29th Parliament · 1st Session
The PRESIDENT (Senator the Hon. Justin O’Byrne) took the chair at 10.30 a.m., and read prayers.
– I give notice that on the next day of sitting I shall move:
That leave be given to introduce a Bill for an Act to amend the Parliamentary Proceedings Broadcasting Act 1946-73.
– I give notice that on the next day of sitting that I shall move:
That leave be given to introduce a Bill Tor an Act to amend the Parliamentary Papers Act 1 908- 1 963.
-I give notice that on the next day of sitting I shall move:
That the Atomic Energy (Prescribed Substances) Regulations, as contained in Statutory Rules 1974, No. 39, and made under the Atomic Energy Act 1953-1973, be disallowed.
– My question is addressed to the Minister representing the Minister for Social Security. Is he aware that up until 1 January 1974 all categories of medical practitioners were paid uniform fees for medical services rendered for the Australian Governmentthat is, for pensioners, repatriation patients, etc. -but now that the Department of Social Security has trespassed so much into the health care field, and as a result of the findings of an interdepartmental committee, different fees will be paid for similar medical services performed by doctors according to the State or Territory in which they live? As an example, a general practitioner in New South Wales and in the Territories will receive $14 an hour, a Tasmanian doctor will be paid only $1 1.50 an hour and in the other States doctors will receive $13 an hour. Will the Minister ask his colleague to inform the Senate on what basis this unfair discrimination is being enforced? Will he ask also why the new fees were not promulgated until June- last month- thus preventing an earlier protest on behalf of all the doctors who have been disadvantaged by this unfair administrative action since 1 January this year?
– I am aware that at the present time fees do vary in the different States and Territories. This is the result of the recommendations of the Medical Fees Tribunal which was set up under Mr Justice Ludeke. That Tribunal was constituted by the Government to recommend appropriate fees, and the Tribunal ‘s recommendations were to the effect which has been outlined by Senator Marriott. The Government felt that having constituted a tribunal of this kind, it was under some obligation to carry out the recommendations of the Tribunal on the matters which had been presented to it. I do not know what precise reasons Mr Justice Ludeke had for bringing down the decisions which he did, but I shall refer that part of the question to the Minister for Social Security in an effort to obtain the report of Mr Justice Ludeke so that Senator Marriott can study it. The Australian Medical Association was advised of the changes of fees in May 1 974 and the new fees came into force, as Senator Marriott has said, in June 1974 but were made retrospective to 1 January 1974.
The fees were in fact increased and although, due to administrative requirements in the implementing of the Tribunal’s findings the increased fees could not be paid until June 1974, certainly no doctor was disadvantaged because payment of the higher fees were made retrospective to 1 January. As for the reasons for the Tribunal making the decision, I shall endeavour to obtain from my colleague a statement of the reasons and allow Senator Marriott to have it.
– I ask the Minister for the Media whether his Department has undertaken any surveys to determine the contribution, employment conditions and status of women in the media. Does the Minister recognise the increasing significance afforded women’s issues both in the media and society generally?
– I can tell the honourable senator that my Department is very much aware of the importance of the role of women in the community generally and is also particularly aware of the importance of the role of women in the media. At present my Department is undertaking a project involving the collection of information from various sources such as the Press, the trade union movement, university appointment boards, the Arbitration Commission, women’s action groups and a whole host of other organisations. We are also considering a proposal to undertake quite a large survey of the opportunities available for women to engage in occupational work within the media. Additionally, realising that next year is International Women’s Year, in conjunction with the Prime Minister’s Department my Department has agreed to convene an international seminar for people engaged in the media, the title of which will be ‘Women in the Media’. The honourable senator can be assured that my Department is very active in encouraging opportunities for women in these areas.
– I ask the
Minister representing the Minister for Social Security: Is it a fact that pensioner iliostomy sufferers are required to spend several dollars a week out of their own pockets on essential medical materials? If so, will the Government consider including this expense in the pensioner medical service cover?
– I shall certainly convey the honourable senator’s question to the Minister. It seems reasonable that the proposition should be at least considered by the Government.
-Can the Minister representing the Minister for Social Security advise me of the number of persons in each State who have applied for the allowance that enables them to care for aged people at home? This allowance is known as the home care allowance.
-I am afraid that offhand I cannot answer the question but I shall obtain the information for the honourable senator and see that it is provided for her.
– In addressing my question to the Minister representing the Minister for Defence I refer to the statement appearing in today’s ‘Australian Financial Review’ indicating that Woomera is headed for mothballs. Is there any truth in the statement that seems to indicate that the Government intends to close down that facility? As the Minister is aware, there is a population of about 5,000 in that South Australian town. If the Goverment intends to close down Woomera, what plans are in hand to rehabilitate many of the people there who are specially qualified? In view of the problems associated with South Australia in recent times because of the loss or danger of loss of various industries will the Minister do all he can to preserve employment for these people in South Australia?
– As the honourable senator knows, the general position is that there has been what could be called a drop in workload at Woomera. But as was announced last year, the Government has agreed with Britain to extend the existing arrangements at Woomera until the end of June 1976. Because of the future commitments the Cabinet will shortly be considering a report on the future of Woomera. I would say that the reduced workload and the prospect of some redundancies has largely been offset by wastage in the area. I can only promise that as soon as Cabinet has received the report of the interdepartmental committee on the future of Woomera I will ask Mr Barnard to comment. But as I have already mentioned, the arrangements with Britain will continue until 1 976.
– ( New South WalesLeader of the Government in the Senate)- Mr President, may I inform the Senate that Senator Willesee is ill this morning. I will receive the questions which would normally be directed to him.
– I direct my question to the Postmaster-General. Will the PostmasterGeneral consider the introduction of a scheme of quarterly billing of telephone subscribers in lieu of the present 6-monthly billing?
-Quarterly billing is already in the planning stage. It will be done progressively. At present the idea is that anybody, particularly business people, who has a bill exceeding $200 will be in the first category of people to have the option of quarterly billing. The next step will be that residential subscribers will have the option of choosing to have quarterly billing or 6-monthly billing. Once the scheme is in operation the chances are that the Post Office will apply quarterly billing to all subscribers.
– I direct my question to the Leader of the Government in the Senate. In answer to a question last Thursday the Minister representing the Minister for Health stated that special precautions are being taken at Darwin with passengers arriving from Bali and Timor to prevent the introduction of foot and mouth disease into this country. The concern for foot and mouth disease arises because of the present outbreak on Bali. Is the Minister aware that Pan-Am, Garuda and Qantas, the 3 airlines flying between Australia and Bali, do not land at Darwin but fly direct to Sydney? Are special precautions being taken at Sydney as well as Darwin? If not, will the Minister ensure that these precautions are introduced because the greatest danger from foot and mouth disease in Bali is presented at the Sydney (Kingsford-Smith) Airport rather than at the Darwin airport?
– I would imagine that in the ordinary course of events this would be done. But I will ascertain whether special precautions are being taken at Sydney and I will inform the honourable senator. In any event I would ensure that they are taken if they are not already being taken.
– They are.
-I thank the former Minister for Customs and Excise who assures me that they are being taken.
– My question to the Attorney-General refers to Senator Marriott’s question yesterday relating to the alleged bugging of Mr Freeman’s telephone. The AttorneyGeneral’s reply suggests that the bugging device in Mr Freeman’s telephone could only have been placed in it for the purpose of being discovered there. Has the Minister now seen reports suggesting that the campaign rooms of the current Liberal Party candidate in the New South Wales byelection for Coogee were burgled? Has he seen a statement by the New South Wales Criminal Investigation Branch that no complaint has been made to it? Is the Minister able to say whether the bugging device found in the telephone is in breach of the Telephonic Communications (Interception) Act of 1960? In view of the Minister’s statement yesterday, will he give consideration to holding a judicial inquiry into all of the circumstances because prima facie it would appear that the incident might be described as a provocation against Mr Freeman’s legitimate political opponents?
– A number of strange allegations of burglary and such matters have been made about the Coogee by-election. I repeat that these matters are not within my area of responsibility as this is a State by-election. But the matter of a device being placed in a telephone is within the area of my responsibility. There is no need to remind the Senate of what I said yesterday -
– You have no hope of proving it.
– The honourable senator from Victoria intervenes and says that he hopes there is some proof of it.
– No, I said that there is no hope of proving it.
-I think that this adds to the considerations which I already have in mind. I am considering proposing that there should be a judicial inquiry to reveal who placed the device in the telephone, whether the device was suitable for the interception and recording of conversations over the telephone by political opponents, as alleged, who employed or engaged the person who placed the device in the telephone, whether it was part of his employment or engagement to put the device in the telephone and whether the discovery of the device was used unfairly in the Coogee by-election campaign to attempt to discredit political opponents.
- Mr President, 1 rise to order. I draw your attention to the fact that the previous question and answer referred to the Coogee byelection. No matter concerning this by-election is allowed to be broadcast after midnight last night. I ask that this question and answer be deleted from the re-broadcast of Senate question time tonight.
– The point of order relates to the broadcasting of the proceedings of the Parliament. That is not provided for in the Broadcasting and Television Act. I rule that anything that happens in the Senate can be broadcast by the Australian Broadcasting Commission.
– I direct a question to the Minister representing the Minister for Social Security. I refer to the Minister’s statement of 9 July 1974 in which he pointed out that there were increased differentials between nursing home benefits paid to Victoria and those paid to other States due to the fact that the Victorian State Government’s staffing and nursing standards were higher than those in other States. Did the Minister then threaten that he would find an alternative system for financing private nursing homes if the States continued to determine standards on an uneven basis? Does the Australian Government mean by this statement that State governments are to be denied the right to determine such standards in accordance with the priorities they present to their electors? Do not the high standards set in Victoria accord generally with the recommendations of the Victoria Nursing Council?
-This seems to me to be a matter which ought to be answered by the Minister for Social Security himself. I ask the honourable senator to place the question on the notice paper.
– Can we have an assurance from the Minister for Repatriation and Compensation that he will follow the policy of his predecessor in expanding the use of the Concord Repatriation Hospital wards to accommodate victims of the rising road toll in the central western suburbs of Sydney? Furthermore, will he undertake an early inspection of the area? If so, will he ask the resident senator in the district to accompany him?
-Certainly, wherever I was going I would be only too delighted to ask the resident senator in the district to accompany me. But apart from that social occasion, I state that the Government does intend to continue the policy of making the facilities of the Concord Repatriation Hospital available to victims of accidents in the surrounding areas. In fact, proposals are now being implemented to expand the casualty clinic at the Repatriation General Hospital at Concord. It is hoped that the new casualty clinic will be working by the beginning of next year.
– My question is directed to the Minister for Agriculture. As there still seems to be a good deal of confusion about the dairy assistance scheme I ask who will be eligible? Is a minimum production standard required to qualify? In the field of retrospectivity, are all costs involved in the changeover to qualify or only those related to refrigerated equipment? WU1 the scheme cover interest paid on other loans, since 23 July 1973? Can a dairyman who paid cash still get a loan if he so wishes? At what point can dairymen start availing themselves of the loans?
– It is not possible immediately to answer all the detailed questions asked by the honourable senator. In the main, however, the scheme will be retrospective to 23 July and any dairy farmer who incurred a loan during that period will be eligible for it; that will include water-cooled systems as well as a normal transfer. Eligibility must be dealt with through the State authorities because the scheme will operate with the States acting as agents for the Australian Government. They will need to make assessments as to those dairymen who will qualify. Those are the broad terms of the agreement. I think it would be better if I gave the honourable senator a detailed answer to his detailed question.
– My question is directed to the Minister representing the Minister for Foreign Affairs. Has the International Committee of the Red Cross written to the Australian Government seeking support for the participation of the Provisional Revolutionary Government of South Vietnam at the conference of government experts on weapons to be held in Switzerland in September and October this year? If so, has the Australian Government replied and can the Minister say in what vein?
– I am not able to answer the honourable senator but I will endeavour to get an answer for him this morning.
– Is the Minister for Aboriginal Affairs aware that the Queensland Government allocated $7m to Aboriginal advancement in that State for the year 1973-74? If so, can the Minister inform the Senate of the allocation of moneys by the Australian Government to Queensland for Aboriginal advancement for the same period?
– I hear the interjection $7m That might have some relevance. Of course, the Queensland Government is allocating Commonwealth money. We are using agencies in the States for welfare, health, education and housing. I cannot inform the honourable senator of the exact figure granted to Queensland by the Australian Government but I will get that information for him as well as the purpose of the grant.
– My question is directed to Senator Townley. It concerns the notice of motion No. 5 standing on the notice paper in his name. I am relying on standing order 98 and also on the precedent that has been established in the Senate to enable me to ask a question of a senator in charge of a notice of motion.
– Go ahead with the question, senator.
– Before I ask my question I may say that I do not approve of the Committee, having regard to its history, origins and objectives. Notwithstanding that, I ask Senator Townley whether he will be good enough to give consideration to extending the terms of reference in his notice of motion by amending subparagraph ( 1 ) (a) by inserting in the first line the words ‘of Australians and’ between the words rights’ and ‘of. Sub-clause (1) (a) would then read: whether the civil rights of Australians and of migrant Australians ….
Will the honourable senator be kind enough to give consideration to my request?
– I raise a point of order. I am loath to intervene at all, as one would expect bearing in mind that one of my colleagues has asked the question. But I feel that it is my duty to assist you, Mr President. I think that it would be an undesirable precedent if question time were to be used for the purpose of asking a question of a senator who has given notice of a motion. Without going into the merits or otherwise of this matter I suggest to you, Mr President, and also to Senator Brown, that this is not the appropriate time to ask such a question.
– I must uphold the point of order that has been taken.
– Is the Minister representing the Minister for Health aware of the existence of the Therapeutic Goods Advisory Committee which was set up in 1972 by the LiberalCountry Party Government? Can the Minister say why this potentially important committee has met only once- in February 1974- since its formation? Will he confirm that a second committee meeting was proposed for June 1974 and then postponed? Will he also confirm that the minutes of the first meeting have not yet been forwarded to members of the Committee? Will he assure the Senate that it is the intention of the Labor Government to see that this Committee will continue to function efficiently and effectively and, hopefully, more frequently?
– I am sure that all of us would agree with the honourable senator that it would be to everyone’s advantage if the Committee were to function more efficiently, frequently and hopefully. I am afraid that I am not really aware of what happened to the minutes of the first meeting or why the Committee did not meet on the second occasion. But I will ask my colleague, the Minister for Social Security, to let the honourable senator have an answer to his interesting questions in due course.
-Has the Minister representing the Minister for Transport seen recent Press reports on the hearing of an injunction sought by Foremost International Tours against the Australian airline Qantas Airways Ltd in the United States District Court in Honolulu? As the suit brought by Foremost International Tours alleges that Qantas copied certain of Foremost ‘s ideas and brochures and conspired with Canadian Pacific Air Limited, can the Minister advise the Senate what action, if any, the Australian Government has taken in this matter?
– I am acquainted with some of the details of this matter. Of course, as the question is now before a court I would think it inappropriate for me to make detailed remarks about the case. However, I would like to say that this is primarily a commercial matter involving aspects of the costing of package tours. I would point out that the tour charges of Qantas are in conformity with International Air Transport Association regulations and have been filed with the United States Aeronautics Board. Qantas has committed no breach and will continue selling tours at the current prices for the time being. The Government has been kept informed of the case and the deals involved, but has not been asked to intervene in any way. It was thought inappropriate for the Government to intervene at this stage in a case which is being decided by the judiciary.
– I address my question to the Leader of the Government in the Senate who is at present representing the Minister for Foreign Affairs. I refer to reports reaching Australia in recent weeks and repeated in the Press today concerning the imprisonment of church leaders in the Philippines and South Korea. Will the Minister ascertain and advise the Senate whether any Australians or Australian connections are involved? Will he take early opportunity in the channels open to him either at government to government level, through the appropriate embassies or through the United Nations agencies to make inquiries and representations in connection with these reports?
-I have a note from the Department of Foreign Affairs on this matter which was published and which reads:
The churchmen involved including the Rev. Harry Daniels were arrested by the Philippines security authorities. It is understood that the Rev. Daniels and 2 other church men were released on 4 July on the understanding that they would voluntarily leave the Philippines. Apparently Mr Daniels left on 9 July for Singapore and the other 2 on 12 July. Neither the Rev. Daniels nor the others involved are Australian citizens.
I shall refer the rest of the question to the Minister for Foreign Affairs so that he may add to the answer if he so desires.
-Will the Minister representing the Minister for Defence inform the Senate of the position regarding new enlistments into the Australian Regular Army? Has there been any increase in numbers? Will the Minister say whether there has been any improvement in the re-engagement rate?
-The latest information which I have from Mr Barnard is that enlistments in the Defence Forces generally have been running at a satisfactory level in most categories. In some cases such as officer cadets and other specialist entries the results have been very good indeed. Total army enlistments for the 1 1 months ended in May 1974 were 3,070, which represented about 84 per cent of the planned input. The report is that the intake was very good. Re-engagement rates are continuing at a high level.
I refer finally to the question which is fairly frequently raised about officer resignations. I wish to point out- as I have done before- that the main reasons for the resignations are that the DFRB scheme was vastly improved and better employment opportunities occurred outside. In some cases under the old scheme officers who resigned more than 3 years before their set retiring age forfeited pensions. At present an officer who resigns after 20 years is entitled to a pension according to his years of service. Of the 484 people who resigned between June 1973 and April 1974, 319 were eligible for pensions and in fact retired early.
– I call Senator Guilfoyle.
– I take a point of order, Mr President. I refer to standing order No. 405. When you first called for questions this morning only 4 senators rose. I was one of them. Since then you have called at least 15 senators to ask questions. I ask you to rule on what basis -
– You have to stand on your seat if you want to be seen.
– I cannot hear the honourable senator; he is croaking again. I am asking you, Mr President, to state the system which you use for calling senators who indicate they wish to ask a question. I felt that I was on my feet before the good lady senator from Victoria. I feel that if you can make a statement on the way you intend to call senators to ask questions you could save the time of those senators who have a lot of other things to do, and thereby help perhaps get some Government legislation through a little earlier than might otherwise happen.
– The standing order states that when 2 or more senators rise together to speak the President shall call upon the senator who in his opinion first rose in his place. Discretion rests with the Chair. I have been impartial and have distributed the opportunity to ask questions between both sides. I have already seen Senator Guilfoyle and Senator Chaney and I have noted that Senator Townley has been trying to catch the eye of the Chair. Honourable senators will be called in that sequence.
– My question, addressed to the Minister for the Media, follows the question he answered in reply to Senator Coleman a little earlier this morning. Is the Minister able to give any information as to why the Government has chosen to give financial support of the type he outlined for the observance of International Women’s Year without giving the traditional grant for administrative assistance to the voluntary committee representative of women’s organisations which was established through the United Nations Organisation to celebrate International Women’s Year in Australia? Will the Minister also give consideration to granting financial assistance to the International Women’s Year committee for the work it has programmed to highlight the observance of International Women’s Year?
– I assume that grants of the nature to which the honourable senator refers fall more within the responsibility of the Prime Minister’s Department or the Department of Foreign Affairs. My Department has not given any grants. In connection with the matter raised by the honourable senator, my Department has merely undertaken to conduct a seminar in Australia on the role of women in the media in conjunction with the celebration of International Women’s Year next year.
– May we seek assistance in the way I have outlined?
– If the honourable senator makes representations to me and the matter is connected with the media I will look at it and make what I consider are appropriate recommendations to my colleagues, the Prime Minister or the Minister for Foreign Affairs.
-I ask the Minister for the Media whether broadcasting stations have been meeting the 10 per cent Australian produced music requirement which was introduced last July. If so, has the 10 per cent Australian music content quota encouraged local recording companies to increase their production of Australian records or has it simply led to the playing of the same records more often?
-The Australian Broadcasting Control Board introduced for the first time last year a quota of Australian performed music of 10 per cent of the total time devoted by radio stations to the broadcasting of music and I understand that since then the majority of broadcasting stations have had no difficulty in meeting that requirement, which, of course, is additional to the statutory requirement that 5 per cent of all music played be music composed by Australians. In the case of stations which have what is known as a middle of the road format, there was, I understand, an initial difficulty in obtaining sufficient records to meet the quota. However, I understand the stations involved- this is to their credit- have been instrumental in encouraging the recording companies to produce the sort of music that the stations play. Indeed, as part of the overall circle effect, they have been responsible for boosting the sales of these records, thus adding to the income and opportunities of Australian performers.
Stations have now been advised by the Broadcasting Control Board that the 10 per cent quota is to be increased as from 28 July. The quota will be increased to 12.5 per cent with the understanding that probably within the next 12 months it will rise to 15 per cent. Frankly, the increase is not as great as I had hoped for but I understand that one of the limiting factors is the concern expressed by the broadcasting industry that at present sufficient recordings may not be available for a more rapid increase than that which has been proposed.
– My question is directed to the Minister representing the Treasurer. The State Government of Western Australia has attacked the Australian Government because the latter has declined to release $2. 3m to irrigate more land on the Ord River for fattening cattle. The State Government has described the project as a new viable industry. Is there any evidence to support the assertion that the project is viable? If not, would an allocation of funds constitute a prime example of irresponsible government spending to which the Liberal and Country Parties are ostensibly opposed? If the Western Australian Government wants a beef industry on the Ord, could it be established on existing cotton growing areas, thereby saving scarce capital and easing the burden on the State Treasury which has previously subsidised cotton production by up to $20,000 per grower in one year?
– There is a long history to the Ord River project, as I am sure most honourable senators would know. The decision to commence the scheme in the late 1960s is one which remains the subject of great criticism. A costbenefit analysis was done at the time. I believe that it was not made public. Nevertheless, the government of the day went ahead with the scheme. Under the agreement in the 1968 Act, the Minister, in this case Dr Patterson, is required to authorise the rate of development of the project. I believe that the current request involves $2.3m for further irrigation channels. It is necessary, under the terms of the Act, for Dr Patterson to approve that expenditure. The project has run into problems, one of which has been an abnormally high rate of spraying which has become necessary- about 3 times the normal rate that would be required. As a result, there have been many complaints concerning the effect of pesticides on the beef development programs in that area.
It is for Dr Patterson, in conjunction with the Western Australian Government, to decide whether the funds should continue at the present rate. I understand that he plans to look at the whole question of the development of the project and to consider the possibility of industrial development in the Ord River area. I think it is a responsibility of the Australian Government to make sure that before any further funds are expended they will be to the economic benefit of the area.
– My question is directed to the Minister representing the Minister for Social
Security. Is there any truth in the report that the Government will shelve or slow down implementation of its promise to provide for latch key children? If the Minister does not know the present position, in view of the urgency of providing care for the thousands of children who are left unattended daily and in view of the undertaking in the Governor-General’s speech that the Government will be guided by the need to ensure that any deferment of expectations shall not be made at the expense of those for whom deferment could mean a lifetime of deprivation- for example, children at school and migrants- will the Minister undertake to make urgent inquiries into the matter and provide an early answer to the Senate?
– I ask the honourable senator to put the question on notice.
-Can the Minister representing the Minister for Labor and Immigration give an assurance that widows now eligible for retraining under the present training scheme for widow pensioners will not be disadvantaged by the proposals in the Government’s retraining scheme which were detailed by the Minister for Labor and Immigration yesterday?
– The present retraining scheme is for widowed pensioners who are eligible for suitable employment. They receive their
S tensions plus various allowances for children, or travel, etc. The scheme is subject to a means test and anything received under it is not taxable. That scheme will be phased into the new scheme, which was announced by the Minister for Labor and Immigration, not before 1 October of this year. Under the new scheme the full time training allowance for all adult trainees will be equal to the average adult male award rate derived quarterly from the Australian Government Statistician. At the present time this would mean a taxable allowance of about $80. It is intended that allowances for living away from home, local fares, home travel, books etc. that now apply will also be paid.
-Is the AttorneyGeneral able to assure members of the Senate that the telephones of senators and other members of Parliament are not being bugged, and have not been bugged during the term of Labor’s office? Will the Attorney-General inform the Senate as to what conditions need to be fulfilled before tapping of any telephones takes place? Who is the officer or Minister who authorises any tapping? Further, will the Minister, when he is considering appointing a judicial inquiry into the matter of the Coogee telephone bugging incident, extend the terms of reference of the judicial inquiry to include all aspects of telephone tapping in Australia?
– I am able to assure the honourable senator that there is no tapping, to use his expression, of telephones of members of Parliament which is authorised by the Government. I refer to legal tapping in terms of the Telephonic Communications (Interception) Act. The authorisation of legal tapping is by the AttorneyGeneral at the request of the Director-General of Security. Such tapping is not to be done unless authorised by that authority, except in the case of emergency. All the provisions are set out in the Act, but I am briefly giving them to the honourable senator. There are safeguards as to warrants and it is also provided that a report has to be made on the use of the telephone, the use of any interception and so on. The honourable senator will recall that last year I gave some figures for the number of tappings. They were relatively minor.
asked me whether I could assure him that no tappings were occurring. I referred to those tappings which were legal or authorised. I suppose that from the experience of other countries and from some indications here, no one could give an assurance as to what might be done by completely unauthorised persons. A disturbing feature of our society- and this has been commented on in other countries- is the great growth of commercial or industrial espionage. It would be reasonable to suppose that some of that might well extend to members of Parliament, that is to say, illegal and unauthorised tappings and tappings in breach of the Telephonic Communications (Interception) Act. I will certainly give consideration to the suggestion that the honourable senator makes about the inquiry into the strange occurrences connected with the Coogee by-election, and the question he raises as to whether there should be an extension of a general inquiry into the unauthorised or for that matter, authorised telephone tapping in Australia. In think it is probably about time that there was some proper inquiry into this general area.
I think there would be little difficulty in finding out about the authorised interceptions, but there is no doubt that there ought to be some inquiry into what is going on in the area of commercial, industrial and other unauthorised interceptions. This inquiry may not be very relevant to what is alleged about the Coogee by-election. I did indicate to the Senate, and I should emphasise in view of the honourable senator’s relating the two circumstances, that the advice I have received is that one can entirely discount that the device that was found in that particular telephone was used or intended to be used by a political opponent. I repeat what I said and I say it advisedly: That particular device, whether suitable or not, was put in the telephone in order to be found.
– I ask the Minister for the Media whether he is aware that next Saturday the third rugby league test between Great Britain and Australia will be played at the Sydney Cricket Ground. Will the Minister ask the Australian Broadcasting Commission to make a direct telecast of the game for the benefit of the people in north Queensland who are avid supporters of the code?
– I am aware that the third rugby league test between Australia and Great Britain will take place at the Sydney Cricket Ground next Saturday. All being well 1 will be in attendance at the game. My colleague Mr Fulton, the honourable member for Leichhardt, and Senator Keeffe have been at me constantly this week to see whether it is at all possible for the ABC to make a direct telecast of the game in Sydney to be transmitted to north Queensland. As the honourable senator knows, under this Government the ABC is guaranteed political and programming independence and the Commission has advised me that whilst it would be most willing to transmit a direct telecast of the game to the areas to which the honourable senator has referred, apparently it was a decision of the Australian Rugby League that the 3 tests were not to be directly telecast but that films of the game could be shown after the game had finished. I understand that the reason given by the Australian Rugby League for not agreeing to direct telecasts to the areas with which the honourable senator is involved is its desire to promote the local games. It is fearful that a direct telecast of the test match at the time it is being played will have an effect on the gate takings of the local games. Therefore, I understand, in the contractual arrangements that have been made between the Australian Rugby League and the ABC, direct telecasts can be made only to areas where the rugby league code is not played. However, I repeat that a film of the game will be shown at 6 o’clock on Saturday evening.
-Can the Minister representing the Minister for Labor assure the public that there is nothing inconsistent in the announcements of the Government relating to unemployment assistance? Has one Minister in the Government given an assurance to textile workers that those who lose their jobs due to the tariff policy of Labor will be paid 6 months full salary or until they obtain earlier employment? Has there been a further Government announcement that all persons unemployed due to Labor’s policy will receive 6 months’ full wages or salary? Has the Government more recently announced that the wage to be paid by the Government will be only about $80 a week? Which is the true situation?
– In view of the comprehensive canvass of the position by Senator Webster, to reply adequately a statement would need to be made by the Minister for Labor and Immigration. I will ask the Minister to give Senator Webster a studied reply. I will briefly summarise the position. When the Government came into office and was faced with the need to control inflationary forces as much as possible it made certain modifications to tariffs as a result of which, over the long term- it has taken 12 months, as honourable senators know- some displacements have occurred. Possibly Senator Wriedt could give a better answer on this aspect but the fact is that the Government then set aside funds to provide for short term displacements so that everybody would be protected. The Government has set up a manpower policy which aims in the long term to provide proper positions for people who may become redundant because positions in the occupations which they previously followed ceased to be available due to economic movements. The Government has also done this in regard to its employees. Special provisions have been made to cover those who have become redundant.
What the Government has done at the various meetings of Ministers has been to provide a comprehensive manpower policy which will ensure that anybody who is made redundant because of these economic movements in the first place will be protected. Anybody who becomes redundant due to economic factors will get protection and retraining. This morning I will be tabling the report by Mr Clyde Cameron in respect to retraining and I will also table the measures which the Government intends to take. So some of the answers to Senator Webster’s question will be covered in that report. Generally speaking, we aim to have a comprehensive planned policy in respect not only of employment but also accidental unemployment.
- Mr President, I wish to ask a supplementary question on the basis that my question was not answered.
– I will allow the question to enable the Minister to elucidate further.
