever would be payable to the patient.
I understand that in Australia today there are about 400 ophthalmologists providing about 500,000 services a year. If the Bill is passed in its present form, many of those services and many of the patients of the ophthalmologists will not attract the Commonwealth benefit. The ophthalmologists are very skilled people. They are men with 6 years of undergraduate training and at least 4 years of postgraduate training. The Nimmo Committee dealt with this matter in chapter 15 of its report. For the benefit of honourable senators I will quote what it said. In paragraph 15.4 it said:
The second item in relation to which health insurance coverage should bc extended concerns consultations by ophthalmologists where the patients are referred by optometrists.
I understand that in this Bill referral by optometrists has been covered. The Nimmo Committee went on to say:
The fact that spectacle lenses are prescribed both by ophthalmologists and by optometrists gives rise to special problems under the scheme. It is claimed by optometrists that unfair discrimination arises from the fact that subject to certain conditions medical benefits are payable for consultations with ophthalmologists but not with optometrists.
The Commonwealth has sought to remove discrimination by a provision in the National Health Act under which consultations with medical practitioners in consequence of which spectacle lenses are prescribed are not eligible for Commonwealth benefits. This provision penalises ophthalmologists’ patients and it is claimed that devices are employed to circumvent it. While it is an unsatisfactory provision the Committee is unable to suggest any other means of achieving the result sought.
At present the ‘specialist rate’ medical benefit is payable in respect of the service of an ophthalmologist if a patient is referred to him by another medical practitioner and spectacles lenses are not prescribed. This specialist benefit is not paid if the patient is referred to him by an optometrist.
I understand that that situation has changed. The Committee continued:
This anomaly has given rise to the practice of optometrists referring patients to general practitioners who then refer them to ophthalmologists. This practice may give rise to unnecessary inconvenience and expense for those concerned. lt seems to us to be only necessary 10 interpose a general practitioner when the ophthalmologist who is the expert in his field requires information additional ro what be is able to obtain by questioning and examining the patient. This, we believe, is not the normal situation. We therefore recommend that a patient referred to an ophthalmologist by an optometrist qualified to practise under State laws be eligible for medical benefits at the specialist rate.
I understand that that recommendation has been implemented in the Bill. But today we have the somewhat ludicrous situation in which, if a person is referred to an ophthalmologist who tells him that he needs spectacles and upon such a diagnosis being made prescribes spectacles, no Commonwealth benefit accrues to the patient.
I understand that the Australian College of Ophthalmologists has written to all honourable senators. In a letter dated 6th May, the Honorary Secretary of that College had this to say, amongst other things:
This anomaly is the denial of a benefits payment to any patient who happens to obtain a prescription for spectacles in the course of treatment or after a medical consultation with his ophthalmologist.
This normal medical service will then become the most expensive item to any insured patient where the common fee is charged.
The cost io the patient will be at least double the maximum promised by the Prime Minister in his election speeches. The Prime Minister and the Minister for Health have said time and again that no medical service where the common fee is charged will cost the patient more than $5.
To the insured patient referred by a general practitioner for examination and assessment, the cost of a visit to an ophthalmologist is SI. SO if spectacles are not prescribed. However, if at the end of the consultation it is found that spectacles are necessary and are prescribed, the patient would receive no benefit from the Commonwealth, and will no longer be eligible for the benefit he would have received in the past from the insurance funds.
The provision of a prescription for spectacles by an ophthalmologist follows a medical examination of the eyes and as a consequence a medical service has been performed. The issuing of this prescription is incidental to the examination and its provision has no more significance than giving a patient a prescription for a drug not covered by pharmaceutical benefits.
The Prime Minister (Mr Gorton) told the Australian people in his last policy speech, amongst other things:
Commonwealth medical benefits and fund benefits will be increased so that the difference between the benefit entitlements and the common fee charged by doctors will not at any time-
I emphasise the words ‘at any lime’ - exceed $5 even for the most complicated and costly surgical procedures. For simpler procedures which are less expensive, the difference between the benefits and doctors’ common fees will be very much less.
– ls an eye test a surgical procedure?
– 1 am only a layman. I. would not know whether it is a surgical procedure or otherwise. But, looking at the matter from a layman’s point of view, I believe that it would be absurd if an ordinary member of the community were referred to an ophthalmologist, who prescribed the wearing of spectacles for that patient, and no Commonwealth benefit was payable in respect of that consultation.
I know that the Minister for Health (Dr Forbes) in another place has said that members of the Ophthalmological Society waited on him - I think it was on 13th May - that they placed new information before him, to use his words, and that he would undertake to put the matter to the Government if he thought it warranted further consideration. We members of the Opposition believe that that is not good enough. We consider that there is discrimination in this matter, that the unfortunate patient who is referred to an ophthalmologist and has spectacles prescribed for him is placed in an unfair situation and that it is unjust. Therefore, on behalf of the Opposition I move the request for this amendment in the hope that it will bring justice to a large number of families.
– The Australian Democratic Labor Party will support the amendment. Wc believe that it is necessary in order to remove from the Bill something which in our opinion is discriminatory and unjust. I do not intend to labour all the issues involved because I think Senator McClelland has dealt with them fully. All I want to say is that I. like other members of Parliament, have been lobbied intensively over recent weeks. Ophthalmologists have come to me as individuals and as representatives of groups and organisations. I told them that 1 had received a submission from the Austraiian Medical Association on 1st May which contained its views on the Bill but did not contain anything, as far as I could see, about ophthalmologists. They informed me that they had expected the AMA to take up their case but they had been let down and had been compelled to fight their own battle. That involved me and other members of my Party in quite a few man hours in hearing these people because they came along in considerable force to put their case. We listened to their case, we thought it was just and we support and will vote for the amendment.
– 1 oppose the amendment while having some sympathy with the point of view expressed. Both the Nimmo Committee and the Senate Select Committee on Medical and Hospital Costs had evidence from both optometrists and ophthalmologists. There is between them a good deal of disputation as there obviously is between the Australian Medical Association and the ophthalmologists.
– That is not right.
– The AMA has not been prepared to support their case, lt is of no use Senator Turnbull interjecting now. He was a member of the Senate Select Committee and had the opportunity to submit a minority report if he supported the case of the ophthalmologists, but he did not do so. This is not a simple matter. The optometrists claim the right to prescribe spectacles and for their patients to receive a benefit. The ophthalmologists are opposed to that for various reasons, lt is obvious that people who go to an optometrist would be. in all fairness, just as entitled to the benefit as would those who go to an ophthalmologist. If that were not so we would reach the situation where everyone who needed spectacles to be prescribed would be referred by the optometrist to the ophthalmologist to obtain the benefit. This would create chaos. We should be very careful about this until this whole very complex question is resolved.
As Senator McClelland has told us, the Minister for Health (Dr Forbes) has received further submissions from the ophthalmologists and is now considering them. He has to weigh their submissions with all the other factors involved in this matter. Senator McManus has heard only one side of the story, and I question whether this Committee should at this time make a decision on a matter as complex as this is without hearing the full case. I point out also that the Nimmo Committee while acknowledging the unsatisfactory circumstances which exist, and which we all acknowledge, was not prepared to suggest any other means of achieving the result sought. The Senate Select Committee found itself in the same position as did the Nimmo Committee. In view of these facts I oppose the amendment and urge the Committee not to be governed by emotional issues but rather to seek a solution to a complex problem which will give satisfaction and justice to all concerned. I do not believe that we will achieve that by rushing in and supporting the amendment.
– I have no emotions whatsoever about this matter but I do recall the clarion call of the Minister for Health (Dr Forbes) that we are doing the best for the people’. 1 think that Senator Dame Annabelle Rankin who represents the Minister in this place also delivered a speech about ‘we are doing the best for the people’. What is best for the people? We are not talking about what is the best for the ophthalmologists or the optometrists. We are talking about ordinary people who are referred to an eye specialist to have their eyes examined. When a patient’s eyes are examined by an eye specialist the patient is entitled to a special item fee. But if the eye specialist goes on to say to the patient: ‘Following my examination I find that you need glasses’, this is part of the examination. You cannot separate them, but he does not receive the special item fee. Are we thinking of the people or of whom are we thinking?
– What about optometrists? Can they not get into this racket too?
– No. This is what I was rising to speak about when Senator Sim rose. The optometrist does not suffer. The eye specialist, having told his patient that he needs glasses does not provide them. He hands a script to the patient and the patient goes to the optometrist and gets his glasses.
– Why not go to the optometrist in the first place?
– I refer people to optometrists, but when I think that they need referral to an eye specialist I do that, and the patient is entitled to an extra benefit when I do that.
– The optometrist is not entitled to it.
– I am not opposed to that. If you think the optometrist is entitled to it, get the Government to do it. We are talking about the fact that at present when a general practitioner refers a person to an eye specialist he does so because he is worried about the health of the patient. Perhaps he is thinking of the best, interests of the patient when he says: You had better go to an eye specialist and not to an optometrist’. But the optometrist still receives payment for the glasses. The eye specialist does not give the patient glasses. He merely writes a script and the patient, goes to the optometrist to get his glasses. There is no injustice to the optometrists. If honourable senators on the Government side feel that the optometrists should receive a benefit, they should get the Government to include that in the Bill.
– The profession opposes it.
– All right. The profession is opposing the fact that the Government is not including this clause. Senator McManus said that the AMA in its submission to members did not mention the Ophthalmological Society. That is only further proof of the fact that the AMA does not represent the doctors as a whole. I assume that what happened in this case - I do nol know - is that the Ophthalmological Society is only affiliated with the AMA although ils members as individuals are members of the AMA. I suppose the AMA thought that the society would take its own case forward, but I do not know whether that is true.
– lt could have been an omission.
– lt could well have been an omission but I may be wrong there too. All we are deciding today is whether, if a patient is referred by a general practitioner to an eye specialist because he thinks that is in the best interests of the patient, he should lose the benefit simply because the eye specialist says: ‘You need glasses’.
– He might need surgery and glasses too.
– -If a member of the Liberal Party goes to an ophthalmologist who prescribes glasses, will he say to the ophthalmologist: ‘Do not do that because I will not get the benefit’? He will think that it is part of the treatment.
– You did not raise this when the Senate Select Committee was sitting.
– I did not give evidence to the Committee.
– Like the rest of us, you heard evidence on it.
– I understood that we agreed amongst ourselves on this point.
– There is nothing in the report about it.
– Then we have left it out. We have been remiss. When the ophthalmologists appeared before the Committee I made it clear that I was in favour of their submission. I have never said anything else. We have been canvassing this for some time now so 1 merely say that I support the motion.
– I too have had correspondence from ophthalmologists and have had discussions with them in my own State and I agree that there are anomalies in this proposal. As Senator McClelland has said, if a patient goes to an ophthalmologist and an operation is required which will result in the fitting of an artificial eye, this is done for an outlay by the patient of only $5. But if the ophthalmologist prescribes spectacles to a patient the patient has to pay the full cost of the consultation. 1 think that this is an anomaly. I would like to know why it is so. J am not suggesting that the cost of the spectacles should bc included, but 1 do query why a patient should be able to be reimbursed to the extent of all but $5 for a consultation with an ophthalmologist, but if spectacles are prescribed the patient has to pay the lot. I believe that a patient should be entitled to the full Commonwealth benefit but not the cost of the spectacles. I do not see why this could not be done. I am in sympathy with the ophthalmologists in relation to the position in which they find themselves. At the same lime, 1 appreciate that there are many problems and complexities in relation to optometrists, but 1 speak in support of the case for the ophthalmologists.
I wish to make quite clear at this stage that 1 am unable to support- the amendment.
asked what is the most important consideration. Honourable senators on this side of the chamber are of the opinion that the public is the most important consideration in relation to the health legislation and the Bill should be passed without delay. 1 am unable to support this amendment because it involves such complexities in regard to the disputations which are going on between optometrists and ophthalmologists, and if it were supported the wrangle could go on indefinitely.
I wish to mention the fact that recently I had discussions with some ophthalmologists. I must admit that ] felt that their approach was an extremely fair one. They did not approach me in a dogmatic manner; they made their request in a very frank and I felt a very forthright and legitimate manner. They did not attempt to pressure me into agreeing to delay the passage of this Bill in order that their request could be included in it. However, they did make it clear to me that they would like to see their point of view included in the legislation and that they hoped it would be included in a Bill at some time in the not too distant future. But, 1 repeat, these ophthalmologists did not ask me personally to delay the passage of this Bill so that their requests could be met now. I admire them for adopting this attitude. What is more important than this Bill becoming law as soon as possible so that the large number of people who, unfortunately, need operations or medical assistance may benefit from it?
– Or glasses.
– Every day that we delay the passage of this Bill we are doing an injustice to the people of Australia. As far as I am concerned, the sooner this Bill becomes law and its benefits are available to the people of Australia the happier I and people like me will be. I am satisfied that the Minister for Health (Dr Forbes) has made it quite clear that he will give serious consideration to the position of the ophthalmologists and to the anomalies which exist within this area. I propose to lend my support to the inclusion of ophthalmologists in the Commonwealth health scheme and to a clearing up of this anomaly in regard to glasses. However, I am not prepared at this stage to delay the passage of this Bill, because it would be against the interests of so many people to do so. But I give the assurance that 1 will fight for whatever I think is right. I will fight for the inclusion of the services of ophthalmologists in the legislation at a later stage. But I am more interested in the passage of this Bill through this chamber at this stage.
– I am not going to delay the passage of the Bill. However, I wish to express the view I hold that ophthalmologists are quite entitled to put up a case to the Parliament for the inclusion of their services in this legislation. I have been impressed by the strength and the justice of their case. I believe that the amendment which has been moved on behalf of the Opposition covers the case which the ophthalmologists have put up. I am most strongly in favour of patients having the advantage of receiving specialist treatment, which they can receive after being referred to an ophthalmologist by a general practitioner. I believe that patients are entitled to have their eyes thoroughly examined.
If, as a result of his investigation of a patient’s eye condition the ophthalmologist with his skill and wisdom determines that the eye condition is such that it is necessary to prescribe spectacles, it is only half-baking the provisions of the national health scheme not to include a provision for a payment by the Commonwealth of the cost of the service provided by the ophthalmologist. I am unable to understand how any person could support the passage of legislation through this Parliament which does not include such a provision. It is an injustice. It is an injustice to not only the patient but also the ophthalmologist. In effect, an ophthalmologist is making a great mistake by treating the patient so thoroughly that, among other things, he has to prescribe spectacles. I believe that there is an irrefutable case for the adoption of the Opposition’s amendment.
People who find themselves in this situation are in need of assistance. This should be the prime consideration of the legislation. The Parliament should make provision for them to be able to receive treatment at the highest level by a specialist. It is not a matter of providing spectacles for these patients. Once the prescription has been written it is up to the patient to decide whether he will obtain spectacles. A patient does not have to obtain spectacles although they have been prescribed by an ophthalmologist, but it would be better for his health and comfort to do so. Regardless of the state of a person’s eyes, if an ophthalmologist prescribes glasses he should be paid the proper fee for doing so. I think that the chamber should put the amendment to a vote without further delay. I hope that Senator Young will support his words by taking action. He could do so by voting in support of the Opposition’s amendment.
[2.57] - I wish to reply io some of the honourable senators who have spoken in the debate. I indicate to Senator Prowse that in doing so I am not closing the debate on this amendment. 1 wish to make 2 points. Firstly, I feel that Senator McClelland is under a misapprehension in regard to fund benefits. He was not sure whether they are paid at present, but he said that he understood that they will not be paid in the future. I have just checked on this aspect with the officers assisting me. lt is quite correct that-
– Will they be paid in respect of the prescribing of glasses?
– No, it is not. for spectacles. This is in relation to consultations.
– I was talking about where glasses are prescribed.
– The honourable senator did not say that at the time. That is why 1 queried it with him. However, the honourable senator may have meant it that way. The honourable senator was quite correct when he said that the Minister for Health (Dr Forbes) received a deputation from the ophthalmologists. I believe that it was on 13th May. The members of the Ophthalmological Society submitted new information to him on the very question which is now under discussion. The Minister undertook to consider it. He advised them that if the new information results in a change in the present situation, which has proved to be a problem to the Government over many years, he will seek Government approval for the sponsoring of an appropriate amendment to the National Health Act when it is next amended. This is the point which the Minister made. The Minister advised that the period allowed for the passage of the present Bill did not provide sufficient time for the new information to be analysed and properly assessed. 1 think that is a very fair statement. I have nothing further to add to the statement that the Minister made at the time. He has given a positive undertaking to give further consideration to the matter. I believe it is a very important fact that he has given this undertaking to give further consideration and, if necessary, to seek the approval of the Government for the sponsoring of an appropriate amendment to the National Health Act when it is next amended.
– I have a question to resolve a doubt in my mind concerning the request lor an amendment moved by Senator McClelland which states:
Other than an attendance at which an examination of the patient’s eyes is made in consequence of which spectacle lenses are prescribed.
I can quite clearly see that a patient could be referred to an ophthalmologist and a variety of conditions could be treated and prescribed for. One of the conditions could require spectacles. If, at the end of that consultation, spectacles are prescribed is it a fact, as now obtains, that the patient receives no benefit at all under the health scheme simply because part of the consultation results in the prescription of spectacles? 1 can see one very ready way out of this situation. The specialist could say to the patient: ‘1 have treated you for a certain condition but in addition I think you need spectacles. Today I will render an account for the services I have given you, but come back tomorrow and I will prescribe spectacles.’
I would like the Minister for Housing (Senator Dame Annabelle Rankin) who in this chamber represents the Minister for Health (Dr Forbes) to explain the present situation. Does the prescription of spectacles under present conditions completely eliminate any claim which the patient may have in respect of other services which the ophthalmologist may have rendered?
– I refer to the statement by the Minister for Housing (Senator Dame Annabelle Rankin) that representations were made to the Minister for Health (Dr Forbes) by opthalmologists in regard to prescription of spectacles and that the Minister has been unable to take any action in regard to this National Health Bill because he has not had time to properly analyse and examine it. Yesterday the Senate was handed a Bill and 30 amendments. There has been no time to analyse or examine them. The Minister gave instructions that the Senate should get on and make decisions although he was not prepared to make a decision himself. He has already had a week but he has not had time properly to examine and determine this matter. Yet having demanded for himself full time to examine the matter he instructs his representatives in the Senate to say - without any time at all for the Senate to examine the amendments - that the Senate should vote on the amendments. I think this is a scandalous example of one law for the Minister and another law for the Senate.
– I am totally in accord with the remarks passed by my colleague Senator McManus but I rise particularly to ask the Minister to explain to the Senate why sub-section (4) as it exists in the principal Act was included in the Act at all. It obviously involves an injustice to the patient who is referred to an eye specialist by a general practitioner. A patient is referred to the eye specialist not only to obtain spectacles but also to have a consultation. The eye specialist may find that the patient’s condition, perhaps the headache from which he is suffering, is due not only to defective eyesight but also to diabetes or a kidney condition or something else. The patient, is treated for the complaint from which he is found to be suffering and in addition the eye specialist may say: ‘Well, spectacles would aid you considerably’ and prescribes accordingly. Because the doctor prescribes spectacles the patient is denied any Commonwealth grant towards the cost of spectacles. The provision is obviously unjust. But I am inquisitive enough and curious enough to ask why this sub-section was ever put in the Act. There must be a reason and I have not heard one. Perhaps the Minister has a good reason, but I doubt it. This is why I rose to ask the Minister to explain why the sub-section was ever put into the principal Act.
– I rise because I was one to whom the opthalmologists presented their case. I was most impressed by the facts they presented to me. The Senate may be benefited by the answers from the Minister on this matter. One comment I made in relation to the National Health Bill when 1 spoke on it previously was that there did appear to be some uneconomical provisions in the Bill. One provision required referral by a general practitioner to a specialist, lt is a pity we could not have changed this provision. In the present circumstances if I have had some contact with a specialist for a particular trouble and 1 later telephone him and say that 1 would like to see him again, his advice should be: ‘Do not be so foolish as to come to me direct. Go and pay your own general practitioner and get a note from him that you are now referred to me.’ Without going first to a GP one might go direct to a specialist, perhaps a bone specialist who would know the patient’s record and the history of his case. The present arrangement appears to me to result from pretty woolly thinking.
But what is the difference between an optometrist and an ophthalmologist? As I understand it the optometrist deals purely with refraction as it relates to the eye while the ophthalmologist represents the medical side of eye treatment. There is a great difference between the two. The case presented by the ophthalmologist is, as has been stated by previous speakers, that if a medical man refers a patient for specialist treatment, such as surgery on the eye or some other problem, to an ophthalmologist he is given specialist treatment. The years of training which this type of qualification calls for should put the ophthalmologist in the field of a specialist. The stupidity is that, under the Act, no matter what the diagnosis may be or what the general survey of the injury may be, if a prescription for glasses results no Commonwealth benefit is paid. A proposition was put by Senator Prowse. Any sensible ophthalmologist would say: Well, I have treated you up to this hour, 11 o’clock, and the fee for that is so many dollars. If you will come back and see me at 11.30 I will write you a prescription for glasses and of course there will be no charge for that’. This is the stupidity we find in the present legislation. At this particular time when the Government is saying that it does not have sufficient finance to support all people’s health requirements which may be for dental, for optical, or for other medical problems which may be experienced, the Government is stating that it cannot support a proposition which leads to one particular sector of the community being able to prescribe glasses and attract a Commonwealth benefit. That is the basis, surely, behind the Government’s argument. 1 would suggest to the Minister that ophthalmologists will be encouraged to advise patients that in order to gain the benefit of their specialty a person should do as is suggested and have 2 visits, one of which may be free. The gentlemen of the group to whom I spoke were absolutely appalled by the idea that this should occur but that is surely what this Bill is leading to. The Bill is leading to a situation in which an ophthalmologist may say to a patient: ‘Yes, I have treated you. You will be given a Commonwealth benefit on an account of Sx and if you go and see the optometrist down the road he will have a prescription ready for you’. That will be telephoned through and the costs will be separated so the Commonwealth will achieve its objective that there will not be a Commonwealth benefit attracted towards the supply of glasses. I. imagine that I see the Government’s difficulty in this. The Minister said that within 6 months this schedule will be reviewed. Certainly this proposition as put forward by the ophthalmologists should be given serious consideration and 1 understand that this is to be done.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [3.1 lj - 1 would like to reply to Senator Prowse who asked about Commonwealth benefit when spectacles are prescribed. No benefit is paid if spectacles are prescribed at a certain consultation. So for the consultation at which the spectacles are prescribed there is no Commonwealth fund benefit. But, of course, the fund benefit is paid. Senator Gair asked why sub-section (4.) of the principal Act was included. It has been considered since 1953 that optometrists’ and ophthalmologists’ patients should be on exactly the same footing as regards Commonwealth benefits if they are given spectacles.
– What about when they are just prescribed?
– If they are prescribed it is the same thing.
– 1 just wish to pursue a little further, if I may, the matter which has been taking the attention of the Senate, namely, the position of ophthalmologists and optometrists in the health scheme. What I would like to say to the Minister is that I can well understand those whose attitude is, firstly, that this is a complex problem; secondly, that it needs consideration; and thirdly, that perhaps the major benefits of the scheme should not be held up whilst this one is sorted out. But what I do hope will happen and what I do seriously suggest should happen is that at the first possible opportunity something in the nature of a White Paper should be published by the Minister in relation to this matter. We should not have to wait for 6 months or more until a review is to take place and then be inundated with a confusing series of submissions and suggestions from various persons concerned. This White Paper should show what the result of the further consideration is and what attitude will be adopted or is likely to be adopted by the Minister when an amendment is to be brought forward, so that we may have the opportunity of consulting with the people who are intimately concerned with this and endeavour to inform ourselves about it and to reach a consensus. This should be done at a reasonable time before the matter is debated in the Senate so we are not trying to do all this immediately beforehand. If that suggestion could bc taken up I am sure it would meet a number of the queries and reservations held by many of us at this time about this aspect of the scheme.
– I just want to make one or two observations on the matters that have been discussed since I first moved an amendment on behalf of the Opposition. 1 will be brief. First of all, the Minister has said that he will review the matter and if necessary take it back to the Government for Government approval to bring down an amendment to an Act that is now being amended. This will be done the next time an amendment to the National Health Act is made. But what an absurd situation this really is. Here we are depriving the patients of ophthalmologists of a rightful entitlement, especially having regard to the promises made by the Prime Minister (Mr Gorton) in the election campaign when he said that no medical service would cost the patient any more than $5. Here is probably the simplest of medical services that could be provided, a person going to an ophthalmologist for an examination and the opthalmologist saying to him: ‘You need a pair of spectacles. I will prescribe a pair for you.’ Yet no Commonwealth benefit attracts to that. The patient then has to pay much more than the $5 specified by the Prime Minister in his policy speech. Frankly, the attitude of the Government in this matter is a repudiation of the undertakings given to the people prior to the last election. Senator Rae suggested that at the first available opportunity the Government should bring down something in the nature of a White Paper or a statement by the Minister as to what the Government’s attitude on this matter is to be. When this matter was under discussion in the House of Representatives on 13th May the Minister said that that day certain new information on the question was placed before him by a deputation that he had received from the Australian College of Ophthalmologists. He went on and said:
If it seems- that is the information - to change the situation, which has proved a problem to the Government over many years, I have undertaken to take this question to the Government and, if the Government agrees, to sponsor an appropriate amendment next time the National Health Act is amended.
That was on 13th May and is is now 21st May. He and his Department have had 8 days to have a look at it. They have accepted certain other amendments in another place, so if they were genuine in wanting this amendment they had time to seek it when the Bill came before the Senate. Frankly, we think the Government is only fooling around. It is tinkering around with this matter and patients are being deprived of their rightful entitlement and we insist on pressing the amendment which we have moved.
– In this argument in regard to the ophthalmologists I would like the Minister to tell me what the Department feels as to whether the inclusion of this provision would be detrimental in any way to the professional calling of the optometrist. I do not think any one of us wants to injure those people and the Department may be able to give the Minister the answer and let us know what effect it will have. I understand that it would not be detrimental to the optometrist, but I think we should ask for some clarification on the matter.
– I would also like to add my support to what Senator Wood said. I would greatly appreciate from the Minister some explanation greater than what has already been said as to why this differentiation appears in sub-clause (4.). I would have thought - and here I am at one, I think, with Senator McClelland - that if the purpose of this health scheme is to ensure that patients who have to undergo medical examination or receive medical advice should be able to look to a fund supplemented by Government assistance to enable them to defray the cost, why should those who go to eye doctors be excluded? I would greatly appreciate a good reason why that should be so because my whole inclination at the moment is to support this amendment. It appears to me that what has been said and what has been written puts forward a cogent case which, as I see it, has not been satisfactorily answered. I. know that this is an area which is in some way tied up with optometrists, but I would view it not from the viewpoint of ophthalmologists or from the viewpoint of the optometrists but from the viewpoint of the patient, the person who has to get some medical treatment.
For reasons which do not enter into the debate, it may be right or it may be wrong that a person who goes to a optometrist does not get any assistance. If a person chooses to go to a doctor - and I think the people with whom we are concerned are those who choose to go to an ophthalmologist - and he is faced with expense, why should he not be entitled to receive a benefit? I ask this of the Minister because it seems to me, as I have listened to th debate, to be the crux of the issue. In the light of what has been said, it appears to me that a satisfactory answer has to be given to justify the continuance of whit is regarded on all sides as a currently anomalous situation.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [3.21] - Senator Greenwood spoke of a person seeing an ophthalmologist - and very properly so - to have some condition looked at and dealt with. The only time the patient does not receive a Commonwealth benefit is when spectacles are prescribed.
– 1 am answering Senator Greenwood. 1 would like to continue. I find it very difficult to continue with the noise in the chamber. If a patient has a condition for which he consults an ophthalmologist for treatment, the Commonwealth benefit is paid, lt is on the occasion when spectacles are prescribed that no Commonwealth benefit is paid.
– I know that the Senate realises the difficulty that the Minister for Housing (Senator Dame Annabelle Rankin) has with these complicated matters.
– There was nothing difficult about that. It was a straightforward answer.
– lt was difficult. The Minister did not understand Senator Greenwood’s question. She made the statement, which everyone in this chamber knows, that if a patient gets his eyes tested and no glasses are prescribed he gets the benefit but if he gets his eyes tested and glasses are prescribed he does not get the benefit. Senator Greenwood asked, as did Senator Wood, why that should be so. Why does the Government have this differentiation between an optometrist and an ophthalmologist? When Senator Gair asked the Minister about that, she said that the provision has been in the Act since 1954. That is not a reason. There should bc no differentiation between an optometrist or an ophthalmologist. One should not have an advantage over the other, but one has an advantage over the other. One is a trained doctor and the other is not. If the Government accepts that principle why does it not include in its definitions chiropractors? They carry out professional services. Surely the Government does not want them to be at a disadvantage when compared with doctors. This is nonsensical.
There is only one point at issue. A patient has to be referred by a general practitioner to a specialist. It is much easier to say ‘eye specialist’ than it is to say ‘ophthalmologist’. The patient sees the specialist, who looks in the patient’s eyes and says: ‘You have a tumour. You will need treatment, but it is impairing your vision. In the meanwhile have this prescription’. The patient gets no benefit. If the specialist said: ‘You have a tumour. You have impaired vision. Get the hell out of here’, the patient gets the benefit for that. How crazy can the Government get? I just do not follow the scheme.
– I ask the Minister a question concerning a patient who is referred to an ophthalmologist by a general practitioner for specialist treatment for the eyes. If the specialist treated the eye condition and suggested to the general practitioner who referred the patient that the patient needed spectacles, would this prevent the patient from receiving the full medical benefit? Spectacles were not provided. An optometrist was not consulted. The ophthalmologist suggested to the referring general practitioner that the patient needed spectacles. Would that prevent the specialist from receiving his fee and the patient from receiving the Government benefit?
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [3.24] - I understand that the ophthalmologist himself would have to prescribe the spectacles before the Commonwealth benefit would not be paid.
– I would not support the amendment at this time because I have taken this matter up with the Minister for Health (Dr Forbes). He has told me that he has a committee examining anomalies. He will examine these anomalies. This one is included. It is likely that this matter will be corrected probably within the course of this year.
– You would fall for the 3-card trick.
– If the honourable senator will give me time I will explain why I am prepared to wait. The ophthalmologists have said that they are prepared to wait. They know that they put their request for this alteration rather late.
I do not see any reason why the Bill should be delayed any longer. I think it is important that the people of Australia should get the benefits to be derived from this Bill. For this reason I am prepared to support the Bill as it is, without amendment. But I will certainly watch what happens. I will watch on behalf of optometrists and on behalf of patients who receive spectacles as a result of visiting an ophthalmologist. I think it is very clear that the ophthalmologists are agreeable to wait until the anomaly is examined. They admit that they have come into the picture late; they did not put their case early enough for it to be considered along with the other clauses of the Bill. The ophthalmologists told me that they would not object to the Bill going through at this stage so that the people would not be deprived of the benefits of it. They are prepared to wait until the committee examining the anomalies has looked at this matter.I am quite sure it will be altered before the end of the year.
– I rise to contradict the statement made by Senator Buttfield. As recently as Sunday last, one of the specialists who was here last week called on me and asked what attitude the Australian Labor Party would take in the Senate. As recently as half an hour agoI spoke to him on the telephone. The ophthalmologists want the Senate to pass the amendment that was not passed in the other place. Senator Buttfield has seen one eye specialist. The specialist to whom I spoke was on the executive of their organisation. He was here as recently as a week ago and I spoke to him on the telephone as recently as half an hour ago. They want the Senate to do exactly what the Opposition has moved.
– While I have not been in the chamber during the recent discussion I have listened to it. I say gently to the Committee that the issues have been canvassed fully. We are getting to the stage where we are arguing 2 points of view. I think the simple solution is to request that a vote be taken.
-I am sorry that the Minister for Supply (Senator Anderson) has intervened. I am quite happy to adopt that principle if we do so with every Bill.
– Let us do it, then.
– In future we will not discuss anything. We will abolish Parliament and go back to bureaucracy and autocracy. That is what the Minister’s suggestion amounts to.
– You are not here half the time that we sit, so it does not matter.
– The Minister should not be stupid. That is a stupid remark.
– You are getting a bit of your own medicine.
– No, I am not getting my own medicine. A study of the records of this place will indicate that my attendance is pretty good. Sometimes I am not in the chamber because I have to prepare my own. material. But I have a blower in my room and I can listen there if 1 want to. If the Minister wants to be in the bar he can go into the bar or anywhere he likes.
– I object to that remark and I ask that it be withdrawn.
– He can go into the billiard room.
-I ask that that statement be withdrawn without reservation.
The CHAIRMAN (Senator Bull)Order! Senator Turnbull, you will withdraw that remark.
– I withdraw it without reservation. The Minister can go into the billiard room as often as he wants to.
– I ask that that statement also be withdrawn without reservation because I do not go into the billiard room either.
– I wonder who started this? I have just said that I have the figures relating to my attendance in this chamber, if the Minister wants to see them. I will produce them because they show that my attendance in this chamber is better than the average attendance of other honourable senators. Whether I am in this chamber is my own business and not the Minister’s. Let us get back to the Minister’s proposition, that every honourable senator in this chamber-
– I have called upon Senator Turnbull to withdraw the remark that I was in the billiard room. I ask that that remark be withdrawn.
- Senator Turnbull, if you used that remark, you will withdraw it.
– 1 will withdraw it if the Minister thought I said it. I said that he can be in the billiard room if he wishes to. I did not say that he was in the billiard room. I know that if the Minister is not at the table of the Senate he is working hard elsewhere. I think he is a bit touchy on this, that is all. All I am trying to get at is that the Minister intervened in this debate and said that we should not discuss anything, that we should vote on the amendment. I was trying to make the point that if we carried it to its logical conclusion, we could do that on every occasion. The Minister does not adopt that attitude when it does not suit the Government. The Minister was not here at the time - I do not know where he was, and I am not interested - but I was pointing out that the Government’s clarion call is its concern for the patient. It says: ‘We are doing it for the patient*. Here we are depriving the patient of a benefit while the Government waits for a committee to decide what should be done to overcome an anomaly. What really prompted me to speak, apart from irritation, was a remark of Senator Buttfield and I want it confirmed by the Minister for Housing (Senator Dame Annabelle Rankin). Senator Buttfield said that the Minister for Health (Dr Forbes) said he would consider favourably the request of the ophthalmologists. Did the Minister for Health say that?
– I have told you that twice this afternoon.
– Why did he not accept the amendment in the other place?
– 1 briefly enter this debate. I was neither in the bar. nor in the billiard room at the time Senator Buttfield made her contribution. There are other places where members of this Parliament can congregate. I heard Senator Buttfield say that she has had some conversation with eye doctors who are prepared to wait on this question, realising they have left it too late to do anything. I think thai some notice should be taken of that remark. I think that if an honourable senator has authority for making that statement in the Senate, we should take notice of it, if it is truthful. But I think we must consider this matter. I rise to say that on Monday last I was approached by Dr Moore who has chambers in the Bank of New South Wales building in Adelaide. He is one of the executive officers of the Australian College of Ophthalmologists who had been to Canberra canvassing this question. Again he asked me for my support to obtain the inclusion of an amendment in the Bill, because it was a very important question and the association had canvassed it. in all directions. The latest report - and I think this would be the latest report heard on this matter - was received as late as Monday of this week when the association expressed its concern and said that it wanted an alteration made to the Bill while it was going through the Senate. That is the opinion of those concerned with the question. Any information that Senator Buttfield is giving to the Senate about a report that she has received obviously was obtained some time before last Monday. Since then ophthalmologists have taken a different stand on the question.
– A very fine point has been discussed. I think it was Senator O’Byrne who asked what was the situation of a patient who went to an eye specialist who then did not prescribe spectacles. The Minister replied and said that if spectacles were prescribed by the eye specialist the Commonwealth benefit would not be paid. I take it in that case that if the eye specialist rendered an account, or charged the person for the visit, although the person did not request spectacles but got them later, the original charge would attract the Commonwealth benefit. 1 take it that is the interpretation. I know that the Minister is in a very difficult situation in handling the Bill. It is not her Bill and she is working under difficulty. I am very interested in this point. If eye specialists were included in this category, would it affect the profession of optometrists?
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [3.35] - I think that we should turn to paragraph 15.5 on page 56 of the Nimmo Committee’s report, which I do not think Senator McClelland read. He read the paragraph above it and the one below it.
– No, I read it.
– I did not think that he read this paragraph. I think it is important and I think it answers the queries raised by both Senator Gair and Senator Wood. It states:
The fact that spectacle lenses are prescribed both by ophthalmologists-
– I read that paragraph.
– I am sorry, I must have missed it. It continues:
When 1 replied earlier to a question raised by Senator Gair concerning subsection (4.) of sectoin 4 of the principal Act I said it had been considered since 1953 that ophthalmologists’ and optometrists’ patients should be on exactly the same footing as regards Commonwealth benefits if they are given spectacles. I think this answers the point which was raised. Senator Wood again asked a question concerning a patient who visits an ophthalmologist. If the ophthalmologist prescribes spectacles there is no Commonwealth benefit. Of course, there is still a fund benefit.If a patient consults an ophthalmologist and spectacles are not prescribed, he receives the Commonwealth benefit.
Question put -
That the request be agreed to.
The Committee divided. (The Chairman - Senator Bull)
Majority . . . . 8
Question so resolved in the affirmative.
Clause agreed to subject to a request.
Clause 6 agreed to.
Proposed new clause 6a.
– I move:
That the fallowing new clause be inserted in the Bill: “6a. Section 9 of the Principal Act is amended by adding at the end thereof the following subsection: - (3.) The Minister shall not disseminate infor mation under the last preceding sub-section in a form that is designed to influence public opinion on a matter as to which the publicly declared policies of political parlies represented in the Parliament differ unless those other political parties are given equal facilities at public expense to disseminate their views on that matter.’.”.
Section 9 (2.) of the National Health Act says that the Minister for Health may disseminate information - I emphasise the next phrase - ‘relating to health or the prevention of disease’. On 4th March last the Minister for Health (Dr Forbes) issued a long statement, at page 9 of which under the heading ‘Dissemination of Information on Fees and Benefits’ he said:
Concurrently with the introduction of the new medical benefits arrangements, a system will be established for the wide and continuing dissemination of information regarding medical benefits and the common fees list on which they are based, in order that contributors may be fully informed on the reconstructed scheme and on a continuing basis thereafter.
Then he went on to say that in the immediate future a booklet describing the new arrangement, together with a list of the common fees for the more frequently rendered medical services, would be widely distributed. Yesterday in another place the Minister for Health said in answer to a question asked of him that the matter has now been typeset but has not yet been printed, pending the passage of this legislation. The Opposition is concerned about the Government’s intent in applying the phrase which I emphasised and which I read earlier, namely, ‘relating to health’. It is this phrase and what we feel could be the Government’s intent that has prompted the Opposition to move this amendment. We suggest that if the Government has no sinister motive regarding the dissemination of political propaganda in connection with the very vital national matter of health then certainly it could have no objection to this amendment. We arc very concerned” at the type of material that could well be circulated under the phrase ‘relating to health’. It could be political propaganda which is being paid for by the Australian taxpayers rather than information on the rights of people under the schemes.
In recent years we have had examples of the Government using the taxpayers’ money to inform school children of the Government’s attitude to Australian troops being in Vietnam and giving reasons why Australian conscripts are being called up to serve in Vietnam. Last year the Government used the taxpayers’ money to advise wheat growers on the stand that the Deputy Prime Minister (Mr McEwen) took in Washington last year when he was there to meet Ministers from other countries which were international wheat producers. Hundreds of thousands of these documents, and other documents of this nature, have been printed at the taxpayers’ expense. The phrase ‘relating to health’ is very wide. It could relate to anything coming within the purview of the Minister for Health.
During or just prior to the 1963 election a document of high political content was circulated by some of the health funds. That document came to the attention of those of us who were members of the Senate Select Committee on Medical and Hospital Costs. My recollection is that the document was referred to in the report of the Senate Select Committee. But assume that such a document were published again by one of the health funds just prior to an election, as the Opposition sees it the phrase ‘relating to health’ would enable the Minister to say that the document related to health and that therefore he intended to use the taxpayers’ money to inform people that the Government supported the document which had been issued by the health fund. We want an opportunity, if that is the situation, of putting our point of view. We want an opportunity to be given, as will be seen by the terms of the proposed amendment, to all political parties represented in the Parliament to put to the of Australia their political philosophies. The Opposition puts its proposed amendment on that philosophical basis, lt is an important matter because we say that the phrase relating to health’ could cover political propaganda in connection with health and we certainly do not move our proposed amendment lightly.
– I rise merely to indicate that my colleagues and I do not support this proposed amendment. I regard it as puerile and unrealistic. Anybody who has had any experience in Parliament and government knows that it is a practice, and indeed an obligation, of the people charged with the government of the country through various departments to inform the public of what is being done by those departments. In the field of tourism money must be spent in advertising scenic attractions. In the field of health the Government has an obligation to tell the public what has been done and what progress has been made in the various sections of the Department of Health. To suggest that every political party represented in the Parliament should be given an equal amount to spend on propaganda literature could not be seriously entertained by the Senate or any other House of Parliament.
I contend that the practice about which the Opposition complains has been followed for a considerable time. It is not something that has happened only since the Menzies Government was elected in 1949. I invite members of the Opposition to cast their minds back to the days of preceding governments when such literature was disseminated throughout the States. That literature had overtones of propaganda. Let us be honest and realistic. I was the leader of a State Government and I did no more or no less than my predecessors had done in that regard. I distributed literature explaining how legislation had been enacted for the preceding 3 years and the effect that the legislation had had or was having in the community life of the State. We felt justified in doing that at the expense of the taxpayers.
Whilst the Opposition plays an important and indispensible part in a democratic system of government, it is not required, to the same measure and extent as the Government is, to give an account to the public of its stewardship. That responsibility rests very heavily on a responsible elected government. I cannot understand why the Opposition would propose this amendment other than that it must feel that the literature that has been disseminated through the various Commonwealth departments is of a very high standard and is having an advantageous effect for the Government.
– What I have seen would not have that effect. The literature on Vietnam was babyish.
– My colleague Senator McManus has interjected that he thought a lot was left to be desired in some of the literature that had been put out, particularly on Vietnam.
– By the Government. Senator GAIR - Yes, by the Government.
– Are you being coached from the sidelines?
– I do not need any coaching. I think I have displayed that here. There are a few lessons I could teach Senator Mulvihill and others. 1 know what I. am talking about when I enter a debate. It is a pity that some other honourable senators do not speak in debates only when they have something worthwhile to contribute and know something about the subject matter of the debate. I was about to say when I was rudely interrupted-
– By Senator McManus.
– Not at all. He did not rudely interrupt me. He just whispered his interjections.
– I will protect you, Senator.
– I do not need protection. I can handle myself all right and they know it. Senator McClelland referred to Vietnam. I have often complained about the failure of the Government properly to inform the people of Australia why we became involved in Vietnam and why we have a presence there. The Menzies Government, the Holt
Government and the present Administration have failed lamentably to inform the people of Australia on this issue. That is why we have lost the propaganda war both here and in the United States - because the people have not been taken into the confidence of the Government and properly informed. I can recollect one pamphlet of some value which was put out by the Department of External Affairs. It was quite factual. But when I made inquiries about the possibility of getting a supply of those pamphlets for distribution I was told that only a limited number had been printed. Is that evidence that there is extravagance in the expenditure of money on literature and other publications for the purpose of aiding the Government? As 1 said at the commencement of my speech, the Democratic Labor Party could not support the proposed amendment because it is feeble and puerile.
– I also oppose the proposed amendment. I think the basis upon which it has been put forward is entirely fallacious. I challenge the proposition of Senator McClelland that the Government has been using government funds to popularise itself and to propagate its own political views. There are certain issues upon which, as Senator Gair has said, the Government has an obligation to the community to publish the facts. Senator McClelland referred to Vietnam. Obviously when the Government sends our troops overseas to fight in the war in Vietnam it is obliged to set out the facts as far as they are ascertainable and to explain the situation. Similarly, when there is an issue of moment in the community a government would be falling down on its job if it did not publish the facts of that issue. I have mentioned that simply because Senator McClelland put that in some way as the basis or justification for the proposed amendment.
I repudiate the basis upon which he seeks to make his case. I feel that the amendment he has proposed suggests a dangerous procedure to adopt - a prohibition in a form which could work against the public interest. His proposed amendment begins in these terms:
The Minister shall not disseminate information under the last preceding sub-section in a form that is designed to influence public opinion on a matter-
That is so wide as to be completely restrictive of action if a government felt obliged to act.
– It refers only to the proposed sub-section (2.).
– I appreciate that. The power which the Minister has under section 9 is provided as follows:
The Minister may disseminate information relating to health or the prevention of disease. 1 imagine that that is a very useful power, albeit a very wide power, which the Minister should have. Senator McClelland’s amendment seeks to impose a limitation or prohibition so that information cannot be disseminated ‘in a form that is designed to influence public opinion on a matter as to which the publicly declared policies of political parties represented in the Parliament differ’.
Let us take health as ‘a matter’, lt might properly be regarded as ‘a matter’. Health is not defined by the principal Act. Accordingly, it may have a far ranging field. Let us take what is concurrently an issue of controversy, namely, whether people should smoke marihuana. There is in the community a viewpoint that no harm conies from smoking marihuana. If the Government took the view, acting on the best advice available to it, that there should be a public campaign to expose the dangers of smoking marihuana and if another political party, be it a large party or a small party, decided to come out with a policy opposed to that which the Government was espousing in the field of marihuana smoking - that is not so very far removed from reality - immediately some limitation would be imposed on the Government. 1 use that as an example. Perhaps I am being unfair in using it as an example; but 1 hope thar by using it I have stressed the point I am making, namely, that when a matter is so wide that it comprehends a number of facets within its field, to impose a limitation of this character, particularly in the field of health and the prevention of disease, is to work a disservice and to act against the public interest rather than in favour of something quite desirable which I think Senator McClelland has as the basis of his approach. Members of the Opposition who feel that the Government may use government funds in an improper way have a far better and far more effective way of voicing their protest - simply by rising in this chamber and expressing their protest - than seeking to have it embodied in a provision such as this. I believe that it is a bad principle. 1 hope that the Committee throws it out.
– I support the amendment. I believe that its operative words are ‘in a form that is designed to influence public opinion’. We have no objection at all to the Government distributing information that is designed to assist the people to know what the Government is doing. But we do object to public funds being expended on political propaganda, with all the machinery of government available to the Government to enable it to enter homes and disseminate this propaganda, whereas no opportunity is given to any other political party to do that. Senator Gair is very experienced in this field, having been the Premier of a State. He said that a government had a responsibility to give an account of its stewardship. With that I agree. But 1 do not agree that any government is entitled to expend public moneys on disseminating information in a form that is designed to influence public opinion.
I ask the Minister: ls the Minister for Health (Dr Forbes) prepared to distribute to each elector in Australia, at government expense, a copy of the Nimmo Committee report. I am not asking whether he can do that. I am asking whether he is prepared to do it.
– Why should he?