-The Minister representing the Minister for Labor and Immigration in this place will be aware that I questioned whether some workers had been told that if they lose their jobs they will get a full salary for 6 months and other workers had been told that they will get approximately $80 a week. What is the true position?
-Senator Webster should know the position because he has read something about it. The papers and reports on the retraining scheme which was announced yesterday by the Minister for Labor and Immigration will be tabled today. Anybody who chooses to retrain because of the general shift in the work force will be entitled to the payment referred to by the honourable senator. But in the case of people who have been displaced by direct government policies, if they cannot be reemployed they will receive the long term payment. I suggest that the honourable senator read the documents which will be presented this morning. If he is not satisfied then I will ask the Minister to give him a comprehensive reply.
– My question is directed to the Minister for Agriculture. Following the decision of the previous Labor Government to cut tariffs by 25 per cent across the board, is the Minister aware that on the published calculations of the Graziers Association of New South Wales the high tariff barriers set by the previous Liberal-Country Party coalition Government were costing farmers about $500m a year? Is it also a fact that every identifiable farmers’ organisation throughout the country welcomed and applauded the Government’s decision? Has the Minister’s attention been drawn to the reported comment on this matter by the Leader of the Australian Country Party, Mr Doug Anthony, wherein he described the Australian Government’s decision as cowardly?
– I have seen the figures referred to by the Graziers Association. They were in fact published in the submission to the working group which prepared the Green Paper. Consequent upon that I drew the attention of the
Senate only last week to the comments by Mr White of that Association in which he pointed out that the decisions that were taken by this Government have been of historic significance to the rural sector. I have seen those comments. They are correct. They demonstrate that there are people in the rural sector who realise the importance and the significance of the initiatives which have been taken by this Government.
-I direct my question to the Attorney-General or to the Minister representing the Minister for the Capital Territory, whichever of those gentlemen thinks the matter comes within his portfolio. I ask the Minister to recall the case which Lanyon Pty Ltd brought against the Commonwealth for compensation for the acquisition of land in the Australian Capital Territory and also to remember that during the pendency of that litigation a Bill, which was rejected, was brought into this place to curtail the amount of compensation. Did that case come on for hearing in recent weeks? Was it settled by agreement by the Minister? Was it a term of the settlement that the amount paid should not be published? What was the reason for that term? Will the Minister tell the Parliament what the amount was that he agreed to pay?
-I recall the case and the Bill. The matter came before the High Court, I think in the last few days of the last Parliament. I may be wrong about that, but I have some recollection of it. The case was settled. As one would expect, it was agreed to pay some substantial amount. I will find out the precise reason why there was an agreement not to disclose the terms or the amount of settlement. My recollection is that it may have had something to do with the fact that there were other settlements pending or other similar situations which might be affected. I think that that was the reason. The honourable senator takes the view that ultimately there is a public interest and an entitlement to know how much public money has been paid. I think that everyone would agree that there may be reasons for not making such a matter public forthwith. I will find out precisely the reasons for the honourable senator. Although I think that there was some such consideration, I am not able to tell the honourable senator with precision now.
– I direct a question to the Minister for Agriculture. I refer to reports that the European Economic Community will ban beef imports until Novermber. What impact will this have on Australia’s beef export industry which is already suffering from a lack of markets?
-It is true that under the common agricultural policy adopted in the European Economic Community entry by Australian meat, and beef in particular, to that area has been severely restricted for quite some time. In fact, this has been the position for almost 12 months. As a result of this, our exports of beef have fallen off very considerably. The recent announcement that amounts to a decision that no favourable treatment will be given to Australia in respect of its exports of meat to the European Economic Community is disappointing. But it is the reality of the position in relation to the EEC. It will not have much impact at this stage because those markets had virtually disappeared for some time. As I mentioned the other day it is for this reason that the Government currently has a trade mission in Japan at the present time to see whether we can interest the Japanese in multi-national talks to try to bring about some stability in the world meat trade.
– I ask that further questions be placed on the notice paper.
- Senator Primmer earlier asked me in a question whether a letter had been received from the International Committee for the Red Cross seeking the Australian Government’s views on the participation by the Provisional Revolutionary Government of South Vietnam in the Conference of Government Experts on Weaponry to be held later this year at Lucerne in Switzerland. I can confirm that such a letter has been received seeking the views of the Australian Government. A similar letter was sent to all those governments that participated in the Conference held in Geneva earlier this year for the purpose of revising the 1949 Geneva Conventions. The honourable senator also asked about the attitude of the Australian Government to participation by the Provisional Revolutionary Government at the Lucerne Conference on Weaponry. The Australian Government is obliged to reply to the International Committee ‘s letter by the end of this month, but the terms of the reply are still under consideration.
-I seek to clear up the answer to a question which Senator Bonner asked me today about Commonwealth expenditure in Queensland on Aboriginal affairs. I was unable to supply the honourable senator at the time with the figures. But I find that the payment proposed to be made by the Australian Government to Queensland for Aboriginal advancement for 1973-1974 is $9,957,000. If there is any short expenditure of that amount, it will be through the inability of the Queensland agencies to spend the money in the year.
– Is that direct or indirect?
-That is direct.
– I seek the leave of the Senate to present a petition on behalf of a number of citizens.
- Senator Brown seeks leave to present a petition which he was unable to present earlier. Is leave granted? There being no objection, leave is granted.
– I present the following petition from 24 citizens of the Commonwealth:
To the Honourable the President and Members of the Senate in Parliament assembled: The humble petition of the undersigned citizens of the Commonwealth respectfully sheweth:
That the present systems of financing of hospital and medical care in Australia are outdated, complex, unwieldy, and provide inadequate or no security against health care expenditure for a substantial proportion of the people of Australia;
That the costs associated with the present schemes fall disproportionately on people having low and middle incomes;
That there is an urgent need for a new national health insurance scheme, to which each person receiving an income should contribute an amount which is equitably calculated on the basis of that income, and which provides adequate security to each person against the costs of care for every kind of illness and injury.
Your Petitioners therefore humbly pray that the parliament will speedily pass appropriate legislation to bring the benefits of an equitably financed, universal, and comprehensive health insurance scheme to the people of Australia.
And your petitioners as in duty bound will ever pray.
Petition received and read.
Senator BISHOP (South AustraliaPostmasterGeneral) For the information of honourable senators I lay on the table the report of the committee of inquiry into Australian labour market training and the report of an Australian inter-departmental commission which studied overseas manpower and industrial policies and programs together with a statement by the Minister for Labor and Immigration relating to an active manpower policy for Australia. Copies of the report are available in the Senate records office.
-Is leave granted? There being no objection, leave is granted.
-Can the Leader of the Government in the Senate (Senator Murphy) indicate when the correspondence and attachments relating to the double dissolution will be tabled? I ask this because I have had a letter from the Prime Minister (Mr Whitlam) and I think that the Prime Minister himself on the first question day of this Parliament- and also the Leader of the Government in this place referred to that same question in reply to me- indicated that it was hoped that they would be tabled this week. As the Petroleum and Minerals Authority Bill is the Bill to which the interest relates, will the documents be tabled in the Senate before we debate that Bill?
– I can inform the. honourable senator that the Prime Minister has this matter under active consideration.
– Pursuant to leave given yesterday I table the interim report from the Senate Select Committee on Securities and Exchange consisting of Part I, volume I, which is the report; Part 1, volume 2, which is the Committee’s documents; and Part II, volumes I, 2 and 3, which are the transcript of evidence.
Ordered that the papers be printed.
Senator RAE (Tasmania)- I seek leave to table the opinion of the Solicitor-General relating to the publication at this time of particular sections of the report.
-Is leave granted? There being no dissent leave is granted.
-I table the opinion of the Solicitor-General which relates to that part of the report relating to the company Mineral Securities (Australia) Limited. I now seek leave to move a motion that the Senate take note of the report.
-Is leave granted? There being no objection, leave is granted.
– I move:
In view of the situation so far as time is concerned I seek leave to continue my remarks at a later stage.
Leave granted; debate adjourned.
Motion (by Senator Wright) agreed to:
That leave be given to introduce a Bill for an Act to determine the site of the new and permanent Parliament House, and to provide for the grounds in the vicinity of the Parliament to be controlled by the Parliament.
Bill presented, and read a first time.
Motion (by Senator Douglas McClelland) agreed to:
That Government business take precedence over general business after 8 p.m. this day.
Motion (by Senator Murphy)- by leaveagreed to:
That a Library Committee be appointed to consist of the President and Senators Bessell, Davidson, James McClelland, Milliner, Mulvihill and Young.
Motion (by Senator Murphy)- by leaveagreed to:
That a Publications Committee be appointed to consist of Senators Bonner, Donald Cameron, Drury, Grimes, Lawrie, Milliner and Missen.
Motion (by Senator Murphy)- by leaveagreed to:
That a Committee of Privileges be appointed to consist of Senators Button, Devitt, Drake-Brockman, Everett, Greenwood, Murphy and Withers.
– I inform the Senate that I have received letters from the Leader of the Government in the Senate and the Leader of the Opposition in the Senate nominating Senators Brown, Button, Devitt, Everett, Scott, Wood and Wright to be members of the Senate Standing Committee on Regulations and Ordinances.
Motion (by Senator Murphy)- by leaveagreed to:
That a Standing Committee on Regulations and Ordinances be appointed to consist of Senators Brown, Button, Devitt, Everett, Scott, Wood and Wright, such senators having been duly nominated in accordance with the provisions of standing order 36A.
Motion (by Senator Murphy)-by leaveagreed to:
That notwithstanding anything contained in the Standing Orders, a Standing Orders Committee be appointed to consist of the President, the Chairman of Committees, the Leader of the Government in the Senate, the Leader of the Opposition in the Senate and Senators Sir Magnus Cormack, Drake-Brockman, Georges, Gietzelt, Greenwood, Mcintosh and Milliner.
Motion (by Senator Murphy)- by leaveagreed to:
That in accordance with the provisions of the Parliamentary Proceedings Broadcasting Act 1946-1973 Senators Col leman and Webster be appointed members of the Joint Committee on the Broadcasting of Parliamentary Proceedings.
Motion (by Senator Murphy)- by leaveagreed to:
That in accordance with the provisions of Public Accounts Committee Act 1951-1966 Senators Grimes, Guilfoyle and McAuliffe be appointed members of the Joint Committee on Public Accounts.
Motion (by Senator Murphy)- by leaveagreed to:
That in accordance with the provisions of the Public Works Committee Act 1969-1973 Senators Jessop, Melzer and Poyser be appointed members of the Parliamentary Standing Committee on Public Works.
Motion (by Senator Murphy)- by leaveagreed to:
That in accordance with the provisions of the Australian Institute of Aboriginal Studies Act 1964 the Senate appoints Senators Baume and Keeffe to be members of the Council of the Australian Institute of Aboriginal Studies and to continue as members for 3 years from 18 July 1974.
Motion (by Senator Murphy)- by leaveagreed to:
That in accordance with the provisions of section ( I of the Australian National University Act 1946-1973 the Senate elects Senators James McClelland and Rae to be members of the Council of the Australian National University for a period of 3 years from this day.
Motion (by Senator Murphy)- by leaveagreed to:
That in accordance with the National Library Act 1960-1973 the Senate elects Senator Davidson to be a member of the Council of the National Library of Australia for a period of 3 years from 19 August 1974.
– Pursuant to standing order 38 I lay on the table my warrant appointing Senators Brown, Drury, Gietzelt, Missen, Mulvihill, Sim and Webster to be members of the Committee of Disputed Returns and Qualifications.
– I have received message No. 7 from the House of Representatives requesting the concurrence of the Senate in the appointment of a joint committee on the parliamentary committee system. Copies of the message have been distributed to honourable senators.
Bill received from the House of Representatives.
Standing Orders suspended. Bill (on motion by Senator Murphy) read a first time.
– I move:
The purpose of this Bill is to amend the Extradition (Foreign States) Act to permit the application of that Act to countries which offer reciprocity of treatment to Australia under their domestic law.
The Extradition (Foreign States) Act 1966-72 deals with extradition to or from countries other than those in the Commonwealth of Nations. The Act provides for continuation of former British extradition treaties and authorises the Governor-General to apply the Act to any other foreign state by regulation where an extradition treaty is negotiated after the commencement of the Act. It also authorises the application of the Act, again by regulation, where a treaty other than an extradition treaty, which contains provisions relating to the surrender of fugitives- for example, the hijacking convention- comes into force between Australia and other contracting foreign states.
When I introduced amendments to the Extradition (Foreign States) Act in March last year, I said:
We need to reduce the number of places where criminals can find sanctuary. Our efforts to do this have simply not kept pace with the increasing crime and the increased opportunities for criminals to move from one country to another.
Treaties with Austria, Sweden and Italy were signed in 1973 and one with the United States of America in May 1974. The treaty with Sweden came into force earlier this year and ratification of the remaining treaties is being pursued. The new treaties with Italy and the USA replace previously existing British treaties while the treaties with Austria and Sweden will provide extradition cover which previously did not exist. Treaties with Ireland, West Germany and Israel should, I hope, be signed this year. Negotiations are now taking place with Turkey. All these are for new treaties to provide possibilities of extradition where none now exists.
We face, however, a daunting task of negotiating treaties with countries which are potential havens for Australian fugitives with which we have no treaties. We must also replace inherited British treaties which are no longer appropriate. We altogether lack extradition arrangement with such countries as Japan, Philippines and Indonesia in our own part of the world. The fact that no arrangement exists with Brazil is notorious. I do not, however, propose to give a full list of all the countries in the same situation- but there is no great difficulty in finding out which they are.
The existence of an extradition treaty is not the only factor in determining whether a foreign country is a potential sanctuary for Australian criminals. The internal immigration policy pursued by that country will determine whether an Australian will be admitted into that country as a resident. It has to be remembered that a person seeking admission is unlikely to be known by the local authorities as being wanted in Australia for a criminal offence when he seeks entry.
Our recent attempts to secure the extradition of the Bartons from Brazil have shown that the present process of negotiating extradition treaties will not meet the need. A fugitive from Australia will always go to the sanctuary which remains open. The negotiations over the extradition of the Bartons have pointed to a short cut which would be appropriate under the law of Brazil. Brazilian law provides for extradition from Brazil where a treaty exists or where in the absence of such a treaty there is reciprocity of treatment. There are a number of other countries, of which Japan is one, where extradition laws provide for extradition where reciprocity is provided. This legislation will enable Australia to offer such reciprocity if the need arises where no treaty exists.
What is proposed now is that the Extradition (Foreign States) Act should be amended to permit the Governor-General to apply the Act to a foreign country where he is satisfied that under the domestic law of that country extradition is provided where reciprocity is offered. The safeguarding of the human rights of fugitive persons in Australia sought by a foreign country are protected by the Australian Act. For example, the determination of whether a prima facie case is made out and whether a fugitive is a political offender are matters ultimately determined by the Australian courts. Nor can a person be surrendered if he were to be prejudiced at his trial on account of race, religion, nationality or political opinion.
Extradition involves two very different but quite fundamental considerations. Firstly, it is necessary to ensure that extradition from Australia is only afforded in a way which takes into account the basic human rights of the person sought by a foreign country. Secondly, it is necessary also to ensure that the increasing number of white collar criminals cannot escape justice in Australia by flight. The Senate should recognise that our legislation has never been found wanting in the first purpose; it has not met the need in the second.
When the Extradition (Foreign States) Act was first enacted in 1 966 it was based on the traditional notion that extradition is to be afforded only to those countries with which there has been negotiated, with all the delay associated with international dealings, a bilateral treaty in traditional form. This view was modified in 1968 when amending legislation took cognizance of the fact that extradition can arise as part of multilateral treaties directed towards other objectives. Aircraft hi-jacking is the first example of the application of this new view. The proposal that our Act should be extended, without treaty, to those countries that afford reciprocity of treatment under their domestic law is a logical extension of what has gone before.
It is not the intention of the Government to use this provision in substitution for the negotiation of extradition treaties in all cases where reciprocity is offered. In the longer term we could seek to replace extradition founded upon reciprocity of domestic legislation with a formal treaty in cases where there was a substantial traffic between the 2 countries and the other country wished a treaty. At the same time we intend to press forward much more vigorously to negotiate extradition treaties with countries which provide extradition only by treaty and with the renegotiation of these treaties which we inherited from Britain.
The proposal that extension of the Act to a foreign country should be by regulation means that the same opportunity will be afforded to Parliament to scrutinise regulations applying the Act to any foreign country as apply to any other regulation made by the Governor-General. Since treaties are applied by regulation in the normal course Parliament will have the same surveillance of regulations applying the Act to a foreign country under the proposed legislation as it has when the Act is applied pursuant to a treaty.
Debate (on motion by Senator Greenwood) adjourned.
– I would like to remind honourable senators that the Senate will rise this evening at 5 p.m. to proceed to Government House for the presentation to His Excellency the Governor-General of the Address-in-Reply. The Senate will resume sitting at 8 p.m. Cars will leave at 5.10 p.m. from the front of the House and I invite all honourable senators to accompany me.
Bill received from the House of Representatives.
Standing Orders suspended.
Bill (on motion by Senator Murphy) read a first time.
– I move:
Mr President, this Bill seeks to amend the Statute Law Revision Act 1973. Honourable senators will probably recall that, when introducing the Bill for that Act in December last year, I referred to it as a preliminary step in the Government’s program of publishing a consolidation of the Acts passed by the Australian Parliament as in force on 31 December 1973. Honourable senators will also recall that on 10 July 1974, in answer to a question by Senator Brown, I told the Senate that the first volume of the consolidation is expected to be available in September this year. However, work on the consolidation has disclosed some further defects and matters suitable for statute law revision in a number of the Acts to be consolidated, as well as some defects in the Statute Law Revision Act 1973 itself. Although the defects are largely of a formal or technical nature, they do give rise to problems in the preparation of the consolidation and it is desirable that they be corrected as soon as possible. The Bill now before the Senate seeks to make the necessary alterations, so that work on the consolidation may be facilitated.
The Bill contains 3 main provisions apart from the amendments set out in the Schedules. Firstly, it provides, in effect, that the amendments made by the Bill are to be deemed to have been made on 31 December 1973, the date of commencement of the Statute Law Revision Act 1973, thus enabling the amendments to be incorporated in the consolidation. Secondly, certain amendments that were wrongly made by the Statute Law Revision Act 1973 are rendered ineffective, so as to enable the amendments to be correctly made by the Bill. Lastly, the Government Printer is required by the terms of the Amendments Incorporation Act 1905-1973 to include in a reprint of an Act a reference to the enactment by which each amendment is made. This would technically require the Printer to make numerous references, in a rather cumbersome form, to the Statute Law Revision Act 1973 as amended by the present Bill. Clause 8 of the Bill will make references simply to the Statute Law Revision Act 1973 sufficient.
As honourable senators will perceive, the Bill deals only with formal matters of statute law revision and does not deal with any matter of substance. I commend the Bill to the Senate and hope that honourable senators will support its speedy passage.
Debate (on motion by Senator Greenwood) adjourned.
Bill received from the House of Representatives.
Standing Orders suspended.
Bill (on motion by Senator Wriedt) read a first time.
– I move: That the Bill be now read a second time.
I seek leave to have the second reading speech incorporated in Hansard.
-Is leave granted?
– Yes, it is. I think it is appropriate that leave be given in this case because the second reading speech has been in Hansard previously.
– There is no dissent. Leave is granted. (The document read as follows)-
The purpose of this Bill is to obtain parliamentary approval for Australia to take up a special increase of US$4 1.1 4m in its subscription to the capital stock of the International Bank for Reconstruction and Development- or, as it is more commonly called, the IBRD. However, only 10 per cent of this amount will be payable: The balance will simply remain at call. Most honourable senators will recall that this Bill was debated and read a third time in the House of Representatives in March of this year. It did not, however, get beyond the second reading stage in the Senate before Parliament was dissolved prior to the recent elections. It was therefore necessary to re-introduce the Bill again in both the House of Representatives and in the Senate.
As most honourable senators will be aware, the main function of the IBRD and its 2 affiliated institutions the International Finance Corporation IFC- and the International Development Association- IDA- is to promote faster rates of economic growth and development in their poorer member countries.
This the IBRD does by extending loans on conventional terms to credit-worthy member countries to help finance soundly conceived and economically viable infrastructure projects in such fields as agriculture, irrigation, rail transportation, highways, port development, telecommunications and electric power generation. More recently, increasing emphasis has been placed- especially by IDA but also by the IBRD to a limited extent- on projects with greater social implications and more direct benefits for the masses of needy people in developing countries, in such fields as education, urban renewal, population control, public health and sewage, and improved agricultural credit and extension services for small farmers. The IBRD is by far the largest and most influential development finance institution in the world today. During the year ended 30 June 1973, it approved 73 loans to 42 countries totalling US$2,05 lm. This brought the total for all loans approved by the IBRD since it commenced operations nearly 30 years ago to a massive US$20,335m. Much of this lending has gone to developing countries of interest to Australia in the Asian and Pacific regions, including Papua New Guinea.
The IBRD obtains the bulk of the funds it lends from borrowings on world capital markets, which it can arrange on relatively favourable terms- the benefits of which are then passed on to member countries- because of the IBRD’s own high financial standards and the backing it has in the form of uncalled capital subscriptions totalling more than US$25 billion at the present time from over 120 member countries, including all of the major industrial countries in the Western world.
However, another important source of funds available to the IBRD for use in its lending operations is the paid-in portions of members’ capital subscriptions. These currently total more than US$2.5 billion. Australia joined the IBRD soon after it opened its doors for business in 1947 and has subscribed the equivalent of nearly US$640m to its capital stock, of which 10 per cent, or approximately US$64m in terms of current United States dollars has actually been paid in. As indicated previously, the balance remains at call as security for the IBRD’s own borrowing operations on world capital markets.
In 1970 Australia, along with 74 other member countries, was granted a special increase in its quota in the International Monetary Fund- IMF- following the regular quinquennial review of fund quotas in that year. As a consequence, all of these countries, including Australia, became entitled in the same year to take up special increases in their subscriptions to the capital stock of the IBRD so as to maintain the previous long-standing relativities between IMF quotas and IBRD subscriptions. The special increases authorised for individual countries are shown in the attached table, which I ask leave of the Senate to have incorporated in Hansard.
Most of the countries listed in this table have since taken up the additional shares to which they then became entitled. However, no action was taken by Australia in regard to this matter in 1970-71 because of the need for budgetary restraint at that time. In 1971-72 and again in 1972-73 the proposal was a victim of legislative and other pressures- with the result that Australia is now one of the few countries which has not so far taken up the special increase in its IBRD subscription to which it is entitled.
Consistent with our general attitude towards external aid to developing countries, the present Government is concerned to remedy this situation without further delay. Australia is entitled to take up an additional 341 shares in the capital stock of the IBRD at a cost of US$41. 14m, allowing for the effects of the 2 United States dollar devaluations in recent years.
As I mentioned at the outset, 90 per cent of this amount will remain at call and only 10 per cent, or US$4. 1 14m, is actually payable. Of the latter sum, US$411,000 is payable in gold or United States dollars while the balance of US$3.7m can be paid in Australian dollars, either in cash in a single lump sum or in the form of a promissory note which would subsequently be encashed only as and when the IBRD required the funds involved, or else as otherwise agreed with Australia.
Consistent with past practice, we propose to use the promissory note technique of payment. It so happens that, as a consequence of the revaluations of the Australian dollar in December 1 972 and September 1973, the IBRD is required under the ‘Maintenance of Value’ provisions in its Articles of Agreement to repay to Australia over the next 4 years an amount in excess of that which Australia will have to pay to take up this special increase in our subscription to the capital stock of the IBRD. By using the promissory note technique, it will be possible to offset these respective payments to and by Australia over a period of 4 years and thereby avoid any net impact on the Budget of the present proposal to increase our capital subscription to the IBRD. I might add that the proposed increase in our capital subscription to the IBRD will result in a slight improvement in our relative voting strength in that institution.
Given Australia’s traditional bi-partisan support for the activities of the IBRD-and all that it stands for- and bearing in mind the various considerations mentioned in this speech, including in particular the financial aspects, I believe that it is in our national interests to take up, in full, the special increase in Australia’s subscription to the capital stock of the IBRD to which we are entitled. I would accordingly commend this Bill to honourable senators.
Debate (on motion by Senator Cotton) adjourned.
Bill received from the House of Representatives.
Standing Orders suspended.
Bill (on motion by Senator Wriedt) read a first time.
– I move:
I seek leave to have the second reading speech incorporated in Hansard.
-Is leave granted?
-I wish to make an observation about this matter. This Bill has not previously come before the Senate, neither has the one which follows it. I have no wish to be discourteous, but it has been the practice in the Senate that as far as possible second reading speeches on Bills which are presented for the first time are read. I ask whether there has been any agreement between leaders that this speech be incorporated.
– I can tell the honourable senator that Senator Withers and I agreed that the second reading speeches of these 3 money Bills be incorporated.
-Is leave granted? There being no dissent, leave is granted. (The document read as follows)-
This Bill has 4 main purposes, each of them quite different. One is to close off avenues for avoidance of withholding tax on interest on foreign loans. Another is concerned with the liability to tax of allowances and benefits received by members of the defence force under the new pay code. The third is related to deductions for contributions for retirement benefits by members of this Parliament and servicemen. The final purpose is to complete, in 2 stages, the phasing-in of arrangements for the collection of company tax by quarterly payments.
The Treasurer (Mr Crean) announced on 2 July 1973 that the Government had decided to introduce amendments to the income tax law to correct an apparent deficiency in the interest withholding tax provisions. The broad effect of these provisions is to impose a moderate withholding tax of 10 per cent on interest paid to overseas lenders by Australian residents or by non-residents who use overseas borrowings in an Australian business. There are some exemptions from the tax. One relevant to this Bill is for interest on money borrowed for use in a business that is Australian-owned and controlled to an extent specified in the law. Another exemption relevant to the Bill frees from withholding tax interest on foreign loans that are used overseas by Australian enterprises in conducting a business through a foreign branch. Some financial institutions with foreign branches have sought to use this latter provision to obtain exemption from withholding tax in respect of loans raised through the branches for use by any Australian clients at all, that is, not only those that are Australianowned and controlled to the required extent. Not only could the loss of revenue from leaving the law as it stands be significant, that course could also lead to a complete frustration of the fundamental policy of the withholding tax that interest paid from Australia by firms that are not sufficiently Australian-owned is to bear Australian tax. The government therefore considers that the changes provided in this Bill must be made.
The primary effect of the Bill is that withholding tax will be payable on interest paid from Australia to a foreign branch of an Australian institution where the institution concerned chooses to arrange its foreign borrowing transactions in such a way that the interest it receives from on-lending the borrowed funds in Australia is derived as income of a foreign branch. The Bill will make the interest subject to withholding tax in these circumstances only where it would have been subject to the tax if it had been received by a non-resident. As announced on 2 July 1973, the amendments will apply to interest payments made after that day.
Complementary amendments of a technical kind are proposed to clarify the circumstances in which interest paid to non-residents can be said to be incurred in carrying on an overseas business, and thus not subject to withholding tax. As explained more fully in the explanatory memorandum being circulated to honourable senators, a related series of technical amendments is also proposed to forestall tax avoidance in 2 other areas of the law which are modelled on the interest withholding tax provisions. One of these relates to the source of royalties paid to nonresidents, and the other to the source- for the purpose of provisions designed to close down Norfolk Island as a tax haven- of both interest and royalties.
I should mention that none of the withholding tax amendments will affect the exemption for interest on ordinary savings bank or fixed deposit accounts kept by non-residents at overseas branches of Australian banks. The amendments relating to defence force allowances are in the main the result of changes in the Service pay structure based on recommendations in the final report of the committee of inquiry into Services’ pay- the Woodward Committee.
One change of particular significance from the tax standpoint is the withdrawal of the general entitlement of members of the defence force to receive free rations and quarters when living in Service establishments, or substituted benefits in the form of cash allowances when living elsewhere. This development, together with a proposal to provide a specific exemption for the value of rations and quarters that are still provided free of charge in a limited range of circumstances, has made unnecessary a provision that fixes the taxable value of defence force allowances in the food and shelter category at $2 a week. Accordingly, the Bill proposes that this provision be repealed.
Another provision of the income tax law governing the exemption of dependants’ allowances and exchange allowances of defence force members is to be amended. One purpose of this is to ensure that, in the limited range of circumstances in which board and quarters are still available free of charge, their value will be exempt from tax. Another purpose is to facilitate the provision, or continuation, of exemptions for allowances paid in reimbursement of certain abnormal expenses incurred by defence force personnel in complying with duty requirements.
The Woodward Committee contemplated that these allowances would not bear tax.
The amendments proposed will permit the allowances that are to be paid free of tax to be prescribed by regulations made under the income tax law. In the same way, it is proposed to prescribe, pursuant to this amendment, that a re-engagement bounty payable to a member of the defence force is to be exempt from tax. The Bill will also remove references in the exempting provisions to service exchange allowances. These allowances have long since ceased to be paid. None of the amendments will affect the tax treatment of allowances payable in respect of service before the date of commencement of the new pay code.
The provision of the law that authorises the allowance of income tax deductions for contributions to superannuation funds needs to be amended because, under recent legislative changes, contributions for retirement benefits by members of this Parliament and by members of the defence force are paid directly into consolidated revenue. The amendment proposed by the Bill will ensure that tax deductions for these contributions continue to be available, notwithstanding that they are not paid into separate superannuation funds.