– Because it is a condemnation of the scheme that (he Government is now intending to prop up by this legislation. The report and recommendations of the Nimmo Committee reveal that. If 4J million copies of that report were published and distributed as, according to the Minister for Health, the Government intends to distribute to the public information on the common fees and the operations of the National Health Act, 1 believe that the public would be equally informed as to the benefits or lack of benefits of a contributory scheme. I suggest that members of the public should be given the opportunity to read and analyse the Nimmo Committee report.
I am not making a similar request in respect of the report of the Senate Select
Committee on Medical and Hospital Costs. That is an interim report and it contains 2 points of view. A dissenting point of view was expressed by the 2 Labor senators on that Committee. But I am asking whether the Government is prepared to distribute to each householder in Australia a copy of the report of an independent committee set up by the Government to analyse its contributory health benefits scheme. In my opinion, that would be designed to influence public opinion just as much as the distribution of the 4£ million copies of the booklet which the Minister says is in type but not yet printed is designed to influence public opinion. In my opinion, that is what it is for.
Government moneys are spent in all sorts of directions. I have here a booklet issued by the Department of Primary Industry and printed for the Government of the Commonwealth of Australia by W. G. Murray, Government Printer, Canberra. Its purpose is to advise primary producers on their taxation concessions.
– Does the honourable senator say that that is improper?
– I would not say that it is improper. I say that if the Government is prepared to do this for one section of the community it should do it for all sections of the community.
– That is only advising them on the law, not on the alternative law.
– It is advising them on their taxation rights and disabilities. If the Government can do this for one section of the community it can do it for other sections of the community. I am not objecting to this being done for the primary producers. But all sections of the community pay taxation and all sections of the community are entitled to have the expert advice of the Taxation Branch, which this booklet contains in respect of primary producers. Why should not the wage workers and the professional men have the benefit of the expert advice of the Taxation Branch? If the Government wants to distribute to the public, in the form of information, literature that is related to health and limited to the prevention of disease, I have no quarrel at all with that. I believe that the people should be fully informed on matters of health and the prevention of disease. But, if literature that is designed to influence public opinion is to be distributed at public expense, I believe that it is quite wrong for public funds to be used for that purpose.
– At first blush, after looking at the Act one would question the need for this amendment. The need for it is apparent from the discussion which has ensued. The Act states that the Minister may disseminate information relating to health or the prevention of disease. It does not give him a licence to go further and to print political propaganda. The information which he disseminates must be ‘relating’ to health, but relating’ to health could give him wide power although I would think that there was some restriction upon his power under the aspect of either health or the prevention of disease. Therefore I think it is essential that the right of the Minister to disseminate such information should be retained. The amendment does not seek to remove that right. In fact it adds something.
The Minister has the right to disseminate information relating only to health and the prevention of disease. Therefore any other publication must be an unauthorised publication or at least a publication not authorised by this Act. We learned from the debate this morning that the Minister can do a lot of things without being authorised to do them. Even the payment of taxpayers money can be made without authority. Over the period there have been some unauthorised actions by Ministers. Senator McClelland justifies his amendment by pointing out that he knows of a publication - this was repeated by Senator Cant - which has been distributed for the purpose of justifying the National Health Bill. The views expressed in that publication are completely contrary to the views of the opposing political parties on the Bill. Therefore, if what the Government has done has not been designed to protect the health of the community but rather to tell the community how beneficial the new legislation will be, and if public money has been used for that purpose, the opposing party surely is entitled to a similar right to use public money.
We know of publications which the Government distributed to school children putting its case on Vietnam. The Opposition’s view was not put. We got support from Senator Gair in that regard, lt appeared to me that he came into this debate because he felt that he was one of the guilty men to whom the amendment is addressed seeing that he had offended in this regard when he was the leader of a State government. However his complaint was that the Government’s propaganda on Vietnam was not as advantageous to the Government as it could have been.
– 1 felt justified in doing what I did in the interests of the people.
– There is an admission that the Government’s case should have been put out at public expense, not at the expense of party funds, and that the Government felt it had failed because it did not put a strong enough case for our entry into Vietnam. Senator Greenwood, I think very unfairly, cited only part of our amendment:
The Minister shall not disseminate information under the last preceding sub-section in a form that is designed to influence public opinion on a mutter.
There he stopped. Of course, as Senator Cant said, the motion goes further as follows: as to which the publicly declared policies of political parties represented in Australia differ unless those other political parties are given equal facilities at public expense to disseminate their views on the matter.
The only prohibition in the amendment relates to where there is a difference of policy of the political parties. This does not prohibit the Government advising the population, if that advice is based on medical reports, of the dangers of smoking marihuana but it does prevent the Government supporting a refusal to legalise marihuana if the policy of an opposing party is for the legalisation of marihuana. If the policy of the opposing party was for the legalisation of marihuana, obviously it would be based on some grounds and the opposing party should have the opportunity to put those grounds. The proposal applies only when there is no alternative policy of an opposing party such as if there is medical reason or a health report that marihauna can be dangerous. In that case, despite the amendment the Government under proposed sub-section (2.) would still be able lo advise the public accordingly. The prohibition, as I have said, applies only when the opposing party has an alternative policy.
– Are you saying that a political party created by 1 dissident senator from either side would have public money pui al its disposal? ls that what you are saying?
– Firstly, there is no compulsion to spend public money on any party. There is a restriction on the spending of public money by the party which forms the Government. Secondly, we on this side of the House do not recognise political parties comprising I, 2, 3 or 4 members.
– That is what the amendment proposes.
– lt is the Government which you support which recognises them as political parties.
– And your Party loo.
– No, we do not recognise them as political parties. They are only humbugs here. The only point which arises is the interpretation of ‘political party’. It was generous of the Labor Party in framing the amendment to recognise political parties. There is an obligation upon the group concerned to show that it is a political party within the meaning of the Act. While there may have been some doubts originally and while I claim that the publication which was distributed was an unauthorised publication, it is obvious from the discussion we have had today - I include in that the submissions of Senator McClelland which have been supported by honourable senators on the Government side and by members of the Australian Democratic Labor Party - that there is need for such an amendment because although there may not be power in the Act to spread political propaganda, that has been done possibly without authority. The proposed amendment seeks to restrict it.
– In rising to support the amendment I hope to be able to buttress on different grounds the case which has been advanced by Senator Cavanagh. I. believe that this is really an exercise in Cabinet ethics. We of the Opposition would not mind if the Minister for Health (Dr
Forbes) remained neutral but far too often he has become partisan in his attitude. Let me illustrate the point. The Minister for Labour and National Service (Mr Snedden) never hesitates to question all and sundry in the industrial field. On the other hand, when there was a violent conflict in New South Wales between the Medical Benefits Fund and the Hospitals Contribution Fund and they were buying full page advertisements in the newspapers to put over their charms, the Minister for Health would not utter one word, and whenever anyone criticised what was going on between the Funds he always said: The choice is either this system or the system that operates in Britain and New Zealand’. The result was that anyone who wanted to criticise the existing fund structure found he was dealing with the power not only of the Government but also of these funds with their vast resources.
The value of this amendment lies in the fact that if the Minister will not give the Labor Party, or any other party, parity of expression and if he will not underwrite the cost of such propaganda exercises, he must do one of two things. When the Australia: Labor Party or any group of subscribers have a slap at what is wrong with a fund the Minister should remain silent or, if he is going to use some of the dollars which have been referred to in order to put over a case, he should state what is wrong with the fund as well as what is right with it. This is not only the viewpoint of the Labor Party but is also the viewpoint of others. Senator McClelland referred to the Commonwealth Committee of Inquiry into Health Insurance, which is known as the Nimmo Committee. We have had a host of inquiries of this nature. It seems to me that one is almost regarded as subversive if one has the temerity to question the motives of Mr Turner or some of the hierarchy of the Australian Medical Association. The amendment which the Labor Party is sponsoring is born out of the betrayal and the suppression which have occurred in the past.
I notice that Senator Gair is walking out of the chamber. If he will be kind enough to come back and listen to mc I will give him a classic illustration of the way in which democracy takes a holiday when the hospital and medical benefits funds can do and say what they like. Some months ago
Nation’, a reputable magazine which is produced in Sydney, published an intersting article months ago in which it criticised what the Hospital Contribution Fund was doing with its hidden reserves and the names of the hospitals it was investing in. lt was only when this legislation came before the chamber that the Minister for Housing (Senator Dame Annabelle Rankin) - and I am not blaming her directly - produced figures which showed the way in which this money was being expended. We are living in the year 1970 when the talk is about mass participation in these funds. However, nobody knows where these funds are investing their money. I retrace my steps and say that I agree with Senator Gair on this. I agree it would be a wonderful exercise if these funds were to publish lovely brochures to inform their subscribers where their money is invested and what salaries are paid to Mr Turner and other members of their hierarchy. But this is not happening. All the Government is doing under the present system is to inform the public that the alternative scheme of the Opposition is no good. While I am a member of this chamber Mr Turner and the element which lives off the backs of subscribers can rest assured that I will not keep silent on this matter.
Senator McMANUS (Victoria) [4.221- If the Australian Labor Party’s amendment represents that Party’s conversion to the principle of equal access to public funds by all parties, I can only describe it as a deathbed repentance. I recall raising in this chamber the question of equal allocation of time to all political parties on Australian Broadcasting Commission stations, but I did not get a bar of support from the Labor Party. The Australian Democratic Labor Party does not have equal access to a lot of other things, such as trips abroad and the use of VIP aircraft, but these benefits are available. They cost the public money. But I have not heard any suggestion at any time that the DLP should also be allowed to dip its nose in the trough.
– I do not think that we accept- the Democratic Labor Party as a recognised political party.
– Apparently Senator Cavanagh does not think that the DLP is accepted as a recognised political party. He should discuss this matter with the Leader of the Opposition (Senator Murphy) because that honourable senator seems to be under the impression that it is. The Leader of the Opposition comes to Senator Gair and addresses him as the leader of a political party and seeks his support on occasions. 1 can only say to Senator Cavanagh that if he is under the impression that the Labor Party does not recognise the DLP then 1 would be very pleased if he would let my colleagues and I know so that when the ALP comes along and says: ‘Will you please support us?’ we will be able to say to the ALP that we cannot answer it because it does not recognise us as a political party.
For years political parties have given out propaganda disguised as statements on questions of public importance. When I first became the Assistant Secretary of the Victorian branch of the Australian Labor Party and endeavoured to clean up the Party’s store room I found 50,000 copies of a pamphlet by Mr Chifley, the then Prime Minister - this was in 1949 just prior to an election - which proved conclusively that it was impossible to lift petrol rationing. The only thing wrong was that another party got in and lifted it. Labor governments, Liberal governments and possibly DLP governments one day will always take the recognised opportunity to explain their legislation to the people. Let us not be hypocritical about it if occasionally a little bit of something which is designed to catch votes creeps in, because this is one of the facts of life.
If the Labor Party had simply moved that the Minister shall not disseminate information under the last preceding subclause in a pro-political form somebody might have supported the amendment. I might have supported it myself. But I simply ask: Who is going to decide whether a publication which a ministry puts out is in a form which is designed to influence public opinion in relation to the publicly declared policies of political parties and so on? Are we going to state a case for the High Court of Australia or are we going to have a sort of censor who will be required to look through everything and decide what goes a little too far and what is all right? I believe that this amendment represents a failure by the Labor Party to recognise one of the facts of life. The amendment puts forward a proposition which could not under any circumstances be put into effect.
– The DLP wants power of expression on the ABC.
– And your are against it.
– Well, the honourable senator’s Party is against it. All I wish to say in conclusion is that, in politics, all sides will play the game a little bit tough and if occasionally an advantage is gained by one side, when the other side gets into office it has an opportunity to do the same thing. I will not vote in favour of this amendment because I do not think that it could be possibly put into effect.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [4.27] - The Government is unable to accept the amendment which has been moved by the Opposition. Those honourable senators who have spoken against the amendment have stated in clear terms the points which I would have raised had I spoken earlier. Legislation concerning, the present health scheme has been in existence for 17 years. This Bill is new legislation and it is obvious that a very special effort will have to be made to put before the public the benefits which will be conferred under this legislation and the changes involved in the present scheme. If this amendment were passed by the chamber it would seem that the Minister for Health (Dr Forbes) would not be able to do so. I believe that the amendment would therefore prevent people from obtaining information which it is important and necessary for them to know. If such a provision were included in this legislation 1 presume that the Opposition would want a similar provision included in other legislation. I believe that such a situation would be intolerable for a government. I repeat that the Government opposes the amendment which has been moved by the Opposition.
– I wish to make my position clear to honourable senators because I do not intend to vote on this amendment. I think it is necessary to adopt a pragmatic view in regard to this matter. The circulation of propaganda has always been regarded as a perk of office. I do not think it matters whether the chamber accepts or rejects the amendment because it will not alter the habits which Ministers have adopted over the years. Regardless of one’s political complexion, one would do the same thing if one were in office. I think that this amendment is redundant. All Ministers circulate propaganda material, regardless of their portfolio. They usually try to have their picture included, too. This material is sent to as many people as the Government will permit. I think honourable senators have to accept that this is a fact of life which should be left alone.
That the clause proposed to be inserted (Senator McClelland’s amendment) be inserted.
The Committee divided. (The Chairman - Senator Bull)
Majority . . . . 1
Question so resolved in the negative.
Clause 7 (provision of vaccines).
– The Government’s new proposed section 9b states: 9b. The Minister may provide, or arrange for the provision of, vaccine for the purpose of immunising persons against any of the following diseases:
I ask the Minister for Housing (Senator Dame Annabelle Rankin), who in this chamber represents the Minister for Health (Dr Forbes), whether the Government will, when this legislation is being reviewed, include what I believe was omitted on this occasion through an oversight. I believe small-pox should be included as one of the diseases against which a person may be immunised. With communications the way they are today and with rapid transport, particularly from Indonesia, where there is practically a continuous epidemic of smallpox, I had my children vaccinated or immunised against small-pox because I felt that at any time Australia could be subjected to an outbreak of that disease. I think provision should be made in this legislation for an Australian wide campaign to persuade people of the possible dangers not only of small-pox but also of some of these other exotic diseases which are so close to Australia because of the daily-
– Why name the diseases?
– That is true, why name them?
– Why not eliminate all the names?
– Yes, eliminate all the names and have immunisation against disease. The Government has specified measles and rubella.
– Why not move an amendment?
– I do not know whether I wish to move an amendment but I would like the Minister to consult with her advisers as to the efficacy of leaving out the disease names, and of having a general campaign throughout Australia to advise people of the possibility of a sudden outbreak of some of these diseases which come from countries such as India, Pakistan, Indonesia, and other parts of South East Asia because of the growing contact between those countries and Australia. The Australian people are vulnerable to disease because they have not been exposed to massive outbreaks of such diseases as cholera, small-pox and the like. I believe provision should be made in a Bill such as this for a wider scope of immunisation to be provided under the health scheme. I would like to hear the Minister’s views on this matter.
– I ask the Minister the same question. Why cannot the Department of Health be given full powers by making proposed new section 9b read: “The Minister may provide, or arrange for the provision of vaccine for the purpose of immunising persons’? It seems absurd that an Act has to be passed every time the Department of Health thinks free immunisation should be available for any disease. No State government will object if it is given free immunisation material.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [4.40] - Senator O’Byrne spoke about vaccination. I believe that he felt that although it is not dealt with in this Bill there should be more conscious feeling concerning the problem of smallpox. We do, of course, have very strict quarantine laws concerning smallpox and there has not been a case contracted in Australia in the last 32 years. There is a very real appreciation of this as regards our quarantine laws.
– If you did have an outbreak, would there be provision made for an Australia-wide vaccination programme?
– Yes, there is no doubt about that.
– Is provision made in this legislation?
– It is made under the Quarantine Act and by the State health authorities. Of course, as the honourable senator knows, one can always receive a vaccination for smallpox at the Department of Health. As I understood him, Senator Turnbull wondered why it was only these 3 areas which the immunisation programme covered. My understanding of this is that these are the ones in relation to which the Commonwealth makes available to the States the vaccine for mass immunisation and this is why they are specifically mentioned.
– But why mention them specifically? Why not have an open charter? I am giving the Minister a free hand in this, something which she should be accepting. After all, immunisation against rubella was introduced only in the last 2 years. There is still doubt about measles in general. But nevertheless this is only just a recent thing and - who knows - tomorrow there may be another immunisation procedure that would be of benefit to the community. The Government would then have to bring in an amending Act. . I hope everyone is in favour of this. We are offering the Minister an open cheque here so that whenever she believes there should be an immunisation substance provided for the States to use she can go ahead and provide it. That is the reason why I raised the matter.
– I enter the discussion only because I was prompted by the question asked by Senator O’Byrne dealing with vaccination. I wish to direct 2 questions to the Minister. I understand that because of possible pressure from travel agencies - I do not say that disparagingly - considerable research is being carried out on ways and means of ultimately superseding the vaccination procedure completely. I wonder if the Minister would comment on that. Since the Minister is again dealing with outbreaks of disease and as she is buttressed by her advisers I wonder whether she could tell me if she has made a decision about the dog which had the unfortunate experence of being picked up out in Botany Bay by a foreign vessel. What happened? Is that dog going into quarantine indefinitely? Will he be destroyed or does the Minister regard it as of no consequence?
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [4.44] - As I understand it, the dog which has come back into our conversation would be affected by the Quarantine Act and not by the National Health Act. But knowing the honourable senator’s interest in it when I have finished with this Bill I will get what information I can for him.
Clause agreed to.
Section 13 of the Principal Act is amended - (a)……
– My proposed amendment relates to clause 8. [ will be brief. First of all, can we clarify the meaning of the expression a medical service that is rendered by, or on behalf of, a medical practitioner’? What 1 am interested in is the question of physiotherapists being included in the Bill. Now, if a general practitioner refers a patient to a physiotherapist, could it be said that she or he is acting on behalf of the medical practitioner? If that is so I do not have to go any further. If it is nol so-
– It is she who gives the service.
– This is it. The physiotherapist gives service on behalf of the medical practitioner, but, of course, the physiotherapist sends her own account.
– She does not go out on behalf of the medical practitioner, does she? It is a different service, is it not?
– That answers my question no.
– I am just asking you. I am just trying lo find out.
– I think technically it may nol be that it is done on behalf of the general practitioner.
– A physiotherapist is a physiotherapist and a doctor is a doctor, therefore she would be performing the service as a physiotherapist.
– But I say to the physiotherapist: ‘Would you carry out the service on my patient?’
– It is the service of the physiotherapist.
– Yes, on the patient, lt would not come under this.
– No. it does not come into it.
– Then perhaps I should move that the Committee report progress and ask leave to sit again as a test vote on whether the Committee believes that physiotherapists should be included in the medical services because 1 have had time to speak to the Parliamentary Draftsman only casually. There have to be a couple of draft amendments and I thought it was no use getting these draft amendments done if the Committee is going to disapprove of the principle.
– What about chiropractors? Do you consider them in the same class?
– I would not mind if there were referral by a general practitioner. In other words, I doubt whether it will ever be done. But it could be done and 1 would not be opposed to that. What I want to see in the Bill is a provision that anyone who is referred by a doctor of physiotherapy treatment should obtain some benefit. That is all I am trying to get. But I do not want to go to the trouble of having the Draftsman - in fact, we do not have the time - prepare an amendment if the Committee is not in favour of the motion. I thought the easiest way to deal with it would be to move later, after o:her honourable senators have spoken, that we report progress and ask leave to sit again. Then, if that motion is defeated 1 will take it that the Senate does not want physiotherapists to have anything. If the motion is accepted, I can then get the Parliamentary Draftsman to draft a proper amendment to the Bill. I do not know whether the Committee is in favour of having physiotherapy included for medical benefits. If it is I will move later to that effect but in the meanwhile I would like to hear whether anyone on either side is in favour of the proposition.
– Does this motion have to be moved first or may I speak to the Bill?
– I understand that I should move to postpone the clause to a later hour. Would that get over the problem? I am not trying to be difficult.
[4.49] - If I might, I would like to speak to the point because I think I might be able to clarify it. We seem to have been having a little chit chat back and forth which I do not think was getting us too far. One point on which I comment is that since the inception of the scheme Commonwealth medical benefits have been limited to payments for services rendered by medical practitioners, lt is not considered that any payment of Commonwealth benefit for physiotherapy services can be considered in isolation. One has to look at all the other paramedical services such as home nursing and the provision of spectacles which may also be recommended by a medical practitioner. As the Minister for Health (Dr Forbes) staled on 4th March, a general examination of arrangements for ancillary benefits is being made. I understand that in the course of this examination of the whole field of paramedical services consideration will be given to the question of benefits for physiotherapy. These matters have been brought before the Minister and are being given constant attention. I suggest that we get on with the legislation as it is today.
Senator Turnbull, do you wish to proceed with your proposal to stand the clause over?
– Not unless there is some support for it.
– There is no support on this side of the chamber.
– It is a waste of time. The numbers are against me.
– On behalf of the Opposition I make a request for an amendment to clause S. I move:
Clause S seeks to amend the interpretation section of the National Health Act. The amendment relates to the definition of professional service’. Senator Turnbull asked what was meant by the words ‘on behalf of in section 13 (b) sub-section (1.) of the Act. That sub-section reads:
I have moved for the deletion of the words ‘in an operating theatre of an approved hospital’ in definition (b). If the amendment were carried, the definition would read: professional service’ means -
In short, our request for an amendment in this connection relates to treatment given to a patient by a specialist dentist approved by the Director-General for the purposes of the definition. It is quite clear that under the Government’s proposals dental specialists covered by the Act and who provide treatment for patients under this section of the Act will attend a public hospital or will tend to encourage their patients to enter hospital for the treatment to be given because in such circumstances, if the treatment given by the specialist dentist is given in a hospital, the patients will attract the fund benefit and the basic Commonwealth medical benefit. The Opposition suggests that these days dental specialists have very modern and expensive equipment in their surgeries which would enable them to provide the treatments covered by the schedule to the Bill so far as that definition is concerned. The Opposition asks: Why should the community have this kind of equipment left lying idle, as it were, while a valuable hospital bed is taken up merely because, as the Government intends by this clause, the dental specialist is trying to assist the patient to qualify for benefit? To us, this again is another ludicrous situation. It is an anomaly that is being written into the Act. by this legislation.
I have moved for the deletion of the words ‘in an operating theatre of an approved hospital’ mainly for those purposes. If the amendment is carried and subsequently accepted by the Government dental specialists will be able to exercise a discretion whether to perform the service in their surgeries or, if necessary, to admit the patients to hospital. In either event, wherever the service is performed by the dental specialist, if it comes within the present schedule to the Act benefit will accrue to the patient. I now raise one or two other matters under this clause. They are in regard to the items to be performed under the schedule by oral surgeons. I understand that about 100 oral treatments are afforded in the schedule but that only a limited number of oral surgeons is available. A medical practitioner colleague of mine in another place has advised me that only about 20 or 30 medical petititioners are recognised as oral surgeons in New South Wales.
– Are not we speaking of dental surgeons?
– I am speaking now of oral surgeons as distinct from dental specialists. 1 ask: Will they be the only oral surgeons recognised as oral surgeons for the purpose of this legislation? Nowhere in the Act does it appear to me to state how these oral surgeons will be declared to be oral surgeons for the purposes of the Act. Further, is an approved dentist under the Government’s proposal to be regarded for the purpose of refunds, as a specialist or as a general practitioner? For instance, does the answer to such a question depend on the type of service to be provided? By way of illustration, 1 mention the removal of a foreign body from a patient’s mouth. 1 should like the Minister to answer these questions for the benefit of the Opposition and for the benefit of the community generally. We believe that this clause because of its restrictive nature will result in the taking up of very valuable hospital beds. Because dental specialists with their modern equipment can well perform the services in their surgeries, it is important that the clause be amended by the removal of the words ‘in an operating theatre of an approved hospital’. A discretion should be given to the specialist as to whether he performs the service in his surgery or in a public hospital. I make such a. request on behalf of the Opposition.
– Do you know what the prescribed services are?
– T cannot name them all. Perhaps our friend, Senator Turnbull, who is a medical practitioner, can advise us in this connection. 1 understand from my medical practitioner colleagues in another place that about 100 services of the type set out in the schedule can be performed.
– Without labouring the point, this is an example of the difficulty in which we have been placed by having to discuss and consider these matters without any opportunity for preparation. There are references in clause 8 to prescribed medical services rendered by persons approved by the Director-General of Health. Normally in a case such as this, with a reasonable time allowed for debate, I would have got in touch with a person who was qualified as a dentist or dental practitioner in the way referred to in the Bill and 1 would have asked his advice. I would have got advice from other people. But I have no advice on this matter at all. Honourable senators on this side have been asking: ‘What are prescribed medical services?’ We are placed in an impossible position in trying to adjudicate on this matter. [ can only throw myself on the mercy of the Minister and ask: Can you please give us some information, because you have not given us any time to seek information ourselves?
– My inclination is to feel that the Opposition’s amendment here would negate the whole purpose of the amendment which is in the Bill, but I should like information from the Minister as to the character of some of these prescribed medical services, and as to whether or not any of these prescribed medical services may in fact be carried out, as Senator McClelland, I think, puts as the basis of his claim, in a dental surgery. It does appear to me that if what is in the background of this provision is to enable benefits to be available for certain medical operations carried out by medical practitioners, this provision would go a certain way towards achieving that. But if, on the other hand, it is merely prescribed medical services carried out by dentists, then, of course, as I understand it, it is breaking some new ground.
– Specialist dentists.
– Specialist dentists. It is breaking new ground, ls the criterion the prescribed medical service, because if it is, that is covered by the Act itself. Is the criterion to be the prescribed medical service in an approved hospital, because that again is making it even more limited. What I would be interested to know is: Why must it be in an approved hospital?
– In an operating theatre.
– In an operating theatre of an approved hospital. But for simplicity, I think it is easier to refer to it as an approved hospital. That is one point I should like answered. The second point is - and it is more a form of wording than getting to the substance of the amendment, but to me it is important: Why is there no provision for the Director-General to make public the hospitals which he approves? It seems to me that so many problems arise in practice because a person believes that he will be covered in some way by being in an institution. I know that the Act has provision designating types of hospitals in respect of which one can get benefits, and people may believe that an institution falls within the approved category when in fact it does not fall within that category. That is not the particular point here. But it is a type of situation which is in a sense overcome if there is a published list of the approved hospitals which is reasonably readily available. That is the second point, and I should appreciate some information from the Minister on each of those points.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [5.4] - I should like to refer to some of the points that have been raised, and if I do not cover them when I have completed my remarks I may be able to get some further information. But I should like to inform the Senate that clause 8 of this Bill was included to give effect to the recommendations of the Nimmo Committee of Inquiry into Health Insurance, relating to certain services rendered by oral surgeons. The recommendation was that medical benefits be paid when a specialist oral surgeon carries out a procedure for which an operating theatre at a public hospital is required and used. The Bill has extended the recommendation so that appropriate services performed in an operating theatre of any approved hospital, whether public or private, will attract benefits. The Bill requires these services which are to be carried out by this provision to be identified by regulation. It is not intended to prescribe services of a kind which will normally be given in a dental practitioner’s surgery. The emphasis in this matter is on the question of what services will be covered. The Government has not yet reached the point of actually prescribing these services. They are certainly not specifically identified in the schedule. I think that covers the point which Senator McManus made.
The Australian Dental Association has recently submitted details of the services which it suggests are appropriate within the context of the Government’s intention. These suggestions went no further than to remove an anomaly in the existing Act in circumstances where services could be given equally well by an oral surgeon and a medical practitioner. At present there is a working party of the Department of Health and the Australian Dental Association examining this situation in detail and, I am informed, examining the particular details of the services which are appropriate.
– Could the Minister give me a reference to the page of the Nimmo Committee’s report on which this recommendation was made?
– Yes, I shall certainly get the page number. I have an extract of the recommendation which I have taken from the report. Another point was raised concerning oral surgeons, and I think this provides the answer. There are several dentists in Australia who are rendering services as oral surgeons in hospitals. These dentists are known to the Australian Dental Association and to the Department, and they will be approved by the Director-General for the purpose. I think that answers the question which Senator McClelland raised. I am sorry that I did not give earlier the page number of the recommendation in the Nimmo Committee’s report to which I referred. It commences in paragraph 15.3 on page 55 and continues at the top of page 56. I hope that covers the points that have been raised. I think I forgot to mention at the outset of my remarks that we oppose the amendment.
– I wonder whether the Minister could make a comment on the point 1 shall make. I am interested in the following words which appear in clause 8: . . a prescribed medical service that is rendered in an operating theatre of an approved hospital by a legally qualified dentist or dental practitioner approved by the DirectorGeneral . . .
I wonder whether the Minister can give us any indication of what criteria the DirectorGeneral may apply in distinguishing between one person and another. This is something that is forever being resisted in regulations. Regulations frequently allow a Director-General to do something, but I would always prefer a rule to be laid down in legislation. For instance, I take it, unless I am assured otherwise, that the DirectorGeneral of Health could approve of a legally qualified dental practitioner who has 1 years service and disapprove of another legally qualified dental practitioner who has 10 years service. I wonder whether any criteria are to be applied. I ask the question: Would it not be better to” write in to the legislation what criteria are to be applied?
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [5.8] - This, of course, is one of the matters that 1 believe is being examined by the working party in the Department of Health and the Australian Dental Association. We will be advised by the Association as to the oral surgeons to be approved. I also point out that the States do not register dentists as oral surgeons. So this would come back to the overall decision of the Australian Dental Association, and we will accept recommendations from it. But 1 assure Senator Willesee that all of these matters are presently being examined by a working party of the Department of Health and the Australian Dental Association.
Senator TURNBULL (Tasmania) T5.9] -I think this emphasises the opening remarks in my speech during the second reading debate, when I said that we have left out of this Bill those things which we ought to have put in. As we continue to discuss these amendments, in answer to every point that we have raised so far we have been told by the Minister: ‘We are having discussions about that. We are going to do it at some time or other’.
– Or a committee is being formed.
– Why did the Government not wait? lt has had 15 years and now suddenly it wants to get the Bill through today, or by whenever it wants to get it through. I do not want to belabour that point. There are one or two other points that 1 want to raise. 1 was not quite sure what the Minister meant when she referred to an approved hospital. I presume that all major private hospitals and public hospitals would come within that category so there would be no problems about that. She said that the service has to be a prescribed medical service, that is, that the service must be listed in Schedule 1. Is that right?
– There are very few items in Schedule 1 that a dentist would be playing about with. But what does it matter whether he does it in an operating theatre? What has that to do with the Minister? If the dental surgeon thinks he can carry out the procedure in the ward bed why should he not do it there? We do lots of things other than in the theatre. We do not have to go into the operating theatre for many minor operations. I am not suggesting that the dental surgeon would not be better off by doing it in an operating theatre. Is the Minister implying that these services must be performed on a patient who is under a general anaesthetic? Some minor operations in private hospitals, although performed while the patient is under an anaesthetic, are not performed in the theatre but in the ward bed. Why is there this insistence on the operating theatre? There are very few items in Schedule 1 that a dental surgeon could perform. Also I am becoming confused by this talk about an oral surgeon. An oral surgeon is a doctor who does oral surgery, but is not a dentist also an oral surgeon?
– That is what we are talking about.
– I thought the Minister tried to differentiate a while ago and suggest that dentists were not oral surgeons.
– The medical oral surgeon comes under the first part.
– He does not come into the picture because he is a medical man and is covered already. Why are we worrying about oral surgeons when we are talking about dentists who are oral surgeons? I am not certain, but I think that a dental practitioner can perform any operation in the mouth.
– The normal dentist?
– Yes, for certain things, but for a fractured mandible or for an intricate job like that usually the dental practitioner would have a medical degree also and so the problem would not arise. Can the Minister tell us what prescribed medical services she envisages would be carried out by a dentist? Why does the dental practitioner have to be approved by the Director-General? ls not the dental practitioner a legally qualified man?
– ls it not a reference to a hospital rather than to the dentist or dental practitioner?
– No, because at the bottom we see added the words ‘or dental practitioner approved by the Director-General for the purposes of this definition’. The Director-General is going to say which dentists are to be allowed to play ball. I think that is wrong also. If the Government were honest with itself it would withdraw this Bill and let us have a good look at it. The Minister has to find out why a service has to be performed in the operating theatre and why the DirectorGeneral has to approve a dental practitioner.
– Does she differentiate between them?
– Yes. The attitude seems to be that if you play ball with me you are all right; if you are on the Government side you can do it but if you are on the Labor side you cannot.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [5. 1 3] I think I have answered already most of what Senator Turnbull has brought forward. We have already discussed prescribed services and 1 gave a reply on that question earlier. I have informed the honourable senator that the Government has not reached the point of actually prescribing these services. Recently details of services have been submitted by the Australian Dental Association. These are being discussed further with the working party which, as I have informed the honourable senator, is composed of representatives of the Department of Health and the Australian Dental Association. I have informed the Committee also that this clause gives effect to a recommendation in the report of the Commonwealth Committee of Inquiry into Health Insurance, which was the Nimmo Committee. The recommendation was that medical benefits be paid to a specialist oral surgeon for a procedure in which a public hospital operating theatre is required and used.
– I feel that possibly problems are arising because of a lack of precision in the wording. I say this with some temerity because I know that the Draftsman knows what he is doing.
– To what is the honourable senator referring?
– To the Bill in the context of the amendment. I notice in regard to the words ‘prescribed medical service’ that an area of confusion has arisen. Initially I had the view, as I think did also Senator McClelland and Senator Turnbull, that that expression related to some of the items in the schedules.
– So it does.
– Just a moment. I am assured by the Minister for Housing that these medical services have not yet been prescribed and that at some stage in the future they will be prescribed. It may be that what is intended is that some of the medical services listed in the schedule will be taken out at some stage or prescribed at some stage as being the particular medical services to which this provision will apply.
– That is required by the definition of ‘medical service’, the first definition.
– With respect I agree with Senator Wright that it is the only way in which those 2 paragraphs can be read together, but when we look at the definition of ‘medical services’ in clause 8 (b) we find that we must refer to the items in the first Schedule. If there is to be a prescribed medical service I can only suppose that the meaning of that is that you take some of these services in the Schedule and by regulation designate them as the types of services which are proposed. Senator Turnbull has suggested that it would be helpful to have some indication of the services likely to be prescribed and of the types of services likely to be prescribed. That is a way in which the paragraphs could be read together. On the other hand, in view of what the Minister said earlier, it may be that by regulation some medical services are to be prescribed in the future and the expression in this clause is not limited to the items in the Schedule. If that be the case I should think that there is possibly some problem in the drafting.
I would be grateful if the Minister could take advice from those assisting her and indicate, so far as she is able, what is intended. Likewise I think the reference in paragraph (b) of the definition of ‘professional service’ to a ‘prescribed medical service that is rendered in an operating theatre of an approved hospital by a legally qualified dentist or dental practitioner approved by the Director-General for the purposes of this definition’ also raises a problem. Do the words ‘approved by the Director-General’ refer to a legally qualified dentist or dental practitioner, which I. think has been the interpretation adopted by Senator Turnbull, or do they refer back to the earlier use of the word ‘approved’, that is, an approved hospital? If it is not meant to be an approved hospital, how do we determine what is an approved hospital? Although I must say that there is room for some doubt my understanding is that the approval of the Director-General must relate back to the hospital. If that is so, what is the criterion upon which the Director-General approves a hospital and why should there not be an opportunity for that to be published so that people will know the hospital to which reference is being made? I would be grateful to have some assistance on that. I notice that in the principal Act ‘approved’ in relation to a hospital means approved under Division 2 of Part V of the Act. But, of course, that is subject to the words ‘unless the contrary intention appears’ in the early part of that definition section. This leads me to my final point. Why does a legally qualified dentist or dental practitioner have to be approved by the Director-General, if that is the way in which the clause is to be read?
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [5.20] - We are referring to the Schedule. Of course, new items can be included in the Schedule and this will be done with those services which concern oral surgery. I thought I had explained the position, but perhaps I did not put it clearly enough. These items are matters of discussion for the working party composed of representatives of the Department of Health and the Australian Dental Association. Another point has been raised concerning approved dental surgeons. They are to be approved by the Director-General of Health. Senator Greenwood referred to hospitals. All those hospitals are approved hospitals, public and private. The honourable senator raised another point, which escapes me for the moment.
– Why do dentists and dental practitioners have to be approved, and how do you go about approving them?
– Recommendations are made by the Australian Dental Association and approval is given by the Director-General.
– I do not wish to interfere in the points that have just been discussed. 1 want to touch on another aspect. I will say in the first place that I do not care what is said by the Australian Dental Association, the Australian Medical Association or anybody else. This Bill is before us and we have to analyse it. It is of no use for the Minister or anybody else to say that we have to listen to the views of the Australian Dental Association later and we may bring in some further amendments. That is no good. Surely we have to know what is before us today. We have to analyse what is in the Bill. I find it most difficult to appreciate that a Bill of this magnitude should come before us without, shall I say, proper consideration by the people responsible.
– There are working parlies all over the place.
– Apparently they are neither working nor parties. I am not trying deliberately to misinterpret what the Minister has said. My understanding of what she has said is that if an oral surgeon performs his duties in a public hospital the patient qualifies.
– It does not have to be in a public hospital.
– I will use the words of the Bill: ‘in an operating theatre of an approved hospital’.
– ‘But not by an oral surgeon.
– Order! I ask honourable senators to cease interjecting as far as possible to give the Minister a chance to hear what is being said. I ask for your co-operation in this regard.
– I repeat that I am nol deliberately trying to misrepresent what the Minister has said, but it appears to me that the Minister said that if an oral surgeon performs an operation in an operating theatre of an approved hospital the patient qualifies; but if the same oral surgeon performs the operation in his own surgery, the patient does not qualify. Have I misinterpreted what you said. Minister? 1 take it that I am correct.
Earlier we carried an amendment. 1 wish to refer to a hypothetical case of a man who goes to an eye specialist to have his eyes tested and is told that he has a tumour in his eye. He can make a claim. But if the specialist says that he requires spectacles he cannot claim.
– But if he prescribes spectacles-
– If he prescribes spectacles - that is what one goes to an eye specialist for. I have some personal knowledge of a case concerning an oral surgeon. A person had Vincent’s disease. She consulted her own dental practitioner and he said: This is too serious for me. I will send you to an oral surgeon*. An oral surgeon treated her in his surgery and gave her most intensive care over a long period. Under those circumstances the patient would not be entitled to claim. Surely that is an anomalous position. An oral surgeon may say: ‘Look, I can treat you in my surgery for this complaint or you can go to an approved hospital. If you go to an approved hospital you will get the same treatment as I would give you in my surgery, but you will then be able to claim. If you accept identical treatment in my surgery you will not be able to claim’. Surely this is an anomalous situation which the proposed amendment would correct. I have not heard any argument advanced to the contrary. Therefore I submit with respect that the proposed amendment should be accepted on the same basis that the Committee accepted the earlier amendment relating to comparable circumstances.
– I was under the impression that the services to be prescribed in the Schedule for oral surgeons were also to be those prescribed for legally qualified dentists or dental practitioners approved by the Director-General for the purposes of this definition. Now, frankly, I am amazed to hear the Minister say that the Government has not yet reached the point of actually prescribing these services - as I understood her - for dental surgeons; that they arc not prescribed in the Schedules and that a working party is considering the matter. 1 had understood her to say earlier that whilst the Government has not yet reached the point of actually prescribing these services for legally qualified dentists or dental practitioners and whilst a working party is being set up for the purpose of considering prescription, nonetheless there are prescriptions in the Schedule for oral surgeons. I do not know how that squares with a statement in the Minister’s second reading speech. In the Minister’s second reading speech she says:
The new definition of ‘professional services’ in the Bill recognises for benefit purposes services rendered by oral surgeons in operating theatres of approved hospitals. The services to be recognised under this provision will be prescribed by regulation. 1 had the impression that an oral surgeon is a doctor who is covered by Class A, in that he performs a medical service. But the Minister has told us today, at the Committee stage of the debate, that the prescriptions have not been made for legally qualified dentists or dental practitioners. It seems from the second reading speech of the Minister that they similarly have not been made for oral surgeons. Why was not all this done before the Bill was presented here? Discussion has taken place for months on this Bill between the Government, the Australian Medical Association and the Australian Dental Association. The Bill was presented in another place on 13th April - more than a month ago. Now it is being debated here.
I was under the impression that the reason for the haste was the need of the patients; that the patients want something done. If honourable senators want the need of the patients to be considered, they will support this amendment which is proposed by the Opposition and in which we suggest the deletion of the words ‘in an operating theatre of an approved hospital’ in order to enable the legally qualified dentist or dental practitioner approved by the Director-General to exercise a discretion as to whether he will render the service in his own surgery or in an operating theatre of an approved hospital.
We could have a situation in which a lady who had a number of kiddies needed something done to her jaw, or her mandible, as I think Senator Turnbull would refer to it. She could go to her specialist dentist, who could say: ‘1 could do the operation in my surgery, but it would cost you money. If you go to hospital it will not cost you so much money because you will receive Commonwealth and fund benefit’. So the whole family is inconvenienced because of these few words in this Bill.
– lt costs the Commonwealth money, too.
– Exactly. As Senator McManus says, it costs the Commonwealth money. Frankly, I believe that this is a ludicrous situation. I appeal to the Government, if it is interested in the welfare of people and patients, to accede to the Opposition request for an amendment.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [5.32] - There is one point that I want to make at this stage. 1 think we should remember that we are entering into a whole new area when we enter the field of oral surgery. This is a very important new field. It is important that we recognise that. It is good that we are having all this discussion about it. But I think it is also good to recall that wc are entering into a new area; that a whole new area is being opened up. Tt is because of that fact that the working party, consisting of representatives of the Australian Dental Association and the Department of Health, is determining what are believed to be the best services to be included.
Perhaps 1 did not answer fully - I thought 1 did - Senator Greenwood’s question as to how the dentists are accepted by the Director-General of Health. They are accepted on their qualifications. The services are such that the dentist has to be recognised as being competent to carry them out. Not all dentists are competent to perform them. Approval will depend upon the experience and qualifications. They will be those recognised by the Australian Dental Association. They are the ones that it recommends to the Director-General of Health for his acceptance or otherwise. The whole basis of all this new area is presently under discussion and is being determined by this working party which consists of officers of the Department of Health and representatives of the Australian Dental Association. Because of the importance of this new area, it is important that they should carry out this work.
– Very shortly I will move, in fairness to the Minister, that further consideration of this clause be postponed until 8 p.m. so that she will have time to discuss this matter with her advisers. We are getting deeper and deeper into the mire or into the oral cavity; I am not sure which.
– Are you being rude to me?
– No. I would never be rude to the Minister. We are really getting into a mess. People keep on interjecting, and I realise how difficult it is for the Minister. I believe that we should have a break and return to this clause at 8 p.m. so that the Minister can take advantage of the dinner interval and come back with answers to the questions that have been raised, Senator Greenwood has raised an important one. f. do not think the Minister has answered him fully.
I am not sure what an oral surgeon is now. Does the Government mean what we call a doctor or will it classify a dentist as an ora] surgeon because he operates in the mouth? Is that what is meant in the Bill? I do not know and the Minister does not know. Can she answer that question? The main point in the mess we are in at the present moment is that we are talking about a prescribed medical service’. That means that it has to be in the First Schedule at the moment. Being in the First Schedule, it then has to be prescribed by regulation. The Minister tells us that she does not know what are the items that are already in the Schedule, but that there is a working party in existence and it will tell us later what those items are. But at the moment we arc being asked to pass a Bill under which the Government will prescribe certain items in the First Schedule. I have asked the question: What are those items? Can the Minister get her advisers to write them down? Her advisers are not even taking any notice. Perhaps she could ask them afterwards.
What we want is answers to these questions: What are the prescribed medical services that are envisaged in the Act at the moment? What is the definition of oral surgeon’? Why does the service have to be rendered in an operating theatre? I asked the Minister that question before, but she did not answer it. 1 admit that many services would have to be performed in an operating theatre. But if the service involved happened to be a prescribed medical service that did not need to be rendered in a theatre but could be rendered in a bed, why would the service have to be rendered in an operating theatre? I think most of the services would be performed in an operating theatre; but why exclude the ones that do not have to be?
I have raised this question before, as has Senator Greenwood: Why does the clause say ‘a legally qualified dentist or dental practitioner approved by the DirectorGeneral’? First of all, what is the difference between a legally qualified dentist and a dental practitioner? Have we a definition of those 2 terms? What is the difference between them? Why are they separated in the Bill? There must be a reason. Is the reason legal? I do not know. Could we find out? Then, having found that out, why does the dentist or dental practitioner have to be approved by the Director-General if he is legally qualified to do this work? We do not want Big Brother to say which ones are to render the service. If a person wants to choose A and not B, let him do so. Why should Big Brother tell him that he has to go to B and not to A? Could we have an answer to that question? If an oral surgeon is what we know as a doctor - a man qualified as a doctor of medicine and surgery - he does not have to go to an approved hospital. A while ago the Minister was saying that an oral surgeon had to work in an approved hospital; but if he is a medical man that does not apply to him because he comes under paragraph (a). So, I move:
That further consideration of the clause be postponed until 8 p.m.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [5.38] - May I speak to that motion?
-I am quite happy to have further consideration of the clause postponed until 8 p.m. if that will make any difference; but I am quite certain that it will not alter the answers that honourable senators have already received. However, we can have the answers consolidated. We may be able to obtain some further information. This is all right with me. However, I want to say that we cannot keep on doing this because there is a time factor involved in this Bill and it is very important. I presume that when Senator Turnbull says that he wants to postpone further consideration of this clause he means that we should go on and deal with the next clause of the Bill
– I am agreeable to that.
Question resolved in the affirmative.
After section 13 of the Principal Act the following section is inserted: 13a. …..
– 1 move:
After proposed new section 13a, insert the following new section: 13b. The schedule of fees shall be reviewed at least once every 2 years.’.
I do not think there is any necessity for me, on behalf of the Labor movement, to outline at length the reasons for this amendment. It relates to the common fees that have been assessed. We suggest that the schedule of fees which has been drawn up should be reviewed at least once every 2 years. In short, the Labor movement believes in a fair economic return to all sections of the community, and that as a matter of common justice this amendment should be carried by the Committee. Practically every group in the community which earns salaries or wages is entitled periodically to an adjustment after a hearing by a tribunal which considers the adequacy of its remuneration. We claim that medical practitioners should not be deprived of this right.
The Senate Select Committee in its interim report to the Parliament dealt with this matter in paragraph 22 in this way:
The Committee recommends:
That urgent action should be taken to reach agreement, by those concerned, on the establishment of acceptable tables of most common fees for all types of medical service; that such tables should be reviewed periodically;
I emphasise those words - and that any variations in the tables should be related to an index acceptable to the medical profession, the Commonwealth Government and the health insurance organisations.
The Nimmo Committee also considered this matter.
– But not as specifically as did the Senate Committee.