The last matter dealt with in the Bill is the scheme for the collection of company tax by quarterly instalments. As announced in the Treasurer’s 1973-74 Budget Speech, the Government proposes that the scheme will be in full operation by 1975-76. When it is in full operation there will be 3 quarterly instalments payable in a financial year before the due date for payment of the assessment of company tax on income of the preceding year. The balance of the assessed tax- in effect, the fourth instalmentwill be payable on the due date of the assessment, the other instalments being credited against the amount assessed.
As a first step in implementing this scheme, most companies were required to pay an instalment of tax in January 1974 for later crediting in the 1973-74 financial year against tax due on 1972-73 income. This Bill amends the provisions covering this first stage of the scheme so as to provide machinery for implementing the later 2 stages. The Bill will provide for the collection of 2 instalments of company tax during the current financial year- 1974-75- and 3 instalments during each subsequent year. Each instalment will be calculated so that it approximates as closely as possible one-quarter of the full tax liability against which it is to be credited.
Companies will receive a notice specifying the amount of instalment payable and the due date for its payment. The due date will be at least 30 days after the date of service of the notice. The Commissioner of Taxation will not be sending notices this year where the amount of an instalment would be less than $250. As a general rule, tax on the 1973-74 income of a company that for this reason remains outside the instalment scheme will be payable in full on a date falling somewhere between 14 February and 30 June 1975.
The earliest due dates for payment of instalments in 1974-75 will be 15 November 1974 for the first instalment and 15 February 1975 for the second. As already explained, the remainder of the tax to be collected on 1973-74 income will be payable on the due date for payment of the tax assessed as shown on the notice of assessment. Where a company has been called upon to pay at least one instalment, this date will not, in normal circumstances, be earlier than 30 April 1 975.
A similar pattern of collection will be followed in 1975-76 and subsequent years except that an additional instalment of tax will be payable. This will be due for payment by a date not earlier than 15 August in the relevant year. Company tax collections will then be spread fairly evenly over all 4 quarters of each financial year thus reducing the size of the seasonal swings in tax payments. The strains on final-quarter cash resources of companies should be much less severe than they have been during the years in which the collections were concentrated within that quarter.
More detailed explanations of the proposed amendments are set out in an explanatory memorandum circulated for the information of honourable senators. I commend the Bill to the Senate.
Debate (on motion by Senator Cotton) adjourned.
Bill received from the House of Representatives.
Standing Orders suspended.
Motion (by Senator Wriedt) proposed:
That the Bill be now read a first time.
– I rise on the motion for the first reading of this Bill, this being an occasion on which matters relevant or irrelevant to the Bill may be raised. I say that merely by way of preface. I use the opportunity to refer to the matter which I raised by way of question to Senator Murphy during the tabling of documents earlier today. I believe that the Leader of the Government in the Senate should exercise his influence with the Prime Minister (Mr Whitlam) to ensure that the Senate has, before the debate on the Petroleum and Minerals Authority Bill, the correspondence and the attachments to the correspondence which led to the double dissolution of the Parliament. On the first day upon which questions could be asked in either the House of Representatives or the Senate questions were asked of the Prime Minister and of the Leader of the Government in this place about whether the correspondence and the attachments would be tabled. In this chamber I was informed by the Leader of the Government in the Senate that it was a matter for the Prime Minister. His indication was that he saw no reason why the documents should not be tabled, but that he could not answer for the Prime Minister. At the end of question time Senator Murphy indicated that he had received a communication to the effect that the Prime Minister had addressed himself to this matter in the House that day.
Referring to the Hansard of the House of Representatives of 10 July last, one reads that Mr Anthony addressed a pertinent question to the Prime Minister. He asked the Prime Minister whether he was aware of the doubt surrounding the justification for a double dissolution in the light of the Senate’s second failure to pass the Petroleum and Minerals Authority Bill, due to the fact that the period of 3 months, as required by section 57 of the Constitution, did not elapse between the Senate’s first rejection of the Bill and the second passing of the Bill by the House of Representatives. In fact, as Mr Anthony has indicated, the period was only 6 days. He sought the tabling of the correspondence. I think Senator Murphy will recall that my question was directed to the same general area of interest and concern. The Prime Minister indicated, in response to Mr Anthony’s question, that the documents leading up to the double dissolution of the Parliament were being printed and that he hoped to table them ‘next week’- that is, he hoped to table them this week. He indicated that the documents would include the advice from the Solicitor-General and the Attorney-General concerning the 6 Bills. Before the Parliament had ever met, I had written to the Prime Minister seeking the tabling of the attachments and the correspondence on the basis that these were matters of public interest. The Prime Minister had tabled certain correspondence but he had not tabled the full material to which that correspondence referred. On 11 July I received a letter from the Prime Minister in which he adverted to my earlier correspondence and said:
The documentation to which you refer is being printed for tabling in both Houses, and I expect this will take place next week.
I think in fairness to the Prime Minister I should read his concluding paragraph. He said:
You will note that I am adopting the procedure of Prime Minister Fisher who tabled the documents relating to the 1914 double dissolution when the new Parliament met, in preference to the procedure of Prime Minister Menzies, who did not table the documents relating to the 195 1 double dissolution until 1956.
I think that the virtue which the Prime Minister discloses there is a virtue which should be seen in full and that the tabling of the documents ought to take place before the debate on the Petroleum and Minerals Authority Bill occurs. I say this for 2 reasons: The first is that the debate on the Petroleum and Minerals Authority Bill and the courses open to the Opposition are very much affected by what is contained in the material which is in the correspondence and the documents that we are seeking. That debate ought to be conducted in the light of the full material.
– Just explain to us what you mean by that, Senator.
-I am not embarking upon an examination of that which I think the Standing Orders would prevent me from discussing, namely, the debate on the Bill or the various courses open on the Bill. I am saying only that the Petroleum and Minerals Authority Bill raises questions which were not open to be raised by any of the other Bills which are now coming before the Senate for a third time.
– Why are you being so coy about it?
-Only because I do not want to transgress the Standing Orders or to indicate the difficulties with which we are confronted not knowing what the full material would disclose. I am making the point that the debate ought to be carried on only when we have full knowledge of the facts. I suggest to the Leader of the Government in the Senate- he was the first to use the word ‘coy’- that he was being rather coy when he responded to my earlier question by saying that the Prime Minister has this matter under active consideration. Why does the Attorney-General not come out and say what he really means by the statement that the Prime Minister has this matter under active consideration?
The second reason why I think the Senate is entitled to this material is that it affects the general powers, the privileges and the assumed rights which the Senate has exercised over many years. I think that it is important to know whether, if a Bill is to be brought into the Senate on one day and if the Opposition or the Senate as a whole does not agree to the passing of that Bill on the day on which it is introduced, that is to be regarded as a failure to pass. I think that is an attitude upon which, irrespective of what government is in power, the whole Senate would wish to express some view. At least it is an area upon which, I imagine, there would be a desire for some debate and elucidation by honourable senators. Until we know precisely what was the basis of the advice given to the GovernorGeneral, and how it came that the GovernorGeneral made a decision which, prima facie, I think gives rise to legitimate concern, we are not able to embark upon the type of inquiry upon which I think the Senate should be able to embark.
I raise the matter only to invite Senator Murphy to do what he can to ensure that this material is placed before the Senate as soon as possible. It is only proper, I believe, that the debate on the Petroleum and Minerals Authority Bill should be conducted in the light of all the material, particularly when there seems to be no reason why the material cannot be produced today. The Prime Minister has indicated that there is no objection to the tabling of the material and that it will be tabled. It seems that the only reason for the delay in tabling the material is that it is currently being printed. If the material is being printed, there must be copies of it available and a limited number- even if a large number is not available- could be made available for the information of honourable senators. That, I think, is a situation which could have existed over the past week. But the Prime Minister has said that the documents are to be printed and we have held our hand. Now that we are coming to the end of the week in which the documents were to be tabled, I now ask what the Leader of the Government in the Senate is prepared to do to get these documents before us, as much to facilitate the work of the Senate as for any other reason.
– I take advantage of this opportunity to use two or three minutes to bring Senator Wriedt ‘s attention to a matter, the neglect of which I think reflects no credit to the Government. Since January 1973 a group of tin miners in northeastern Tasmania have been claiming compensation for the effect upon their businesses of the revaluation of the Australian dollar. Repeatedly throughout the intervening period the miners have had conferences with the Minister for Defence (Mr Barnard). During that period I have been asking, by way of questions and by making representations to members of the Ministry for a favourable decision in respect of the promised compensation for revaluation. No decision has been given and no payment has been made.
I think that it is not creditable to the Government that it is seeking to take advantage of an upturn in the price of tin that took place subsequent to the first half of last year. The group concerned asked for compensation only for miners whose incomes were modest and low. The miners pointed out that the costs that they had to bear in the operation of their mines was threatening their very existence until the upturn in mineral prices on a world-wide basis towards the end of last year. I simply take advantage of this occasion to make those few comments and to put forward the proposition that it is the right of electors of that sort who make representations or a claim for compensation to have the matter determined and not indefinitely deferred. It is the right of the miners in this case, having regard to the promises made to them by their local Federal representative, the Minister for Defence, who was then the Deputy Prime Minister, to get a decision on the matter. That decision should not be affected by the favourable turn of the market in the latter part of last year which occurred only because of the Government’s delay in making the decision.
- Senator Greenwood, the Deputy Leader of the Opposition, has again raised the matter of the tabling of certain documents. I informed him this morning that the question of when the documents should be tabled was under active consideration by the Prime Minister (Mr Whitlam), and that is so. Without going into the matter more deeply one might reflect upon the fact that certain events have occurred even since the statement by the Prime Minister about these documents. Advice might need to be given about those events and possible coming events, rather than past events.
– Are you saying, then, that the documents cannot be tabled?
– I can easily see that certain matters should, if only on the ground of propriety, be considered in relation to the particular request that Senator Greenwood has made. I do not want the honourable senator to make assumptions about anything. I have told the Senate that the matter is under active consideration. The Bill before the Senate seeks to enable certain things to be done by altering the laws of this country. In any event, that can be dealt with on its merits. I fail to follow the honourable senator’s argument about the relationship between the advice and the particular Bill. That does not mean, and he should not assume, that simply because his arguments were not accepted something would flow from that. I repeat that the question is under active consideration.
– I want briefly to comment on Senator Wright’s contribution to this debate. He referred to tin miners in Tasmania. 1 was under the impression that that matter has been resolved and that they had been advised. However, I think it ought to be said, as I have said on many occasions in this chamber, that it was never the Government’s intention that a system of compensation apply, much less on the means test basis which Senator Wright has indicated. There was in fact an upturn in the world prices for tin at that time. That affected, and had to affect, the Government’s decision in respect of any adjustment payments made after revaluation of the Australian dollar. However, I shall confer with my colleague the Treasurer (Mr Crean) and find out precisely what has happened. I must add that I am surprised that the people involved have not had final advice at this stage.
– Would you not expect that I too would be advised?
– I would have assumed that the Minister responsible might have informed the honourable senator either through me or directly. I could not say more. I shall certainly find out from the Treasurer precisely what has happened.
Question resolved in the affirmative.
Bill read a first time.
– I move:
Mr President, I seek leave to incorporate my second reading speech in Hansard.
-Is leave granted? There being no objection, leave is granted. (The speech read as follows)-
This Bill, which is complementary to the Income Tax Assessment Bill 1974, is of purely technical import, lt will repeal existing legislation that declares the rates of withholding tax on dividends and interest paid to non-residents, and will re-declare those rates. The Bill is necessary only because the existing legislation has a title consistent with the present scope of the withholding tax as a levy exclusively on income of non-residents. As I have explained, the Bill I have just introduced has the effect that, under the sort of arrangement I described in my earlier speech, interest withholding tax can be payable on interest paid to a resident. This Bill will ensure that the rates legislation is expressed in a manner consistent with that position. I commend the Bill to the Senate.
Debate (on motion by Senator Cotton) adjourned.
Bill received from the House of Representatives.
Standing Orders suspended.
Bill (on motion by Senator Cavanagh) read a first time.
– I move:
The purpose of this Bill is to provide parliamentary approval for construction of the Googong Dam and associated works in New South Wales as the next major water supply for Canberra and Queanbeyan. The existing water supply for the Canberra-Queanbeyan region will cater for a population of 225,000 people. There is a need for an immediate start to this project, as current population projections indicate that a population of 225,000 is likely to be reached in the Canberra-Queanbeyan area as early as 1975-76. The Googong project, in conjunction with the existing Cotter system, will meet the requirements of a population of 450,000 people. This population is expected to be reached in the region between 1982-85. The urgency of this project was recognised by the Government in August 1973. At that time Cabinet agreed that enabling legislation should be introduced which would authorise the project to be carried out by the National Capital Development Commission. Due to the dissolution of Parliament, it was not possible to introduce this urgent Bill as had been intended and it is therefore now introduced as a matter of priority.
The Googong project will be completed in two stages. It will include a regulating dam, pumping station, a treatment works near the dam, bulk supply mains to Canberra, a power supply and an access road to the site. When the project is complete, it will impound approximately 26,000 million gallons of water. This compares with 20,000 million gallons which is the capacity of the present Cotter system. The latest estimate available for the first stage of the Googong project, which is the major part, is $26.5m. The second stage of the work involves augmenting the water treatment works and pumping station.
The dam site is located on a short gorge of the Queanbeyan River approximately 5.5 miles from the main road bridge in the city of Queanbeyan. Five alternative schemes were carefully evaluated. A report on these alternatives prepared by the Department of Housing and Construction recommended that the Queanbeyan River should be developed as the next major step and that the dam should be built at Googong. The report concluded that the Googong proposal had a marked economic advantage over the other proposals examined, took advantage of a separate rainfall pattern, and provided water for irrigation and maintaining the water level in Lake Burley Griffin during drought periods.
The preparation of this Bill has required contributions from numerous New South Wales and Australian government officials. This demonstrates that major public works projects can be successfully co-ordinated across Federal and State boundaries. The Seat of Government Acceptance Act 1909-1973 gives the Australian Government paramount rights over the waters of Queanbeyan River and Molonglo River and the right to undertake such construction works as are required for the use of these waters.
The proposed works will be located within the State of New South Wales. This Bill, as well as adding the planning and provision of the Googong Dam project to the existing functions of the National Capital Development Commission, will also extend the Commission’s charter to enable it to operate within the Googong Dam area for the purposes of this project. Direct negotiations between the relevant Australian and State authorities have focussed upon the important matters of land acquisition, provision of future water supply for Queanbeyan, regulations for control of the catchment areas and the interests of owners and occupiers of land downstream of the dam. It was necessary for the Australian Government to acquire an area of approximately 4,900 hectares, or 12,000 acres, in New South Wales. This acquired area will include the reservoir, dam and building sites, and an area about a half mile in width around the top water level of the reservoir and extending about 4 miles upstream on the Queanbeyan River and Burra Creek. The land was formally acquired and gazetted on 17 October 1973. Although the water from the Googong Dam area is intended primarily for the Australian Capital Territory, this Bill allows the Australian government to provide water to Queanbeyan and other places in New South Wales. I might mention that the future growth of the Canberra region will mean that much more consideration will need to be given to regional water supply systems.
Ownership of land in the catchment other than the acquired area will remain with current landholders under New South Wales State law. Catchment regulations have been developed by New South Wales authorities in consultation with Australian government officials. These regulations will be enacted by New South Wales. While these regulations will apply at the outset, the Australian Government will retain the right under the Bill to make its own catchment regulations within the acquired area. The main catchment area consists of 8 1,000 hectares or 200,000 acres of land. It has been largely devoted to grazing and cropping. The circumstances in which compensation for owners or occupiers of land who suffer loss or damage as a result of this project may be paid is explicitly denned by this Bill, particularly in clause 13.
The basic purpose of this project is to ensure an adequate supply of high quality water to meet the needs of a rapidly increasing population in the Canberra-Queanbeyan region. The passage of this enabling legislation is urgent so that tenders may be called for the project as soon as possible. This will ensure that impounding of water starts not later than May 1977. It will also reduce the possibility of water restrictions in the region during drought. The project has been developed with careful consideration for the protection and enhancement of the natural environment. Measures designed to protect the natural environment will include a soil conservation program to reduce erosion in the catchment area and sediment deposit in Lake Burley Griffin; the preservation of permanent geological features including the London Bridge; a natural limestone bridge over Burra Creek which is a geological feature with tourist potential; and the undergrounding of pipelines. The project will provide the opportunity of making available additional recreational, picnic and scenic areas close to the growing cities of Canberra and Queanbeyan. Undoubtedly, the creation of this large new expanse of inland water will present an opportunity for public enjoyment of it.
A comprehensive environmental impact statement was prepared to consider the main environmental effects of the Googong water supply project. I have emphasised a wide variety of positive results which will be derived from this project. However, the environmental impact statement identifies a number of areas which will require careful attention during the development of the project. Two areas which should be mentioned are the mine waste pollution from Captains Flat and the sewerage effluent from Queanbeyan. In this area, the Minister for Mines and Power, representing New South Wales, and the Minister for Urban and Regional Development, representing the Australian Government, convened a joint technical committee on mine waste pollution of the Molonglo River. A report of that committee has stated that unless remedial work is undertaken at the mines there will be increased pollution from the waste dumps and that this could affect the usefulness of Lake Burley Griffin.
In addition, the report has concluded that the construction of the Googong Dam could marginally increase the concentration of mine waste projects in the Lake under some circumstances. It should be stressed however, that the basic source of the pollution is the abandoned mine workings and is not due to the construction of the dam. The report recommended remedial works to improve the water quality of the Molonglo River. The committee estimated the cost of these works at $2.5m. In May of this year, the New South Wales Minister for Mines and Power agreed with my colleague, the Minister for Urban and Regional Development, that the committee should proceed to tender readiness, for the implementation of the works as recommended by the committee. The Minister for Urban and Regional Development will shortly be discussing with him the method of financing these works.
The problem of sewerage effluent from Queanbeyan has also been carefully considered. Possible solutions to this problem include the construction of a more advanced waste water treatment plant for Queanbeyan, or the acceptance of Queanbeyan effluent into the Canberra sewerage system. This problem will have to be faced irrespective of the Googong Dam project. The Minister for Urban and Regional Development is awaiting a report resulting from the CanberraQueanbeyan investigation set up by his Ministry which has been carried out by the National Capital Development Commission in association with the Queanbeyan City Council and the Yarrowlumla Shire Council. The effects of both the mine waste pollution and the sewerage pollution will be lessened if necessary by releasing water storage reserves from Googong. Such releases are only possible until such time as the regional population of 450,000 is reached. However, both problems must be resolved at their source. My previous remarks should make it clear that the Australian Government is concerned to achieve this.
Mr President, early passage of this Bill is necessary to ensure that an adequate water supply is continuously available for the rapidly developing Canberra-Queanbeyan region. Tenders will be called in September 1974. In this way advantage can be taken of seasonal conditions to raise the dam embankment through its critical levels during the expected dry season between September 1976 and March 1977. Impounding of water will then start in May 1 977. The Googong Dam project is acknowledged by both the Australian and New South Wales governments as essential to the future development of the Australian Capital Territory and the surrounding regions. The building of this dam shows what can be achieved through cooperation between New South Wales government and Australian government ministers and New South Wales and Australian officials. As the nation’s foremost growth centre, the Canberra region is in a position to draw off population from the major urban areas of Sydney and Melbourne. The construction of the Googong Dam is an essential condition for the adequate water supply of this region for the next decade. I commend the Bill to the Senate.
Debate (on motion by Senator Guilfoyle) adjourned.
Debate resumed from 17 July (vide page 25 1 ), on motion by Senator Wheeldon:
That the Bill be now read a second time.
-Mr President, you will remember that when the time for debate ran out last night I was in the middle of dispelling some of the charges that had been laid against our existing health scheme and I was also dispelling some of the reasons given to warrant the introduction of these new Bills. I had pointed out to honourable senators that any health scheme in any State or nation must exist solely for the patient as an individual and not be based on a system of regimentation of either patients or doctors. I had pointed out that 74 clauses of the 1 34 clauses of the Bill- over half of them- deal with controls and restrictions on the scheme. I had pointed out that one of the difficulties in trying to implement a scheme such as this new one arises from the fact that only a small proportion of the population is sick at any one time. This Health Insurance Bill proposes to cover all the people as if they fall sick all the time. Not only does it do that but also it tries to cover them for catastrophic illness and long term illness which may follow catastrophic illness requiring intensive care. Any health plan which promises that much is doomed to failure because it cannot fulfil the promise. That is the position with these 2 Bills.
The Bills promise the patient freedom from the fear of the financial consequences of illness ‘. But, Mr President, the patients are like you and me; they are taxpayers. We will not be freed from any of the financial consequences of illness. Indeed, we have good reason to fear the financial consequences of illness if these Bills are passed. The Bills purport to provide social equality in health insurance. I had pointed out that this claim was made on the grounds that the rich receive cheaper health insurance because of the tax deductibility of their health insurance premiums. I had also pointed out in order to refute this claim that the rich pay higher taxes anyway and that much of that money was returned to the people in the form of health benefits for pensioners, repatriation cases and other health expenditure. The Health Insurance Bill tries to make costs predictable by assuming that it is doctors ‘ fees that cause increases in costs whereas in reality it is the utilisation of the service that determines the extent of the cost of the service. For example, a person may go to a doctor with an ordinary chest infection and require only one visit and a course of treatment with antibiotics to be returned to normal health. But the condition may be complicated. He may need to come back to the doctor for a further course of treatment, for X-rays and for referral to a specialist. The bills can mount in that way. It is useless and perhaps ridiculous to try to form some idea of the predictability of costs because whether the doctor’s fee is above or below some scheduled fee or determined fee has very little to do with the actual cost involved in a medical scheme.
It is claimed that the present health insurance scheme wastes public money simply because 1 5 per cent of the premiums collected is used in the collection of those premiums. The Government claims that it can do better. It claims that it could collect those premiums cheaper. Indeed, it proposes that it could do the job for half the cost.
However this would not be everybody’s experience in relation to Government expenditure. The claim was made that over one million people in Australia do not have proper medical protection. It was a Government claim. As Senator Guilfoyle pointed out, it was an inaccurate figure and it would be difficult to find the right figure.
– It was also a Liberal Party finding.
-But also the figure was given as 500,000 people when the Bill was read in the Senate. I will assume that it is one million. That is the Government’s figure for election purposes I presume. I suppose if we talk to any insurance agent he will assuredly tell us that we need more cover than we already have. We tried to identify these people. Were they migrants? Honourable senators will remember that I told the story of migrants, living within the area of my practice, who wished not to have insurance cover and wanted freedom to spend their money in the way they desired. The introduction of these Bills would take away that right and freedom from the migrants. Certainly, the people of Queensland would not be disadvantaged because everybody is covered for medical treatment and covered free of means test. I have mentioned the poor. A document which dealt with the poor was tabled in the Senate today. It stated that they could not afford the premiums. But the means test takes care of that. These people can apply for inclusion in the subsidised health benefits scheme under 3 levels of cover for lower incomes. Thus, they become entitled to the same benefits as anybody else who is covered by the medical benefits schemes. I pointed out, and I insist upon this claim, that if any person is too poor to pay a doctor, that person should certainly go to the doctor because he would not be refused attention to his needs.
– Where are these unique doctors?
– They exist all over the country. I mentioned that such action would make that person’s entry into the health machine easier. If he goes to the doctor he can still retain, if he so wishes, his choice of specialist by a general practitioner referring him to a specialist who can then treat him in a public ward.
I also asked the question: Are Aborigines lacking proper protection? I gave the answer to that question. Certainly not. They are a proud and a noble people. They have a fierce independence in regard to their health care. I work with them and I treat many more. I can say that none of them is unhappy or dissatisfied or even dissatisfied with their health care. I also mentioned that we can do much more for Aborigines. They have 10 times our rate of blood pressure and 10 times the incidence of our rate of diabetes. One child in every five dies before the age of 5 years. But this is not a problem to be dealt with in these Bills. That is work we have yet to do. Our health services can be improved just as those for the Aborigines can be improved. That is not an argument in support of these Bills.
– Your State is the only State that has not operated.
– We do not need to cooperate; we have a free health service. Where is the huge public demand for this scheme? I have not heard it and nobody else has heard it. We have heard only a government demanding that we change our health services. Nobody has claimed that Australian health services have gone to the dogs or that they have got too costly. I admit that private fees are high at the moment, but that is largely because it is the only area in which the doctor can increase the charge for his service. He treats pensioner patients, repatriation patients and compensation patients at Government fees. These fees are too low and have been slow in catching up. I pointed out also that the doctors treat pensioner patients, repatriation patients and compensation patients for a reduced fee. Although the Government says that it is subsidising the doctor, the boot is on the other foot; the doctors are subsidising the Government.
The claim was made that the present scheme encourages unnecessary operations. I proceeded to dispel that argument by pointing out the tremendous organisation that it would take even to be able to do this sort of thing. I stated that the medical profession has the power to police itself, and ordinarily did so. There was the other charge that the present scheme encourages doctors to keep their patients sick. I pointed out that a doctor lives by his reputation and his ability to cure people. Would it be right to think that we are all so daft that we could not see when a doctor was not giving proper service?
– He buries his mistakes and forgets about them.
-No-he does not. We call very quickly for a second opinion. Common sense should dispel any fears that the present scheme is encouraging unnecessary operations or encouraging doctors to keep their patients sick. One has heard the charge made against doctors that they have been bloody-minded and money hungry grubbers. Despite the comments made by Government members I can assure them that doctors are not rich. The old saying ‘Show me a rich doctor and I will show you a rich real estate agent’ probably has a fair deal of truth in it. Under the present system doctors assume responsibility for the patients they treat, and they work long hours. To discount the epithets I would like to point out that under the conditions promised in the new Bills doctors will be a lot better off financially, even if they go to the extent of bulk billing their patients and accepting only 85 per cent of their fees. Under this Bill also a doctor will be relieved of his responsibility to the patients. He will be paid whether he kills them or cures them. He will be paid on the basis of the number of patients passing through his surgery. In other words, he does not have to worry about the patients. But he wants to worry about and care for the patients.
– If he wants to worry about him, what is stopping him? Is it just the financial consideration?
– It will be, because a doctor has to live, he has to raise his family and send his children to school. The only way he will be able to increase his income will be by seeing more patients, and what has happened under the Canadian scheme will happen under our scheme.
– He would be like a politician and see more constituents.
– Yes. But what about the quality of care? If a doctor is paid by the Government then he is working for the government, not for the patient- and that is a critical change that will disadvantage every Australian. With all the rules, restrictions, checks and the inquiries proposed under these Bills, does the Government think a doctor will jeopardise his government job for the sake of the patient? Certainly he will not. As the patient looks into his new doctor’s steely eyes he will see that a government wedge has been driven between him and the doctor. The doctor will no longer have to satisfy the patient; he will have to satisfy the government. He will no longer have to listen to the patient or even care about him, he will be paid anyway. Another ill effect that will occur is that the moment the patient irritates, annoys or even begins to worry the doctor, the doctor will refer him immediately to somebody else who will be paid a little bit more to take on such knotty problems. He will be what is known overseas as a referologist’. The patient will just come in and the doctor will not listen to or worry about him but will send him to somebody else who will be paid to do the worrying. I described earlier what happened in Canada when the doctors were put on a low fixed fee and increased and speeded up their throughput of patients through the surgery. I think that the average time a patient spent in a surgery was 3 minutes,- which is barely enough time to learn his name. Of course, those doctors’ incomes skyrocketed and so the Canadian Government had to fix a ceiling to their incomes. As a result the doctors worked hard and at the rate they were putting patients through it took them only about 6 months to reach this ceiling. So the government had to rule that they could not see more than 300 patients a week.
– It is a sad commentary on doctors, it is not?
– It is a sad commentary on governments and their silly rules. The main problem we have is government interference in our health services. These sorts of schemes have been tried all around the world. They have always been brought in by socialists and have always proved disastrous. Of course everyone assumes that the patient is the white haired boy in the health scheme. The way the patients can abuse the proposed scheme as they have abused the British, Canadian and Scandanavian schemes beggars the imagination. The patient will have no restriction on the number of doctors or specialists he can go to and so he can build up some staggering bills which we, the taxpayers, must pay. Under the proposed scheme doctors are not encouraged to improve their practices. They will not be paid for any procedures performed at the time of consultation. All they will be paid for is the passage of patients through the surgery. So a doctor is not encouraged to supply ancillary services such as X-rays, electrocardiography, pathology tests and all those other things that save the patient’s time, travel and inconvenience. This is a withering way to force doctors to practice.
The British national health scheme, by the way, was born of tragedy and has lurched its way over the years to its present chaos. It had one brief period of glory about 10 or 15 years ago but it was able to exist only because it did not destroy private medical practice; the two kept going together. These Bills propose to destroy private medical practice and have doctors working for the government. If this is done it will put Australia in an impossible position from a health point of view. The Queensland free hospitals scheme exists only because it is complemented by an active and vigorous private medical practice. The balance between private and public practice acts to improve health standards because of the competition between the two.
Patients must be given a choice between the two and doctors and staff also must be given a choice between the two so that we can have optimal standards and healthy co-operation between the two. The British national health scheme has broken down. Australia is short of doctors and if we do not pass these Bills we can expect very shortly another influx of refugee doctors from Great Britain. This of course would not be in the financial interests of local doctors but they would not begrudge it because they know that Australia needs the medical services. Australia does not produce enough medical graduates to serve its needs. This is an area, I point out, where the government could operate most urgently and successfully rather than turn all its energies to these revolutionary Bills.
In my own State of Queensland, now that the universities have been nationalised, severe quota systems have been imposed on the medical schools, even to the extent that a student can pass his first year medical examinations and not be accepted for the second year. This, I think, is gross government negligence. The last influx of refugee British doctors to Australia was equal in number to the output of one of our medical schools. So not passing these Bills would in effect be as good for the Government as building a whole new medical school. The most important feature at the moment is that all national medical associations are opposed to the implementation or even the introduction of these Bills. They have all considered them carefully.
– Does the honourable senator suggest that they represent all doctors’ opinions?
-Nobody represents all opinions on anything, particularly the honourable senator. He certainly does not represent my opinion. The Australian Medical Association represents general practitioners, specialists and salaried medical officers. It is the largest body and it is totally opposed to the introduction of these schemes. The National Association of Australian General Practitioners also is totally opposed to these schemes. The Government would know just how opposed is the General Practitioners’ Society to the scheme. Probably all the Royal Colleges are against the introduction of these schemes but being academic bodies they do not express political opinions. Only two small, isolated groups of doctors support these Bills. We must respect their right to their opinion; there are socialists even in my own profession. What is sad, though, is that the Government has lost the goodwill of the medical profession- and my profession operates on goodwill. If these Bills are implemented the Government will lose the goodwill of the hospitals too. In fact, it has lost the goodwill of private hospitals and nursing homes.
– I thought doctors operated on people.
Sitting suspended from 1 to 2.15 p.m.
– Before the suspension of the sitting I was discussing the subject of goodwill in the medical game. I was propounding the theory that goodwill was all-important and that it was worth just about anything- and it is, too. The goodwill of doctors, the nurses and all hospital staff and health workers is most important, just as confidence and faith also are important in the health game. When you get sick you need help and a lot of this help can be provided simply by goodwill among people at very little cost. But if you destroy the goodwill you increase the costs no end. The point that I was making was that the Government had lost the goodwill of the medical profession and of the private hospitals and that all national representative bodies of the medical profession were implacably opposed to the proposed legislation. I count among those bodies the Australian Medical Association, representing as it does specialists and general practitioners and salaried medical officers, the National Association of General Practitioners, and the General Practitioners Society which has been more active than any of the other societies because it was the first to see the light.
I mentioned that probably all of the royal colleges would be opposed to the new legislation but as they were academic bodies they did not express political opinions. So the Government in losing this goodwill will create great extra cost. In the face of this opposition it will be impossible to implement the Bill at all because no national health scheme anywhere can work without the co-operation of the medical profession. In Australia there is not only the absence of cooperation but there is outright hostility between the medical profession and the Government. The Government has even tried various means to get the doctors back on side. It has tried coercion, it has tried public ridicule, and it has tried the golden handshake in order to try to enslave doctors and patients as well to its will. I am tempted to ask: ‘Why cannot the Government just leave us all alone?’, because government intervention is the main reason why there is this terrible problem in the health industry today. All that the Government’s scheme will do will be to tell you, the patients, how much health the Government will let you have and it will tell me, the doctor, how much health I am allowed to give you. That is just not good enough. People want more than they need; this is a natural human characteristic, and the Government should take note of it. Under this legislation, when people do want more than they need they will have nowhere to go to get it.
All of the national health schemes which have been implemented in Western countries have been set up by politicians trying to curry favour with the voters on the promise of relieving them of the financial burdens of illness, particularly catastrophic illness. These schemes have certainly not been generated by the people in the business, the doctors, nurses and allied medical personnel- not because of any vested interest in such a scheme but because they know that socialised health will not work. If honourable senators want to take this argument to extremes- I am sure that some of them have been to Russia, and I have been to China- they should take a look at the socialised medical services of those 2 countries? Russia has had 50 years to make socialised health work and China 25 years. But by our standards those countries are medically backward. This is simply because of government restrictions on health care unopposed by any private medical service. In our experience of socialised health services in other countries, the promise of health care ‘free to the consumer at the point of consumption’ immediately creates an unlimited demand for those services. But there is a limited budget from which those services can be supplied. Then these 2 factors diverge from each other- as the demand for health care goes up and you start spending to meet it, the available finance diminishes, and the only way the government can fix this situation is to put restrictions on the demand- and it does. Controls are placed on patients and on doctors. This leads to huge dissatisfactions first among patients, second among doctors and third among the government. This has happened in other countries. 1 would like to mention one scheme about which we will be hearing more shortly. This scheme is probably the last refuge of the politically diagnostically destitute. I refer to the Kaiser Permanente Scheme which I think will be the subject of the next device which the Government will resort to. I can dismiss this scheme in a few sentences. It is a scheme implemented in America within the Kaiser industrial empire and is based on pre-paid medical care. The scheme applies only to employees of the Kaiser empire. It involves, first, medical examination. It has many exemption clauses and it does not provide a complete cover. Anyone who suffers from a condition not covered by the scheme has to get medical attention in the big private hospitals such as the Cedars of Lebanon in the Sacramento Valley. In other words, without the backup of private hospital services this whole scheme would crumble and fail.
I hope I have said enough to show that Australia’s present health organisation is not ramshackle, inequitable and wasteful’. Certainly it has some shortcomings but it does not have the shortcomings that the scheme proposed by the legislation would have. The shortcomings that the present scheme has arc not of sufficient magnitude to warrant an about face into socialised medicine. For a start, the Government has done nothing so far- it has been in office over 18 months now- about putting pensioners into the subsidised health benefits scheme. Pensioners could already be receiving the benefits covered by ordinary medical insurance. The Government’s scheme if implemented would reduce all of the rest of us down to the second class scale by which pensioners are covered now. It would be an act of high social responsibility for the Government immediately to put all pensioners into the subsidised health benefits scheme.
Also, 1 think that we could probably give a better service to our repatriation patients. Instead of making these people fight for acceptance of certain disabilities due to war service, simply put returned ex-servicemen into the higher scale of medical benefits and let him and probably his family be covered for all illnesses. I believe that this would stop the row. If this were done Repatriation hospitals would not be needed and they could all be made general hospitals. The Pensioner Medical Service was originally a magnificent concept, but it was a limited service. The Sendee limited pensioners to ordinary general practice consultations. But it helped people in reduced circumstances out of trouble. It stopped them creating bad debts and it was a help to doctors, and doctors did see these pensioners at the reduced rates. The only reason why the Pensioner Medical Service is failing now is because of lack of ideas and lack of initiative by the Government. The Service should have been updated as time went by into a better and better service until the time when all these people could have been put in the subsidised health benefits scheme. Rather than destroy the service we have built up over the years we should build on it and make it better. This could be easily done.
I note from the Bill that the Government is to move into the pharmaceutical industry. The production of new drugs is very costly and fraught with danger, not only for the patients but also for the drug companies and the doctors. The drug companies have been accused of being multinational operators which are here to exploit a drug crazed public in order to make excessive profits for bloated capitalists. Actually the drug companies last year made a 7 per cent profit on the sale of drugs. That could not be called anything but modest, particularly in view of the inflation that exists today. We hear now that the Government intends investing our money- the taxpayers’ money-in this risk enterprise. I think that is an improper use of our money. Only risk capital should go into the production of these substances.
Private hospitals are now in an unenviable position. Very few truly private hospitals exist in Australia today. Most of them are religious and charitable institutions which depend heavily on Government subsidy for their livelihood as they should, because they are religious and charitable and exhibit a power of goodwill by the maintenance of their institutions. In return for this Government subsidy the organisations provide teaching facilities for nurses and also provide a small number of public beds. But, with the implementation of the provisions contained in these Bills, the private hospitals will be swamped with public patients simply because the Government has not gone ahead and provided new public beds. The private hospitals will be swamped with public patients in their beds and their livelihood will be reduced at the command of the Minister. In other words they will be forced to comply with the command for their own destruction. These institutions were born of goodwill. They will be tom from the bosom of goodwill and put under Government control. To me this is socialisation.
Nursing homes have been subjected to a most vicious form of price fixing. It has been enforced to such an extent that many have now closed and the price fixing has been carried out by the Government. A national shortage of nursing home beds exists at present and the Government argues that up to 25 per cent of patients who were in these beds should not have been there. The Government says that those patients should have been looked after at home. But by whom? Many do not even have a home. Does the Government expect the youngest daughter to stay home, as she used to, and look after her parents. This would be a form of social injustice. These patients could even qualify for a small home nursing allowance. But instead of making facilities available for the patients, the Government’s solution has been to strangle the nursing homes by fixing low subsidies and rebates for patients and by allowing costs and wages to rise to such a level that the homes have been forced out of business. The Government has lost the goodwill of the administration of private hospitals and nursing homes. This is a pity because, as I mentioned before, goodwill is the sounding board of good health.
I mention now the development of community health centres. These community health centres which are being established are ill advised, ill conceived and even ill defined white elephants. I mentioned community health centres when 1 was speaking last night mainly to dismiss them. Out of the 44 community health centres built in Great Britain during the last 12 years only 4 remain in existence and are operating at present. They have been tried and have failed lamentably. But they are making their appearance in Australia; they are appearing here in Canberra, and even my own State, Queensland, has built 4 of them. No doubt honourable senators have read of the problems in Canberra and the lessons which have been learned by at least one doctor who tried to work in a community health centre. Even at this stage I might add that it costs 3 times as much for a patient to visit a doctor in a community health centre as it does to visit a general practitioner. It is planned to fill these centres with all sorts of services- including psychiatric services, social welfare services, guidance agencies and expert therapists. I should like to have a word about manpower and womanpower at this point. The number of these expert therapists and guidance experts in Australia today could be counted on the fingers and toes of the people sitting in this Senate. So, where will the staff come from?
– After 23 years of LiberalCountry Party rule we have not caught up.
– Well, good luck. No other country could find the staff. Those are high sounding words. Whoever conceived the idea must consider we are a nation of nuts. Community health centres were promulgated as a device to supply a much wanted need in the area of general practice. In other words something was lacking and the health centres were to complement and supplement the general practitioners. I have been in the business for 20 years and I have seen no such need for such a massive infusion of costly failures. In reality they represent a futile attempt by the Government to compete with private health services and to put the private services out of business or, at least, to bring the private sector under Government control. The Government ignores completely the future requirement for health care in Australia. There is a natural role for government in health care. I refer to the provision of medical education and research, preventative medicine and administrative medicine. The Government has only a limited role in curative medicine. Obviously the more the Government puts into medical education and research and preventative medicine the less it will have left to put into curative medicine. It is with curative medicine that private enterprise can come to the rescue of the Government. It can do so by taking the burden off the Government so that the Government does not have to supply a great deal of curative medicine. In addition, private enterprise can satisfy the patients better than the Government can. Under the private enterprise system the patient remains in control of his illness and the amount of the health service he wants to use. Under the Government service he compulsorily has to use and do what he is told.
Medical insurance is tailor made to meet the sudden and unexpected needs of health care. It needs to be a flexible system. Suppose there was a single national medical insurance scheme and a person was dissatisfied with it. Where would he go? To whom would he appeal? He would have no-one.
-What appeal does a person have against the overcharges that you people make? If you think a person has a lot of money you charge him more than another person whom you think does not have as much.
– That is your opinion. We certainly do not overcharge for our treatment of pensioners, repatriation cases and all Government cases.
– But you do overcharge people, I have plenty of evidence of it.
-I doubt it. These Bills are designed to turn us about and plummet us to the bottom of the hodge-podge of socialist health schemes which have proven themselves to be failures right around the world. Health is too important a matter to each and everyone of us to place in the hands of any government, Liberal or Labor. A person’s health transcends political boundaries and it must not be shackled by party platforms or political philosophy.
These Bills, if passed, will disadvantage every State in Australia and every person in Australia, but particularly they will disadvantage Queensland and Queenslanders. If the Senate is to perform its proper role as protector of the States and their people, no-one in this chamber should vote for the passage of these Bills, especially the senators from Queensland who have a mandate to reject them, as I have.
– I rise to support the Health Insurance Bill. I am pleased that at the conclusion of his speech Senator Sheil began to talk about health insurance which is, I understand, the subject of the debate. During the course of his contribution he talked about a great variety of other subjects which may be of concern to certain medical practitioners but they are not relevant to the topic before us at the moment, which is a health insurance scheme. In opening this debate on behalf of the Opposition Senator Guilfoyle began by referring to an actuarial report obtained from E. S. Knight and Co., of Melbourne, a very well-known firm of actuaries. The firm is particularly well-known to the legal profession in Melbourne and is very highly regarded by it. I think it is common knowledge amongst lawyers in Melbourne that you go to E. S. Knight and Co., if you have a damages case for somebody and the facts are not good. If you have a bad case you go to that company for actuarial assistance. I suggest that this is what the Opposition did through the agency of the Australian Medical Association on this occasion.
Any actuarial assessment depends on the information given to the actuary. If one examines that actuarial report, or what is available of it, one will see, firstly, that to the extent that the cost increases which are estimated in relation to the Government’s scheme are purely inflationary they would apply equally as well to the existing scheme. Secondly, the report of that company was based on projections of high utilisation of the health service, and no doubt those projections were supplied by the AMA. To say the least, they are highly speculative projections. In any event, an actuarial report of that kind is open to a great variety of criticisms unless one knows the exact information given to the actuary.
I am slightly critical of this selective use in this House of the services of an actuary. For example, has any actuarial assessment been made of the escalating costs of the existing health scheme in this country? Was one ever made in the past during a period of Liberal-Country Party Government? Was one ever made at the instigation of the AMA when the Liberal-Country Party Government existed? When the Fill was ordered in 1963 was any actuarial assessment made of the escalating cost of that project? When Australia went into the Vietnam war in 1 965 was any actuarial assessment made of the escalating cost of that project? The answer to all those questions is ‘no’. The Vietnam war was not a health scheme of concern to the Australian people; it was a death scheme of a completely different variety which was not costed and the costs of which have never been given to this House. All that, of course, is now hopefully forgotten but today we have the assistance of actuaries to look at the Government’s health insurance program.
I am not saying that the cost of a health scheme is not a very important matter but it has not been neglected by the Government. 1 refer the Senate to the introductory portion of the Government’s White Paper entitled ‘The Australian Health Insurance Program’ which was presented in November 1973. Without reading the relevant section in any detail may I make the point that the great emphasis of that introduction is on the escalating cost of health services in Australia, the escalating cost of health services throughout the world, and on the need to provide a scheme on which the Government can keep an eye from a financial point of view. I want to quote from page 2 of the White Paper where it states:
This year health services will cost more than $2,000m. This is 5.3 per cent of gross domestic product; in other words, over $5 in every $100 of the wealth produced by our nation in a year goes to these services. Moreover, the cost is increasing at such a rate that it will double every five to seven years. If unchecked, it could reach 12 per cent of gross domestic product, or $12 in every $ 100, in the next 25 years or so. The Government has a responsibility to ensure that any growth in health costs is justified. It must establish that any of this growing cost is not due to avoidable waste, extravagance or inefficient methods of delivering or financing health services. At the same time it is determined not to do this by allowing a decline in the quality of care. Indeed, it aims to improve services.
The cost of health care in Australia as it is projected into the future has been a prime concern throughout the documents published by the Government in relation to its health insurance scheme. The Government has been aware of the situation in Canada and other countries where they also have escalating health costs and these matters have been taken into account in the preparation of the legislation which is now before the Senate.
– Why does the Government pretend that 1.35 per cent of taxable income will cover the cost together with the link with the Commonwealth contribution?
– I do not think that is what the Government pretends. If the honourable senator thoroughly reads the White Paper I think she will find that the 1.35 per cent will cover it for the first year, if I recollect correctly. I want to deal with one other aspect which was raised by honourable senators on the Opposition side. Throughout the debate so far Opposition senators have referred to the Health Insurance Bill as a nationalised health scheme. Whether that is loose terminology, a bad habit or some sort of pay-off for the $431,000 which the AMA spent last year on opposing the Government’s health scheme I do not know, but it is not correct and every honourable senator in this chamber knows that it is not correct. After all, we are here to discuss a health insurance scheme for the whole of the Australian people. We are not here to project the anxiety neuroses of a certain paranoid section of the medical profession, and that is where those expressions begin. I refer to those expressions describing the Government’s scheme as a nationalised health scheme, socialised medicine, and so on. Even the shadow minister in another place disowned the use of this terminology, during the course of the debate last year, to describe the Government’s scheme.
The facts about the Government’s scheme are quite well-known. They were most eloquently expressed, as usual, by the Minister for Repatriation and Compensation (Senator Wheeldon) in his second reading speech. The purpose of the scheme is to introduce in this country a health insurance system which is equitable, fair and efficient. Those facts ought to be known by everybody in Australia because in 1973 we had what is euphemistically called the ‘the great health debate’ which went on from April 1973, at least, until the end of the year. The merits of the Green Paper and subsequently the White Paper were discussed throughout the community. In 1972, prior to the election in December that year, the Government put before the people its health program for Australia. It was endorsed by the people in December 1972. Throughout 1973 it was debated in the debate to which I have referred.
The Government’s scheme was a response to one very important fact. It was a response to the widespread recognition in this community, amongst doctors and others, that the scheme as it existed at that time was a ramshackle scheme. The evidence for that statement is supplied in the report of the Nimmo Committee, the Committee of Inquiry into Health Insurance, which was appointed by the Liberal-Country Party Government in 1969 to look into the question of the efficiency and adequacy of health services in Australia. Briefly, that report said that the system was unnecessarily complex and inequitable, that the benefits were inadequate, that it imposed hardship on certain sections of the community and that the private health funds had very high operating costs. In essence, they were the findings of the Nimmo Committee. That report was commissioned by the previous Government. From 1969 to 1972 nothing was done about those criticisms which were made as findings by the Nimmo Committee. That inertia is typical of the myopic social vision which Opposition senators display and which may be a case for making spectacles a free item in the national health insurance scheme.
There are other important facts to which the Nimmo Committee did not refer. The first is that in Australia approximately one million people are not covered by health insurance benefits. Senator Sheil began his speech by saying that the figure was much lower. Later he said that the figure may be one million. If one wants authority for the proposition that approximately one million Australians are uninsured, it can be found in paragraph 8 of the background statement of the Liberal Party of Australia Committee on Social Security, Health and Welfare. It states:
It must be remembered that although only 8 per cent remain uncovered, it represents about one million people. These people can be grouped into 3 categories: First, the wealthy group who consciously opt not to insure, and when medical and hospital expenses are incurred simply pay the total bills. Secondly, there are the poor, some newly arrived migrants, who cannot understand English or the complexities of the health scheme.
The report refers to a third group which it calls the middle class punters. The Government estimated that the number of uninsured people was approximately one million. The Liberal Party background paper agrees with that figure. One million people not covered by health insurance is a lot of people in a country with the pretensions which we have of being a modern and an efficient democracy. When we remember that approximately 60 per cent of the one million people who are not covered are migrants, I think the problem becomes one of even greater social significance because the majority of those migrants come from countries which have compulsory health insurance schemes. They are not used to coming to a modern, progressive country such as Australia which has no compulsory and comprehensive health insurance scheme. That problem is a very grave social one for this country, and I ask Opposition senators whether they really care about that very large group of migrants who are not covered by health insurance. If they care, what have they offered since the Nimmo Committee report was presented and what do they offer now to those people?
The debate on health insurance last year was a long and a confusing one in which the Government’s policy on health was grossly misrepresented. In some ways it was an abuse of the democratic process rather than an attempt to embrace the democratic process. Few constructive suggestions were heard from the Opposition during that debate. Now, the third time that this legislation is before the Senate, Opposition senators behave like a collection of King Canutes dispossessed of their kingdom but still determined to turn back the tide. Look at the criticisms which were made in the so-called great debate in 1 973. Firstly, it was said that the Government’s scheme was reprehensible because it was compulsory. What sort of society provides that a person who rides a motor cycle must wear a safety helmet to stop himself from getting hurt, that a person in a car must wear a seat belt to stop himself from getting hurt- these safety measures were introduced by State Liberal governments- and that a person must have an X-ray to see whether he has tuberculosis but does not require people who suffer disabilities in terms of ill health or injury to insure themselves? What is the virtue of non-compulsion in that situationin a society which is compulsive in those other ways to which I have referred?
Secondly, it was said that the Labor Government’s health insurance scheme would result in gross overuse of medical services. There is very little evidence to support that statement. The only evidence which has been adduced on that point relates to the province of Alberta in Canada. The figures clearly suggest that in the first year of compulsory health insurance in that Canadian province there was a marginal overuse of the health services. In the second year the overuse lapsed considerably. By the third year of that scheme’s existence the level of use of medical services was almost back to the point at which it started. I believe that is the only documented material relating to the level of overuse of any compulsory health service. Thirdly, it was said- I mention this point because it is still being saidthat the Government’s scheme was a nationalised health service, socialised medicine and so on.
Fourthly, it was said that the Government’s scheme removes from the patient the freedom of choice. It was said also that the scheme would destroy the doctor-patient relationship, whatever that may be. Senators, by virtue of their position in the community and by virtue of their backgrounds, may enjoy very happy doctor-patient relationships with their medical practitioners. One has only to speak to anybody who does not enjoy such a privileged position to find that the much vaunted doctor-patient relationship leaves very much to be desired. The question of the absence of freedom of choice under the Government’s scheme was recognised by the shadow Minister, Mr Chipp. In an article in the Melbourne ‘Age’ of Thursday, 4 October 1973, he is reported as saying:
And I say in fairness that under the Labor scheme, notwithstanding what has been said, you will be able to go to the doctor of your choice in so far as the general practitioner is concerned . . .
They were the sort of criticisms which were being made of this scheme by the Opposition during 1973. They have not changed much in July 1 974, apart from the production of an actuarial report.
Other criticisms were levelled at the schemecriticisms by pressure groups and vested interests. There was the influence of the General Practitioners Society, the more paranoid section of the medical profession, which had a very strong influence on the AMA which was constantly accused of not leading the push in the opposition to the Government’s scheme. The AMA came into the great health debate at a certain stage with the sort of advertisements which appeared regularly in the papers. They suggested that under the Labor Party’s scheme, which was referred to continually as nationalised medicine, people would become a statistic in a computer. The unhappy fate of patients under the nationalised health scheme, as it was called, would be to become a statistic in a computer. In those advertisements the question was asked: Wouldn’t you feel much happier if your records were safely locked away in your doctor’s surgery?’ That is a question to which I would like to get an answer from many people in the community because I am not quite sure what the answer would be. There were a number of other advertisements of this kind which highly misrepresented the Government’s scheme. They were largely dishonest and they confused the public. They influenced a wider section of the medical profession, and now they are clearly influencing a significant section of the Liberal Party and Opposition senators in this chamber.
Of course when one looks at the attitude of the organised medical profession and its political organisations, one must ask to what degree these organisations really represent the views of the medical profession as a whole. There is always a great deal of talk in this chamber from the Opposition benches about the need to have secret ballots in trade unions, the need to keep an eye on what trade unionists do in their day to day activities and the need to have agreements, which are certified by a court, in relation to trade unions and so on. There has never been the same sort of clamour that the representative bodies of the medical profession should provide the same facilities for their members. I understand that there are not too many Australian Medical Association meetings at which there is a quorum and there are not too many doctors- it is a bad thing for our democracy- who take too much interest in the affairs of the AMA or the General Practitioners Society. I believe that most doctors in this community work hard and are dedicated to their profession. I believe that doctors, like everybody else who has had the advantage of specialist or technical training in a particular field, perform their duties to the best of their ability. But they do not have very much time to think about the social consequences of what they are doing and, more particularly, to think about the social consequences of what their purported leaders are saying on their behalf in the community in relation to the social problems of health.
The attitude which has emerged from this situation is one of a desire to resist change in this matter at any price- to delay the deliberations of this chamber in order that change, which we on the Government side say is inevitable, can be delayed even for another week or so. That change has been resisted by the various medical associations, and it is now resisted by Opposition senators in this chamber. Last year the Opposition spokesman on health matters in the other place said:
This debate has become more unwholesome as it has proceeded. Some argument has been based on false assumptions and advertising by some professional organisations which have demeaned the professions they represent; advertisements in deplorable taste, by professional bodies that should have known better. It has degenerated into personal abuse of Ministers and of individuals.
That sort of misrepresentation which was widespread in 1973 is still continuing. Of course, 1973 was the year of the so-called great debate which in a sense, ended with the election on 18 May 1974. In that election, the timing of which was chosen by the Opposition, the Government obtained nearly 50 per cent of the votes throughout Australia. I put it to the Senate that if the people who voted in the election of May 1974 were clear about anything, they were clear about one thing- that if the Government was re-elected it would introduce its national health insurance scheme, because that scheme was discussed throughout 1973. It was foremost in the political debate in this country in 1973, and every elector who voted in May 1 974 surely must have been clear about the fact that if the Government was returned, it would introduce its national health insurance scheme. In spite of that, and in spite of all the horrors which Senator Sheil and others have said this scheme might create, the people still voted to return a Labor Government in May 1974.
– That may be the reason they voted for us.
– It may be the reason, Senator Cavanagh. But we have on the other side of the chamber this concept of a sort of selective mandate. It seems to me that Opposition senators have one thing in common about this scheme- they must each have the capacity to see through a keyhole with both eyes at once, because the selections are clearly made. I think that the Liberal-Country Party Opposition has interpreted what the people of Australia said in December 1972 and again in May 1974 only by looking, as it were, into every living room in Australia and saying: Look, the Australian people might have voted for the Labor Party on 2 occasions but no, they did not vote for a national health insurance scheme, or they did not vote for Senate representation for the Territories, or they did not vote for electoral reform or for anything else that we happened to dislike. The people voted for the Labor Party, but they did not vote for any of those things! Perhaps one day an Opposition senator will stand up in this chamber and tell us what the people of Australia did vote for. As Senator Cavanagh has suggested, one thing is perfectly clear: The Australian people knew what was going to happen about the health insurance scheme if they voted for the Labor Party. If anything can be said in summary, it is that the people voted for the Labor Party against the Opposition, and they knew the Opposition’s attitude to health insurance and they knew the Labour Party’s attitude. So the concept of the selective mandate is one at which we must really look closely in this chamber.
Of course in the 1974 election campaign a new factor was introduced; suddenly the Liberal Party produced a new health scheme of its own. In spite of everything that was said in the findings of the Nimmo Report in 1 969, throughout 1973 the Liberals told us that the existing health scheme was satisfactory and that the Labor Party’s health scheme was disastrous. Yet suddenly, on 23 April 1974, a new policy was produced by the Liberal Party. That policy went to the people in May 1974 and somehow it did not seem to appeal to them very much. Between 1969 and 1974 nothing was done about the inadequacies of the existing health scheme; nothing was done about the condition of the Liberal Party policy in relation to the provision of health insurance. Yet suddenly, before an election, a policy emerged- a son of Liberal Party jet lag of 4 years; Nimmo to Chipp, one might say.
One might ask whether even now the new Liberal Party health scheme is understood by Opposition senators, or has even been read by Opposition senators, because we have heard very little about it in this debate. Maybe it is like the Opposition’s education program which was produced in April 1974. A survey in Victoria found that 60 per cent of Liberal Party candidates did not approve of what was in that program because they had never been consulted about it. So much for democracy within the Liberal Party and for the policies which were produced in those dramatic days over Easter of 1 974; the policies which suddenly emerged but which still do not seem to receive universal acceptance among Liberal Party supporters themselves. But the significant fact about the production of a new health insurance program by the Liberal Party in April 1974 was that it was an admission that everything they had said in 1973 was wrong. The significant thing is that the Nimmo Report was right and that the whole debate of 1973- ‘the great health debate of 1973’- was nothing more than a farce and an obstructionist tactic against the Government of the time.
The new Liberal Party health scheme accepts in a background document that there are about one million people in Australia who are uninsured. It accepts that there was a need to introduce a sort of half-baked compulsory element into the scheme. As I understand it, the scheme has not been costed. There is no evidence that it has been costed. It fails completely to recognise the inequity of the present tax concessions as they fall on poorer people in the community. Of all things, it provides for a system of using the Taxation Office to collect premiums for private insurance funds. We might all have our quarrels with the Taxation Office from time to time. We all might have views as to what is its proper function, but has it ever been suggested seriously before in Australia that a function of the Taxation Office is to collect premiums for private organisations? That is what the Liberal Party’s proposals amount to- the use of a government agency to assist the working of private funds.
We might also ask: What is so magical about the private health funds in Australia? Will the Liberal Party senators go to bat in this debate to expound on the virtues of the private health funds, to tell us how efficient and democratic they are in terms of consumer representation, and to tell us what sort of say the members of the funds have in the level of contributions and the level of benefits provided? Will they tell us what sort of voice contributors have in the policy of the funds? Will any Liberal senators get up and explain to us what are the great virtues of privacy, of competing private organisations in the provision of health care to the Australian community? Somehow the magic view that private institutions are better than government bodies still lingers on in spite of everything that the Nimmo report says and everything that has been said since.
We on this side of the Senate do not say that the health insurance scheme which we propound is perfect. We say that it represents a change. We say that it is an answer to the criticisms and inadequacies of the health insurance provisions in this country. We say that it was quite clear in 1969 that the existing level of services provided to people in the community in relation to health was totally inadequate. It has been quite clear to everybody who has followed the debate ever since that the services are inadequate. The introduction of a new health scheme will involve difficulties. There are always problems associated with change and it requires a degree of courage to face up to them.