– No, I agree. In paragraph 4.72 on page 30 of its report the Nimmo Committee has this to say:
Apart from adjustments to the honorary and concessional arrangements, it will be necessary as previously indicated, for the established common fees to be adjusted periodically to meet rising costs and incomes. We suggest that the Australian Medical Association when it considers that such an adjustment is necessary should provide the National Health Insurance Commission with full details of the basis of adjustment proposed, including particulars of the economic indicators used in calculating the adjustment and the manner in which they have been used. Provided the adjustment proposed is in conformity with the general movement of the economy and takes account of other developments affecting the income of doctors, the National Health Insurance Commission should negotiate a revised medical insurance table wilh the medical benefits funds. Before new fees become operative sufficient time should be given to the registered organisations to introduce tables of insurance to cover the increases, otherwise contributors would be underinsured for a period.
There you have 2 committees of inquiry - one, the Senate Select Committee recommending that the review be made periodically, and the other the Nimmo Committee suggesting that the matter be referred by the Austraiian Medical Association to the national health insurance commission which it proposed and which has not been established by this Bill. The Labor Party has considered the matter and believes that 2 years is a reasonable span for an adjustment of the most common fees which have been decided upon. I think it is practical, fair and reasonable. It will ensure that as costs increase within the 2 years medical practitioners will know that their fees will be adjusted. Therefore I move the amendment on behalf of the Opposition.
[5.44] - In opposing this amendment on behalf of the Government I use the same reasons which were used by the Minister for Health (Dr Forbes) in another place when he discussed this point. The Minister said, very rightly I believe, that it is desirable for an arrangement to be negotiated with the Austraiian Medical Association for a review of the common fees on which the Medical benefits are based. A further point of considerable importance is that a ‘schedule of tees” does not appear anywhere in the principal Act or in the amending Bill but the Bill does provide for schedules of Commonwealth and fund benefits and ‘specified excesses’. These in turn are based on the common fees for the various medical services. Of course, there is no schedule of fees proposed to be included in the legislation.
The Government has given an undertaking - I think 1 should stress this point - that it will pursue the matter of reviewing the common fees on which the benefits are based to the point where there is an agreed method of arriving at a review of fees at regular intervals. The Australian Medical Association has put a particular proposal to the Government as to the way in which this should be done. The Government has not yet made a decision on that proposal but it is considering it and hopes to give a decision shortly. After the Government has made its decision there will be, inevitably, negotiation with the Australian Medical Association. I think that this is a very satisfactory way of working on an agreement for this revision. I have no doubt that a satisfactory method of updating common fees will be agreed upon, but it is not felt by the Government that this amendment should be accepted. Instead it believes that its proposal to review this matter with the Australian Medical Association is a better way of approaching the matter.
– My Party will not support the amendment. From what we have heard from the 2 reports which Senator McClelland quoted, we agree that there should be provision for a regular re-examination of the fees but we have not heard anything which proves to our satisfaction that 2 years is the proper period. We have not had time to consult with members of the medical profession and others to get an opinion on it and to decide what would be the right thing to do. In the circumstances we think that the safest thing is to leave the provision as it stands.
– I take it that the fees referred to for adjustment are those in the scale of basic Commonwealth benefits in the First Schedule, the fund medical benefit in the Third Schedule and the specified excesses in the Third Schedule. Those are the components which go to make up the list of common fees, lt is important to have some provision in the legislation for an adjustment of the fees. I am not particularly wedded to a period of 2 years but my Party has agreed on an amendment providing for a period of 2 years and it thinks that that is reasonable. Therefore I support the amendment.
Last night I spoke extensively on the concept of common fees, more particularly the differential geographical common fees, lt will be necessary as time goes on for the differentials between the various States to have the common fee adjusted lt may not be 2 years before this requires adjustment. Adjustment may be required in a lesser period or adjustment may not be required for a greater period, lt is not sufficient to accept what the Minister has said, namely, that there will be some periodic adjustment of the common fees in consultation, I take it, with the medical profession. I must ask the Minister which branch of the medical profession will be involved, ls it the organisation which represents the general practitioners or is it the Australian Medical Association?
– lt seems to me that the AMA does not represent the medical profession in Australia at present. It is something like the Australian Wool Industry Council, which is supposed to represent the wool growers. The Government will finish up consulting a body which does not represent the medical profession.
– No, it will not.
– Well, if one can believe the news media and the correspondence which one receives from the AMA and the general practitioners, it would appear that there is a considerable area of difference between the two of them. This afternoon Senator McManus said that, after consultation with one branch of the medical profession, he agreed with it having its case put to him by the AMA, but when he received submissions from the AMA that particular branch of the profession was not even mentioned. Therefore, it could not be said that the AMA was at that stage representing the views of that branch of the profession. 1 think something more will have to be said here as to whom the Government will negotiate with. 1 would like to know why this branch of the Australian work force is placed in the privileged position of being able to negotiate with the Government on a matter such as the income of its members but other branches of the Australian work force have to submit to an independent tribunal their cases for an improvement of their working conditions and wage levels. Until now, and 1 suppose it will be so in the future, the medical profession has engaged accountants to study the costs of operating the practices of its members, the increase in the cost of living and other matters which the medical profession believes to be charges upon the conduct of the practices of its members. As a result, the medical profession has arbitrarily increased the fees which it charges lo the public. We know from experience that the charges imposed by the medical profession have got completely out of hand. I am not saying for one moment that the members of the medical profession who provide professional services are overcharging or anything of that nature. All I am saying is that they have been able to increase the fees charged for their services at a quicker rate than the Government has been prepared to amend the National Health Act to ensure that a reasonable scale of charges is imposed upon the patients of these professional people.
What will happen if the matter of common fees is left to negotiations between the Government and whoever are the representatives of the medical profession? I do not accept that the AMA represents the medical profession. But what will happen if we leave it to these 2 parties to negotiate? We have had practically 9 months of disagreement between the Government and the medical profession prior to the introduction of this legislation. Are we to have months or even years of disagreement between the Government and the medical profession as to how the fees should be adjusted? And no doubt in the meantime the charges imposed on parties requiring medical services would be continually increasing.
After all, when one wants the services of a doctor one cannot just wait around until some adjustment has been made in his charges. Generally, if one wants the services of a medical practitioner one wants to go and see him straight away and not wait until such time as the haggling which is going on in regard to the benefits provided is concluded. If the common fees are adjusted 1 take it that the Commonwealth’s contribution towards the patient’s expenses will also be adjusted and the contribution by the registered fund will also be adjusted. There is in effect a 3-part programme here and negotiation is required on each adjustment. When this has been concluded the matter has to come back to the Parliament for approval. lt seems to me that if the provision which is outlined in the amendment of Senator McClelland is not included in this Bill we will be in a very short period of time faced with the same situation as the Government was faced with when it appointed the Commonwealth Committee of Inquiry into Health Insurance - the Nimmo Committee - and the Senate Select Committee on Medical and Hospital Costs. The national health scheme had got out of hand and the Government - and I do not expect the members of the Government to be experts on all of these subjects - required advice on how the position could be rectified. It got advice from the Nimmo Committee, which was its own independent committee, on how the position could be rectified. Unfortunately it has not acted on all of the Nimmo Committee’s advice. I drew attention to some of the advice which the Government has not acted cn but which 1 thought it would have been fundamental to accept. The Nimmo Committee recommended that there should be adjustments from time to time in the scale of common fees. We know that in its interim report the Senate Select Committee also recommended action of this nature. The Labor Party, which is the Party which is closest to the people of Australia, now seeks to have something mandatory written into the legislation so that a similar position will not arise again. Therefore, I must support the amendment which has been moved by Senator McClelland. I am sorry that the members of the Australian Democratic Labor Party cannot see the position in the same way as I do.
– They are not here to hear you.
– It is unfortunate that they are not present in the chamber because they are constantly complaining about the work force wanting increased monetary benefits or improved conditions. The members of the DLP are constantly critical of the work force when it goes on strike. We had an example of this today when Senator McManus raised this subject in a debate on the disallowance of a regulation. But when the Labor Party seeks to provide measures whereby a very valuable arm of the work force in Australia will have its wages and remunerations adjusted periodically - we have proposed it be done once every 2 years at least - the members of the DLP fail to support this. I often wonder what would happen if the medical profession were to go on strike, lt is quite likely that in the near future we will have a strike by a branch of the medical services over wages and working conditions. I refer to the nurses. Such a strike would completely disrupt the health services of Australia.
Sitting suspended from 6 to 8 p.m.
– Before the suspension of the sitting 1 was talking about the amendment moved by Senator McClelland which states:
The schedule of fees shall be reviewed at least once every 2 years.
I said that the nurses may be taking industrial action aud it would not be hard to imagine some form of industrial action taken by the medical profession within the terms of its oath. Unless the Government is prepared to include in this legislation some form of escalation clause it is sowing the seeds of the destruction of the national health scheme. Unless the scheme is required to be adjusted from time to time it can quite easily get into the mess which the national health scheme has got into over the past couple of years. In the inflationary spiral which we are going through at the present time it is quite easy to envisage this scheme collapsing unless there is some provision for making adjustments. It is necessary that the adjustments be made at fairly short intervals so that the geographical effects of the common fee concept may be coped with. I cannot see the doctors of Western Australia continuing to give a medical consultation for a fee of $2.80 whilst the general practitioners-
The CHAIRMAN (Senator Bull)Order! The honourable senators time has expired.
– 1 rise to suggest that the Opposition’s proposed amendment ignores the actual provisions contained in clause 9 which is sought to be amended. The Opposition seeks to insert a new section 13b into the legislation. 1 think there is an ingenious procedure which carries with it a necessary consequence that the legislation will be reviewed and amended from time to time. As I understand the new provision the fees contained in any of the schedules may be amended from time to time by regulations. lt is provided that those regulations shall not operate for a period in excess of 1 year and 16 sitting days after those amendments or regulations have been gazetted! This is quite clear from an examination of subsections (1) and (2) of the proposed new section 1.3* which carries with it as a necessary consequence that unless any amendments made to the regulations from time to time are to lapse and to be of no force or effect - which is unthinkable - there must be an amendment to the Act at some stage thereafter. Alternatively, further regulations may be introduced and there would not be the need for an amendment to the Act. Whatever procedure is adopted the necessity exists for a constant review in terms of sub-section (2) of proposed new section 13*. When this is taken into account with the repeated assurances which have been given by the Minister that the common fee will be constantly reviewed, I think that the intention and the machinery are available. I have no doubt that unless these common fees are kept in touch with what the doctors feel they should be charging the basis of the present scheme will break down. I do not believe the Government has any such intention. For those reasons I think that the amendment moved by Senator McClelland on behalf of the Opposition lacks the necessary foundation for it to appeal to the Senate. 1. think the present provision contains all that is required.
– I. must support the amendment The Minister for Housing (Senator Dame Annabelle Rankin) has stated that the Government has given an undertaking. I would be happy with an undertaking from the Government if I could trust the
Government. Let me give honourable senators facts and figures about this. They will see for themselves whether they can trust the Government. The Government introduced a scheme of medical benefits and for over IS years it has refused to increase its contribution to the scheme although, as I have pointed out time and time again, the cost of living has risen over 100%. The Government has not increased its contribution. I suppose it is reviewing its contribution. 1 expect it is having a working party. But 15 or 16 years have elapsed. The Government having made a promise to the people, it sits on it. lt does not review the scheme. The Government gives an undertaking that it might look at the contribution again. There is no way of getting the Government to do that.
Let me take the case of the chemists. I am not supporting the chemists or opposing them. I am not saying whether the amount of money given to the chemists in the first place was too high or too low. The chemists had an agreement with the Government. A figure was reached in agreement between the chemists and the Government, lt was also agreed that when the chemists felt the figure should be increased they would go to arbitration. I think it was in 1961 that they went to arbitration. This is the year 1970. 1 am not quite certain of the exact time of the arbitration but the point is thai the last increase was in 1961. When the arbitrator decided in favour of the chemists the Government said that the arbitrator did not take into account certain details, etc. lt gave an excuse. I do not care what the excuse was. But excuses were brought forth and the Government refused to accept the arbitrator’s decision. Is this the Government one is supposed to trust when it gives an undertaking which is not even written? The chemists had a written agreement with the Government that it would be subject to arbitration and that the chemists would accept the arbitrator’s decision. But the Government did not accept the arbitrator’s decision. With great indignation the Government pointed out that the arbitrator did not take this into account and did not take that into account. Why did the Government not point these facts out to the arbitrator at the time? If it did the arbitrator must have noted these points but he still arbitrated in favour of the chemists. Yet the arbitration was a complete washout. Nothing has happened since 1961.
Honourable senators may ask why doctors have very little faith in the undertaking. They have only to look at the fact that about every 2 years a fight takes place about the pensioner medical services. Every time the Government is going to look into the service. I expect there is a working party in the Department of Health. 1 do not know because I am not on the executive of the Australian Medical Association. But I do know that the doctors finally accepted a compromise, under duress. The Government is looking into the matter again, and so it goes on. Another fight will occur when the 2-ycar period is up, and on and on it will go. The Australian Democratic Labor Party stated that it had not been advised of the amendment by either side. I do not think the DLP ought to vote for the amendment, but that is up to its members. The 2-year period in which the schedule of fees shall be reviewed is insufficient. When do honourable senators think is soon enough for parliamentary salaries to go up?
– About 6 years.
– It is not 6 years; it is only 3 years since the last one.
– Is there another one coming up?
– I expect so, as soon as the elections are over. I would not mind betting my seat in Parliament - no, I had better not do that because they might deliberately not do anything, so as to get rid of me.
– We would hate to lose you.
– Thank you, but I would not mind betting a substantial sum of money that after the Senate elections are over our salaries will go up.
– You have no reason to say that.
– I have every reason to say it because we have not had an increase, as the honourable senator pointed out, for 3 years.
The CHAIRMAN (Senator Bull)Order! I suggest that the honourable senator gets back to the clause.
– Yes, I will come back to this clause. What I am pointing out is that there is no guarantee on which to accept the Government undertaking. Two years is supposed to be too short a period. The Government at one stage agreed to 3 years. I do not know where that proposal has disappeared to. In fact, I have heard the Prime Minister (Mr Gorton) mention this 3-year period and say that there would be a review in 3 years. The medical profession says 2 and with the rate of galloping inflation I think once in 2 years is quite sufficient. I do not mind if the Government makes it once every 3 years. Surely that is fair enough. There is the reverse suspicion that if we have this every 2 years the medical profession will put its fees up, but the common fee is not a set fee. It is not a price control and no honourable senator will insist on it. In fact, in my practice until I sold out we were always - as I have pointed out before - charging 50c more than anyone else, 50c above the common fee. So honourable senators would then say that we have gone up 50c already, but that is not true. Some charges are just above the common fee. The common fee is what most people charge but there are many people who charge more.
The argument of the Democratic Labor Party is that if we have a fixed period and the rate is upgraded then the doctors will raise their fees too, but is not the purpose of the review to make it an equitable and just upgrading? It would be argued that if the cost of living had risen by only X% that is all one could expect the common fee to rise. If we do not have an upgrading every 2 years the doctors themselves will put up their fees when they feel that inflation has hit them. There is nothing to stop them doing that. Then the Government will have a new review of the common fee, the computers will point out that it is higher and the Government will be in trouble again. So for that reason I think it is far safer to keep the common fee at a set level fixed to some index if we have a review once every 2 years. The other reason for having it every 2 years is a very sound one, 1 think, because if the common fee - with every justification - should go up to a certain figure agreed to by the Government and the AMA, then so should the Commonwealth contribution.
– And the fund benefits.
– And the fund benefits, but 1 am not worried so much about the fund benefits because that is a matter for the people’s pockets. It is their own contribution. But the Government, of course, would be faced with the necessity to do it. That is the real reason why the Department has set its face against this time and time again. If the doctors’ common fee went up the Department would have to put its common fee up as well. I think it is quite logical. The Government is doing more harm to the principle of the common fee by not having a review. Suppose the Government does not have a review. There is no doubt at all that if within a year inflation has soared the doctors will put their fees up just like anyone else does, lt is of no use for the ‘Daily Telegraph’ to growl about it. It has just put the price of its paper up by 2c. 1 think that is a 50% rise, is it not? It has every excuse in the world-
– With the Sydney Sunday papers it was 100%.
– Well, the newspaper proprietors blame rising costs or whatever they like to put out. They have just raised their prices. They feel this is necessary and so it is done, but when anyone else wants to raise theirs then it is tragedy. So 1 suggest that honourable senators should support the amendment because this is a better reason for the concept of the common fee. This will stabilise the common fee far more than it will be stabilised if the Commonwealth does not accept the amendment.
– I want to state again the reasons why I on behalf of the Opposition moved the amendment for the insertion of a new clause 13 b, namely:
That the Schedule of fees shall be reviewed at least once every 2 years.
Let me query the argument put forward by Senator Greenwood that there is an ingenious provision in the Bill and it flows from that ingenious provision that the Act will be amended from time to time. Might I point out to Senator Greenwood that the Schedule may be amended from time to time but the Bill certainly does not provide that it shall be amended from time to time. That is the very reason why the Opposition is pressing this amendment. At the present time clause 9 provides:
After section 73 of the Principal Act the following section is inserted: 13a. - (1.) The regulations may provide that this Act shall have effect as if a table in a Schedule to this Act were varied-
But it certainly does not say that the regulations shall provide that this Act shall have effect as if a table in a Schedule to this Act were varied from a certain time. Senator Greenwood says that if the regulations are brought in to vary the Schedule then they will lapse within 1 year and 16 sitting days after they have been gazetted. That is true but, as I pointed out, it is not mandatory on the Government to vary those regulations at any given time. For instance, although the fees to up it might be felt that there are not sufficient funds in the Treasury coffers at a certain stage for the regulations to be amended and so the day is put off.
I certainly agree with Senator Turnbull that if it is not written into this Bill that there shall be a review at least once every 2 years, then not only are the fees of the medical profession left up in the air but so, too, are the benefits that will flow to the patients. Under the present situation with there being no compulsion on the part of the Government to review the situation every 2 years, not only so far as fees are concerned but also so far as benefits are concerned, we could very quickly reach the stage, as we did in former years, where the gap between the fee charged and the amount of the refund is as wide as the Gulf of Carpentaria. If this scheme is to function somewhat efficiently - as efficiently as it can in the circumstances - then it is important that there be a provision in the Bill that the Schedule and the fees set out in the Schedule are to be reviewed at least once every 2 years. We regard it as a vital measure for the future success of this scheme and we press this amendment.
– 1 rise to oppose this amendment. We all recognise, as the Senate Select Committee on Medical and Hospital Costs did, that there must be a review of fees from time to time but it seems to me to be a very foolish proposal to suggest that fees should be reviewed at some set period because our experience is that if they are reviewed as proposed, every 2 years, we will always face the pressure for an updating of fees every 2 years whether it is justified or not. The Minister has had some discussions with the Australian Medical Association on this matter and. as I understand it, the Australian Medical Association has put some proposals to the Government. The Government recognises that there must be a review from time to time. The proposals of the Australian Medical Association are being considered and a decision will be made. I do not think there is any doubt that an amicable arrangement will be reached.
– Ha, ha.
– Despite the guffaws of Senator Turnbull, 1 understand that he is not opposed to the idea of periodic reviews as against a set time for reviews. I do not remember him pressing for 2 years when he was a member of the Select Committee, although he now seems to be attracted to it. But I do say that there should be periodic reviews and this is the proposal which the Government is now considering. I can see dangers if the Government is forced to accept a set period for reviews. This seems to me to be a matter for arrangement between the Government and the AMA. I do not think there is any doubt that an arrangement as to the period or the time when reviews should be made can be reached. To my mind, this is more sensible than the proposal of the Australian Labor Party, supported by Senator Turnbull. For those reasons, I oppose the amendment.
– I would like to make a brief observation in support of the amendment. The Minister, in her second reading speech, referred to the adjustments that may be necessary. I think this sentence is a very important one:
Such adjustments may be necessary as more comprehensive data, collected over a longer period, comes to hand regarding fees commonly charged by doctors; mainly in regard to medical procedures infrequently carried out.
Those words contain a lot of qualifications which indicate that the scheme may not be reviewed as regularly as it should be.
– Who is to decide when it should be reviewed?
– The Parliament should decide Chat.
– Then you cannot agree with the 2 years.
– I agree with the period of 2 years and I will give the Committee my reasons. I cannot understand the Government’s reluctance to accept this amendment. It has been pointed out - and it is my understanding of the Bill - that clause 9 (2.) specifies a period at which the regulations shall cease to be in force. It is 1 year and 16 days after the commencing date on which the regulations were notified in the Commonwealth ‘Gazette’. The implementation of clause 9 (2.) would create a void. Nothing else in the Bill determines when or how the scheme will be reviewed. We believe that there is nothing magical about the 2-year period. Nevertheless, we believe that a specific period should be stated. As far as we can ascertain, it would be to the advantage of all concerned if the period were the 2 years as indicated in the amendment.
– I shall speak once more because I want to put on record that I have warned the Government about this matter. If a set period is not inserted and if in the next quarter there is a considerable increase in the cost of living the Government will not be able to deny the right of the doctors to raise their fees if they wish. This will ruin the whole concept of the common fees. I think most doctors are prepared to accept the common fee, if the Government treats them properly. They have to be assured of a review - not merely promised one. I have shown that doctors cannot accept the promises that are made. The assurance has to be written into the legislation. If the Government fixes a set period I am certain that most doctors will keep their fees at the present level until the end of that review period which, it is suggested, should be 2 years. If the Government does not do that, the doctors will not know when the next review is to be. In the next quarter it is quite likely that we will have a rapid increase in the cost of living. When the next cost of living figures are given the doctors will have every right to raise their fees, just as has the baker to increase the cost of a loaf of bread to meet rising costs. The same situation applies with hospital fees. No-one complains about hospital costs which rise enormously. Virtually every year the costs and the fees rise.
The Government is asking the doctors to help implement this social service scheme. They are prepared to do so but only if they are given an assurance. I warn the Government that if it does not insert a clause providing for a fixed period doctors will have no faith in the Government. In fact, they have no faith in the Government now. If a fixed period is inserted, the Government is committed to that period of time.
– What does the AMA ask for?
– It asks for 2 years. The Government could make the period 3 years if it wished. I think 3 years is too long a period with the inflation from which we are suffering now. I think 1 year is too long. That will be verified by the next quarter’s figures. I must warn the Government. If a fixed period is inserted I think the doctors will play ball with the concept of the common fee and keep to that common fee until the end of the period. If a fixed period is not inserted, with every quarterly increase in the cost of living index the doctors will raise their fees. The Government will have no-one else to blame but itself. I want to correct something that was said about the Nimmo Committee report. The Committee said that every 3 years a review should take place. I know that the Prime Minister favoured 3 years but the Minister for Health objected because the Department did not want to have to increase continually its contribution. The Department realised that if the review were every 3 years the doctors would have every right to increase their fees and the people would have every right to expect the Government to increase its contribution.
This brings me to my final point, because the matter may as well go to a vote. Why does the Government wave the Nimmo report when it suits the Government to do so? Why does it not wave the report all the time? The Government has not carried out all the Committee’s suggestions. The Government should not say that the Nimmo Committee said something and forget to add that the Nimmo Committee also said something else which the Government is not implementing. It is very simple to pick out the best things in a Committee report and utilise them for your own convenience. There are other matters in the Nimmo report which the Government should be introducing if it has so much faith in that report. It does not recognise the report of the Senate Select Committee. It is a wonder that the Government has not moved an amendment to the Opposition’s amendment to make the period 3 years because that was supported by the Nimmo Committee. I will not say much more. I warn the Government that if it wants the concept of the common fee to work it must insert in the Bill a time factor. Otherwise the doctors will not feel bound in any way to the principle and will raise their fees with every increase in the cost of living.
[8.27] - Senator Turnbull said that the doctors want an assurance.I have already informed the Senate that the Government has given an undertaking that it will pursue this matter of reviewing the common fees on which the benefits are based. This review will be made at regular intervals. I believe that the Government has given an important assurance. I oppose the amendment. I believe that, for the benefit of the legislation, we should proceed to the next clause.
That the words proposed to be inserted (Senator McClelland’s amendment) be inserted.
The Committee divided. (The Chairman - Senator T. L. Bull)
Majority .. .. 1
Question so resolved in the affirmative.
Clause, as amended, agreed to.
Postponed clause 8.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [8.34] - Prior to the suspension of the sitting for dinner we were discussing clause 8. A request was made to postpone consideration of the clause until after the dinner adjournment, and that request was acceded to. Now once again I want to go through the points which we were discussing. The purpose of paragraph (b) of the definition of professional service’ is to bring within the definition and thus make eligible for Commonwealth and fund benefits certain services rendered by certain dentists in certain circumstances. The services concerned are such of the services set out in the new first schedule, or in that schedule as amended in the future, as are prescribed by regulations to be made under the Bill. The dentists concerned are dentists who are approved by the Director-General of Health for the purpose. The circumstances concerned are that the service is rendered in the operating theatre of a hospital approved under section 40 of the National Health Act.
The expression ‘legally qualified’ in the Bill applies to both dentists and dental practitioners. Those persons who will be approved will be either legally qualified dentists or legally qualified dental practitioners.
The approval of dentists or dental practitioners as oral surgeons will be given after consultation with the Australian Dental Association by the Director-General, and all approvals will be notified to the medical benefit organisations. The oral surgeon services which are intended to be prescribed for the purposes of the Bill - and I think that this is the area in which we got into a little difficulty earlier today - are those which, generally speaking, involve work of a kind which is undertaken by both medical practitioners and oral surgeons. The services will also be restricted to those of a kind which are ordinarily performed in public and private hospitals approved for hospital benefits, and in practice these will be confined to hospitals which have the appropriate facilities for the conduct of surgical operations.
As the benefits are intended to be limited to services of a kind performed generally in hospitals by medical practitioners and oral surgeons the Government is not prepared at this stage to authorise payment of benefits in respect of services provided in oral surgeons’ surgeries. However, the Minister for Health has undertaken that in the course of the consultations which are to be held with the Australian Dental Association’s representatives - I referred to this matter this afternoon - the list of items for the benefits which will be available will be settled. Information will be assembled regarding the extent to which these services are provided in dentists surgeries as well as in hospitals. The conditions relating to payment of benefits can be reviewed when this information becomes available. The Government believes that it would be inappropriate to go beyond the recommendations of the Commonwealth Committee of Enquiry into Health Insurance recommendations until detailed information in relation to particular services has been assembled and examined.
This afternoon honourable senators made the point that there is still much to be done and the provision should not have been included in the Bill until all the details were Finalised. If this view were accepted the benefits to patients would have to be delayed unduly. At present major oral surgery - the more important surgery which is performed in and about the mouth - is usually performed by either medical practitioners or dentists. The medical practitioner has the benefit of the medical fund. We are extending the provision and bringing in this new area so that dentists who do oral surgery may benefit. 1 hope that the Committee will see fit to support the clause as it now stands.
– Mr Chairman, I seek guidance from you and also from the Minister. As we are dealing with clause 8 which defines ‘contributor’, am I in order in asking a couple of questions about definitions?
– 1 should like the Minister to elucidate a point for me. In New South Wales there are people - not many, but some - who have dual membership of medical benefit funds. For example, they might be members of the Hospitals Contribution Fund of Australia and at the same time be members of another very thriving fund, the New South Wales Railway Transport Employees Hospital and Medical Fund. Can the Minister tell me whether people would gain any advantage from maintaining a dual membership, or would it be to their advantage to cut the painter to one of the funds.
Sena:or Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [8.45] - I am informed that there is no advantage in having dual membership.
– I wish to thank the Minister for bringing in such a wealth of information, some of which does not seem to be relevant. Nevertheless, she is having a very trying time. I congratulate her on her sense of humour in being able to stand up to this and even be able to laugh with us about it. We all realise the position that she is in. Apparently a prescribed medical service is not to be prescribed but rather will be prescribed in the future. The Minister has mentioned only 3 items that are prescribed but has stated that by regulation the Government will in the future prescribe a few more, subject to the approval of various people. I do not think that is the way to deal with a Bill.
Why were these prescribed services not thought of before? The Minister keeps talking about our having a week to study this Bill, but the Government has had it for months and has done nothing.
The second point is: Why must a prescribed medical service be rendered in an operating theatre? Admittedly many things have to be done in an operating theatre, but item 3137 refers to a ‘tumour, cyst or scar, removal of cutaneous, subcutaneous or in mucous membrane’ up to a certain length. Depending on the particular case, this could be a very minor thing for a dentist. L doubt whether a dentist would ever be involved with this other than as a result of an accident in the dental chair while he is making an incision when he may incise the mucous membrane. I think the Minister’s advisers have had to think very hard to include that item. This piece of surgery may not occur in an operating theatre. There is no necessity for it to be done in an operating theatre as it could be done in a dental chair.
The other 2 items referred to were 6601 and 6596. Those items refer to the same thing, except that one is external and the other internal. Item 6601 is the treatment of a fracture of the maxilla, which is the bone of the upper jaw, with external fixation. In other words, it is not oral surgery, lt is not within the mouth, lt might be necessary to manipulate it with a blunt instrument in order to lift it in the very rare case, but I doubt that it could be done because there is the sinus alongside it. I am trying to give the Minister every benefit. This external fixation has nothing to do with the mouth, although this is near the mouth, and is not oral surgery. The situation is becoming fantastic.
Apparently I mentioned the wrong one; it is the internal one.
– I refer next to item 6596 which more than likely would have to be done in an operating theatre, although it need not be done there. Many people work wilh local anaesthetics and many dentists have quite well set up rooms where they have anaesthetics of their own which they use when extracting teeth. A dentist - I suppose it would be a top dentist - would he able to carry out the procedures mentioned by the Minister, the 3 procedures which now have become only 2 prescribed procedures. In effect we are having all this fuss about 2 procedures. I cannot accept that these have to be rendered in an operating theatre. If they have to be performed there, well and good.
– For my edification, could it mean, if it were not in an operating theatre, that a dentist could extract all the teeth and say that this was not an operation? Would this not open up the field?
– But dentists do not go into an operating theatre.
– Bui they would.
– I think that the Government will make them go into operating theatres. There are 2 ways of handling this matter. One way is to admit a patient to a hospital. This costs the patient a lot more money.
– And an operating theatre has to be available.
– It is necessary to make appointments, but it is done. We have been giving anaesthetics for them. I would say that about 60% of all dental extractions under general anaesthesia are done in doctors’ surgeries or dental surgeries.
– Or in hospitals.
– No. I am giving a rough assessment. After all, I gave anaesthetics for years.
– But this is the extraction of teeth.’
– It. is oral surgery. That term includes any operation in the mouth. A dentist may have problems in removing an impacted wisdom tooth and might have to incise the gum. That is surgery.
– That is not in the Schedule.
– Therefore it is not prescribed. You have, told us of only 2 things that are prescribed and 1 should not be in the Schedule at all.
– Would you go back to item 3137. please?
-f-Ye$. That concerns a tumour, cyst or scar, removal of cutaneous, subcutaneous or in mucous membrane. If the trouble is inside the mouth it will be prescribed for in this legislation. That could be treated in a dental chair without any trouble. I think that the Government is bringing trouble on itself. You will increase greatly the cost to the Government. We are not trying to hinder you. We are trying to help you. You would have got this information in another place but you did not allow people there to give it. You sit and say: ‘The Government decided this’. We are asking you to listen. There are people with brains outside the Department of Health who think about these things. I appreciate that the Minister has to listen to her advisers, but there are other people who are equally talented and have other opinions about the same things. The Minister has not really told me who are oral surgeons. Every dentist can be an oral surgeon - by definition. There is no definition of an oral surgeon in the legislation and I think there should be.
– What about cancer of the mouth? Would not that involve surgery?
– Yes, but it is probable that that would be performed in hospital.
– ls not the matter of the definition of oral surgeons left to the States? ls not that what the Minister said? Did she not refer to oral surgeons who are accepted as such within the meaning of State legislation?
– Not oral surgeons, oral surgery. Even taking a tooth out is oral surgery. I do not like the provision which concerns an operating theatre and I think it should be removed. But a far more important provision to which I take exception is that which discriminates against people who are qualified. You are going to get a committee to say that only certain of our dentists are to be allowed to do this work. Dentists are legally qualified. You have taken an example of minor surgery. It was not my example. You are going to say to dentists: ‘You are not allowed to do this unless you have the approval of the Department.’ I do not like that. I think we are becoming crazy if we have to have the approval of the Department, or even the recommendation of the dentists to the Department so that the
Director-General can give approval. It does not matter who gives the approval. The point is that approval has to be given.
I now fully understand that some people are called qualified dentists and some are called dental practitioners, but I still cannot accept that the Director-General must give approval. A dentist is legally qualified and is therefore entitled to do the work and the Government should have no say in it whatsoever. I would like to see that provision removed which states that approval Qf the Director-General is necessary. The provision should relate to a prescribed medical service that is rendered by a legally qualified dentist or dental practitioner, and a full stop should appear after the word practitioner’. I do not think the Government has a right to insist upon approval. I think I will foreshadow an amendment that we delete the words relating to approval by the Director-General for the purposes of the definition. I will foreshadow that proposal after the vote has been taken on the proposed amendment relating to the operating theatre provision. I do not believe that the Government has thought about this matter. If you give any thought to it you must agree that the provision relating to the operating theatre is monstrous and nonsensical. I will foreshadow an amendment.
– I will be brief. Having heard the Minister, I press the proposed amendment on behalf of the Opposition. The Minister has persisted that the dentists concerned are to be dentists approved by the Director-General of Health for the purposes of the legislation, and the proviso still exists that the service to the patient must be rendered in the operating theatre of an approved hospital. The Minister also said that there are some services within the schedule that can be performed by oral surgeons. She mentioned item 6601-
– We altered that. It should be item 6610.
– You stated that there are 3 services in the schedule which can be performed by oral surgeons.
– At least 3. There are more.
– The Minister now says that there are at least 3 services in the schedule that can be performed by oral surgeons. During the suspension of the sitting for dinner I had discussions with the honourable member for Prospect (Dr Klugman) in another place. He is a medical practitioner and he told me that in studying this Bill he had discussions with oral surgeons. He was assured by them that there are about 100 items in the Schedule that can be performed by oral surgeons. He made this point at page 2078 of Hansard of 13th May, 1970.
We believe that by the deletion of the words ‘in an operating theatre of an approved hospital’ an extension would be achieved of the proposal now contemplated by the Minister for the benefit of the majority of the community. This afternoon I gave an example of a mother with a number of children who could quite well receive treatment with modern equipment in the surgery of a dentist. However, in order to qualify for the benefit under this legislation she would have to go into the operating theatre of an approved hospital. I suggest that that is unfair. It would be a great inconvenience to a great number of households. Modern equipment is available in dental surgeries today and dentists should be given discretion to exercise as to whether the services to be performed should be carried out in a dental surgery or the operating theatre of an approved hospital. It is in the interests of the Australian community that the amendment proposed by the Opposition be carried.
That the request (Senator McClelland’s) be agreed to.
The Committee divided. (The Chairman - Senator Bull)
Majority . . . . 6
Question so resolved in the affirmative..
– Now that we have had a full description of what this clause was supposed to have meant and we have removed an injustice by deleting the words ‘in an operating theatre of an approved hospital’, I wish to remove another injustice. Therefore, I now move:
That the House of Representatives be requested to make the following amendment: ‘In sub-clause (b), in paragraph (b) of the definition of “professional service” leave out the words “approved by the Director-General for the purposes of this definition”.’.
Taking into account the amendment already agreed to, this would make paragraph (b) read: a prescribed medical service that is rendered by a legally qualified dentist or dental practitioner;
I move this amendment because I have just as much faith in the integrity of the dentists as 1 have in the integrity of the doctors. The point is that if a legally qualified dentist thinks he can do a job he should not have to wait for the approval of the DirectorGeneral before he does that job. No dentist will fiddle around with the fixation of a mandible unless he is a qualified oral surgeon. Usually he will have the qualifications of both a dentist and a doctor. In that case he will not need to rely on paragraph (b) because he will come under paragraph (a). If a dentist is qualified to carry out dentistry or oral surgery I, for my part -I do not know what the rest of the chamber thinks - believe that it is discrimination against him to make him subject to the approval of the Director-General. I do not want to flog this point. I spoke about it before. I simply move this amendment.
– The proposition put forward by Senator Turnbull seems to be a reasonable one. I am prepared to second his request for an amendment.
– I also believe that what has been proposed by Senator Turnbull is eminently reasonable. We are dealing with dentists. We are dealing, above all, with qualified dentists. If a qualified dentist regards himself as capable of undertaking what will be a prescribed medical service, I fail to see why a patient who goes to that dentist should be denied the benefits that he would obtain if he went to another dentist, lt seems to me that the distinction between when a patient will receive a benefit and when a patient will not receive a benefit depends upon the approval of one man, and that man is the Director-General. There is no provision in the clause that we are now considering - as I understand it, there is no provision in the Bill at all - under which any dentist who may consider himself aggrieved because he has not been approved can appeal to a body which can have him put on the list of approved dentists. I believe that this is a type of situation in which the Committee would be very unwise to confer the power of approval and also the power of exclusion of persons who are qualified in their profession to undertake services in respect of which patients would legitimately expect to receive benefits.
– I believe that the amendment moved by Senator Turnbull has merit. Like Senator Greenwood, I consider that it is wrong for the Director-General to have the right to exclude people when there is no right of appeal. So 1 support the amendment.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [9.8] - There is one point I would like to make. I have already made it, but I think I should make it again. In respect of dentists, dental practitioners or oral surgeons, the approval will be given after consultation with the Australian Dental Association. It is not just an approval by the Director-General; it is an approval after consultation with the Australian Dental Association. So there is a point of contact with the people who are associated with the people who are being approved.
– That is not in the Bill, is it? That is just the procedure.
– That is just the procedure. No, it is not anywhere in the Bill. The Minister for Health (Dr Forbes) has undertaken to do this. That is the point.
– He may not always be the Minister.
– I am just making the point that this undertaking has been given. Then, of course, as I informed the Committee earlier, the working party consisting of representatives of the Department of Health and the Australian Dental Association is presently in operation. These are all matters which are under discussion by the people associated with them. I want to make it clear that this is not merely a matter of the DirectorGeneral approving a person. The approval is given after consultation with the Australian Dental Association.
– I believe that there is in this an implication more serious than might appear on the surface. Where we are dealing with medical practitioners insofar as, say, differential rebates are concerned in relation to specialists and general practitioners, 1 do not know that the Commonwealth attempts to come in and set up its own roll of eligibility. We accept the designation as it is laid down under State law. If a person is registered in a State as a medical practitioner I do not think, for the purposes of the application of this Act, that we should step in and say: We will regard so and so as a specialist, and so and so as a general practitioner in relation to their eligibility’. Apparently this clause attempts to do that in relation to dental practitioners. On the face of it that seems to be a very grave trespass into the field of State jurisdiction in the acceptance of the qualifications and registration of dental practitioners.
I think that the implications of that are very much more serious than appears on the surface in relation to the deprivation which has been discussed by other honourable senators. After all, as Senator Turnbull has said, there is no reason to believe that dental practitioners do not have the same high ethical standards as have their fellows in the medical profession. In the medical profession, if a person purports to be a specialist (he Commonwealth accepts it on his registration and his own avowment of competency. Why should a dentist be put in any other and any different position? It would appear that the Commonwealth is reluctant to accept dentists under this Bill. Only on persuasion that they will set the roll of those competent in the field, and therefore delineate very severely the situation and the circumstances in which their practice can be accepted for the rebates available under the statute, will they be permitted in. Therefore 1 think that the Committee should be particularly jealous in protecting and accepting the registration given under State law and leave it to the ethical standards of the dental profession itself, and the individuals, to show whether they are competent in that field. If they purport to practice in that field they should be accepted by us and, accordingly, the rebates should apply.
Senator Dame IVY WEDGWOOD (Victoria) [9.13] - What disturbs me about this is that we are dealing not only with a general service and a specialist service; we are dealing also with a basic service. I wonder how a patient attending a dentist will know, in these circumstances, whether or not that dentist has been approved by the Director-General of Health. A patient could have the service and then be told that the dentist was not an approved dentist. That would lead to a great deal of, confusion.
– 1 want to raise again the point that I raised before the suspension of the sitting tonight. This is why 1 support the amendment which has been moved by Senator Turnbull. If the Committee leaves this clause in and defeats the amendment on which we are about to vote, we will have the situation where a qualified dentist or a dental practitioner will be approved by the Director-General for the purpose of this definition but inevitably we come back to the situation where an officer in a department will discriminate between 2 people as to who will be approved.
The criteria on which a person is approved should be written very clearly. I do not think that at any time in legislation we should leave the situation where it becomes a matter of the whim of some officer to delineate between 2 people. There could be the situation that a person qualified for 6 months could be given the approval of the Director-General, and the best dentist in a capital city who had been working there for some time would not be given the approval of the Director-General. This is just not good enough in any Commonwealth law. A rule of law as to what these people are should be established and laid down very clearly.
If a dentist does not hold certain qualifications, a certain type of office or a certain degree of experience he will know that it will be of no use making an application. We will have the situation I have mentioned if the Committee does not accept the amendment. That is why I urge the Committee to accept the amendment and to throw out this clause altogether. If the Government wants to bring it back in another form, at least do as I have suggested, namely, lay down a rule of law and take it out of the hands of some departmental officer who can decide which of 2 persons should be approved.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [9.15] - Senator Byrne referred to State registers but all States do not have a register.
– There is a register of dental practitioners.
– But not of oral surgeons.
– No. That is why 1 say that it is left to the competence and the ethics of the men professing that competence.
– I shall continue. Where there arc registers of oral surgeons in a State, those are the people who will be approved. Unfortunately for this particular purpose there are not registers in all States. I merely wanted to make that clear.
– I should like to revert to the definition of ‘oral surgeon’, lt is stated specifically in the Minister’s second reading speech that oral surgeons should have recognition, yet in the definitions and in the Bill that aspect is not mentioned. The Bill speaks of dental practitioners and legally qualified dentists. The Minister should be able to assure the Committee that legally qualified dentists, dental practitioners, orthodontists and oral surgeons are one and the same person for purposes of recognition. If the Government cannot make that definition clearly, the Committee is being misled. In addition it seems that the Government is exhibiting an obsession against certain parts of the human anatomy - teeth, eyes, ears, bones and muscles. The man who looks after anything to do with the eyes is in a grey area and we are told to exclude him. He is beyond the pale even though he may be an ophthalmologist, a very highly qualified medical graduate.
– The ayes are very important.
– Of great importance. The ayes had it on a couple of occasions tonight. The teeth are also very important. Where will you draw the line of demarcation if a man has a fractured jaw and an orthodontist or an oral surgeon or a dental practitioner or a legally qualified dentist has to delineate between the extraction of teeth from a fractured jaw and making repairs to a fractured jaw? We have come up against other problems too. The point is that the Government is backing away from this important issue, lt docs not want to recognise the highly qualified dentist or the ophthalmologist or the physiotherapist or the chiropractor. We want the Government, to realise that these are medical services. They are requirements that should be provided for in any national health legislation.
In the second reading speech the Minister referred to an oral surgeon and then forgot him. It sounds all right in a second reading speech, but in the Bill on which posterity and the Department have to operate we have regard only to legally qualified dentists or dental practitioners operating in a theatre of an approved hospital. The whole thing is so restrictive that I believe it needs a lot more definition and widening so that the Committee will know what the Minister, the Government and the Bill mean with regard to services given by highly qualified people.
– I shall be brief in my remarks. I believe that honourable senators are in danger of accepting hastily an amendment to this legislation which may have far reaching effects. The chamber had only just taken a vote after a division on another amendment and honourable senators were finding their places when Senator Turnbull rose in his place and said that he wanted to move a further amendment. He read it once. As far as I am aware his amendment is not in writing. Nobody in this chamber has been able to study the wording of his suggested amendment to the legislation. Senator Turnbull hardly explained his amendment at all. Previous parts of the debate were referred to.
I am not attacking Senator Murphy personally; I am only trying to relate what I believe to be the true situation, but Senator Murphy rose and said that he thought the proposed amendment of Senator Turnbull was a good idea. He then resumed his seat. I do not think that Senator Murphy will disagree with me or say that I have been unfair in saying that he has been carrying on conversations, as is his right, with other members of the Opposition, but no real speeches have been made which clarify the situation. 1 understand that the Standing Orders have not been adhered to in that Senator Turnbull’s amendment has not been circulated. In fact, it has not been committed to writing and placed in the hands of the Clerks. I do not think that, apart from Senator Turnbull, there is any honourable senator in the chamber who could tell you. Mr Chairman, the wording of Senator Turnbull’s amendment.
– Ask Senator Greenwood.
– He may be able to do so.
– The honourable senator is the only one who does not know.
– I am not the only one who does not know. In all sincerity I point out to honourable senators that an amendment of this nature should be very carefully considered because in my opinion it introduces into the field of the so-called national health scheme or the medical benefits scheme quite a new phase. The amendment may be of great merit. 1 think I should point out that it is known by anyone who is interested in the affairs of the dental profession that the Australian Dental Association wishes to introduce a dental benefits scheme but it has not been able to prepare one which it would recommend to the Government that it should institute. The adoption of Senator Turnbull’s amendment might be of benefit, or it might be of great harm to this proposed scheme because it would mean that part of the dental services performed at present would come under the National Health Act. This scheme may have many loopholes in it when it is put into practice after royal assent has been given to the Bill. I am not against Senator Turnbull’s amendment but I do believe it should be calmly considered. Perhaps Senator Murphy could enlighten me on it.
– I respond to the invitation of Senator Marriott. I think the honourable senator will be enlightened if he looks at the definition of ‘professional service’ in the Bill. He will see that ‘professional service’ means:
A prescribed medical service that is rendered in an operating theatre of an approved hospital by-
And this is the critical factor - a legally qualified dentist or dental practitioner approved by the Director-General for the purposes of this definition.
As Senator Willesee has pointed out, the definition indicates that the approval of the Director-General of Health is necessary, for the purposes of this definition, in relation to whether a person is a legally qualified dentist or dental practitioner. The Opposition does not know any reason why there should be such a restriction in this regard. Here we have a prescribed medical service which has to be provided by a legally qualified dentist or dental practitioner - and any dental practitioner has to be legally qualified.
– Registered and practising.”
– That is right. Why is it necessary to have this restriction in a Bill which concerns payment Of moneys to members of the public - in effect, subsidising them, insuring them or whatever one may wish to call it - to assist them in the payment of fees- for medical or, in this case, dental services which have been provided? If they choose to have such a service provided to them why should it be that they will be covered only in the instance where the service is provided by a practitioner approved by the Director-General? I think there is a strong and good sentiment in this chamber about extending benefits to members of the public. I do not think there should be a power of this nature which, without applying any criterion, is, on the face of it, offending against the rule of law in that discrimination is made between one dental practitioner and another - I repeat, without any standard being applied except the unqualified discretion of the DirectorGeneral. Why should the rights of a member of the public to a reimbursement or payment be dependent upon this condition?
– How long would it take to get the approval?
– That is another matter. If a person is fit to be registered as a dental practitioner - a legally qualified dentist - why should this provision apply? Nothing has been advanced to show why this provision, which is unrestricted as no criterion applies, should be included in a Bill which is directed towards extending benefits available to. the public. I hope I have made clear to Senator Marriott the basis upon which the Opposition approves of Senator Turnbull’s amendment.