It requires a large degree of myopia to say that we will not. face up to change at all, that we will go back to the old scheme which has existed in this country for a long time, even with some modifications. It is myopic to say that we will defend that scheme to the last; that we will defend the existing interests of private health funds; that we will defend the position of the General Practitioners Society and the Australian Medical Association; that we will adopt defences in relation to all those matters but we will not be prepared to face up to change. I nave said that change brings problems and nobody on this side of the Senate pretends that the introduction of the new health insurance scheme will be without difficulties. Of course it will have difficulties but I believe that as a government and a Senate we must be prepared to face up to those difficulties. We must not try to preserve the position and patch over the cracks of the ramshackle existing scheme.
The Government has authority from the people of Australia for the introduction of a new comprehensive health scheme. If we do introduce such a scheme we will not be embarking on a unique and unusual development in health care. Many other countries have comprehensive health schemes of a compulsory nature. I have in mind the Union of Soviet Socialist Republics, United Kingdom, Finland, Norway, Denmark, Sweden, Federal Republic of Germany, Netherlands, France, Switzerland, Austria, Belgium, Czechoslovakia, German Democratic Republic, Italy, Greece, Poland, Romania, Yugoslavia, Canada and New Zealand. Australia, with pretensions to being a just, modern and democratic society, should be proud to join those nations in providing new health insurance and health care schemes. I repeat that the Government has a mandate and the authority of the Australian people to introduce such legislation. I commend the measures to the House.
– In this cognate debate we are debating the Health Insurance Bill and the Health Insurance Commission Bill together. I oppose the Bills and support the stand of Senator Guilfoyle. I say at the beginning of my speech that I reassert that this is a new Senate, that there are 15 people here who were not present in the last Parliament and who took no part in a health debate at parliamentary level at any time. We have our right by virtue of election to have our say and to be heard, and it would be quite improper for the Senate to demand that these Bills be put through- guillotined through as happened in another place- without new members democratically elected having their say, being heard, and expressing their points of view.
I am willing to accept that there is an inevitable chain of events which may unfold. I was elected by people who support the point of view I adopt, people who believe it is right to oppose this bad legislation. They want this view put and put forcefully. I accept the right of the Parliament to hold a joint sitting and I will abide by the verdict that it reaches, but we will have our say and will vote as our consciences dictate in the meantime.
In terms of health care by world standards Australia has been a high performance community. Although by world standards Australia is a high performance country there are pockets of unevenness. In some areas our health performance has been poor. For example, Aboriginal health care has been poor but it is an aberration within what is basically a high performance country. The health of our citizens is good, as is their longevity. Infant mortality is low, infectious diseases are controlled. By world health standards we have no malnutrition, with the exception of a few small well-defined areas. We are a high performance country and our health delivery system keeps us that way.
What is being sought is a major alteration in the structure and delivery of health and we have to be certain that we are not going to end up with worse health care as a result. That is what we have to look at. What matters in the end is the health care we receive, the health care actually received by my wife and children as consumers of health care. In studying this legislation we should ask: What will it mean to us in terms of health care received, not just now but in 5 years’ time? That is the essential question. If the health care is to be worse, or no better, the Bills have nothing to recommend them. If they are to produce a system the results of which are worse, the changes can be justified only on ideological grounds. We know that the Labor Party has planned this legislation on ideological grounds. The Prime Minister (Mr Whitlam) in his Fabian lecture of 1971 said:
The major act of socialisation in the traditional sense to be undertaken by a Labor Government in its first term of office is through the establishment of a single health insurance commission.
He said that as a matter of ideology this scheme is to come in. Whether it is appropriate, whether it is right, whether it results in better or worse care we are to have it because it suits the ideological needs of his Party. We are being asked to accept a scheme which is a hybrid. In terms of primary care, that is to say, care in the community, we are adopting the Canadian model. In terms of hospital care we are seeking to adopt a model which is very close to the English model. But the legislation has been produced on certain premises and I believe these premises are false.
The first premise is that a large number of people are not insured and therefore they are without medical care and without access to care. I believe that is nonsense, that it is not true and that we can show that it is not true. We are being asked to endorse a single government fund. Senator Button, who is now out of the chamber, pointed out that there was nothing magical about private health insurance funds. I ask him what is so magical about the concept of a government health insurance fund if it will not improve access to care for people presently without it. The second point is that the new scheme will overcome the deficiencies in health care. Again I say that is nonsense. This new scheme will do nothing to deliver any services to anyone who is not now able to get them. The third point is the assumption that governments are competent to deliver personal care to communities. Again I say this is an extremely doubtful view and one which we shall examine shortly.
I turn to the question of how many Australians are at present covered by health insurance. This is a very important question. I believe the figure is well over 90 per cent. We have a situation in which most Australians have access to and cover for care. I submit that our job surely is to look at the remaining group. We should not make the whole 90 per cent alter their present cover. Let us see what we can do to improve the small group that is not now covered. We have a health scheme which was introduced by a LiberalCountry Party Government and one which has continuously been improved and upgraded. Senator Button said that every scheme has difficulties. Our scheme has evolved, it has improved and there has been continual improvement. The latest initiative was the subsidised health benefits scheme. Expenditure on that scheme has increased year by year. It reached $1 lm in the last year for which I have figures.
I believe that our scheme is adequate for the needs of the Australian community. It is certainly adequate as a basis for improvement. For the Labor Party’s approach we must prove that a large number of people are not covered, that they are in need and that they need extra help. Mr Hayden in another place has said that Vh million people are not covered. This is the figure which was included in the second reading speech in this place. We have seen other figures which attempt to show the number of people who are not covered. These figures were derived from figures compiled by the Bureau of Census and Statistics in 1973. They are incorrect. The figure which Mr Hayden produced on the sample survey excluded everyone under the age of 15 years. Those people were not included in the assessment. Mr Hayden ‘s figure excluded Defence personnel who had separate cover for medical care; it excluded Queenslanders; and it excluded those with pension entitlements. The Government attempted to assess the number of people who had access to health insurance by excluding large numbers of people who should have been included. It was an improper way to assess health care cover.
I seek to introduce other figures into the debate. The Right Honourable William McMahon published last year a letter which incorporated these figures. A copy of the letter appeared in the Sydney Morning Herald ‘on 4 February 1974. 1 seek leave to incorporate in Hansard a table setting out the percentage and the number of people covered for hospital and medical care.
The ACTING DEPUTY PRESIDENT (Senator Wood)- Is leave granted? There being no objection, leave is granted. (The document read as follows)-
– What is the original source for those figures?
– I will give the original source of the figures. The table sets out population figures which were obtained from the Bureau of Census and Statistics ‘Summary’ issued on 30 November 1973. It includes figures derived from the first annual report of the Department of Social Security for the year 1972-73. It includes figures derived from the 1973 Defence report. The figures were obtained from Australian government documents. The table shows that the total number of people insuredincluding Queenslanders, because we were able to dissect the figures- for hospital benefits is 10,519,000. A total of 1,351,000 are covered under the pensioner medical service. There are 160,000 war pensioners and widows covered. There are 74,200 Service personnel covered. The balance of Queenslanders number 619,100. The total number of persons with hospital cover is 12,723,000 or 96.9 per cent of the population. That is another set of figures which bring some evidence to bear on the number of people covered for hospital benefits. In that same table which has been incorporated in Hansard the figures indicate that 95.9 per cent of the population is covered for medical benefits.
Why has it been necessary to overstate the number of people who lack insurance cover? It has been necessary to overstate the number because the Government has a weak case which had to be bolstered up. It has been necessary to overstate it in order to sell a confidence trick to the people of this country to try to convince them that large numbers of people are without insurance cover or do not have access to care. Clearly that is not the case. The Government’s figure of 1.5 million people not being covered shrinks to 450,000. Let me say immediately that I should like to see a situation in which no one is without access to insurance cover or health care. I suggest that the seeking out of 450,000 would be within the wit of government without the need to alter the scheme radically or to destroy it.
The second question we have to ask is why it was necessary for Senator Keeffe to allege in his speech last night that the people not covered included pensioners and widows. Obviously that is nonsense. I draw Senator Keeffe ‘s attention to what he said. He said:
There are people dying in Australia because they are not able to afford health care under the system that the previous Government nurtured for so many years. This applies particularly to the fixed income groups, pensioners, widows . . .
What nonsense! Pensioners are clearly covered. Widows are clearly covered. The existing scheme provides cover for people in need. Again, why is it necessary to overstate and exaggerate the extent of the problem?
I want to go further into the kind of people who are not covered under the present scheme. I seek leave to incorporate in Hansard a table setting out the number of people who are not covered.
The ACTING DEPUTY PRESIDENT (Senator Wood)- Is leave granted? There being no objection, leave is granted. (The document read as follows)-
-This table is a breakdown of the number of people who are not covered by health insurance. The figures were derived from information provided by the Bureau of Census and Statistics. The table shows that whereas almost 92 per cent of the Government’s sample of people aged 15 years or more are covered for insurance, only 85 per cent of those born overseas are covered. In other words, 92 per cent of people born in Australia are covered but only 85 per cent of people born overseas are covered. It is clear from that summary that there is, as Senator Button has said, an excessive number of migrant people who are not covered by health insurance. If we look further at the statistics we will see, for example, that 62 per cent of Greeks are covered; 78.6 per cent of Yugoslavs; and 76 per cent of New Zealanders. We can go further than that. The Bureau of Census and Statistics also breaks down the figures into occupations. We find that workers in certain occupations- process workers and construction workers, for example- are the ones who are not covered. Do we suppose that the provision of this Government’s scheme will necessarily help these people. The construction workers, the process workers and people in the low income groups will be automatically included in the subsidised health proposals put forward by my Party earlier this year. We put forward a very progressive policy on a sliding scale entitlement to subsidise health care. It is a better proposal than the one which the Government has put forward now. That scheme will have a fixed entry point. A person below that entry point will receive nothing and a person above the entry point will receive the benefits. But we have a sliding scale to bring in people as part of our proposition. It would include many of these people in the lower income groups.
The Labor proposal contains nothing which will help these people in the Greek and Yugoslav communities to obtain better health care. As I hope to point out in a few minutes, their problem is not simply one of health insurance. Their problem is that frequently they live in health scarcity areas. They have cultural and language blocks and this insurance scheme will not help them one bit. I want to put this statement on the record now so that in 12 months’ time we can face the Government with it and ask it: ‘How much better off are the people in the Yugoslav community of Wollongong, for example?’ How many more health workers will there be who can speak their language, understand their culture and give them the kind of care they desire?
I want to move on to another point. The Labor scheme is said to be universal. The Labor scheme will not be universal. It is based on the payment of tax. There is a group in every society which will escape that net. We have the experience in other countries where this type of universal scheme was brought in. But these so-called universal schemes covered only 80 per cent or 85 per cent of the community, certainly in the first years of their operation. Mr Acting Deputy President, I put it to you that, if there are citizens of this country with children who for some reason best known to themselves are not paying taxation and if their children become sick, those people will feel a constraint or a reluctance to seek medical care. They will feel a reluctance because this would put them back into the system and put them in danger of being found out.
– Are you in favour of tax evasion?
– I am not in favour of their tax evasion. What I am saying is that the sufferers might be the members of their families who need health care. Let me move on to deal with questions of health care delivery and what we are really seeking in the Australian community. The Labor Party’s scheme will give insurance entitlement to no greater care than we have now. For example, it will have no effect on the number of doctors in the Mt Druitt area of Sydney. This insurance scheme contains nothing that will help the people in these health scarcity areas get to a doctor quicker for consultation because there is not the health personnel there to see them. We have to accept that the Labor Party has tried to sell this program on the basis that it is selling better health for Australians. What nonsense that is. It is selling a method of insurance and it will not provide the service which the people will want to use once they are insured. If there are not enough doctors in Mt Druitt now, there will still not be’ enough doctors under the Labor scheme. The people in the State that I represent will still be faced with the fact that they cannot get health care even though they are paying their 1.35 per cent taxation levy and even though they have been promised all kinds of care by this Government of the little man.
The ethnic communities in Wollongong will be no closer to breaking the barriers which now keep them away from the health delivery system. As I said, these barriers are cultural and language barriers. Until we get a kind of health program that is concerned with care itself, with attitudes, with personnel who understand what is required, until we have the kind of program that provides people who understand the ‘evil eye’ and the practices adopted in certain communitiesthe members of certain communities will not be treated by people who understand their cultural background which involves a belief in magic. There are communities in which we must understand the cultural background in order to understand certain emotional responses of people in certain areas- people will feel foreign in this country and they will not understand our health care delivery system. They will not feel comfortable with it, they will not use it and they will continue to receive second class care.
Let us examine the entitlement to health care received by people in the Australian Capital Territory at the salaried community health centres. I believe that there is one at Narrabundah which opened not long ago. It closes at 5.30 in the evening. I interpolate here that the features of good health care are quality, accessibility, efficiency and continuity. They are the features we want. There has to be good quality, it has to be accessible, it has to be efficient and it has to be continuous. What do we find in the Australian Capital Territory? The health centre closes at 5.30 p.m. If a person wants health care after that time he has to go to the Woden Valley Hospital casualty section until 9.30 p.m. and after that time he has to go to the Canberra Hospital casualty section. That is the kind of continuous and accessible care that is likely to be offering under the salaried service which is foreseen as one result of this Labor plan. Mr Acting Deputy President, I can understand how this must grate on the socialists opposite who like to have it all their own way.
I return now to the ‘It’s time’ folders put out for our edification before the 1972 election in which all the promises were made. We find that Labor’s concept of health care, as contained in this folder, is to do with hospitals. The folder contains nothing significant about primary care, the kind of primary care people receive in their communities. It is quite clear that the Labor Party does not understand what primary care is all about, except perhaps Senator Grimes, but I would say that he was trained at a good hospital by good teachers.
I would now like to ask: Where are the doctors in Australia today? We have a situation in which there is a severe maldistribution of medical manpower. We know that in 1965 across the country we had one general practitioner to each 1,568 people. In 1972, the ratio had worsened and is now one general practitioner to every 1,843 people. We do not have enough doctors in private practice offering primary care. The number of doctors in Australia has increased. But they have been taken up by the hospital systems, I am not denying that these systems require extra manpower. The situation in primary care has worsened. The number of doctors in Australia has increased under initiatives introduced by Liberal-Country Party governments. There were 6,644 doctors in 1947 and in 1971 there were 16,000 doctors. But again, the picture for primary health care was not very good. Let me cite the position in Sydney, the city in which I live. In that city there is a gross maldistribution of medical manpower. In certain areas- for example, the Mosman district- there is one doctor for every 800 people. The people of Mosman get good health care because there are enough doctors. But in the rapidly growing areas of Sydney- the fringe areas- there is one doctor for every 3,000 people. Those people do not have the manpower available to get the care they need. The doctors do not have the chance to give the kind of care which they want to give. I wish to quote from page 70 of the Karmel report headed ‘Expansion of Medical Education’ produced in July 1973. It deals with conclusions on the present position relating to medical manpower, because this is one of the important points in any kind of scheme for health care in a society. I quote:
Some of the outer suburban areas in Sydney have relatively few general practitioners in relation to population and the number of these areas has increased between 1968 and 1972.
Next, I quote from page 71:
The rapid growth in the number of doctors who are specialists ana of those who are salaried, especially those who are employed by hospitals, partly explains the paradox of the apparent scarcity of doctors in a time of almost unprecedented expansion in medical manpower, . . .
The final quotation from this very important document is taken from the same page and is as follows:
The average workload of general practitioners in terms of service appears to have increased in the last 10 years . . .
The point I make is that we do not have the capacity in this country to offer a millennium of medical care to anyone. We do not have the doctors out there where the work has to be done. We do not have the other personnel either. It is a hoax to suggest to the Australian people that they are in for a new deal in health care. All that they are in for is a new tax. The Government has made it quite clear in the documents it produced that it wants to work towards a fully salaried system. The Government would immediately introduce sessional payments for those working in hospitals.
I have worked in a public hospital. It may interest some of the honourable senators opposite who have poured a tirade of hate towards the great profession of which I am a member to know that for the past 8 years it has been my privilege to give to the society of which I am a member one day a week of my time free of charge as a community service; to give my time free for clinical work and the care of the sickand to do this because it is part of the duty which I as a doctor felt I should give and because the privilege was offered to me. In return for this I was allowed to work in this hospital, to be associated with the stimulus of professional contact and to admit patients to the hospital. Honourable senators opposite should not forget that I, like many other doctors, have given my time in the service of this community. The Government wants to pay us for it. Under the Government’s scheme my salary and the salaries of all my colleagues would rise immediately and significantly. We would enjoy a marked increase in salary- yet the profession is implacably opposed to these proposals. It is not just a question of money- I would have earned more money. It is a bad scheme under present conditions, and it would be a bad scheme even if I were paid more, I remind honourable senators that in 1947 Mr Bevan claimed that he stuffed the doctors’ mouths with gold and that he did it for only one purpose: To try to get them to buy into what was a bad scheme in that country.
If the Government introduces sessional payments, under the present provision this might cost $20m in one year, on the Government’s own estimates. That is what the Government is willing to pay to recompense New South Wales doctors for time which they now give free- and they have been doing that for 50 years. Their cumulative investment in their community of New South Wales over past 50 years at today’s prices amounts to $ 1,000m. This is the value of an investment by my profession in the welfare of society. Therefore I think that in the interests of fairness and fair play honourable senators opposite might have moderated some of the hatred that they have poured on our profession.
I should like to move now to hospital care and the hospital system. Hospitals are increasing rapidly in number. The Labor Party’s scheme is obviously built towards institutional care. It is a party that understands institution and it sees health care as being given by institutions. I would like to point out, firstly, that only a very small number of items of sickness in a society need to go to hospital. Most items of care are afforded to us as outpatients; we do not need to go into hospital. The hospitals of Australia are increasing in complexity and manpower and are producing less and less effect upon the health statistics of our country. Heart transplants are producing nothing in terms of care and community results. The big challenges in care are not in the hospital system but in the areas of primary care and of treating people in their communities where care now is lacking.
We have been told, though that the hospital system is to feature largely in Labor’s proposals. We are not told how it will cope with the Government’s new legislation. We have had no detailed discussion with the State Governments or not with the Government in my State, anyway- as to what their role or commitments will be. This is to be discussed later when the amendments to the Health Insurance Bill will be possible. What are these changes going to mean in terms of hospital functioning? What about the financing of hospitals? Will the Australian Government call on the States to pay 50 per cent of hospital costs when the Australian Government will increase the case load to hospitals? Is this another way of milking the States of their finances? This is building up the hospital system that will follow and building up the outpatients services. This directs people from the community health services to the Woden Valley Hospital and the Canberra Community Hospital for night care and will build up the hospital system. It is contrary to the spirit of Dr Sax who has called for a reduction in hospital utilisation in the years to come.
What will happen in terms of hospital care in our country is that people will be queueing. People who need hospital beds will not be able to find them and so they will have to queue for them. Only those whose condition is urgent will be admitted, or those who are private patients or those who are interesting. But if a person’s condition can wait he will not be admitted. Let us recall the experience of people in England and in other countries such as New Zealand, as my colleague Senator Townley reminds me. Thank you, Senator Townley. There queueing has become the feature- and it is not the wealthy who miss out. I say this to the Labor Government which thinks it is going to give a new and a fair deal to the little man: It is we on the Opposition who care about the little man. It is the little man who will wait and join the queues when the Government ruins the Australian hospital system. He will not be able to get his tonsils taken out or a hernia repaired or be admitted to hospital.
I would just like to get back to this question of the needs of migrants. Recently, with Senator Mulvihill,.! attended a seminar concerned with the welfare of children in hospital. I am sure that the honourable senator would agree with me, if he were in the chamber, that it was an excellent seminar. Speakers there made the point that we have a very great problem even understanding the needs of our migrant communities. I make this plea to the Government: Please look at the way it will utilise this insurance scheme to try to provide care, not just cover, for these communities.
I would also like to return to the question of costs and amplify only one point that was made by both Senator Guilfoyle and Senator Sheil. I would just like to refer briefly to the fiction of Mr Whitlam ‘s driver. We are all aware of the policy speech during which Mr Whitlam said it was inequitable that he should pay less for insurance than his driver. Mr Acting Deputy President, I have a third paper, copies of which I have presented to the Minister for Repatriation and Compensation (Senator Wheeldon) and to you, which I seek leave to have incorporated in Hansard.
The ACTING DEPUTY PRESIDENT (Senator Wood)- Is leave granted? There being no objection, leave is granted. (The document read as follows)-
– I thank the Senate. This table shows the tax payable by Mr Whitlam. We do not know the actual salary of a Commonwealth driver but we do know that it might be, without overtime, roughly $6,400. The table shows that Mr Whitlam pays income tax of $21,249 and a health insurance premium, after tax, of $43. A Commonwealth driver, without overtime, would pay income tax of $1,403 and health insurance premium, after tax, of $77. So that to save $30 premium the Prime Minister pays $ 19,800 more in income tax. Is he seriously suggesting that there is unfairness here? Senator Button pointed out the percentage of our gross domestic expenditure that goes on health. We can say that about $1,000 of the tax paid by the Prime Minister in income tax would be specifically ear-marked for health. The argument is a fraud and a hoax and we should have expected better.
Let us look at what the Labor Party has done during its 18 months to try to improve health care in this country. What has it done to try to improve the lot of the average Australian? The Government wants to spend hundreds or thousands of millions of dollars now. But what has it done? In 1973-74 and 1974-75 it allotted $7.5m each year for research into mental health, alcoholism and drug dependence. In 1973-74 it allocated $10m for certain community health projects. Apart from that it has carried on certain other programs- the Meals on Wheels subsidy, the personal care subsidy for the aged in hostels and the grant for home care services for the aged. These were all programs which were introduced by the Liberal-Country Party government before it went out of office. The contribution of Labor to care has been minimal.
I want to move on to the other question I want to ask, which is whether a Labor Government, or a central government, is competent to administer a scheme of this kind. Senator Keeffe has already assisted me on this point because in his speech last night he pointed out the things that can happen under government sponsored schemes. Honourable senators will see a reference to this point on page 245 of yesterday’s Hansard. In his speech last night Senator Keeffe highlighted his own belief that the so-called free scheme in Queensland has diminished the standard of care. Of course we know that this will happen throughout the country.
What do we already know of governments as employers? We have some little experience of governments as employers. We have some experience in South Australia where doctors went onto a part time sessional basis. Here we have a most interesting situation because the doctors obtained a contract with the South Australian Government which established an employeremployee relationship which entitled the doctors to seek the protection of industrial agreements and to take themselves to arbitration. The Labor Government in South Australia in conjunction with the Australian Government made an attempt to destroy that relationship and to have those doctors made casual employees to diminish the protection afforded to them under the various Acts. The matter had to be taken to private arbitration. It was recently taken to arbitration, the arbitrator deciding that the doctors had every right to maintain their employeremployee basis and their rights to go to arbitration to protect themselves.
The issue in the Australian Capital Territory has to do with this very point. Doctors in the Aus.tralian Capital Territory are asking-and I say this to the good trade unionists sitting oppositefor the same right as any other workers entering into industrial agreements. They want the protection which an agreement will give them. They want the ability to go and seek arbitration. There is a very big difference between a contract of service and a contract for services. A contract of service is a contract for employment. It is covered by industrial law and arbitration is available. If the employee is dismissed he has a right to demand that this action be on fair grounds. Such a contract is suitable for pan-time employment. It carries fringe benefits under industrial law. This type of contract exists in Queensland and South Australia at the present time. This is the type of contract that the doctors are seeking.
On the other hand, a contract for services makes the doctor an independent contractor. It is a common law contract and arbitration in the Australian Capital Territory would be possible only under common law. This type of contract severely limits the rights of a doctor in matters of reappointment. It is the type of contract appropriate to the employment of casual workers. It does not carry fringe benefits. It is the Repatriation Department model. The Government is trying to force a contract of this type upon the profession, when what members of the profession are asking for is a fair kind of contract which would give them some rights when the skulduggery which they expect is brought to bear on them in the next few years. The Government is trying to by-pass the industrial system. We think that eventually it will try to establish tribunals which will prevent the doctors going to industrial law.
We can look at one other area for the effects of government as an employer. I wish to refer to the Report of Inquiry into the Health Services of the Northern Territory which was tabled in the Northern Territory Legislative Council in November 1972. The 3 commissioners who prepared the report were Mr Edmunds, Dr Vanderfield and Mr Dearlove. I wish to refer to page 2 1 1 of the report which contains their conclusions. The report states:
However, the greatest handicap under which the service operates, is not the climate or geographic isolation, but the system’. The Public Service Board System and its method of administration is oriented to procedural requirements and Departmental Regulations and not to patient care, whereas the ONLY reason for the existence of a Health Service should be patient care.
The Commonwealth Department of Health is not by tradition, structure, background or experience suited for providing health care at a patient level. We agree completely with the Member of the Legislative Council who described the system as ‘domineering, cumbersome and outmoded’.
The system is more important than patient care or staff welfare so that staff are discouraged by it and its methods of employment.
In one of the laboratories which government had available to it, the Northern Territory, where it is running a salaried health service, a commission of inquiry found it necessary to condemn the Department of Health as a suitable employing agency. What chance have we got of expecting any better health care under Labor’s proposals?
The Australian public was surveyed in Gallup polls. The results of a survey which were published in the ‘Sun’ newspaper of 12 September 1 973 showed that 54 per cent or more than half of Australians said ‘no’ to the health scheme. If honourable senators opposite want to think that they have a mandate to try to get their scheme through this chamber let them put this issue to a vote when they are ready and see how strong their mandate is. None of us got here except by the votes of the Australian people.
Before I conclude my speech I would like to quote from one other document which I am very pleased to bring to the attention of honourable senators. I refer to the policy speech of the Liberal Movement delivered by the leader of the Liberal Movement Senator Steele Hall at the Unley Town Hall on 1 May 1974. When talking about the consequences of a Labor victory, Senator Hall said:
I would like to move on to another part of Senator Hall ‘s policy speech in which he said:
In general terms, we do not support Labor’s plan and we will fight their proposals which will ultimately lead to nationalised medicine.
I must say how pleased I was to read that policy speech and to know that we have support from that area.
It is my belief that all the talk of free health care is a hoax. There is no such thing as free health care and there never was. Someone has to pay, and it will be the Australian people. But we will not pay only in terms of money, we will pay in terms of quality, we will pay in terms of satisfaction and we will pay because this scheme will not work unless it has the co-operation of the medical profession.
The scheme cannot work if the profession is implacably opposed to it. The Government’s job is to seek some kind of reconciliation, to seek some modification and to seek some fair dealing so that its scheme for payment under the health insurance proposals will be more equitable. If the Government does not do so, quality will suffer, costs will rise, queues will form, and doctors will continue to leave primary care. There will be a 2- tiered system of medicine with the wealthy willing to pay whatever it costs for private care. This is the last thing we wish to see. One of the country’s best care systems will be converted into a vicious class distinctive system- the very opposite to what the Labor Party thinks it is trying to do. I oppose the Bill and I support the remarks of Senator Guilfoyle.
– It is with a feeling somewhat of deja vu that I stand here, I hope for the last time, to debate this health scheme because it has been debated since 1968 in this country. It has been debated day in and day out. More words have been poured out by both sides, probably, than any other recent debate. A lot of money has been poured into the debate. A lot of money has been poured into the vilification of the Government and of the Minister for Social Security (Mr Hayden) who is in charge of the Bill in another place and who is in charge of the development of this scheme. It is rather strange for me to be speaking after Senator Baume in these circumstances. Many years ago Senator Baume taught me medicine. Honourable senators may be surprised to know that he did not teach me philosophy, politics, economics or anything else.
– It is a pity he did not.
-It may be a pity but, unfortunately for Senator Jessop, I went on reading after I read Adam Smith’s book which was written 200 years ago. Senator Baume and certainly Senator Sheil seem to have read nothing since and seem to have accepted everything in that book as being the Bible truth. It surprised me to hear Senator Baume commence his speech with the nationalistic jingoistic business that we have the greatest doctors and that we are such a high performance community when we consider the parameters by which we judge world health. It is only in the last few weeks that our performance in relation to the World Health Organisation figures has been questioned. It has been demonstrated to be not all it should be by Dr Michael Goldacre both on programs on the Australian Broadcasting Commission and in a recent article in the ‘ National Times ‘.
– Figures which have been challenged.
-Figures which have not been challenged. The figures come straight from the World Health Organisation. They are the only figures available to compare these parameters. The figures show, in fact, that amongst comparable nations we lie 11th in the infant mortality rates for the world. We lie below Holland, Norway, Japan, Finland, Denmark, Switzerland, France and New Zealand in infant mortality rates. I admit to Senator Baume, that we have pockets of underprivileged people, in particular the Aborigines whose infant mortality rate is an absolute disgrace to this country. But if the infant mortality rate for Aborigines is separated from the figures for the rest of the country we lie ninth. It seems incredible that we are proud of our performance when we lie below countries like Japan and France which had to spend so much time reconstructing their societies after the war. It is even more disconcerting when we know that during the 1930s we were regularly in the first 3 countries in the world in regard to infant mortality figures. If, as Senator Baume implies, these figures are the result of our good health delivery system we do not seem to have a very good health delivery system.
I refer now to longevity- the expectation of life. Australians can expect to live a shorter time at birth than people from the United Kingdom, Canada, Japan, Greece, Italy, Malta and Spain. These are extraordinary circumstances in view of Senator Baume ‘s statements. I will agree that health delivery is not the only factor in those figures. But I think it is disturbing to see how our infant mortality rate compares with other countries, particularly when we are so very much below Sweden, a nasty country with a democratic socialist government and a socialised medical scheme, not a national health insurance scheme such as we are trying to introduce.
– Tell us about the suicide rate in Sweden and Denmark.
– The honourable senator should know that the story that Sweden and Denmark have the highest suicide rates in the world is false.
– What about their mental health rates?
-We will get them for the honourable senator if he wishes. But these are the parameters which Dr Baume says demonstrate the quality of our health delivery service. I am sure honourable senators opposite are undoubtedly pleased that I do not intend to go into a long dissertation on the many clauses in the 2 Health Bills. Unlike the Opposition I will not try to pretend that these 2 Bills represent the only 2 concepts in Labor’s scheme to improve health services in this country. It is wrong to argue and to take these Bills in isolation and imply that we are saying that if these 2 Bills are passed that is all we need do and we would, in fact, suddenly solve this country’s health problem. A lot of other plans are involved and some of them are in action now. Our Health Insurance Commission plans to improve and develop hospitals in this country, to develop local health centres of various types, both salaried, fee for service and ordinary private schemes which Senator Sheil dislikes so much.
These 2 Bills are part of the whole concept of improving the health care and the health delivery service in this country. We believe- and we make no bones about it- that we consider that the provision of an adequate medical health system in this country is a part of the social services for which it is appropriate that this Government should legislate. The Constitution provides that we can do so. Mr Gorton, in an article in the Nation Review’ last weekend agreed with this. We make no bones about this matter and we agree that there is a philosophical difference between us and the more extreme conservatives on the Opposition side of the Senate. We are not pretending that we are anything different than we are. To suggest that this national health insurance scheme is in fact socialised medicine and is conscripting doctors- as Mr Chipp has pointed out on a couple of occasions- is arrant nonsense. In fact, to suggest that this Government would conscript doctors in peacetime when it is opposed to the conscription of young men to go to war in times of peace is, I think, a bit rich coming from the Opposition.
Senator Sheil obviously does not think much of these 2 Bills or of the scheme proposed by the Government but unfortunately he made it obvious in his speech that he did not think much of the Liberal-Country Party scheme proposed by Mr Chipp during the last election campaign. He does like one scheme. Apparently he thinks one scheme is all right. It is the system that they have in the Queensland hospitals where public hospital care- standard hospital care- is available to all members of the community without means test. Funnily enough we quite like that principle; we give it the greatest praise by copying it.
The basis of our scheme is hospitalisation in standard wards without means test. The difficulty with the Queensland scheme is that under the conservative governments which have been in power since the scheme started the hospital system has suffered from lack of funds and neglect. However the Labor Party’s scheme will provide more funds for the Queensland hospitals, will provide more hospitals, and will increase the number and quality of beds in those hospitals. An even more interesting fact is that because of the system in Queensland, which has a standard hospital bed without means test, private hospital beds in Queensland are the lowest priced in this country. In Tasmania, which is the other State which provides public hospital beds without means test, although a fee is charged, private hospital beds are the second lowest priced in the country. Private hospital beds in Australia are at their most expensive in those States where people have no freedom of choice in their hospitalisation.
For Senator Guilfoyle to say that there is freedom of choice in the present hospital system is nonsense in Victoria and New South Wales. Whether you go into a public ward or an intermediate ward depends on your income. It is not a matter of choice; your income has to be low enough for you to get into a public ward. If you want to go into a public ward but earn too much you must go into an intermediate ward. In those States the costs of private and intermediate wards in fact are higher than in Queensland and Tasmania. It would seem that the presence of a public hospital system, admission to which does not depend on a means test, in some magical way cuts the expenses of the private hospitals. It mystifies me. I do not know why it happens. It is significant but I will not draw any conspiratorial sort of theories to explain it. Senator Sheil, however, really exceeded anything else I have heard in this health debate by his remark that nobody wants this scheme. He really topped the bill with his remarks about Aborigines. He said:
They are a proud and noble people.
I agree. He continued:
They have a fierce independence regarding their health care.
They may well have that. He also said:
I work with Aborigines and I treat many more than those with whom I work. None of them are unhappy. None of them are dissatisfied. None of them are disadvantaged.
Those words may haunt Senator Sheil for the rest of his political life because today he went on to explain to us that these people who are not disadvantaged have an appalling death rate in the ages from one to five years. He could have gone on and said that these people who are not disadvantaged have one of the worst infant mortality rates in the civilised world, which is a blot on this country. He could have gone on to say that they have the highest incidence of tuberculosis and almost every other illness except degenerative illnesses in this country. He could also have gone on to say that their expectation of life in general is the lowest in this country. I am referring to these people who he says are not dissatisfied, are not disadvantaged and are not unhappy.
I think that sort of attitude is typical of certain people in the area from which he comes. It is a sort of philosophical mixture of the works of Premier Bjelke-Petersen, Eric Butler and Senator Sim. From remarks like this I would think that Senator Shiel practices in Utopia where there are a lot of happy Aborigines running around, all healthy, none disadvantaged and none dissatisfied. Really, it is extraordinary. The honourable senator also made some remarks about the poor. He said that if people are too poor they should go to their doctor and say that they cannot afford treatment and then the doctor will treat them for nothing. Of course, in most cases the doctor will treat them for nothing, but that is the sort of attitude that this Party has been trying to drag this country out of ever since it came into existence. This attitude that charity somehow uplifts the person who receives it and ennobles the person who gives it is nonsense and comes from the last century. This charitable nonsense shames the poor person who has to accept it and degrades the person who gives it. Surely we can get away from that attitude in 1974.
Honourable senators on this side of the chamber have a funny sort of principle. We believe that this country is affluent enough and holds enough of this world’s riches to provide its citizens with adequate medical care. We also think it has enough of this world ‘s riches to pay the people who provide that medical care.
– What about night care in the Australian Capital Territory?
– What about night care in Sydney, Senator? Night care in Sydney and night care in the Australian Capital Territory by private doctors operating on a fee-for-service basis is exactly the same. A patient hears a recorded message telling him to ring some service.
– What about the salaried service here?
– In the salaried service here there are people on call just as there are in Sydney. The difficulty with some people in private practice in Sydney and Melbourne is that they have decided that they will work 5 or 5lA days a week. I have no objection to their making that decision. I have no objection in their deciding that they will not do any night work or weekend work. Therefore locum services grew up in such districts because there were sufficient doctors to support the locums. Unfortunately the doctors who decided that they would not work at night or at weekends and that they would pay a locum service to do so also decided that their salaries would stay unchanged. So up went the fees. This is an explanation, as the honourable senator well knows, for the extraordinary fees in Melbourne and Sydney compared with those of their poor cousins in Tasmania, and even Queensland, whence Senator Sheil comes.
– The honourable senator knows that it is not nonsense. Freedom of choice under those circumstances is ludicrous. No one in this country except the right wing extremists of the General Practitioners Society and the League of Rights- frankly, I do not know how to distinguish between those 2 organisations- is opposed to a national health service. We already have one and not even the Liberal Party, Country Party, National Party, National Alliance coalition in opposition opposes it. We have a scheme that has worked relatively well, a scheme which is the sort of evolutionary predecessor to the proposed Labor scheme, but we can do better. To be successful a scheme should be socially equitable and efficient, and to do this universal coverage is essential. The Labor Party believes that the provision of adequate medical care is a social service, and the best way to fund this is through the system of progressive taxation that we use for every other social service in this country.
The Labor Party’s proposed scheme provides for the retention of the fee for service and for the retention of choice by doctor and patient. The scheme is little different from the present scheme. The only difference is in the provision of health insurance by an efficient single organisation instead of by the 160 organisations that we have now. The AMA agrees with us on the fee for service. The Liberal-Country Party Opposition agrees also. The AMA agrees with us on the freedom of choice for doctor and patient, and it also agrees on the inclusion of pensioners in the service, which stops pensioners being treated as second class citizens. It takes the pensioners out of the hospitals- out of out-patient care- and puts them in private surgeries. The scheme provides surgeons, physicians, skin specialists or any other sort of specialist with an adequate fee for their services.
The possibility of bulk billing under our scheme worries the AMA. The possibility of bulk billing is absolutely opposed by the association.
It surprises some people that the association is so opposed to the provision in our scheme of bulk billing. Under our proposed scheme the doctor, not the patient, can choose, whether he bulk bills, whether he bills the patient or whether the patient can make over to him that pan of the fee which the Government will pay. It has nothing to do with the patient It is the doctor’s choice. He has the choice. No one else has. What worries the General Practitioners Society and members of the Australian Medical Association is that doctors are sensible people- general practitioners particularly are sensible people- and they will bulk bill because it is an economic and sensible way to do things, and it saves an awful lot of trouble.
Both Bills envisage, above anything else, that the whole scheme will have predictable costs. It will have predictable costs because it wants to make and will make a provision that doctors’ fees will be uniform, that doctors’ fees will be changed in an orderly manner and that doctors’ fees will be like almost all other fees- they will be changed by a system of arbitration. This is where the scheme gets most opposition, as Senator Baume and particularly Senator Sheil know. This scheme attacks the sacred right which doctors have had to charge what they like, where they like, when they like. Senator Sheil demonstrated this fact clearly. He said that the patients cannot be trusted. His attitude to patients is a bit like Senator Wood’s attitude to the electorate. The patients are a bit simple. They cannot be trusted. They are cunning and nasty people who will muck up the system. But the doctors are noble, pure, honest people who can regulate their fees fairly without any outside interference. I will concede that most of my colleagues are noble, pure and honest, but unfortunately some of them are not. Some of them, through ignorance of what goes on in the outside world, have a strange concept of what is a fair fee for a fair service.
This part of the scheme draws the most opposition. This part of the scheme draws the right wing lunatic fringe into an organisation such as the General Practitioners Society. The taking away of the sacred right to charge what you like when you like, without any outside interference and without any outside questioning, is the thing that makes doctors so opposed to the scheme. It is no good a senator from New South Wales, particularly, saying that if the patients do not like the present system they can shop around and go to a cheaper doctor because New South Wales general practitioners, above all others, have even that game beaten. For many years they have formed themselves into regional associations in certain areas of that State. In Sydney organisations meet to fix a uniform fee for their area. Only by going out of that area or to the public hospitals can patients avoid having to pay this fee. There is no shopping around. Why should people shop around, when they are sick, to get the cheapest care that they can get?
– Who claimed that this was so?
-That is the continuous and particular claim of the opponents of this scheme, and the honourable senator knows it. The third part of the opposition to this scheme comes from the voluntary health organisations.. They are noble organisations. They have done a very good job. They have done an especially good job supplying the Opposition with public relations personnel, funds and supporting advertisements at election time. They are consumer organisations. They are non-profit organisations for the benefit of the consumer. The only thing wrong with them, in this modern age when consumers are becoming more concerned with that is going on around them, is that the consumers have no say in these organisations. In very few of the 160-odd hospital and medical benefits organisations in this country do consumers have any say at all. The largest voluntary medical scheme in this country, the Medical Benefits Fund of Australia Ltd, has always had an extraordinary setup. It has 20 directors. Ten are members of the medical profession. They are medical directors. Only they can elect the other 10 directors who, I believe, are called consumer or contributor directors. It is almost an incestuous relationship.
The voluntary health schemes, some of the bigger ones particularly, have become very large and have become little empires for those who manage and look after them. They have become considerable investors in various financial organisations in this country. They remain largely beyond the control of any of the people who put their money into them. I for one objected- I know others objected strongly- to the thousands and thousands of dollars which were poured out by these organisations into a political scheme. This money was money which contributors had paid to cover the costs of their sicknesses. When we made inquiries we were told that it was none of our business, that we just put our money in and they would do what they liked with it.
For a long time we have known that the health insurance scheme was not working and that it was breaking down. Senator Button referred to the Nimmo report of 1969. It showed very clearly the inadequacies of the scheme. The Liberal-Country Parties, when in government, took no notice of it One of the few people who realised the inadequacies and who realised that something would have to be done before disaster struck was removed from the office of Prime Minister. I am not suggesting that there was any connection between the 2 events. I repeat Senator Button’s listing of the findings of the Nimmo Committee. One of the Committee ‘s findings was that the operation of the health insurance scheme was unnecessarily complex and beyond the comprehension of many. The mere filling out of a form to claim a simple benefit from any of the voluntary health schemes is a complex and difficult problem for many people. Another finding of the Committee was that the benefits received by contributors were frequently much less than the cost of hospital and medical treatment. The former Government did something in this regard. It introduced the magical $5 moiety whereby any surgical procedure would not cost more than $5. Unfortunately, distinguished physicians such as Senator Baume were not considered to be as good as surgeons and people who suffered medical illnesses and could be treated by clever people like Senator Baume without having a hole cut in them still had to meet the large gap between the doctor’s fee and the amount of the rebate from medical benefits.
People join a voluntary health insurance fund because they believe they are covering themselves for illness, but they find that they are not covered and that they have to find a lot of money, in addition to what they get back from the health insurance schemes, to meet their medical expenses. The Committee’s third finding was that the contributions had increased to such an extent that they were beyond the capacity of some members of the community and involved considerable hardship for others. This is the reason why so many people in the community find that they cannot adequately insure themselves for illness under the present scheme. Another finding of the Committee was that the costs of operation in some of these schemes were too high and that the level of reserves held by some organisations was unnecessarily high. Fortunately this Government is endeavouring to reduce these excess costs in some way.
This son of report with its 7 findings and its 42 recommendations for change was recognised by the then Minister for Health and the then Prime Minister at the time as indicating that the scheme was falling to pieces, that it was ramshackle and that it was not leading anywhere. The main recommendation of the report and the main realisation of the then Minister for Health and the then Prime Minister, was, in fact, that unless there was predictability of cost, and unless there was some control, some arbitration over the fees that the medical profession was charging, this scheme would collapse. This was the thing that brought the most resistance from the medical profession at the time. This is the thing which still brings the most resistance from the medical profession. Any attempt by government, arbitration, any independent committee or anybody else to interfere with the sacred right of the medical profession to charge what it likes when it likes brings this reaction and resistance.
We find that the Liberal and Country Parties proposed health scheme which was introduced prior to the last election, went a long way along the lines of our scheme. The Liberal and Country Parties recognised the necessity for universal coverage and in fact gave people the voluntary choice- either they would join a health scheme or an amount would be taken out of their earnings as taxation. Some choice! But if one really felt strongly about the matter one could write to the Taxation Commissioner once or twice a year and not have the contributions taken out of one ‘s earnings by way of taxation. This was the concession to freedom of choice that the Liberal and Country Parties gave. But what Senator Baume did not point out is that this was the concession that the Liberal movement policy said was ridiculous, that everybody should be in it, and that this nonsense of writing to the Taxation Commissioner as a let out was silly.
But Mr Chipp admitted, as Mr Gorton had admitted previously, that we had to have some control, some predictability of costs. No matter how obvious it was, this had to be done, no matter how obvious it was that there should be uniform fees, the previous Government just could not make itself do it. Articles in the Press at the time suggested that Mr Chipp wanted to do this but that the more conservative members of the Opposition would not let him do it. Enlightened people in the Opposition like Mr Chipp could see that this was the main problem in the Opposition’s scheme, that this was where it was going to break down, but the Opposition just could not do it. The previous Government protected its friends and vested interests in the voluntary health insurance schemes and said: ‘Go ahead’. Despite the Nimmo Committee report which said that there were far too many schemes, the previous Government said: Go ahead, keep your jobs, keep your positions of privilege, keep your trips overseas to the world voluntary health insurance conferences -
– And purchase aircraft.
– It also said: ‘Purchase your planes to travel around New South Wales, keep your nice air-conditioned offices in Sydney, Adelaide, Brisbane and everywhere else. Let them do this’. Honourable senators opposite protected them. Because the terms of reference of the Nimmo Committee provided that the Committee was to investigate only voluntary health schemes it could not suggest any alternative scheme. Even that Committee stated that there should be only one open scheme in each area, but Senator Sheil does not agree even with that proposal. He says that we should not interfere; that no government should interfere with the sacred right of the doctor to do what he likes with fees. Naturally, the General Practitioners’ Society does not agree with any of these proposals. It considers that the Opposition is socialist and it considers that we are socialists. It considers that every government that Australia has ever had has been socialist- something which must amuse Sir Robert Menzies. The Society’s secretary, Dr Duncan Yuille, considers that we should throw the destitute and poor a few vegetables in order to keep them from starving and let them fend for themselves. He, like Senator Sheil, thinks that the poor and the destitute should go begging for charity from the local doctor and that the local doctor will somehow be a noble bloke.
All these arguments have been advanced against our proposed scheme. All these arguments have been trotted out. Actuarial reports have been trotted out with results depending on who compiled the reports. It has been suggested that the cost of our scheme has increased by $200m, and this morning I think it was suggested that the cost has increased by $350m. At the moment people are looking at these reports to see what they are all about, to see why people claim these things and to see whether the figures produced bear any resemblance to what the real cost of the scheme will be.
Finally I repeat that the basis of the scheme is that there will be universal coverage for the Australian people for the cost of medical care and hospitalisation in a standard ward. This cost will be met by the National Health Insurance Commission. Hospitalisation will not cost patients anything at the time of hospitalisation but, of course, it will cost them something in their contributions. This scheme will remove the differences between pensioners and the rest of the community. It will preserve the freedom of the patient to pick the doctor of his choice at first attendance. It will preserve the freedom of choice of the doctor. It will retain the choice of the doctor that we have now in standard wards in every hospital in Australia. It will allow people to insure separately for private hospital care. If people want private hospital care they will make one conscious decision to insure for it, in the same way as they make one conscious decision to insure for a health scheme now. The scheme will not socialise doctors or nationalise doctors or conscript doctors as the Australian Constitution proscribes such an activity. It will not be the same as the British Medical scheme and it never was. It will lead to a new era in Australia in which both doctor and patient will not have to spend their time worrying about money and accounts. It will not set up a financial barrier between doctor and patient. It will bring a new and enlightened period into health care in this country. The cries of socialism, communism, conscription and everything else we have heard from the opponents of the scheme will have no meaning. In two or three years we will have a health scheme from which no one will want to go back to the old ways. No one will even consider throwing it out because it will be a scheme which we will be proud of and the rest of the world may well envy.
– The Senate is conducting a cognate debate on the Health Insurance Bill and the Health Insurance Commission Bill. I express my opposition to the measures and my support for the speeches that Senator Guilfoyle, Senator Baume and others on this side of the Senate have made since the debate commenced. The Opposition is totally justified in continuing its opposition to the Bills. It initiated its opposition some considerable time ago and is justified in continuing that opposition. The justification stems from several sources and reasons one of which is based on the principles that are involved. In spite of the learned comments that have been made this afternoon, as I read the measures I see that the principles include what can only be the destruction of the systems which are serving this country well and which provide opportunities for improvements in the service. The principles include the destruction of the hospital system and division of the Australian community.
Another reason to justify our opposition relates to the developments that have taken place since the plan was first announced. We have been the recipients of many contradictions and uncertainties, changes of announcements and a variety of explanations which have left the people concerned and confused. An important factor about the concern which people feel is that these measures and the debate deal with the nation’s health. In dealing with the nation’s health this legislation cuts right across national life in every detail- social, medical and in every other way. What is more, the measure is an attempt to impose upon the people a scheme which we believe the people do not want. Recent public opinion polls have indicated that a very large percentage of the Australian community is concerned, worried and even frightened by the possibility of the scheme which is the subject of the measures before us today.
In my contribution to this debate I want to deal only with the general field of hospitals simply because I bad an interest in a church hospital in Adelaide. I know something of the concern felt by that hospital and other hospitals like it. The Bill entitles people to treatment in public hospitals, either at public ward or standard ward level. If passed the measure will entitle a great number of additional people to apply for admission into our public hospitals. Surely it can be seen that that will create a great number of problems of a vast and complex kind. I have seen no evidence in the speeches made or in the measures that the Government has done any practical planning for the situation.
I suggest that the Government has not adequately taken account of what I call the human nature response to an issue of this kind. However the scheme may be described, people will say that they are paying for the scheme out of their own taxation, that they are paying taxes for everybody else ‘s health scheme and so they will ask: ‘Why should we not have some hospitalisation and try to get our money’s worth?’ It is a fact of life. A study of the health schemes of the United Kingdom and other countries will reveal that to be so. Any of us who have visited the United Kingdom, or indeed, have required medical attention there, will have observed that trend.
It also occurs in other areas of life where services are provided freely out of compulsory taxation. There simply will not be enough beds to cope with the new demand. There will be an enormous demand for construction of new public hospitals on a speedy scale. That is not possible and so we will run into the most wretched of all situations- queues, waiting time and delay for what are called the non-urgent cases. The waiting time will be vastly extended. The waiting lists will grow, as will the queues and the dissatisfaction. Worst of all, the suffering and discomfort will grow. I read recently that in the United
Kingdom what are called non-urgent cases are placed on a waiting list for something like 3 years. This is a very difficult and unfortunate situation simply because it creates another kind of anxiety not only for the people who are suffering but also for their relatives. The amount of discomfort and worry will be even greater. This will happen here if we are not careful. The people who need health care will be at the mercy, I suggest, of some bureaucrat. They will probably have no choice, and unfortunately no escape.
The unfortunate aspect of this observation is that the people who will suffer the most in these circumstances will be the very people that the Government champions. These are the people who now have ready and reasonable access to public hospitals and early treatment. They will be called upon to jostle for places and to compete with people who could afford to go elsewhere. I suggest that this is not justice, that it is cruel and, worst of all, chaotic. Part of any total health scheme surely relates to the system of private hospitals. I am speaking more particularly of the hospitals belonging to institutions, churches, orders or communities. These hospitals have a value additional to the medical contribution and the medical services they provide because they are associated with orders of various kinds. They have special reasons for existence. They all have their extra and additional therapy. They know, most advantageously of all, the involvement of the community that is surrounding them. What is to happen to the community of auxiliaries, visitors and others who are helpers and contributors?
What is to happen to these worthwhile institutions when they are without patients because the public wards are flooded by people seeking free treatment? The organisational hospitals will be left with empty beds. The Government simply will be unable to provide adequate accommodation in public hospitals and there will be one of those difficult demands upon the private, institutional or organisational hospitals. Inevitably they will come under some kind of persuasion or even control of the Government. Ways will be found for them to surrender accommodation to the Government and they will become part public hospitals, part private hospitals or even may be converted to total public hospitals. This is unavoidable as is conclusively shown by clause 34 of the Bill. Private hospitals will find themselves with empty beds simply because so many patients will be seeking access to public hospitals while sufficient people will be unable to afford extra insurance policies to enable them to obtain admission to private hospitals. All of this means that private hospitals will find themselves with empty accommodation.
As the clause in the Bill provides, such hospitals may apply for a grant. I ask honourable senators to read clause 34 and observe the provision for the unrestricted control and power of the Minister in such cases. He can determine the number of beds in a hospital that can be declared public beds. For his own reasons he might even want to declare that all the beds in a private hospital are public beds and from then on an organisational, private or church hospital can be declared and become a public hospital completely at the mercy of the Government and the Minister. I suggest that the provisions in this legislation reveal the amount of control which the Minister will be in a position to exercise should this measure be passed. Should these private hospitals become public hospitals they will be at the mercy of the Minister and I suggest that the standard of service and in particular the excellent relationship now existing between the community and hospitals will be gone. I also suggest that what I call the absolute freedom of choice as far as a doctor within a hospital is concerned will disappear.
References have already been made to the White Paper which was put down in November last year. A note in that White Paper reads:
As a general proposition the proper staffing of public hospitals and the team-work which modern medical care requires are best achieved through a system of salaried, sessional or contract services rather than through fees for services.
Therefore it seems to me that it is extremely unlikely that under the Government’s scheme there would be full freedom of choice within hospitals. I draw the attention of the Senate to the difficulty of people and organisations responsible for the administration and running of church and other organisational hospitals. Under this legislation the beds in these hospitals which become public beds will attract a benefit of $ 1 6 a day. But as the Bill says, that is a fixed amount. In view of the inflationary spiral that exists today there will be a great number of difficulties in this regard. The Bill provides for a supplementary daily bed payment but as the relevant clause says- I emphasise these words- it is ‘at a rate fixed by the Minister’. Further on in that clause it says that the Minister shall only take into regard the ‘loss of revenue’ and ‘any increased cost’. From my reading of the Bill the location of a private hospital will not be taken into account, nor will its relationship to the community or the purposes for which it exists.
As I said, as soon as a private hospital finds itself in some difficulty and places itself under the notice of the Minister that hospital and the organisation behind it will be completely at the mercy of the Government and the Minister, possibly a minister and a department centrally placed here in Canberra. Under the Government scheme private and church hospitals will be running a very grave risk of being forced into this position. All their identity will be removed and the major impact of their particular and notable contributions to the community will be done away with. Church and community hospitals have provided a very valuable complementary service to the public hospital system established in this country. I think they should be encouraged to continue their services but under the proposals outlined in this legislation I cannot see this happening. We do not get these sort of community contributions under a total government scheme.
The Government still does not know what the cost of its scheme will be to the nation. We are all familiar with the reference in the second reading speech to the 1.35 per cent levy which, of course, will yield a larger sum of money as wages rise. In times of inflation the total amount of money raised by the imposition of the levy may increase very sharply in short periods of time. I draw the attention of the Senate to the fact that in April last year the Health Insurance Planning Committee estimated that such a levy might yield $325m in 1974-1975. The White Paper on the Australian health insurance program presented in November last year revised that assessment by upwards of 1 1 per cent and estimated that the levy would yield an amount of $360m.
Reference was made in today’s newspapers and also in the debate last night to the presentation of a report commissioned by the Australian Medical Association. The report states that the Government has greatly underestimated the cost of the scheme. The report fixes the underestimation at a figure between 25 per cent and 38 per cent. The report points out that the increased cost is due to a larger population, increased use of hospital services and the fact that under the proposed scheme everyone would be ‘ totally insured and therefore have an entitlement. They are the 3 reasons to which I have already referred and they are obvious reasons. Indeed, in the development of any health scheme they are completely predictable reasons but in my view the Government has not given us any assurance on any of them or any reasons like them.
The Minister is reported to be studying the report and undoubtedly he will give us his views in due course. But the report is one of some accuracy. The gap referred to is a major one. All these things create the concern and the confusion to which I have already referred. We are concerned because the health scheme which exists in Australia has built up over the years a cooperation between the government and the people. It has worked and it is serving us well. Of course, there is always room for improvement and it must continually be improved. The present scheme is based on sharing the responsibility and surely this system produces the very best result.
The scheme proposed in the Bill now before the Senate goes much further than referring to private, organisational or community hospitals. A thoughtful discussion on this area is a very good example of the way in which the scheme will work, the effect it will have on communities and indeed the power which will be given to the Government. It is a good example of the power and control that the Government will have if this legislation be passed because the measure before us today deals with the total social dimension of all Australians and within that total social dimension lies the nation’s health. If the scheme is fully implemented it will give the Government of the day enormous control over the nation’s people and its institutions. I warn the people against that control and power which the Government of the day will have over them if this legislation is passed. The Government will create a monster which later governments unfortunately will be unable to control. I have made these references to this area of the health insurance proposal and I indicate my opposition to the legislation.
– It seems to me to be time to say what the Bills we are debating are all about. One Bill provides payments by way of medical benefits and payments for hospital services. The other Bill seeks to plan and establish the organisation required to implement such a scheme. It is not nationalisation of medicine, despite the attempts of the Opposition to start the counter revolution on those grounds. To quote the Australian magazine ‘G.P.’, which in turn quoted Webster, nationalisation is defined as ‘the vesting of the control and ownership in the nation of some body or thing’. The Government is setting out to provide the vast majority of citizens in this country with a valid and sane health insurance program to replace the present inadequate voluntary scheme. It is in no way interfering with the right of private persons to practice as doctors, nor can doctors on a salary in any way be said to be owned any more than an engineer working for a Commonwealth department.
This Government is attempting to bring social welfare in Australia into line with most other countries. This scheme seems to have raised the most hysterical opposition, not from the people of Australia- the patients- but from the doctors or, rather, some of the doctors’ organisations. We will see how representative they are of the majority of doctors. Other countries which have similar schemes do not appear to have been subverted by their introduction. We have heard it alleged during the long time that this matter of the doctor-patient relationship has been debated in Australia that the Government’s scheme will break down this relationship, will ruin health care in Australia and reduce standards. We have been led to believe by many spokesmen for doctors that their main concern is their patient and the welfare of their patient and that they sacrifice more of their health, leisure and general wellbeing, in pursuit of such perfection and full personal care of their patients than do the rest of us run-of-the-mill citizens in our pursuits. To quote the ‘G.P.’ magazine: ‘Private medicine is personal care’. But just how personal is that care? How much privacy is attached to it under the system that the Opposition would prolong?
We hear talk about this sacred doctor-patient relationship with its free choice of doctor and specialist. But let us look at it a little more closely. More and more doctors are now in group practices. Several doctors bind together in partnership or by other means to run a medical clinic. The patient goes along to that clinic and sees a doctor- not her doctor, not Dr Smith, but the doctor on duty. That doctor on duty has the patient’s card, knows what goes on, treats her and does it well. I have no particular quarrel with that system. Often, in the days when I grew up, doctors were terribly overworked. Certainly, they established a relationship with their patients. They were family friends and confessors. Times have changed. I think that doctors are entitled to some free time for family life and recreation. I doubt whether the different relationship is very detrimental to the care and wellbeing of the doctors’ patients. But let us admit that times have changed and stop this humbug about a particular relationship that is no longer in existence because doctors themselves changed the system.
We are told there is a free choice of specialists. Patients would have no idea of who was the best specialist to whom they should be referred. Doctors, like all other human beings, have friends and favourites. If a doctor refers you to Dr soandso, you go. If your doctor recommends him, you accept the recommendation because you must have faith in your doctor and also because as an ordinary patient you would have no idea to whom else you should be referred. It is nonsense to say otherwise and to put such arguments shows no appreciation of the intelligence of the general public.