– I have listened very carefully to the debate and in particular to the final contribution of the Leader of the Opposition (Senator Murphy). Although he put a point of view he left a qualification out of the actual decision to be made by the Director-General of Health. The qualification is significant. The Director-General will, as has been explained by the Minister for Housing (Senator Dame Annabelle Rankin), who represents here the Minister for Health (Dr Forbes), have the advantage of the views of the Australian Dental Association. There is nothing unique about this. In the upper echelons of medicine medical practitioners give advice in general hospitals all over the Commonwealth. If the Australian Dental Association should not give advice to the DirectorGeneral, who should? There is a slight difference between the approach of Senator Turnbull and the approach of Senator Willesee. Senator Willesee said that in this instance the Director-General will be given an open go to play God as to who shall or shall not be included. On the other hand, the amendment of Senator Turnbull purports to let him play God by including everybody. This is the essential difference between the two.
I return to the point raised by Senator Marriott. In a spirit of, perhaps, getting on with things, honourable senators are taking the hurdle with an amendment without taking a little time to reflect on it. It is quite clear in my mind, and I think it is clear in the minds of the Minister and the supporters of the Government in the main, that it is not in the nature of things expected that the ordinary dental practitioner will be either competent or qualified to carry out very complicated oral surgery.
– I think he would reject the case if he thought that he was not competent.
– Senator Cant has raised an interesting aspect. I think Senator Turnbull will agree with me that it is a fact of life that there have been many dental practitioners down through the years- who have carried out very difficult surgery which would perhaps have been ^better performed by a specialist. I think a more practical approach would be to defer the clause so that we can have another look at it.
– But the Government only has until 1st June.
– This procedure was adopted earlier and the matter involved was resolved during the suspension of the sitting for dinner tonight. I think honourable senators should realise what they will be in fact doing if they vote for this amendment. Deferring the clause would enable Senator Turnbull to circulate his amendment and thus conform with Standing Orders. If it did nothing else it would do that. Senator Turnbull suggested that every dental practitioner would be thought competent to do oral surgery.
– He does not say that.
– -He does. He wants to open up the field to all dentists. Perhaps the Senate could give Senator Turnbull another opportunity to make the point clear. I saw a difference between the argument he was putting and the argument Senator Willesee was putting that the Government should not put this power into the hands of the Director-General of Health. The Director-General is going to make these recommendations in the background of advice he receives from the Australian Dental Association. Who would be more competent to advise the DirectorGeneral? Who would honourable senators have advise the Director-General? Would they have some politician make the recommendation? Perhaps another amendment is appropriate which would spell out the basis of the Director-General’s recommendation or decision and which would be founded on advice which he would receive. If honourable senators are going to vote on the amendment as it now stands they are going to vote for one principle but they seem to have 2 points of view for the reason they are voting.
– I enter this debate to discuss the matter which has just been raised by the Leader of the Government in the Senate (Senator Anderson) in reply to the amendment which has been proposed by Senator Turnbull. Bearing in mind the decision of the Senate to delete the words: ‘In an operating theatre of an approved hospital’ clause 8 paragraph (b) will then read, if Senator Turnbull’s proposal is carried: ‘ “professional service” means a prescribed medical service that is rendered by a legally qualified dentist or dental practitioner.’ Senator Anderson said that Senator Murphy left out one significant point in his submission and that was that the Director-General is to have the advantage of the views of the Australian Dental Association. The Senate has already been told by Senator Dame Annabelle Rankin that a working committee has been appointed. The Senate has been told that the provisions which are to be prescribed by regulation in fact have not yet been prescribed by regulation. These matters are not yet in the Schedule. If this amendment is carried and ultimately accepted by the Government - because it is a request for an amendment - then the working committee which is functioning between the Australian Dental Association and the Commonwealth Department of Health will know that the Senate wants to extend further the provisions which are at present in the Bill before the Senate. The working committee can take this into account when giving consideration to what medical services will be prescribed in the Schedule when it is presented by way of regulation.
– That will be done by any legally qualified dentist. That is the point I was making.
– A legally qualified dentist is a dentist who has had a number of years university training and who is enrolled on the register of his own State. The situation might vary from State to State but at least the working committee which has been functioning for some time with this present Bill in mind will know that Parliament desires the medical service to be prescribed. The services are not prescribed as yet. The Committee should take into account the fact that those services shall be rendered by a legally qualified dentist or dental practitioner. The matter is quite simple. It is an extension of the existing Government proposals. It is in the interests of the Australian community and contributors to health funds. 1 believe the amendment should be strongly supported by the Senate.
Senator Dame IVY WEDGWOOD (Victoria [9.36] - I believe a great amount of confusion exists tonight. The Senate has been talking about oral surgeons, qualified dentists and dental practitioners. I have not quoted from the report of the Senate Select Committee on Medical and Hospital Costs before. I believe that if the recommendation of that Senate Committee had been accepted hone of the discussion we have had tonight would have taken place. I will read the recommendation of that Committee because it follows the practice which the Government has adopted with regard to medical practitioners and to referral to specialists. The Committee’s recommendation was unambiguous, easily understood, and it followed a pattern. The report stated:
That existing legislation should be amended to provide that dental patients who are referred by a dental practitioner to an oral surgeon- he is a man with extra qualifications - should receive the same rates of benefit as would be payable if the referral were authorised by a medical practitioner.
In other words the Committee’s recommendation required a dental practitioner to refer patients to oral surgeons. On such a referral the patient would receive the benefits. As I said before this follows the whole pattern of the health scheme. If this had been adopted there would not have been this discussion which took place tonight.
– I think the Senate should remember an important point is that we are commencing something new in the legislation and I believe it is very important. When we speak of oral surgeons we speak of oral surgeons who are dentists but who are specially qualified by examination or by experience to undertake oral surgery. The qualifications and experience necessary to undertake oral surgery vary from State to State. As I have said in this chamber, in some States there are registers of oral surgeons. Where there is a State register the persons approved for the purpose of this National Health Bill will be those on the register. In States where there are no registers of oral surgeons - and this is important - the question arises as to which dentists are properly qualified with higher degrees or with special experience for this particular work of oral surgery, decisions will be made in the light of advice received by the Director-General of Health from the Australian Dental Association and its oral surgeon section. Surely this is the best advice the Government and the DirectorGeneral can receive. I think the point the Senate has tended to forget is that the Government wants people approved who will carry out this work to be highly qualified and experienced. I think that is the important thing we have to bear in mind. I believe the Senate should be very careful how it alters and amends this clause. If this amendment is passed the DirectorGeneral may not receive the advantage of experienced and highly trained people. The Senate should be very careful that it does not bring about a state of affairs which would not be to the advantage of the people the Government wants to benefit.
– This argument is going back and forth on the basis of oral surgeons and I challenge the Minister and her advisers to find anywhere in this Act anything that refers to this new expression oral surgeon. The simple situation is that we are talking about dentists carrying out work in a dental surgery in the interests of the people who go there. We have the Government now defending the situation whereas at first it desired to have all this work done in an approved hospital. Once that was eliminated by amendment there was no reason in the world why any dentist who is qualified could not carry out this work of oral surgery. This is like the new name for eye specialists that we have been hearing all day today. The Government is trying to confuse us with new words and not using the simple terms of the Bill. The Minister’s second reading speech did not go into this great detail that we are being told now. lt stated:
The new definition of ‘professional services’ in the Bill recognises for benefit purposes services rendered by oral surgeons.
But we cannot find anywhere in this document that is the Bill and will be the Act a reference to oral surgeons. The Bill says, in fact, ‘qualified dentist or dental practitioner. F ask the Minister what is the difference between a dentist and a dental practitioner. In my humble view there is no difference, yet we are being told here that there ure to be specialists appointed by the Director-General to carry out this work. This is because the Government had confined this work to activities within an approved hospital. The Committee in its wisdom has said to the Minister that it does not agree with this and that a dentist can cany out this work within his own surgery with the same competence and the argument that we are to have stick orderlies appointed by some person in high authority which will give some section of the dental community the right to do work in hospitals is eliminated because we have eliminated the necessity to go into the hospital.
– And that is not in the Minister’s second reading speech.
– That is not in the Minister’s second reading speech, as I am reminded by Senator McClelland. The simple fact now is that we are asking that the Director-General be not the person who appoints dentists or dental practitioners. There is no definition in the Act that differentiates between a dentist and a dental practitioner. The Government is using words that are getting it into trouble. This is its problem. It is getting itself into so much mud that it cannot swim out of it simply because on the one hand it used some simple terms in the Bill and on the other hand it started talking about oral surgeons, who are people who pulled my teeth out with or without cocaine when I was a kid of 14. This amendment moved by Senator
Turnbull clears this up and states that dentists who are qualified can carry out this work and that people who go to them are entitled to some benefit. That is the humane approach, is it not? This will give the people within the community some rights under the National Health Act and that is all we are asking.
– It is unfortunate that the representative of righteous indignation has left, having made his little speech, but what we are really debating at the present moment is: Has the Director-General the right to approve or not? I have suggested we delete that bit because I do not believe in it at all. If the Government feels so strongly about it perhaps it could arrange a working party to investigate the possibility of reinserting here the words ‘members approved by the Australian Dental Association*. That, takes away my objection although I do not think we should have that. I think the Government is carrying things to the lengths of absurdity. It is worrying about these people. The Minister said that they have to be highly qualified or experienced. She said ‘or experienced’ and not :and/or’. They do not have to bc both, do they? They can have a senior degree or they can be experienced without a senior degree. The Minister has prescribed only 3 things, lt is so ridiculous that she should keep on arguing about deletion of this approval. She has referred to tumours, cysts and scars in the mouth. A resident dental officer or junior dentist could deal with those without any problem ur all.
– That would not bc a malignant tumour, would it?
– No. polyps and things like that. I think the Minister even mentioned the maxilla. Let us face it, a dentist who has a complicated fracture is not going to try to deal with it. He will hand it over to one of his colleagues, so 1 think it is a little redundant to keep on stressing that these people are going to try and do it. The Minister has only 3 items. We have been promised more in the future.
– I did not say there were only 3; I. said these were some of them.
– I would like the Minister to tell us some more because they are pretty weak ones that she has suggested.
We might be more convinced. If one is legally qualified to do the work he can do it. One does not have to be approved by the Director-General. Why have him in at all? Let the Australian Dental Association do it if we must have somebody to discriminate. Again, ifI may use an analogy in regard to the medical profession, it is not one’s peers who judge one, it is the general practitioner who judges the specialist. He is the one who refers cases. Everyone can have a degree these days. In fact, every young boy, as soon as he leaves, gets a senior degree. It is going to get to the stage where everyone will have a senior degree. It is the general practitioner who realises that A is a much better practical man than B. They may both have senior degrees but he knows and he is the judge of what should be. So I do not think that if the Government leaves it to the Dental Association it will get them picked. The man who does the referring knows what sort of a person he is referring to- someone whom he can trust and in whom he has confidence. We have argued so much on this that if the Minister feels we ought to postpone the whole Bill I will be happy to move this for her.
That the request (Senator Turnbull’s) be agreed to.
The Committee divided. (The Chairman - Senator Bull)
Majority . . … 9
Question so resolved in the affirmative.
Clause 8 agreed to subject to requests.
Clauses 10 to 13- by leave- taken together, and agreed to.
Section 18a of the Principal Act is repealed and the following section inserted in its stead: “18a. Where a person becomes a contributor on or after the proclaimed date (not being a person who, immediately before he so becomes a contributor, was a contributor within the meaning of Part III. of the National Health Act 1953- 1969 and had been such a contributor for a period of 2 months or more), Commonwealth benefit is not payable in respect of medical expenses incurred by the person during a period of 2 months commencing -
– So far as clause 14 is concerned, I make a request for an amendment on behalf of the Opposition. We seek to leave out all words after ‘repealed’ to the end of the clause. That means that clause 14 would then read:
Section 18a of the Principal Act is repealed.
Section 18a of the principal Act relates to Commonwealth benefit not being payable in respect of the first 2 months of membership of a fund. If this amendment were carried there would be no waiting period for contributors to health insurance funds from the time when they entered the fund till the time when they became eligible to receive benefits from that fund. At the moment a contributor must have been a member of the fund for a period of, I think, 6 months before he is eligible for benefits. The proposal in this Bill is to reduce that period to 2 months. At present, if a person joins a fund and has a pre-existing illness or suddenly, immediately after joining the fund, becomes ill, he has to wait 6 months to receive entitlement to benefits. Under the proposals in the Bill, the waiting period will be 2 months.
In short, the Opposition suggests that the health scheme should take into account all the health needs of the Australian community. If such a health scheme is worth its salt, any person who is sick is entitled to receive a benefit at any time that he is a member of the fund. We suggest that the provision, as it now exists, is a bar to a number of people who could be quite genuinely ill receiving the benefit. We suggest that there should be no discrimination whatsoever. The section of the Act, as it now stands, imposes an undue burden on many people-. We believe that there should be no waiting time. We request that the clause be amended to leave out all words after the word ‘repealed’ so that the clause would say that section 18, relating to the non-payment of Commonwealth benefit for the first 2 months, is repealed. 1 move:
Leave out all words after ‘repealed’ to the end of the clause.
[9.58] - The Government opposes this amendment. I think we ought to look at it rather carefully. Tt is quite true, as Senator McClelland said, that the effect of the amendment would be to remove the 2 months waiting period. Although the amendment would mean that Commonwealth benefits would become payable immediately a person joined the fund, the fund benefits would still be subject to the 2 months waiting period. Notwithstanding this difference, the change would reduce the incentive, we believe, for persons to preserve the continuity of their membership of medical benefit funds. It would encourage people to wait until illness actually occurred or an operation was pending before joining a fund. I do not think that would be in favour of the contributor.
The amendment could have a disastrous effect on the medical insurance system. To the extent that it dissuaded people from maintaining a continuous membership, it would have a serious effect on individuals because they would lose approximately half the total benefits to which a person remaining in insurance is entitled. I think these points should bc considered before any vote is taken upon this amendment.
It is worth mentioning that persons uninsured at present could become eligible for Commonwealth benefits, immediately they joined the fund. The amendment could have an effect on the appropriation, which is another matter to be considered in connection with the amendment to the Bill. I think the point that we should bear most in mind is the importance that we place on people getting both benefits from funds. We should ensure their continuing insurance in the funds for their own benefit. I repeat, after having listened to the points raised by the honourable senator, that the Government cannot accept the amendment.
– I am nol very happy about this amendment. Some aspects of it are good. But there is no doubt, as the Minister has said, what will happen if we accept the amendment. People will insure with a fund prior to having an operation, and after they have had their operation they will drop their insurance and reinsure again in a year or two. We have not got sufficient time to consider these matters. We are always rushing. Could we not bring forward an amendment - of course, we could postpone consideration of the Bill - to provide that anyone who has not had an illness for 2 months prior to joining a fund would be eligible to receive the benefits? What I am trying to gel at is this: lt often happens that people join a fund in good faith and they either have an emergency operation or suffer an emergency illness. Obviously they would not be faking either of those things. 1 feel that it is rather harsh to disqualify those people from receiving benefits, especially when we consider the huge reserves held by the funds. ls there any way of combining what I am suggesting with the proposal which is contained in Senator McClelland’s amendment? He is seeking to repeal the 2 months waiting period altogether. Perhaps we could provide that anyone who has not suffered from an illness for 2 months, or 3 months if you like, prior to joining a fund is eligible to receive the benefits. That would eliminate liability for some operations because some people would wait 2 months to have an operation if they knew that they would be eligible to receive the benefits. ls there some way of getting this provision into the Bill? I would be happy to vote for an amendment along those lines, but I am not happy to vote for the amendment as it presently stands. If Senator McClelland would like to withdraw his present amendment, think about the matter and introduce a new amendment incorporating what I have suggested, I would be happy to vote for it, but I will not vote for the amendment as it presently stands.
– Dealing with the point made by Senator Turnbull about deferring or altering the amendment we are considering, the inevitability of the matter is that requests for amendments to the Bill have been agreed to, and therefore the Bill will go to the other place with requests. So if honourable senators have a point of view to express, they should do so, but this is not the end of the road because, as I say, the Bill will go to the other place with requests and it will then come back to the Senate. 1 would think that the logic of the situation at this point of time is not to think in terms of deferring consideration of any amendments, but to express the will of the Senate, without any stifling of debate, knowing that in fact the matter is still very much alive.
– 1 should like to caution the Senate about accepting this amendment, for the reason put forward by Senator Turnbull. But there is one other aspect. This country is being served by a national health scheme on a contributory basis. While this Government remains in power, it appears that this will be the national health service. Therefore, I believe that we as a Parliament should do all we can to encourage people to join medical benefit funds of their choice, because no-one in this world knows from one moment to another whether he will be struck down by illness or injured in an accident and incur heavy hospital and/or medical costs. If it gets abroad, as a result of this legislation coming into the Senate at this time, that the waiting period for receipt of Commonwealth and/ or fund benefits has been wiped out people will take a risk, as Senator Turnbull suggests. They will not insure until the enemy of illness or accident strikes.
Although there is criticism in some quarters of the reserves held by the funds, surely it must be agreed that the amounts of contributions and the benefits paid are worked out on an accurate actuarial basis, and the whole of this working out would be shot to ribbons if people could, as Senator Turnbull suggested, insure for the length of the illness, then stop making payments to the funds for 6 months, 1 year, 2 years or 5 years and then insure again. I know that as a family man it costs me $20.35 every 3 months to insure for hospital and medical benefits. If I get ill, or if one of my family gets ill and it is a serious illness which warrants an operation, it will cost the fund and the Commonwealth a lot more money than the S20.35 which I pay in contributions to the fund every 3 months. I could let my membership lapse at the end of 3 months and probably for a year or 2 years I could pay nothing into the fund until another illness or accident struck my family. As there would be no waiting time I would know that I would receive the benefits. If we allowed this I believe that we would be aiming a very dangerous blow at the stability of the funds and also imposing a very heavy cost on the revenue, and we would be encouraging - which I believe we should not encourage - people not to join funds, not to carry medical and hospital insurance.
– My Party would not be able to vote for the amendment as it stands. We feel that it would strike at the whole existence of the funds.
– I am sorry, but I may have given a wrong impression. 1 think I used the phrase ‘fund benefit not payable in respect of the first 2 months’. If I did say that, what I should have said was ‘Commonwealth benefit not payable in respect of the first 2 months’. What we say, in short, is that not only is the fund benefit being withheld from a person for the first 2 months of membership of the fund, but also the Commonwealth benefit is withheld from him for the first 2 months that he is a member of the fund. We say that the Commonwealth portion of the benefit going to such a contributor - and, after all, he has contributed towards the benefit by way of taxation - should not be withheld from him. We say that this imposes an undue burden on a number of people.-
We believe that the Commonwealth benefit should not be held over that contributor, as it were, in a coercive way, to get him to join a fund in order to receive both the Commonwealth and fund benefit. We say that once a person becomes a member of a fund, within the first 2 months certainly that person should become entitled to at least the Commonwealth portion of the refund which would accrue to him if he were in the fund for a period of 2 months. It is on the basis of the Commonwealth benefit not being payable in respect of the first 2 months, that we seek to repeal section 18a of the principal Act. Apart from that, all the other arguments that I put earlier still remain.
That the request (Senator McClelland’s) be agreed to.
The Committee divided. (The Chairman - Senator Bull)
Majority . . . . 3
Question so resolved in the negative.
Clause agreed to.
Section 19 of the Principal Act is amended by omitting from sub-section (2.) the definition of “professional service” and inserting in its stead the following definition: - “ ‘professional service’ does not include a medical service covered by item 631, 641, 651 or 661 in the First Schedule to this Act or by any item in Part 7 or Part 8 of that Schedule:”.
– The purpose of my request for an amendment to this clause is the same as in the previous case, that is, to repeal the provision. On behalf of the Opposition I move the following request for an amendment:
Leave out all words after “is” to the end of the clause, insert “repealed”.
This clause relates to section 19 of the principal Act which states that the Commonwealth benefit is not payable where the medical expenses are payable to a public hospital. The Opposition believes that in a proper and effective extension of the health scheme section 19 as it stands at present should be repealed. The amendment proposed by the clause deals with professional services provided at hospital. At present a person who attend for treatment at the outpatient section of a hospital does not qualify for benefits under the existing scheme although he has to pay for the treatment he has received. In short, the Opposition suggests that such a person should be eligible to receive a benefit and upon application and the payment of a fee should obtain the benefit.
This is a situation which must affect a great number of people, especially at weekends. For instance, a man might be at home at the weekend mowing his lawn and cut his foot badly with the mower. As we all know, such an occurrence is not uncommon. He could try to find a doctor but a doctor might not be available. If he were able to find a doctor and called him in or was able to attend for treatment at the surgery he would be eligible to receive a fund benefit. But supposing he was rushed to the hospital where he was treated for the wound he had suffered. In that case he would pay for the service at the public hospital but would not be eligible to receive a benefit. If he had been able to get the service of a private medical practitioner he would have been eligible for the benefit.
We suggest that in some respects the repeal of this section would only ease the burden on a contributor to the scheme but also could result in an easing of the burden on the State hospital systems. We suggest that the provision that exists at present is anomalous and unjust, and that if a man is treated for a medical condition and he is a member of a fund he should be eligible to receive the Commonwealth and fund benefits, irrespective of where the service is provided. We suggest that the present situation should be rectified while this national Parliament is giving consideration to a national health scheme. Therefore 1 make the request for an amendment on behalf of the Opposition.
[10.18] - I have listened to the honourable senator concerning this proposed amendment. Honourable senators will appreciate that the amendment proposes the repeal of section 19 of the principal Act. The effect of this would be to make Commonwealth benefits generally payable for medical services received at public hospitals. I inform the Committee that section 19 of the Act was introduced for the protection of patients. Many services have traditionally been provided by public hospitals without charge to patients or provided at a nominal charge. It would have been to the disadvantage of patients if the medical benefits scheme had caused this situation to change. If benefits had been generally payable for services given at public hospitals it is probable that hospitals would have introduced charges somewhat comparable with those applied by private doctors. Such a development would no doubt assist hospital finances, but certainly it would not have assisted the patients for whose benefit the scheme was introduced. It was to benefit the patients that this section was put into the Act.
I am aware that the Senate Select Committee on Medical and Hospital Costs recommended that out-patient and in-patient services at public hospitals be incorporated in the health insurance system with payment of appropriate Commonwealth and fund medical benefits. The Nimmo Commonwealth Committee of Inquiry on Health Insurance made a similar recommendation. The general question is one of several that are presently being discussed between Commonwealth and State officers as a preliminary to their being considered by the Government. So I believe it is very important that the amendment be opposed at this time and deferred for consideration when the Commonwealth and State negotiations have been completed. I repeat that the Government could not at this time accept the amendment moved by the Opposition.
– I am no: quite clear about this matter. I presume that it refers to public beds where a charge is made for X-rays and pathology. Is that one of the things?
– It could refer to out-patients.
– Yes, and also lo intermediate beds in public hospitals. Would this have application to intermediate beds in public hospitals as well?
– We have not had time to discuss these things. We have been sitting here all day and I am trying to find out: now what it all means. The Government has working parties for every darned item in the Bill. We have not. We must try to find out this information by extracting it very slowly.
– You really want a search party.
– That is right.
– It is Senator McClelland’s proposed amendment and it is up to him to make his case.
– All right. The Minister has made her case several times but even then we have had to get explanations. All I want to do is have the matter clarified. Does this mean that in public hospitals for intermediate beds there is no Commonwealth payment?
– No. It does not apply to intermediate wards. It concerns public wards and out-patients.
– But it should. If you are in an intermediate ward do you get the Commonwealth benefit?
– The medical benefit. I am just trying to find out about this matter. I want it to be clarified. The time is rapidly approaching when honorary systems in hospitals will be eliminated. I am not certain whether the Government has a working party on that, but it is obvious that that change is coming. Once the honorary system is eliminated obviously the public hospitals will have to be able to recoup the money to pay the former honorary staff who will become salaried staff. They will therefore charge for those services and will expect to get money from the fund benefits. Therefore the Commonwealth should pay. If the Commonwealth pays, this relieves the State hospitals of a certain amount. I believe that when a patient leaves a hospital he can sign a form directing a fund to make a payment direct to the hospital. If we accept the proposed amendment it will help the State hospitals. On that ground alone I think we ought to accept it. But there is another problem. There is no doubt that the time is coming when out-patients will be charged. I think again the Commonwealth can say: ‘We give grants for hospitals in the loan funds and therefore we do not want to give them again in benefits.’ I think that any medical services should attract not only a fund benefit but also the Commonwealth benefit. Therefore I am inclined to vote for the proposed amendment unless I hear something to change my mind.
– Did I understand the Minister to say that this procedure was recommended by the Senate Select Committee on Medical and Hospital Costs and the Nimmo Committee and that no doubt those recommendations are under active discussion and consideration between the Commonwealth and the States? Is that the position?
– And it is for that reason that the Minister suggests it would be untimely and premature to adopt the procedure suggested in the proposed amendment in anticipation of what may emerge from the discussions?
– That is right.
– There seems to be a misunderstanding on one point. Senator McClelland tied his case to out-patients and that was clearly understood. I can speak with knowledge only of New South Wales. For intermediate patients in a New South Wales hospital, and generally speaking there are no private beds, a doctor has a right to charge a fee. The hospital also charges a fee. But if you are a public patient you undergo a means test when you are admitted. Subject to that means test the hospital makes a charge but there is no doctor’s charge.
– What about pathology and X-rays?
– This is the point the Minister makes. These are matters under discussion between the Commonwealth and the States - the methods of means testing by the States and the charges that they make for fees. It would be completely premature at this point to get into that field. I think that Senator Dame Annabelle Rankin has made quite a valid argument. In the case of intermediate patients the hospital and the doctor each charge a fee. Public patients undergo a means test, and subject to that means test a hospital can charge a fee; but there is no medical fee because the treatment is given by honorary visiting medical staff, plus the resident medical staff, under the supervision of the medical superintendent of the hospital.
– I thank Senator Anderson for his elucidation but I still have a problem in my mind. Some public hospitals do charge for services like X-rays and pathology. I heard an interjection that a charge is made in the public wards of the Mater Hospital in Brisbane. Perhaps the officers can tell us whether that is so.
– A charge for what?
– Services. Senator Gair - No.
– Not in the public wards?
– Queensland is a different case altogether.
– But in some other States I believe a charge is made, for services like radiology and pathology.
Senator Dame ANNABELLE RANKIN (Queensland - Minister for Housing) [10.28] - Exceptions are made in respect of pathology and radiological services because such services were not generally available in private practice. Section 19 of the National Health Act provides:
The Commonwealth benefit is not payable in respect of a professional service where the medical expenses in respect of that service are paid or payable to an authority conducting a public hospital or to a person or body of persons acting on behalf of an authority conducting a public hospital.
Butthe exceptions are in the cases to which Senator Turnbull referred - mainly pathology and X-rays. Where a fee is charged for these services a benefit is paid.
-I would like to clarify that. There are charges for pathology and X-rays in certain public hospitals.
– And for beds.
– But the point we are dealing with does not concern beds. And the Commonwealth benefit is paid?
– Yes, for those cases which I mentioned, with the exceptions of pathology and X-rays - the point you raised.
– You said except for them. The Commonwealth benefit is paid for pathology and radiology?
– That is correct.
– Not in all circumstances.
That the request (Senator McClelland’s) be agreed to.
The Committee divided. (The Chairman - Senator Bull)
Majority . . . . -
– There being 25 Ayes and 25 Noes, the question is resolved in the negative.
Clause agreed to.
– 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.)
– 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.
– I want to take a few minutes of thetime of the Senate to refer to cases of acute hardship in South Australia which could be relieved bythe Department of Social Services if it had some means of getting decisions down to the lower levels of the administration. For the past few weeks there has been a cement workers strike in South Australia which has resulted in loss of employment for all the men employed in all the industries that rely on cement.
– This might be a good time to call for a quorum.
– I would suggest that the honourable senator not press the point. There are reasons why he should not do so.
-I wish he would, because tactics are busily engaged in.
Although there was a gentlemen’s agreement tonight, it was not observed on the Government side; so I do not see why we should be the only ones who observe gentlemen’s agreements.
In South Australia there was a lot of unemployment as a result of the industrial dispute in the cement industry. Included in this unemployment were employees of the firm of James Hardie and Co. Pty Ltd both at Birkenhead and at Elizabeth. Of those who were dismissed or stood down because the firm did not have supplies of cement with which to carry on working, those who had had 4 months employment since their last annual leave were awarded 7 days annual leave and those who had not had 4 months employment since their last annual leave received no annual leave. After being off for a fortnight, they have now returned to their employment with the resumption of work by the cement workers. They have to wait a further fortnight before they will receive their pay. That will be a month after the beginning of their period of unemployment.
Immediately they were stood down, they applied for unemployment benefits. After 7 days of unemployment they were entitled to unemployment benefits. When they applied for unemployment benefits at the office of the Department of Social Services in Elizabeth, they were told that their applications had been received and then after 7 days they were told that the papers had to be sent to Canberra to be processed in order to determine whether they were eligible for unemployment benefits.
Yesterday I inquired at the office of the Minister for Social Services (Mr Wentworth). I spoke to his secretary, who said that he would make inquiries and let me know the result. This morning he rang me back. He said that he had inquired into the matter and he set out the details as follows: If the men were members of a union that was engaged in a strike they were not entitled to social service benefits; if they were members of a union whose members were out on strike in sympathy with strikers they were not entitled to social service benefits; but if they were members of a union whose members were unemployed by virtue of inability to carry on because of lack of supplies as a result of a strike they were entitled to unemployment benefits. He said that this information had been passed on to the office in Adelaide. He thought that by the time he was speaking to me the officers in Adelaide would have the information.
I immediately rang the union concerned and told the union officials the position, namely, that the notification would be in Adelaide and that if the men applied they should receive payment. They went and again were refused because the officers had heard nothing from Canberra. The union secretary got in touch with Mr Mander, Senior Assistant Director of Social Services in Adelaide, who said that he knew nothing about it. I then rang Mr Wentworths secretary who told me that the information should have been there but it was then too late to check.
Some of those who were stood down received a week’s annual leave but there are others who did not. There are some cases of hardship. In this regard I have in mind the case of a Mr Richardson who has 6 children. He had no annual leave entitlement. He has been off work for a fortnight and he has to wait another fortnight before he receives any pay. He is entitled to at least 7 days social service benefits. The Minister’s secretary here has clarified the position. I have learned that because of the inability to get the money to South Australia the man is without pay.
He called again late this afternoon. He is desperate. He cannot feed his children. He went into the union office in Adelaide in a nervous state. People in the office offered to lend him money but he said that he has booked up debts everywhere and cannot commit himself to borrowing any more money. This man is desperate and most upset. Through some mix up he has not received his entitlement. I ask the Department to act more thoroughly and more quickly on this and other claims which have resulted from the dispute in South Australia.
– I rise to give further information on a matter I mentioned this morning in relation to the price of petrol and taxes which oil companies have to pay. This matter came to my notice in a radio broadcast that I heard this morning and I thought that it was of such importance that I brought it to the attention of the Senate. I certainly was aware of the difficulty of the
Leader of the Government in the Senate (Senator Anderson) when 1 asked him the question this morning because I realised that he might not have any information on it. I have since tried to apprise him of certain material that I have received. Recognising how questions can be fobbed off and feeling that, this is a serious matter, I sought information from the radio station concerned and secured the text of the story that was broadcast in the 6.45 a.m. bulletin this morning and on a number of occasions later. I think that I heard it on the 7.45 a.m. broadcast. The text of the story which is headed ‘Petrol Prices’ is as follows:
A petrol company executive said yesterday that Australians would pay less for petrol- if the Commonwealth Government stopped refineries exporting petrol from Australia to beat taxation costs.
The Chairman of XL Petroleum Pty Ltd, Mr Sykes, said that overseas owned refineries exported more than 60 million gallons of petrol in the last financial year at an average price of 10.7c a gallon. This compared with the selling price of super grade petrol in Melbourne of 43.4c a gallon.
Mr Sykes said that in the same period the refineries had imported 74 million gallons. He said that Australians were bearing the cost of millions of gallons of petrol being moved around the world. He said that Australia’s foreign exchange position would be improved by stopping oil companies evading tax.
I felt that that was a most important statement. I am not vouching for its authenticity but I have asked the Government to look at the matter. I am aware that at present there is an application before the South Australian Prices Commissioner from the oil companies for a rise of at least 2c a gallon in the price of petrol. J believe that the South Australian Prices Commissioner has been sitting on the application for some time and it is expected that a decision will not be given before the end of this month because of certain things which are likely to take place in the States and in the Australian Capital Territory.
The point is that if the statements made by Mr Sykes are correct not only are the oil ompanies evading tax, which is important to every Australian, but as well we could sell petrol in Australia at a much lower price than the present price. Unless there is some investigation over the next 2 weeks it is obvious that petrol prices will be increased, not reduced. I apologise for raising this matter at this late hour, but it is so important for the wellbeing not only of motorists but also of all Australians if a charge of evasion of tax can be substantiated. This is a matter which affects every Australian and it should be ventilated. The Minister should be given all the information and advice that is available. I have already given him the information that I have and I hope that this matter will be investigated before the inquiry into the application for an increase in petrol prices gels under way before the Prices Commissioner in South Australia.
– I shall respond to Senator Cavanagh on behalf of the Minister for Housing (Senator Dame Annabelle Rankin) who represents in this place the Minister for Social Services (Mr Wentworth). I have gained the impression from what the honourable senator said that he already has made contact with the secretary of the Minister: for Social Services in regard to what he says is a delay in the payment of social service benefits which have become due by reason of a series of circumstances. In the honourable senators view the delay has been caused by a lack of communication between the executive and the Salisbury office. All I can do is promise to direct the attention of the Minister for Social Services to the honourable senator’s remarks. I will do that first thing in the morning.
Senator Fitzgerald raised at question time this morning a matter which flowed from a report he had beard of a statement made by Mr Sykes, Chairman of XL Petroleum Pty Ltd. It was a fair enough question. Very properly I took it under notice because it has many implications. Mr Sykes has chosen to say that because petrol is being exported from Australia a reduction in the price of petrol is being denied to Australians. That is the assumption that Mr Sykes is making. I would wish to have the matter looked at closely within the complex of the Department of Trade and Industry and the Department of Customs and Excise which, I think, administers the requirement that Australian companies take a certain percentage of Australian crude oil. 1 rather fancy that an abridged comment was put over the air. It may be an abridgement of what Mr Sykes said. One would need to look at the whole thing in context.
It is true that the retail price of petrol is fixed across the Commonwealth on the basis of what is decided by the Prices Commissioner in South Australia. There is price control in South Austraiian and for convenience other States use the retail prices fixed by the Prices Commissioner in that State. I am convinced in my own mind that the export of petrol from Australia has many implications which would be linked to the obligation - a very wise obligation which this Parliament has imposed - that all oil companies must take a certain percentage of Australian crude. That is an essential ingredient associated with the search for petroleum crude in Australia which has been a great success so far. I think that factor will be found somewhere in this series of complexities. Therefore it would be more appropriate to obtain for the honourable senator a reply from the Department of Trade and Industry and the Department of Customs and Excise which, I think, administers this section of the law.
– I advised the Minister for Housing (Senator Dame Annabelle Rankin), who represents the Minister-in-Charge of Aboriginal Affairs (Mr Wentworth), that I intended to speak tonight. As she is not in the chamber may I direct my remarks to the Leader of the Government in the Senate (Senator Anderson)? I will not detain the Seriate for any lengthly period but I want to raise 2 matters both of which deal with the conditions of Torres Strait Islanders. - The first relates to an urgent telephone call that I received from a responsible member of the Aboriginal and Torres Strait Islanders Advancement League this evening. He advised me that the construction work which is being carried on at present in relation to a new dam on Thursday Island has necessitated the removal of 2 families - one with 6 children - and may involve up to 5 or 6 families in this area. They have been told that they will not get other accommodation. Tn fact, they are being turfed out on their ears without ‘ any alternative accommodation. I appeal to the Government to intervene in this matter and ensure that accommodation is secured for these people.
For those honourable senators who do not know Thursday Island I should perhaps point out that it is virtually an island of decay with old houses which are being let by unscrupulous landlords at exorbitant rentals to those people who are non-white. There is a lack of government assistance, there is one islander on the Island who has secured a war service home, although a large number of them are qualified to obtain them. I make this urgent appeal to the Government. I have promised the gentleman concerned that I will ring him back after the Senate adjourns tonight to let him know whether his case will be considered.
The other matter I wish to raise, which also concerns these people, is the decision of the Queensland Government to call tenders for the development of the wolfram deposits on Moa or Banks Island. Mr President, you may recall that this morning I asked the Minister for Housing who represents the Minister-in-Charge of Aboriginal Affairs in this chamber, whether something could be done about this matter. I believe that further developments have taken place in the last few hours. It is obvious that this matter is going to be pursued to the bitter end. There is a co-operative in the area whichhas been registered and operates in other fields. It has been registered in such a way that it is able to carry out mining operations.
I do not know the extent of the wolfram deposits on Banks Island. ‘ They are fairly extensive, but they may not be of high quality. At current prices the mining of these deposits probably would be a profitable proposition if properly developed. The Bureau of Mineral Resources has been approached, but it has said that it does not have the personnel or the equipment to carry out proper surveys to determine the extent of the deposits. I believe that Government departments, with the equipment personnel and knowledge which they have at their disposal, should be able to help these people develop their resources.
I fear, and I think my fears are justified, that this venture will be leased to private enterprise. Probably about 10% of its net profits will go into some obscure trust fund. I contend that the property is owned by these people. It is so called Crown land, but it is in fact tribal land. I make this appeal tonight because I believe that, having regard to a letter I received from the Minister in Charge of Aboriginal Affairs only today, the Commonwealth has power to carry out a supervisory operation. I wish to quote two or three of the relevant paragraphs. I wrote to the Minister in Charge of Aboriginal Affairs last October. I am not complaining that I received a reply to my letter only today. It has taken him some months to reply and it is obvious that he has given fairly serious consideration to the matters which 1 raised. The Minister has made certain statements in his letter which I believe will have far reaching effects. The Minister’s reply was precipitated by a letter which 1 wrote to him on 13th October concerning the rights of people on Aboriginal reserves in Queensland, or the people in charge of them, to exclude people who have in fact a perfect right to enter those reserves. The Minister’s reply to mc states in part:
The particular cases you were concerned about derive, as you know, from the provisions of the Aborigines and Torres Strait Islanders Affairs Act 1965-67, regarding entry to reserves. The restrictions apply to non-Aborigines also. However-
And this is a very important point - 1 do not regard this as a total argument to justify such restrictions.
The Minister’s reply went on to say:
In his policy speech on 8th October the Prime Minister stated: “In recent years, most discriminatory legislation against Aborigines has been abolished. We intend to see that this process is completed in the life of the next Parliament upon both State and Federal levels.’
As a result of the 1967 referendum the Commonwealth has concurrent legislative power with the States regarding Aborigines.
This is a very important declaration of policy by the Government. I contend that if the Commonwealth has those powers it has power to ensure that the people on Moa or Banks Island receive the justice to which they are rightly entitled. The Minister’s letter went on:
The Commonwealth and the States have been discussing discriminatory and special legislation for some years, and in the last decade, major changes have been made in all State Acts relating to Aborigines. I would hope that the Commonwealth will not be compelled to bring down legislation in order to invalidate some sections of a State law.
I repeat that the Minister says that the Commonwealth has the power to bring down legislation to invalidate State laws. As you know, Mr President. I and other honourable senators of the Opposition have continually complained in this chamber about the far reaching effects of the 1965 legislation in relation to Aboriginals and Torres Strait Islanders in Queensland, particularly those sections of the legislation which are being partially implemented by a number of employees of the Office of Aboriginal Affairs and by the relevant State Ministers. The Minister’s letter continues: 1 and my colleague, the Minister for the Interior, met with State Ministers responsible for Aboriginal affairs in March this year.
You will recall, Mr President, that I have described this conference as being a secret conference because we have heard very little about the matters which were discussed. The Minister’s reply continues:
State legislation deemed to discriminate against Aborigines was discussed, and it was agreed that discussions between the Commonwealth and individual States proceed. I have asked my colleague, the Attorney-General, to assist me in these discussions.
So far as 1 am concerned this letter is about the most important document which has been produced by the Minister since the Office of Aboriginal Affairs was first established a few years ago. I believe that the island council met some weeks ago - about 18th or 19th April - and it was attended by a number of people who are not members of it. Most of these people were from State bodies although one or two came from the Commonwealth’s Office of Aboriginal Affairs. I have been led to believe - and I think justifiably - that some of the people in the background of the island council were what we say in good Australian language ‘conned’ into giving this authority to the State Government to call for tenders. Originally a company was established which was going to give 50% of the net returns to the people who owned the deposits. This proposal subsequently fell through. The co-operative I mentioned a while ago ought to be in a position - with Government assistance, proper administration and proper guidance - to develop these deposits so that not less than 95% of the net profits would go to the people who own the deposits. I hope that this is what the Government will try to do. I issue this word of warning, Mr President: If I feel that we are not going to get any assistance I believe I would be perfectly justified in taking out a miner’s right over the whole of these deposits in order to preserve them for the people who own them. I would do so not because of my interest in what is there but because T believe that some organisation, some Government department or somebody has to assert this authority to ensure that the rights of these people are protected.
If that fails and if the right to mine these deposits is given away to private enterprise, which will exploit the people and pay them $5 or $10 a week at the very outside while the profits are taken -off the island, I shall be personally responsible for inciting - if you want to describe it that way - every islander on these islands not to work on the project. This is the only way in which they will be able to protect the deposits for themselves and their children and, if the mining continues over a number of years, for their children’s children. These deposits may prove to be quite vast. This is not the only island with minerals of some sort on it. These are other areas which are worth prospecting and perhaps later exploiting. 1 appeal to the Government to do what I have requested in these two instances. I am not trying to blackmail the responsible Minister into replying, but .1 hope that she will be able to tell me tonight that I can ring the organisation concerned and tell its representative that there will be at least some sort of leeway while the matter is sorted out and that people will not have to sleep on the beaches tomorrow night.
– 1 wish to support in a brief and general way the matter raised by Senator Keeffe. It concerns the people of the Torres Strait islands. 1 would like to impress upon the Minister in Charge of Aboriginal Affairs (Mr Wentworth) that the people of the Torres Strait believe themselves to be in a neglected position. They seem to be in a no man’s land between New Guinea and the mainland. Australia is spending a tremendous amount of money in New Guinea which is close by but is spending very little in the Torres Strait. The Torres Strait islanders on Thursday Island are living in a condition of degradation. No other word describes it. They are beginning to live in conditions which are primitive. They are living in shops which have been boarded up with broken fibre They have been subjected to invasion by trawler fishermen. They arc influenced by quite a number of hotels. The whole of their life is beginning to fall away. They are not receiving the assistance they ought to be receiving.
Australia has made a grant of $53 m to Indonesia. The decision to make the grant is known in the Torres Strait. The people are beginning to feel that perhaps they are not being thought of. Unfortunately it is neglect on the part of the State Government which has control of this area. It is the State Government which is at fault. What the Australian Labor Party is trying to impress upon the Federal Government, the Department of Social Services and the Minister-in-Charge of Aboriginal Affairs is that some initiative will have to be taken in this area. I have a copy of the letter which was sent to Senator Keeffe and which seems to indicate in fairly strong terms that the Minister is thinking that the Federal Government may have to take a firmer initiative and may even have to invade another territory of State responsibility. Personally I think this would bc a good thing for the Torres Strait islanders. I think it is necessary for the Department to look at this possibility, when it considers the legislation for control of territorial waters, of restricting the waters around the Torres Strait islands for the benefit and use of the islanders who have a natural capacity to work the seas.
Senator Keeffe has spoken of the mineral wealth to be found on these islands. He has stated that it is necessary that these minerals be exploited for the good of the island people. An agreement was made by the Government in connection with Groote Eylandt, lt is favourable to the people of that island although I do not think it goes quite far enough. In any legislation which is likely to be brought down the Department should make certain that if any mineral exploitation is to take place in that area the rights of- the Torres Strait islanders should be protected. The Australian Labor Party asks the Department to go further and see whether the riches of the seas surrounding the islands shall be exploited by the islanders for their benefit. A problem exists here. I ask the Minister to look at this. On Banks Island or Moa Island - the island to which Senator Keeffe has referred - is situated the village of St Pauls. It is a Christian community which consists of people who are descendants of Pacific islanders. They are people descended from the Kanakas who were brought to Queensland as forced labour. There is no other term one can use. Their descendants are now living on Banks Island.
In the general appeal the Australian Labor Party is making for these people in the Torres Strait I want to ask the Government whether the benefits which it has provided under the federal aid programme for Aboriginals cover these people. Are they entitled to seek assistance under the Commonwealth Capital Fund for Aboriginal Enterprises? These people are not Torres Strait islanders and they are not Aboriginals. It is my feeling that some definition will have to be given by the Department which will cover these people so that they can receive assistance. They need assistance in a great number of directions. They need employment; they need assistance with employment; they need housing; they need all these things. This area has a tremendous potential to assist the people of the islands but the initiative must be taken by the Federal Government. The State Government has not accepted its responsibility in this area and in many other areas.
Increasing pressure will be put on the Department and the Government to take over these State responsibilities. The indication in this letter from the Minister, Mr Wentworth, to Senator Keeffe is that the Federal Government has the power to do so. Pressure for the Government to take action is increasing. This is what we arc asking tonight. We ask the Government to accept greater responsibility in this area and in particular this island of Moa which has fairly extensive deposits of wolfram. The wolfram deposits concerned no-one for many years until the natives set up a cooperative for the purpose of exploiting these deposits. Immediately they took this step everyone took interest in the deposits. They were told that they could hot take it, or that if they did exploit the deposits it would have to be for the whole of the Aboriginal population or the whole of the Torres Strait islanders. No consideration was given to those people who have lived, existed or subsisted on that island for generations. Now consideration is being given to them because there is some prospect of great wealth. The Australian Labor Party asks the Department to take firm steps to protect the rights of the islanders. I believe this can be done by the Department making a survey through the Bureau of Mineral Resources. It is no use saying that the Bureau has no geologists available. When we suggested a survey the answer came back that no geologists were available. There must be some geologists available. We are asking that priority be given to this proposition that the depth of the deposits on Moa Island or Banks Island be investigated by a Government department. A private firm should not be allowed in to speculate, take out feasibility tests or try to make a killing on the share market by saying:’There are signs of wolfram there; buy shares because they will give a capital gain.’ The Government should not allow this to happen. The Bureau of Mineral Resources should make a survey to determine the extent of the deposits and take every precaution to see that the people both at Kuban Village and St Pauls Village are protected.
[11.8] - I listened with great interest to Senator Keeffe and Senator Georges who both come from Queensland and who raised points concerning the islanders. I shall certainly take the ‘ matter up with the appropriate Minister and see what information I can obtain for them.
Question resolved in the affirmative.
Senate adjourned at 11.9 p.m.
Cite as: Australia, Senate, Debates, 21 May 1970, viewed 22 October 2017, <http://historichansard.net/senate/1970/19700521_senate_27_s44/>.