The other area of break down between doctor and patient has been brought about by what appears to be the doctors’ overriding concern with how much money they earn. Patients once saw doctors as men of principle, people who cared about their fellow human beings and, in fact, took an oath saying just that, namely, that their prime concern was the care of their fellow men. Good people- people of integrity who worked hard- held doctors in high regard and as a matter of honour paid their bills. Of course, they did not go to the doctor when they could not afford to pay the bill. But over the last three or four years particularly, doctors appear to have been more and more concerned with their fees and have lost the regard of many of their patients. The very good thing is that many doctors themselves are concerned at what is going on in their profession and are themselves expressing their disgust with the doctors’ organisations, the things that are being said and the work and regard that is being lost.
In many areas of Victoria now a sign on the door of a doctor’s surgery states: ‘Cash in advance ‘. So many people know that they do not go to the doctor unless they have the money in their hand. Doctors themselves are coming out more and more and calling their colleagues money grubbers because of their lack of ethics. More and more of these doctors are going into salaried service, and doing so happily, because they find they can deal with people’s problems more fully and that it is a relief to help people without putting out your hand for the money. Doctors are also going into salaried service because so many of them are coming to realise that they were trained as physicians and surgeons and not as accountants, and that they are in practice to deal with the care of people and not to spend time balancing accounts and collecting bad debts.
The General Practitioners Society has again recently come out and urged its members not to participate in the scheme- indeed, to fight it. It has urged them to stop issuing special referral forms and it has called on them to ignore regulations under which they seek permission of the Department of Health before prescribing certain restricted drugs. The Australian Medical Association in Canberra has called on its members, if the Government establishes further health centres staffed by salaried general practitioners in areas which in the opinion of the AMA are already adequately served by private medical practitioners, not to participate in the scheme. The doctors will say what areas are adequately served. There are areas of Melbourne where there are no doctors. There are women and children in Melbourne who, if they wake up in the night, have no recourse to the services of a doctor. That is the type of area where we want to set up health centres so that the people can have medical care. But here we have the AMA stating that it will decide where and when medical centres will be set up. The General Practitioners Society in Australia was so concerned about general health care that at its recent conference it passed a resolution which read as follows:
That the Committee should consider giving advice to members of the Society that they should boycott private pathologists in favour of public hospitals from any date on which combined Commonwealth and Fund rebates for pathology procedures performed by GP’s cease to be afforded to patients.
The letter in which notification of the resolution was given goes on to state:
The Committee of the Society deferred consideration of this matter until its next meeting, but resolved to ask all pathologists in private practice for their views on the evidence given on their behalf to the recent Rebates Tribunal set up by the Federal Labor Government.
The Committee would appreciate your views on this controversial matter and wishes to inform you that members of the Society are determined to preserve private medical practice, but not at the expense of private general medical practice.
But honourable senators will notice that the patient receives no mention whatsoever.
Address-in-Reply: Presentation to Governor-General
– For the purpose of presenting the Address-in-Reply to the Governor-General, the sitting of the Senate will be suspended until 8 p.m. Cars will be available at the front steps of Parliament House at 5.10 p.m. to take honourable senators to Government House.
Sitting suspended from 5 to 8 p.m.
– I have to inform the Senate that this day, accompanied by honourable senators, I waited upon the Governor-General and presented to him the Address-in-Reply to the Speech by the Right Honourable Sir Paul Hasluck on the occasion of the opening of the Parliament, which was agreed to on 11 July 1974. His Excellency was pleased to make the following reply:
Thank you for your Address-in-Reply which you have just presented to me.
It will be my pleasure and my duty to convey to Her Majesty the Queen the message of loyalty from the Senate, to which the Address gives expression.
Debate resumed (vide page 305).
-Prior to the suspension of the sitting I was drawing the attention of the Senate to the fact that so many of the doctors’ organisations felt they had a beholden duty to obstruct the health insurance plan that we wish to introduce. We are about to reach a position which was reached in Britain recently when the British Medical Association decided to stop issuing free contraceptives- a measure introduced on social grounds by the duly elected government- until they received an extra fee for service. I think that is indicative of the sort of attitude that doctors’ organisations in Australia may shortly take. It is no wonder that in some areas of Australia women have been forced to set up their own health centres.
We have heard honourable senators on the other side talk about goodwill. We have heard how we must foster the goodwill of doctors and the goodwill of staff in health organisations, but I think it is time someone did something about fostering the goodwill of patients. These doctors to whom I have referred are the sort of people that this Opposition supports at the cost of the Australian people who want a scheme that will take some of the terror out of being ill or having loved ones ill by at least giving to the people comfort in the knowledge that the money part of it is under control. Such a scheme brings to over one million people the assurance that this is a responsible society and it will not let them die or go unattended because they do not have the income with which to obtain medical care.
To quote the ‘G. P.’ magazine again: ‘Doctors are traders, like everyone else in a free society and they should bear that title proudly considering the crucial importance of the services they offer’. Traders in the first place-your money or no service- and blackmailers in the second place because people need medical attention and doctors know it. I could understand the Opposition’s stand more readily if it were supporting all the medical practitioners in Australia- if it were standing up for that section of the communitybut it is not. Fortunately for humanity, not all doctors feel this way. All over Australia doctors are going to the media vehemently denying that they are opposed to the proposed scheme and dissociating themselves from societies such as the Australian Medical Association and the Society of General Practitioners. Indeed, they are setting up other organisations such as the Doctors Reform Group to battle against these very inhuman tactics that are being employed. These doctors know very well- and they say it publicly- that a health insurance scheme that is competent and universal is very badly needed. They know that it in no way interferes with private practice and that it makes sensible and practical changes in the funding of a health scheme.
The new program is not socialistic but merely represents the intention by the Labor Government to update this aspect of our social security in line with the standards of the second half of the twentieth century. Just about every developed country- and some developing countries too- have adopted comprehensive universal health insurance as part of their social security system. Once the new program is introduced in Australia only a handful of countries such as the United States and South Africa will remain as bastions of voluntary insurance. In Western Europe and Canada universal health insurance is settled policy, despite the misinformation with which we have all been bombarded. For years sensible people have realised that the private health insurance schemes were not practical or logical. Well over a hundred schemes all buying buildings, all buying computers, all employing staff, all creating their own bureaucracies and building their own empires, do not bring any greater benefits or assistance to the contributors who hold them together. In the past 9 months the administrative costs of the Hospital Benefits Association in Victoria were almost $6m. If one multiplies that amount by the number of health schemes in Australia it will be seen that it is a ridiculous amount to spend on administrative costs. The HBA in Melbourne is run by a committee of 28, only 8 of whom are elected by the contributors. The other 20 are appointed by the various hospital associations, the AMA, the Pharmaceutical Society of Victoria and the Bush Nursing Association. Of that 28, 11 form the executive committee and under that set up there is no way that that 1 1 represents the contributors. The large committee on which contributors have some voice meets twice a year.
The executive committee meets more regularly. The HBA has now employed a public relations consultant to promote its activities and to enable it better to give information to the media, parliamentarians and agents, to quote its own literature. The HBA is producing a magazine for these people, the latest edition of which contains inches of material denigrating the Government’s proposed health insurance scheme and pointing out the faults in the Swedish health scheme, which is a scheme of nationalised medicine. This is a move to misinform, and frighten people and to sidetrack them because the Government is not, of course, nationalising medicine. But what have public relations and promotional gimmicks to do with health insurance? Why should money dearly won by good people to provide against that dreaded day when they become ill be used in this way? While fees go up the benefits go down and at the same time over one million people are outside the scheme altogether. Ordinary people want assistance.
The remedy proposed by our opponents is to extend the subsidised health benefits plan to bring in all the pensioners and low income earners. One would have thought that if any aspect of the present scheme has been proved to be a complete disaster, it would be the subsidised health benefits plan which covers about one person in 20 of those who are eligible for it. Some 18,000 were eligible to apply but only 6,000 bothered. Under the subsidised health benefits plan, people here with financial handicaps, some of whom have been deprived all their lives and who are often not very good at managing their own affairs, have to attend, fill out forms and go back and forth from department to insurance fund to produce evidence in order to get the same sorts of subsidies, in many cases, as a rich man gets automatically in the form of income tax concessions.
Our program is to relate contributions to a capacity to pay. We are using taxable income as the best measure we have of people’s capacity to pay. It is a straightforward one and one in which the collection costs and the marginal inequities are as small as it is possible to make them. One thing you just cannot do under the present scheme is bring about a fair and consistent relationship between people’s means and the contributions they pay. Under the new program we can not only make a general rule which is equitable but we can also provide for further exemptions for low income families and other special groups which leave everyone protected but which do not add significantly to administrative costs.
The justification for this scheme and the pride of this Labor Government is that we know that this program will promote the development of a better health care system. We know that providing good health care means not only spending money- the present scheme does that in large measure- but spending money and using resources in a planned and proper way. When one looks at the advantages offered in this scheme one wonders why the Opposition should have made such an issue of it. Why did the Opposition use such exaggerated statements as ‘go to the barricades’? Those statements bring us back to the true reason for this Opposition’s objections to the scheme. It is not because there are so many people in Australia who need it so very badly. In fact, it is because the Opposition stands for the protection of vested interests and subsidies to the rich against the greater good and welfare of the great mass of the Australian people. I commend the Bills to the Senate.
– The Senate might well be reminded that it is debating 2 Bills in a cognate debate. They are the National Health Bill and the Health Insurance Bill. Of course, it should be debating along with those Bills several other Bills including an assessment Bill. I say that the Senate should be reminded of the Bills it is debating because in a completely lack-lustre, defensive, apologetic debate from Government senators one thing was clear Government members are not articulating a scheme as spelt out in these Bills. So that those on the Government side who are articulate can aid me in this matter I want to take the speeches of honourable senators opposite one by one. The last speaker, in common with all Government speakers, said that this is not a scheme of nationalised medicine. I wish to quote the remarks of Mr Whitlam, the Prime Minister of Australia and the leader of Government members who said:
A major act of nationalisation in the traditional sense to be undertaken by a Labor Government in the next term will be through the establishment of a single health fund administered by a health insurance commission.
Is the Prime Minister of Australia the only person who is incorrect when he says that what the Government is contemplating is a major act of nationalisation in the traditional sense? Senator Button nods and says that Mr Whitlam is the only person in step in the regiment.
– No, I was nodding off.
-I can understand that the honourable senator would be nodding off because his colleagues have put him to sleep with the arguments that they have put forward. We are told that this is not to be a scheme of nationalisation. But I wish to quote the remarks of another Minister, Dr Cass, the Minister for the Environment and Conservation. Perhaps Senator Button may nod off again. Is Dr Cass the only one in step in the regiment when he says:
Private hospitals and private nursing homes are irrelevant to the Labor Party’s concept of a national health scheme and the vast majority of people can easily be catered for in the public hospital sector.
Is that not a nationalisation statement? Is that not an expression of socialisation of medicine? Perhaps I can help Government senators again, because the silence is deafening. I quote Dr Gun. Perhaps Government senators will have to disown him; because by their statements they have disowned Mr Whitlam and Dr Cass. Dr Gun says:
Full salaried health services will be introduced in Australia sooner or later.
That is his statement.
– Hear, hear!
-Senator Cavanagh, the Minister for Aboriginal Affairs, who is the presiding Minister in the chamber says: ‘Hear, hear!’, acknowledging that the Labor Party’s policy is full salaried health services.
– What is wrong with it if it benefits people?
– I am not arguing about what is wrong with that. I am trying to flush out from the Government the truth of the position, namely, that it is a scheme of nationalisation as the Prime Minister says.
Mr Acting Deputy President, as I see it the Bills have 6 main characteristics. I will invite the Minister to say yes or no to them as I identify them. The first characteristic is that the Bills seek to abolish all existing voluntary medical and hospital schemes in their present functions and to replace them with one single nationalised, governmental, compulsory scheme. I ask Senator Button through you, Mr Acting Deputy President: Is that not the main characteristic of this legislation? The answer must be: Yes, it is.
The second characteristic is that the legislation seeks to compel every citizen of Australia, through a compulsory tax levy, to contribute to this nationalised scheme- to this National Health Insurance Commission- by an openended tax levy. It started off in Labor Party policy as a 1.25 per cent levy, moved quickly in less than a year to 1.30 per cent, is now teetering at 1.35 per cent and is on its way upwards. Is that not a characteristic and is not a compulsory tax levy on all people for a National Health Insurance Commission a nationalised health scheme? The Prime Minister says that it is. Is it not open-ended? Is it not a fact that during last year the amount of money that the Government must contribute to back this scheme has been increased by the Government from $1 from Government funds for $1 from the taxpayer’s pocket to $1 to $1.50 and that the amount the taxpayer has to contribute is now being cited as $1.80 or $2? Senator Button smiles because the Labor Government will rob the taxpayer in a second way. It will do so by putting its hand in his pocket and taking extra money from him by way of taxation for this scheme. I have identified 2 characteristics.
To detail the third characteristic I ask: Is it not a characteristic of this legislation that doctors practising in public hospitals shall be forced to be salaried or receive sessional payments? The answer by way of silence is yes. Is that not compulsion? Is that not nationalisation? Is that not forcing salaries on doctors? I then ask: Is it not a proposal of the scheme to force private hospitals to provide an open-ended number of public ward beds or standard ward beds? I invite Government senators to go to the Mercy Hospital in Melbourne or to any other private hospital and ask what the proposition is. Is it not a fact that the Government will force on private hospitals a number of standard bed wards and have the ability to escalate that number of beds? Is that not the thin edge of the wedge aimed at the nationalisation of private hospitals? Is not Dr Cass right and more honest than those Government senators who have spoken in the debate? In effect, he said that the Government was going to shrink the private hospital sector.
I listened to Senator Melzer with interest. I was sorry to hear her talk about the Government wanting to take the terror out of illness. She said that this is what her Government was going to do.
– Hear, hear!
-‘ Hear, hear! ‘, says Senator Cavanagh. But today right throughout Australia in every private nursing home there are people- pensioners and the loved ones referred to by Senator Melzer- being kicked out of the homes and being robbed of their rights to receive medical attention because this Government has not the compassion to pay to maintain the private nursing homes. This Government which mouths compassion and talks socialisationmouths these pretty words that it will take the terror out of illness and that it will look after the loved ones- is now, like Evelyn Waugh, putting our loved ones into the crematorium. Do not let us take notice of this hogwash that has been talked in the Senate about this subject.
Honourable senators opposite came into the Senate today with their apologia. At least the new senators can be forgiven for not knowing that this Government does not want these 2 Bills that it is bringing forward today. Before the double dissolution, the Government tried to modify the Bills and to make bargains outside the Parliament. In fact it wanted to alter them and to bring in entirely different legislation. The Government has reintroduced them only because it thinks that is part of its trickery in a double dissolution.
Let me move now to the next item, number five that I identify. Is it not a fact that the Government proposes bulk billing in this legislation. I listened today to some speakers talk about the choice of the doctors in bulk billing. In my State we have a quaint old phrase called Buckley’s choice. No doctor confronted with bulk billing has any choice at all. I think it was Senator Button who talked about choice. Let us have a little look at it. The choice is for a doctor to agree to bulk bill a patient, and therefore not to give the patient a bill at all, or to say to the patient: ‘I am giving you a bill. By doing this I am forcing you to pay 1 5 per cent or more of this bill’. This is freedom of choice? It is freedom of choice to say to the doctor: ‘The onus is on you. We are going to bludgeon you into bulk billing or, alternatively, you, the doctor, by your action, will have to inflict the 1 5 per cent charge on the patient’. Yet honourable senators opposite get up on their feet and have the gall to talk about freedom of choice. Bulk billing is a device invented by this Government to nationalise general practice in this country. The Minister for Repatriation and Compensation (Senator Wheeldon), who is at the table, had the grace to acknowledge what Dr Gun had said, that this was in fact the goal. The simple way to force the ordinary general practitioner out of private practice into salaried practice is, firstly, to force him into bulk billing- and this measure will do that. Having done that, since the Government then becomes the master at both ends- the master at paying the bulk billing and the master at fixing the fee- the simplest thing in the world for the general practitioner to do is to accept a salary and not go in for this hocus pocus This is a bludgeon, a duress and an undue influence designed entirely to squeeze doctors out of private practice into salaried practice. Senator Button smirksbut these are the facts.
The sixth item I identify is that these pieces of legislation aim to standardise downwards. They aim to force away freedom of choice of people who may wish to have intermediate or private wards and to force standard wards on them. Let nobody fail to note what happened in the United Kingdom in recent days when trade unions said they would starve patients out of private wards to enforce standard wards upon the people. In this modern age, this model of socialised medicine acted that way. Senator Wheeldon acknowledges it, because no doubt he would applaud the techniques. This is the model of hospitalisation which they are upholding- British medicine. Senator Melzer said: ‘These horror stories from overseas have been exaggerated; we must not talk about them’. This practice which occurred in the United Kingdom the other day was characterised by trade unions saying: ‘We will starve private ward patients out of private wards to force them into standard wards.’ Is this part of the exaggeration? Is this part of humanity, a freedom from terror? Let us have a little look at this. What a quaint situation.
I have identified the 6 characteristics. Here we have a really Irish, wrong-headed approach. Here we have 96 per cent of the people well equipped with all the characteristics of freedom of choice, belonging to funds and being able to go, by right, to a private doctor of their choice or to a hospital of their choice, and some 4 per cent or 5 per cent with difficulties. What are we going to do? The sensible thing would be to take the 4 per cent or 5 per cent and ensure that they are raised to the level of the 96 per cent. No- that would be too simple, too rational. This Government proposes to take the 96 per cent who are today fully covered and compel them by standardisation to conform to the Government. What an extraordinary situation. I see that Senator Grimes shakes his head. Are we not taking this 96 per cent out of voluntary medical and hospital funds? Yes, we are. Are we not forcing them to pay into an extra private fund in order to enjoy a private ward? Are we not forcing a compulsory tax levy upon them? Senator Grimes head stops quivering when I put it this way. It is extraordinary, when we come to the facts of this Bill, how the whole tenor of the Government changes.
Let me examine this. The line of the argument is this: We are going to make this much better for ordinary people. I will tell Government senators this, and prove it, that the scheme put forward by the Government will produce for everyone a scheme inferior to the scheme that exists today for everyone. The proposed scheme will cost substantially more for everyone than the existing scheme and will be one which robs them of freedom of choice. Let me have a little look at this. Today a married man can go to a medical and hospital fund and insure the whole family. If his wife is working, he can insure himself, his wife and his children for one family payment for treatment in the top private hospital, all for about $130 at this moment.
– I think you would have to add another $20 or so.
-The Taxation Commissioner and I have had a little look at what I have just paid for a year’s cover. I think it is $ 135 a year for the top table in my State. Having done that the taxpayer can then put in his claim for a taxation deduction and will end up by paying about $80 or $90 net for the cover. His wife will be covered and his children will be covered. His wife will pay nothing out of her wages for this extra cover. The Bills which the husband pays to his doctor are tax deductible. Under the scheme proposed by the Government every person who earns wages or salary above a very low minimum will be taxed at the rate of 1.35 per cent, at the moment- but in the future, when both husband and wife are working, both will be taxed.
-You think that is unfair.
– Yes, I think it is unfair. I think anything that forces a working family to pay more money in this inflation-ridden country which the honourable senator and his colleagues have inflicted upon the people is wrong and wicked. It hurts honourable senators opposite when I remind them that the medical and hospital scheme has been wreaked in higher charges and the record inflation that has been brought on by this Government. Here we have a proposition that the husband, the bread winner of the family, pays one sum for all and it is tax deductible. The Government says ‘That is not good enough. We believe in women’s lib so we will tax the one million working wives in this country as well’. The Government says this, as if those working wives did not have to struggle enough as it is. Senator Grimes interjects that they are not struggling now.
– How much will they earn?
– Let us take a little look at this. They will not be able to claim a tax deduction when they pay it. Today a single person pays one half of what a married person pays to join a fund.
– You are talking nonsense.
-The fund charges a single person 50 per cent of the family rate and it is tax deductible. Under the Government’s plan, a single person will be forced to pay the same rate as a married man. No doubt that is egalitarian; and no doubt it is egalitarian to force working wives to pay. This is being done by these people who talk about looking after the women of the world. They are the people who are robbing the working wife more and more for a lesser standard. Under this scheme everybody in Queensland will pay more for an inferior service. All unmarried persons and all working wives will pay more. What will they get for the privilege? They will get less because they will get standard ward treatment. Senator Grimes interjects, in a fit of freedom, that they can join a private fund if they want to. Of course they can- but they will have to pay an additional amount on top of what they will pay into the Government’s scheme. Today we can have a scheme inside the all-up price of the Government’s scheme but tomorrow the people will have to pay more and get less.
If the Government wants private wards or private hospitals why does it not write into its present scheme the freedom of people to receive a tax deduction for the fees they pay for intermediate or private ward accommodation. But the Government does not do that because it wants to standardise the system and have standard wards. So here we have a most incredible situation, a situation in which the Government is coming forward and saying: ‘There are a number of people not covered so we are going to force all of you-
– You are crucifying them.
– No, you are doing the crucifying of the public, Senator Milliner, not I.
– Why do you not stop boring us?
-Senator Poyser is at liberty to leave the chamber any time he likes. He looks as though he might well do so. Here is a situation in which today we have been told that the Government’s scheme will be a better scheme than the present one. But on analysis it is highly costly and highly discriminatory. Does anyone say that under the scheme all working people in a family shall pay? Let us have a look at the situation. Here is a scheme that is put forward to us and on analysis we find that it is infinitely more costly. Worse than that, a government can at will raise the compulsory tax levy. Incidentally there is a Bill that this House has not seen at the moment which allows people engaging in tax swindles to get away with blue murder. I am talking about those people who have the quaint old way of running their incomes into tax losses. Of course, under Labor’s proposal they would not pay for a health scheme at all; their tax payments would be on one of the lower scales. This is great stuff. At the moment these people have to pay the full rate for the health scheme. But tomorrow by means of a tax swindle they can dodge contributing to the Government’s scheme on the full rate. The Government did not have the grace to bring in the assessment Bill for us to debate it here.
So here we have a scheme which will cost more, which will penalise all working women and young single people, which will provide for only standard ward accommodation and which will shrink the number of private hospitals -
– At least it will give something.
-I acknowledge that the honourable senator, who has not made her maiden speech yet -
– I have.
– May I apologise to the Senator for that remark. No one here has said what the scheme offers on top of the existing -
– Withdraw and apologise.
-I acknowledge the whimsy of Senator Wheeldon. I acknowledge that I was mistaken when I said that Senator Coleman had not made her maiden speech. I have acknowledged that and have apologised to Senator Coleman for it.
– It is not usual for you to make mistakes.
– The honourable senator is quite right. No one would know more the ability to make mistakes than Senator Poyser. Having established that, here is a scheme that has been brought to us which enforces compulsion on six main points, which costs individuals more, which forces bulk billing on the public -
– It forces bulk billing on nobody.
– The Bill-and I stand to be corrected- says that the doctor may bulk bill or alternatively the patient shall pay the patient’s moiety of 1 5 per cent.
– It is up to the doctor.
-It is up to the Government because the Government says so in the Bill. Does Senator Grimes deny that the effect of the
Bill is this: If the doctor bulk bills the patient pays nothing -
– It is the doctor’s choice.
– You do not deny it?
– It is the doctor’s choice, not the patient’s.
-It is being put by the Government as the choice of the doctor to say to the patient: ‘If I give you a bill it will cost you 15 per cent; if I do not give you a bill at all it will cost you nothing’. Quite clearly this is no choice at all. It is a forcing of the doctors by duress. Let us have a look at this matter. We have a situation in which you demolish the private health funds. Senator Melzer and others talked about costs. It is a quaint thing that when they quote from the Nimmo Committee report they are all somewhat over-sensitive to this paragraph from that report. The Committee stated:
The Committee found no support at all for the often expressed view that the number of different organisations adds to the cost of the scheme.
– Why did it recommend a reduction in the number of different organisations, senator?
-I repeat what I said:
The Committee found no support at all for the often expressed view that the number of different organisations adds to the cost of the scheme. We examined the operations of a large number of friendly society and closed funds and found their service to contributors was extremely good and that they had been the most successful organisations in keeping management expenses within proper limits.
I wonder why Senator Melzer when talking about the high costs of these funds did not refer to what the Nimmo Committee said. Why did he not read that part of the Committee’s report which said that so many of these funds were extremely good in their administration and highly successful in keeping their costs down? I wonder why Government speakers have not referred to the built-in costs in last year’s Estimates for the establishment of this commission which included from my memory a little item of $ 14m for computers alone. But Senator Melzer finds it strange that an item of $6m was stipulated in the case of Victoria.
Here is a scheme which aims to diminish all the funds that are in existence today. These funds are established in buildings, they have staff, machinery and telephone lines. The Government would need tens of millions of dollars or hundreds of millions of dollars to enable it to construct buildings and acquire staff all over Australia. This extra money when spent would not add one iota of benefit to any person who is at present a member of a fund. It simply adds to the taxpayer’s burden. As I have said, Senator Melzer queried some administrative expense in Victoria. So here we have a scheme which aims to demolish all the existing schemes and to nationalise. The Prime Minister (Mr Whitlam) stated:
It would be intolerable if a Labor Government were to use the alibi of the Constitution to excuse failure to achieve its socialist objectives-doubly intolerable because it is just not true that it need do so.
He went on to state:
My basic proposition is this: If Section 92 is held up as the bulwark of private enterprise, then Section 96 is the charter of public enterprise. . . .
The Prime Minister is using section 96 of the Constitution to take over the public hospitals of Australia and to shrink the private hospitals and absorb them into a nationalised scheme. Does anyone say that is not a program of nationalisation? The Prime Minister intends to use grants on the end of a string to force this. We will have the abolition of funds, the centralisation of funds and the spending of hundreds of millions of dollars on capital and capital equipment for nothing and to advance nothing. There will also be the compulsion for taxpayers to pay a tax levy which is open ended and which will go up and up. There will be the forcing of salaried or sessional doctors in hospitals, the Buckley’s choice in bulk billing and the standardising downwards so that the standard ward shall be the norm. All these things do not add one single benefit at all to what is existing today. They cost more and they detract from the present scheme. If anyone wishes to seek out those people who are not members of the finds today or who are not entitled to repatriation benefits or are not members of the Armed Services, there are ample ways of doing so. The first thing that could be done is to do what the former Government did- to offer a subsidised or totally free system to those persons below a particular level so that they can have the full benefit of a fund. Indeed, that was quite possible to do. The second thing was to provide for migrants and for other persons in a position similar to that of migrants a service pending their establishment. There is no reason at all, why, if in areas of this country there are people who are under-doctored and who are not receiving good medicine, the Government cannot set up a salaried doctor to provide the services if there is evidence of underprivilege. We can upgrade services and community medicine.
The fact of the matter is that this Government has come forward and said: ‘We will bring in a scheme of community medicine which will be less costly, more efficient and less rapacious than the doctors of today and still supply good medicine.’ I draw the attention of the Senate to the statements of Dr Jarvis as reported in this morning’s Press and on ‘AM’ which show why he resigned from the Melba Centre which was run by the Government. He said that he was overrun with bureaucracy and unable to carry out his duties properly because the system was openended and he was having over-visiting of patients. He said that those patients with vital and significant illnesses were not getting the full services from him because of patients who came with trivia. It is important that throughout the world wherever socialised medicine has been introduced the illusion of free medicine has created the harsh reality of over-visiting. In Canada today -
– Come off it.
-The honourable senator could go to the Parliamentary Library and see reports from the various provinces of Canada which show the open-ended costs of running the system because of” the over-visiting and because of the cosmetic surgery. If the honourable senator were to go to the Library he would learn that the waiting list for entry into hospitals in Canada today is months and months and that in England it is years. Because so much of the patients’ bed occupation is for the more trivial operations or procedures, many other patients are being denied treatment. This is not the Liberal Party or Country Party viewpoint. I am referring to a report of the governments of the provinces of Canada.
If honourable senators were to read what is happening they would find that groups of people in England are getting together to build community private hospitals in order to overcome the huge lag in trying to get into public hospitals. Let us look at the question of turning back the clock. I think Senator Grimes spoke to us about Scandinavia. Let us look at it. In Stockholm today- the centre of nationalised medicine which the honourable senator applauds- more than half of the population- it is a rising percentagebelong to private medical schemes because they find that the nationalised medical scheme is not good enough. This is the system that Senator Grimes invited us to have. He said that Scandinavia is better than Australia because it has a nationalised system. He forgot to say that so much do its people detest the scheme that more than half of them are forced into private hospital and medical benefit schemes. Why throughout Europe are the people turning away from nationalised medicine? Why are they building private hospitals? Why are they proliferating private health insurance? Why, in Western Germany, are there 283 private health schemes? Western Germany- I think it is a social democratic kind of country- believes in efficiency, I think. It has some 283 major voluntary health schemes. That of course was overlooked. With this scheme we are going back to the past. What have we got?
– You have sent Senator Greenwood to sleep.
– I hope so. He deserves tranquility after listening to honourable senators opposite all day. Here is an opportunity for the Government to learn of the errors of the past- of the United Kingdom, of Canada and of Scandinavia. It should bring to this country the more important things. It should consider how it can get good health care to the individual, not how it can achieve institutionalised health in a bureaucratic way. It should not consider how it can fund a scheme socialistically. The real test is whether, in the end, it will give better health to the persons concerned. Demonstrably this scheme cannot do so. Demonstrably this scheme, even in embryo in the various community centres- which are misnomersis producing worse medicine at treble the cost of the private doctor. Even at treble the cost it is producing worse facilities. The Government is trying to turn the clock back and advocate the things I have mentioned.
During the day in this debate Government supporters have run away from the fundamentals of this scheme and have pretended that the fundamentals do not exist. The fundamentals are that this scheme aims to demolish freedom of choice for voluntary health and medical schemes and to substitute a single national health insurance scheme with a second layer in which a patient can receive some private treatment and some paramedical treatment which the Government scheme does not provide, if a patient reinsures in another way. The Government scheme imposes a direct levy on every person which is open-ended and escalating. In its own time the levy has escalated into 3 categories. It is -
– What do you expect?
-Senator Button asks: What do I expect? I expect many things when the Government comes forward and says of its scheme: ‘This is a scheme which will stabilise health costs’. That is what Mr Hayden has said. Mr Hayden has said that he will stabilise health costs and have a better and cheaper scheme than the existing one. Already in 2 levels- the percentage tax and the indirect tax grabbed from Consolidated Revenue- costs are rising.
This scheme will force the consultants, the surgeons and the doctors in the public hospitals away from a fee for service into salary or sessional payments. In fact this will make freedom of choice of the patient infinitely more restricted. This scheme aims to restrict and ultimately to wipe out the private hospital and, indeed, the private nursing home centres. It aims to force the independent hospitals that exist today into having a percentage of public beds. This percentage will be forced upwards. I notice that Senator Coleman acknowledges that the scheme aims to take the great independent hospitals of today, which provide such dedicated service, and to force them to take a percentage- presumably an increased percentage- of standard ward beds. The effect of this would be ultimate government control and therefore the destruction of freedom of choice under a system of health delivery which has no equal in this country. I pointed out that it is aiming, by Buckley’s choice, to force bulk billing on the private practitioner and ultimately to force him into salaries.
Senator Cavanagh acknowledges the virtue of Dr Gun’s idea that a full salaried health service would be the ideal, the goal. This is slightly different from the way the debate has been presented today because now we have a wrong headed system that forces 95 per cent of the people to conform with 5 per cent instead of looking to 5 per cent and raising them. This is a scheme which costs more for a poorer service and no freedom of choice. This is the scheme that this Government says is a reform. I say that it is a turning back of the clock. In fact it represents a step backward into the socialist 1920s and 1930s. It is an attack on the freedom and dignity of the individual.
I want to summarise the position. If the goal is to be a scheme that will provide the best possible health service for the patient, the patient must be the master of the situation. The patient must be the employer of the doctor. If the patient employs the doctor the patient can choose between doctors. The patient can go to a doctor or not, reject a doctor or not, and the doctor is responsive to that freedom of choice. The Government’s scheme aims at the government being the employer of the doctor, through bulk billing and through fee fixing. But when a government is the employer of the doctor the needs of the patient are quickly lost sight of, as has been the case overseas. Or is it not true that the amount of time that a national health scheme patient receives from a general practitioner in Great Britain is shrinking and shrinking? Is that wicked propaganda? The government calls the tune and the patient simply becomes a number on a card.
We on our side see the patient as the goal and first class health care as the goal. We say that you can overcome inequality and under-privilege by lifting upwards; by going outwards and looking for those who are under-privileged and giving them help and restoring their dignity. That we would do. Our policies, as enunciated 2 months ago, would accomplish that. We believe that this Government’s policy is levelling downwards, is destructive. Instead of being one of reformist zeal it is reactionary and would produce a very bad scheme.
– I rise somewhat bemused. For the first time in my short few days in this House I seem to be in spirit on side with the major numbers of the Opposition. It makes me look again at my stance to see if I am correct. I am in agreement in opposing these Bills. Together with a lot of others in this House I listened with a great deal of admiration to the speech of Senator Baume just before the suspension of the sitting for dinner. I thought it was a magnificent exposition from a man who really knew his subject. It was extremely enlightening to the House because he was able to put the essentials so clearly. I think everyone would have been very impressed with his factual assessment of how the output of the medical services which are needed by Australians in fact will be lowered and diminished by the operation of this proposed scheme.
However, while so many Opposition senators decry these measures and find so much fault with them, I again remind them that it was their action in forcing a double dissolution which gave the Labor Government the power to proceed. The opposition that Opposition members now give to these Bills should cause them to think about their actions because it is they who have given the Government such a strong position. Therefore, as we symbolically discuss these Bills in this House-I say symbolically because there is no real weight in the vote which will be takenthose honourable senators who caused that conflict might reflect on what they have done. They will not receive the thanks of the medical profession for what is about to occur.
If there is one sad thing about these measures it is the great dissatisfaction that they have raised among the medical profession with the Government. This should not be. At least there should be enough common ground to provide medical services for Australians for any government to confer with the medical profession and come out with some reasonable and mutually agreed course. Pursuing that line, in my early investigations of what this matter was all about I was told by representatives of the Australian Medical Association that the Association had approached the previous Liberal-Country Party Government approximately 18 months before it was defeated with quite significant proposals to amend the voluntary health scheme. The Government of the day thought so much of the Association’s proposals that it did not even reply to them. As I have gleaned from the AMA, one of the reasons why the Labor Party is able more convincingly to proceed with this legislation with the Australian public is because of the neglect of the previous Liberal-Country Party Government in ignoring the AMA which wished to improve the scheme as it then was.
It is true that the Labor Party’s plans are to nationalise the medical and health services of Australia. I noticed that Senator Button said that this scheme was not perfect. I wonder why it is not perfect in his view as it is his Government which is introducing it. I guess from looking at his Party’s platform in regard to health services that it does not go far enough. I take it that it is an initial step. Last year, in investigating these schemes, I looked for one of the sources of my information to the Labor Party’s platform and in an article I wrote on this matter I listed three of the significant points that I found. I would like to read them to the Senate. I do not want to weary honourable senators but I do not think that anyone has dealt with this aspect. The second point in the Labor Party’s platform is headed ‘General Practitioner Service’ and it states:
The provision of general practitioner medical services staffed by salaried medical practitioners willing to join and available without charge and without means test to persons who choose to use such services.
We have seen this in operation because it has been instituted. The fifth point relates to hospitalisation and states:
A national hospital service, including hospitalisation without charge and without means test, in public wards of public hospitals and appropriate financial provision in approved private beds.
The eighteenth point is headed ‘Registration’ and I think it is the most undesirable of all the points in the Labor Party’s platform. It states:
The Australian Government to approach the States and the appropriate professional bodies to achieve national recognition of qualifications, registration and uniform discipline for general medical practitioners, medical specialists and other qualified personnel.
I emphasise the words ‘uniform discipline’. When we examine even these few points in the Labor Party’s platform we can see why Senator Button is not quite satisfied with what we have before us because it does not exactly fulfil the final pronouncement of Labor Party policy. I also listened last year to Dr Deeble in Millicent in the southern part of South Australia when he tried to explain the general import of Labor’s plans to a gathering of country hospital administrators. The big thing that I came away with after listening at that meeting is that he did not have the answers to most of the questions posed to him. He did make one thing quite clear and that was that there would be no room for private hospitals under Labor’s plans. As much as Labor spokesmen might say that there is a provision for private insurance for these particular hospitals, it will not work. There will not be enough people, certainly in the initial stages of this plan, to provide sufficient patients for the great private hospitals of South Australia owing to the high personal cost to patients. In my State we are very proud of these hospitals. The general consensus among people involved with them is that at a certain time in future they will come to the Government and say: ‘Take us over’. They will have no alternative. Following that meeting I was extremely alarmed that no one could really see a future for these private institutions, despite what Labor spokesmen may say.
I think it goes without saying that honourable senators on this side of the chamber would adopt the general Liberal view that a government’s hand in all things is to support, where possible, a fair private operation and to support it on behalf of the whole community In this way, the same standard of government approach would apply to medical and health services. It is quite evidence that many of our services today are provided, as Senator Baume pointed out, by extremely hard working medical practitioners who do not know what a 40-hour week is. Many of them do very well financially. They deserve to. But if they are put on a salary, will they work their 80 hours a week? We know they will not. So Senator Baume ‘s point about reduced medical output will soon become evident.
I have many friends in the medical profession. Some of them have told me that they have no desire to continue in private practice under Labor’s scheme. They would far sooner be in a salaried position and out of the bureaucracy to which Senator Carrick, I think, referred. One of the major problems confronting the Government is certainly this factor of diminished output. It alarms me considerably. On inquiry, I found that at the Queen Elizabeth Hospital in Adelaide people who receive free medical services under the present scheme have been waiting for 2 years for non-urgent but necessary surgery. If there is to be a reduced output in the medical field, how much longer must they wait? A different bureaucracy will not produce the services which they need. The point was extremely well made by a previous speaker who said that today Australia, because of the voluntary aspect of its medical and health services, attracts from overseas a considerable number of medical officers. If we adopt what amounts to a nationalised scheme, that supply of medical people will dry up. So the necessary practising members of the profession would not be available for Australians.
There are one or two aspects of the Liberal plan with which I do not agree. I certainly do not agree with the Liberal proposal that people can opt out of a future medical scheme. I believe that everyone should be covered. There should be universal coverage. I believe that the coverage should be as universal as the third party coverage in relation to motor cars.
– It is compulsory, is it not?
– I would have compulsory coverage, yes. I am not here to pontificate as to how that would be arranged. I would fit it into the voluntary scheme as to choice and associated details. Over the years I have dealt with a number of people who have had problems which may have arisen over medical and health services. I have spoken to many people who have not been covered by medical funds and who have had a humiliating experience. They received treatment. At least we are civilised enough not to deny them the treatment that they require, but it is very humiliating for them and they should not be humiliated. Whatever the number- whether it is 400,000 or one million people- who are not covered by the present service, that situation should not be. Not one person in Australia should be humiliated because he had to ask for something for which he has not made some provision when he should have. I do not agree with the opting out aspect of Liberal policy.
There are ways to improve the present scheme. The previous Government should have taken advice from the Australian Medical Association. It should have talked to the Association and evolved a proper approach to that very important problem in the present scheme. I do not intend to say much more. My speech has been a simple statement of where I stand on this issue. I believe that this subject was one of the main subjects at the election. I agree with Senator Baume that new members have a duty to express their opinions. It would be wrong not to express an opinion if one had not spoken on this matter previously in the Senate. I believe that the same reasons- they are very sobering reasons- which led to the double dissolution apply fairly heavily to this Bill also. I again say to those who so violently object, as I do to Labor’s ultimate plans, that, as they were senators in the previous Parliament and were the cause of the double dissolution, they can reflect for a long time in future, as they commiserate with the Australian Medical Association, on how they gave a socialist government the power to do that which they did not want it to do.
– I will state briefly my position in relation to this Bill. I have said publicly that I am against these health Bills.
– You are never for anything.
-That may be your opinion. If you interject would you speak a little louder so that I do not have to take quite so long replying to interjections?
– We will get you a hearing aid.
-That is what I need. A former colleague of mine had one.
-Interjections are highly disorderly.
-Thank you, Mr President. It has happened so early in my speech -before I finished my second sentence. This is the third time that the Bill has been before the Senate. I shall be brief because I, like a lot of other people in this country, feel that it is time that this Parliament got down to some new business rather than rehash all these old Bills.
– Do not worry about that.
-I am not worried about it. It is the Government’s job to worry about it. I will give the Government whatever help is required to get down to new business as soon as possible.
– There is plenty of that coming.
– I will bet that you will not be voting for it.
-You might be surprised. But give me a go. I have just finished my second sentence, and already there have been 15 interjections. I was quite pleasantly surprised at the flexibility which the Minister for Social Security (Mr Hayden) showed in relation to some aspects of this Bill as a result of public pressure and suggestions made to him about it. I suppose that all honourable senators feel that there are some basic aims when it comes to discussing a health scheme. There are 7 basic aims that I feel a health scheme should have. Firstly, it should provide universal access to adequate health care. Secondly, it should offset the individual’s financial burdens. It should encourage the attainment of higher standards of medical practice. It should give patients the right to choose their doctors, as far as possible. It should give doctors the right to practise their profession free from coercion. The scheme should include incentives to the profession to cover areas of special community need. It should be conducive to maximum efficiency and economic and other aspects, with maximum privacy for individual patients. I think that all honourable senators want those kinds of things. When we are ill or when anybody whom we know is ill we want them treated as quickly as possible with the best treatment. That is the real issue that is before us. We want everybody treated properly.
I think that the Australian Labor Party is going about its scheme in a slightly misguided way. We heard, particularly from Senator Baume earlier tonight, points made on many aspects of this scheme. I congratulate him on his speech. I think that all honourable senators should read it in Hansard tomorrow. I wish to make a few points. My opposition is based on them. Firstly, a gallup poll has shown that about 56 per cent of the people who have an opinion about the health scheme are against the Labor scheme. Secondly, many responsible professional organisations have stated their opposition to the Bill. Thirdly- perhaps this has already been covered but it is something upon which I should like to touch- this Bill will cause the death of private hospitals. With the introduction of the scheme we will see the gradual destruction of the benevolent and philanthropic interests of the thousands of people who work to keep private hospitals operating. Once the drive and enthusiasm of these people is destroyed I think that it will be impossible to rekindle it.
Perhaps the Labor Government could learn from what has happened in other countries. The cost of the health scheme in Canada is increasing at such a rate that if it continues, in 1 1 years Canada’s entire budget will be spent upon the health scheme. Some health centres were built in Saskatchewan by the socialist State government, but of the 47 originally built, 43 have closed because of lack of personal care and also because of the cost of running them. In Sweden the authorities eventually got rid of general practitioners, but after many years the system collapsed because of the cost. In the United Kingdom at the present time a massive injection of funds is necessary to prevent the health scheme from collapsing financially. The difficulties in New Zealand have already been mentioned; patients can wait upwards ofl years to get into a hospital for anything other than major surgery.
I will now deal with the question of who has organised the Government’s proposed health scheme? Who has really been at the back of it? In the last few months we have seen how economists all over the world can be wrong. Yet this proposed health scheme that we now will see forced upon the Australian people has been dreamed up by economists. Already the estimate of cost of the scheme has been shown to be out by hundreds of millions of dollars. Today’s ‘Australian’ reported that the cost of the health scheme is estimated- admittedly by the Australian Medical Association, and it may be a little biased- to be $400m out. Today’s ‘Mercury’, which is my local newspaper, has pointed out that the scheme now could cost more than $ 1,400 in the first year. That is an increase in cost of $400m in a very short time- since 1 July last. If we are going to finance this scheme by the imposition of a super tax and if the costs of the scheme increase, I expect it is fair to say that the rate of taxation must also increase.
We all know that at the present time Government expenditures should be decreasing and not increasing. Mr Whitlam, in one breath, has promised to control Government spending, yet in another breath he is asking us to authorise this money-munching white jumbo. I think that this proposed health scheme is something that the Whitlam Government and the people of Australia will live to regret because they will not be able to afford to feed it financially. Perhaps Mr Hawke would love this one because it would be an excuse to increase taxes to an even higher level than they are at in Australia at the present time. Perhaps I could be permitted to make a brief aside. I think that we have reached the stage in Australia where the public should be encouraged to work a little harder, and in my book the way to do this is to reduce taxation, not to increase it. I would think that 50 per cent should be the maximum rate for personal income tax, as is the case in Canada and New Zealand. That is something at which Australia should be aiming.
I think that this proposed health scheme will be murder to the economy of Australia. So I oppose this Bill primarily because of its costs, not because of the basic ideas contained in it. If the scheme is introduced private hospitals will go out of business; they will be effectively nationalised. As Mr Chipp said, the whole thrust of clause 34 of the Bill puts the private hospitals of this country at the mercy of a Minister in Canberra. Under a socialist Minister dedicated to the destruction of private hospitals, that will be catastrophic. Already people have pointed out that the 1.35 per cent super tax will not be imposed on only one working member of a family; it will be imposed on every working member of the family. At the present time these people would be covered for health insurance by making one payment to a medical benefits fund. Senator Hall said that the 1 .35 per cent super tax has not been fully justified by Dr Deeble or by anyone else.
I agree that the present scheme needs altering. It has, though, resulted in the provision of good quality health care. It has resulted in freedom of choice of doctor and hospital. The proposed health scheme cannot give a guarantee against a lot of things. It cannot guarantee that there will be a sufficiency of standard ward beds, and in this context I shall refer to what Dr Forbes said in the other place on 1 1 July 1 974. He said:
There is absolutely no guarantee that a doctor will be able to follow his patient into hospital, even if the doctor happens to be attached to the visiting staff. There is absolutely no guarantee that private hospitals will remain in existence . . . There is absolutely no guarantee that large numbers of able specialists will not be forced out of private practice into salaried public service by economic deprivation.
Dr Forbes went on to make a couple of other points which this Bill does not cover. So I am opposed to this scheme of nationalisation; I am firmly opposed to it. I would agree to the making of sensible alterations to the present health scheme. But in my opinion, the proposed scheme is not in the best interests of Australia. Once again, to use an example which the Government is fond of using, if a referendum were held on the proposed health scheme I am sure that the people would soundly toss it out. I do not think that nationalisation, in a lot of fields is necessary for Australia. I have already said that I think that Mr Whitlam and the Labor Government will live to regret this move. I suggest to them that if they get this Bill passed at a joint sitting of the Parliament, they should postpone its implementation until the country can somehow afford the economic mess that I believe it will cause. I oppose the Bill.
– I join with other Opposition speakers in opposing the measures that are before the Senate this evening. I should like to commend Senator Hall for his approach to the Bills that we are considering. I am glad to know that he has shown some sympathy with the Liberals on this side of the chamber by opposing this measure. I think that this will give some encouragement to the people who sent him here and who charged him with the responsibility of opposing the Labor Party’s socialist measures and of protecting the interests of the Australian States. I welcome this support and hopefully look to a continuation of this stance.
Senator Hall referred to the double dissolution, as he has done on many occasions. I suggest that the calling of the double dissolution is the reason why he is able to be in this place to put his point of view. I could not quite follow the consistency of what he said when he criticised the Liberal and Country Parties’ proposals for improving the existing health scheme. He said that he did not agree that people should be able to opt out of the scheme. I find that inconsistent with what is stated on page 6 of his policy speech. It reads:
Our concept of medical and health services is that they should remain a free choice for patients.
A little further on it states:
We do not agree with the LCL that an individual should be able to opt out of the system.
I would have thought that the principle of freedom of choice should apply right through. But I thank Senator Hall for his support on this occasion and I hope that he will be able to put forward some suggestions that will help us in a constructive way to meet any objections that he may have to the existing scheme. I certainly would welcome any suggestions that he could put forward and would help to influence my Party into agreeing with them.
I oppose this measure which obviously is the fore-runner of a compulsory 1.35 per cent taxable impost on the people of Australia in order to establish a Government-run health fund in this country. I believe that it will ultimately prove to be a socialised salaried medical program provided at greater cost to many people in the community. I have noted that some honourable senators opposite- I believe they should be in Opposition- have challenged the suggestion that it will be a nationalised scheme. Tonight when Senator Carrick was speaking the Minister for Aboriginal Affairs (Senator Cavanagh) interjected: ‘Nationalisation is all right. What is wrong with nationalisation?’ After hearing that statement from a Minister of the Government it is clear what we are facing here in Australia.
Many people will have to pay more for their health care in this country. Under the existing scheme a single person is able to insure himself at a lower rate than will apply to him if these measures are passed. We have to consider the working man and his working wife. We must also consider the young people who, with the supreme optimism of youth, maintain in thenown minds that they cannot get sick. Are we to force them to become insured under the compulsory scheme? We must also consider those people who for religious reasons do not want to be involved in an insurance fund. We must also have regard for the people who prefer to pay out of their own pockets for the medical attention they require. I believe that this Government is retrogressive in its approach to health care in Australia. It is looking at schemes that have been in existence overseas and has formulated some sort of hotchpotch of those schemes in attempting to introduce a similar type of system in Australia.
Such a scheme has operated in the United Kingdom for a quarter of a century but there the authorities are reviewing the scheme. It seems to me that in the United Kingdom there is a tendency towards a growth in private insurance organisations and an increasing number of people who are wanting anxiously to insure themselves in a fund through which they may seek private attention and obtain it almost immediately. They do not want to queue up at hospitals for surgical procedures available from the national health service institutions. I have here an interesting supplement to the London ‘Times’ dealing with health care in the United Kingdom, published only a few months ago. I do not wish to hold up the Senate but I would like to read one or two extracts from the supplement that seem to indicate that the health scheme in the United Kingdom has not been what Minister Bevan thought it ought to be when it was created that long ago.
– Who wrote the article?
– Not the Geoffrey Smith?
– He is an eminent writer on the staff of the London ‘Times’. He wrote:
The birth of the National Health Service more than a quarter of a century ago was a painful process. It is easy to look back now and to assume that as Minister of Health Aneurin Bevan was able to establish the pattern that he wanted. That was far from the case.
Various special interests had to be placated. The new regional hospital boards and hospital management committees took both the voluntary and local authority hospitals under their wing, but not the teaching hospitals.
Local authorities were so upset at losing control over their hospitals that it was essential to leave them with the community health services. General practitioners were so fearful of losing their independence that they would not be directly employed by the NHS at all, but would become only independent contractors under executive councils, with a membership equally divided between the medical professions and laymen.
The result was that the three branches of the service came under separate administration. That was not merely offensive to the bureaucratic mind: It was contrary to the best interests of the patient. For most of the time he would be under the care of his GP, but when he went to hospital for treatment or diagnosis there would be less continuity of care than there should be or generally had been.
Relations between hospital doctor and GP were more distant; nor was contact sufficiently close with the community health services or the welfare services under local authority control. The total needs of the patient tended to be lost in the gaps.
It was not so long before this began to cause concern.
Of course, the same applies to hospitals. I commend the whole of the supplement to honourable senators for their education. Is also contains the following reference to hospitals in an article written by John Roper- the John Roper, another eminent journalist on the staff of the London Times’. He wrote:
When the National Health Service began in 1948 there were 3,040 voluntary and municipal hospitals, of which 2,688 were taken over. A few hospitals closed but about 250, many belonging to religious orders, remained outside the service.
Today there are 2,250 NHS hospitals. There is not a central register of independent hospitals but there are probably about 200.
Right through the article runs the theme that health care provided in the national health service hospitals is certainly second rate compared with that supplied by the very few private hospitals that are in existence in England at present. That opinion is supported by Dr Stanley BalfourLynn who, I think, is director of the Harley Street Clinic. In the supplement he is quoted as making these points:
The efficient running of hospitals necessitates good management. In the NHS there is enormous waste and the private field could teach the public service a lot. What apart from privacy and the great benefit of treatment on the day he wants it does the private patient get?
The article states that under the NHS in the U.K. a patient is denied immediate treatment for surgical procedures, and so on. The articles get down to the mundane question of selection of food in hospitals. In the public institutions patients are denied a choice of meals, a matter which is very important to patients. It seems quite obvious to me that there is a growing demand iri the United Kingdom for private insurance protection in order that people may attend the doctor of their choice and can be sure that they will have that doctor available for surgical treatment or whatever treatment may be indicated. In the same supplement Dr Tony Smith has written that no doubt in an ideal world doctors should insist that everyone is treated in big modern hospitals staffed around the clock by resident doctors, nurses, technicians. He went on to write:
No doubt in an ideal world this would be the case; and it is certainly true that where there is a modern NHS hospital with a full complement of staff and no waiting list there is little demand for private practice. Unfortunately these ideal conditions are rare. Most hospitals have long waiting lists for non-urgent surgery; many are still using old depressing Victorian buildings and have serious staff shortages.
In fact, in the United Kingdom taking 10,000 people as a basis there are 12 doctors, 32 nurses and 41 beds available for that number. In the United States for the same number of people there are 16 doctors, 51 nurses and 47 beds. Against that background private practice can offer some real medical advantages. The patient who pays his fees knows he will be able to obtain the services of the consultant of his choice. Should he be in need of an operation or specialist treatment, the treatment will be given by his own doctor and not by the surgeon who happens to be rostered for duty under the national health service scheme.
After 25 years of experience in the United Kingdom it can be seen that a change is taking place. The demand by patients for private treatment seems to be becoming more frequent.
– Do you believe everything you read in the newspapers?
-I believe what I read in that newspaper because it substantiates the views that have been put to me by doctors who have come to Australia to escape this public service environment and it has also been put in letters which I have received over the years from hundreds of patients who believe that the system in Australia is far from preferable to the one that they experienced for many years in the United Kingdom. I believe that in recent times there has been an upsurge in the discontent amongst the doctors in the United Kingdom and a tendency for more and more doctors in that country to want to go overseas to practice. That seems to bear out the opinion I have just expressed.
I turn to the situation in Australia and I draw the attention of honourable senators to recent Press articles on the running costs of free medical health centres in the Australian Capital Territory which, I believe, is the socialist laboratory of Australia. I understand that this socialist laboratory which exists in this area is to be extended to
South Australia with the co-operation of the Labor Government in that State. I have my ear to the ground. I believe that this concept of salaried doctors in medical centres is likely to spread to South Australia in the very near future. I remind honourable senators of an article which appeared in the ‘Australian’ of 29 May headed Free health “more costly”. 126 p.c. above private care- study shows’. The article is a report on a study undertaken by a Canberra accountant, Mr East. The article states:
The cost of treating patients in the Federal Government’s free health centres could be up to 126 per cent higher than treatment by private general practitioners.
His findings were presented to the post graduate committee in medicine of the Australian National University. He compared the costs and incomes of IS Canberra doctors selected at random with the cost of maintaining doctors at the free health centres in the capital.
Mr East found that at a conservative estimate the cost of treatment to patients going to free health centres was at least 62 per cent more expensive than treating them privately.
The report states that Mr East indicated that administration, rental and staff salary costs for each doctor employed by the Government at free health centres meant an additional $5,000 a doctor over and above the costs of a doctor in private practice. Mr East also suggested that whereas the average general practitioner treated 40 patients a day, according to the health centre estimates salaried doctors there treated 28 patients a day. Mr East is reported to have said that on that basis it is at least 62 per cent more expensive to treat patients in health centres than in private practice. He said that on average, according to Australiawide surveys, doctors treat only 20 patients a day and at this rate the cost rises to about 126 per cent higher than the cost in private practice. I think it is interesting to note that within the last 24 hours or so a doctor has resigned from the Melba Health Centre. He has been very critical of the conditions of public practice in that area. He says that when he took up his salaried position at Melba he did not think people would abuse a free medical service. He is reported to have said:
To start off with they did not but I am quite certain that towards the end of my time there this was the tendency.
He thought that more people with trivial complaints went to the centre than would normally be the case with a fee for service doctor. He comes down solidly in support of the concept of fee for service medical treatment in the community centre environment.
– Where is he practising in the Australian Capital Territory?
– He has been practising in the Australian Capital Territory in a public service environment at Melba.
– Where is he practising now?
– In the newspaper article he goes on to say where he will be practising. The honourable senator can read this if he wishes. That doctor is going back into practice on a fee for service basis at Kippax health centre. My colleague Senator Baume has very adequately described the way in which the people of Australia have demonstrated their opposition to the proposal which has been put forward by the Government because the polls have indicated that 54 per cent of the population are opposed to the scheme. I believe that is a conservative estimate. I believe that the many petitions that have been presented in this Senate and in the House of Representatives, signed by hundreds of thousands of people, adequately reflect the public antipathy towards the socialist measures which are being put to the people of Australia by the democratic socialists who sit opposite.
I am opposed to the measures which are put forward by the Government. However, I do recognise, as Senator Melzer said in her speech, that there are in Australia areas which are not being properly catered for medically. The honourable senator chose to mention Melbourne suburban areas and I believe that is fairly significant, but I think it is more significant to refer to the remote areas of Australia. In its aim to improve the existing scheme the Liberal Party recognises the need to pay more attention to general practice and the area of primary health care. We have outlined in detail the proposals that we would put to overcome this problem. I have had experience in my own profession when I worked with the Royal Flying Doctor Service in providing a service in remote areas such as Oodnadatta, Coober Pedy and Andamooka which are fairly remote areas in South Australia. I recognise that more should be done to provide medical care in those types of areas and perhaps more significantly the Eyre Peninsula area which occupies a fairly vast part of South Australia and to which it is difficult to attract medical practitioners. Another such area is Kimba.
I believe it is the responsibility of the Government and the Australian Medical Association to ensure that these remote areas are serviced. I suggest that we have to pay more attention to encourage general practice to be taught at the universities and in the teaching hospitals. I believe this is essential in the quest to service these areas adequately. In my opinion this is the responsibility jointly of government and the university authorities, the teaching authorities, the Australian Medical Association or the appropriate medical authority. Doctors ought to be given some incentive to go out into these areas for two or three years before they are able to go into some specialty. I personally believe that general medical practice is a specialty in itself and I also believe that specialists would be far more effective if they had some basic knowledge of family medicine. This is an area in which the Liberal Party certainly has recognised the problem and about which, by its policy, it would do something. I have not seen any constructive suggestion coming from the Labor Party as to how this sort of problem will be overcome.
As far as the problem in the suburban areas of Melbourne is concerned, I believe that this is the sort of situation in which the principle of a community health centre could be applied. I think that this is a similar sort of case to that existing in Elizabeth in South Australia, an area of the State which is under-doctored. I think that firstly we should be looking towards the establishment of a fee-for-service community health centre staffed by doctors and supported by adequate back-up facilities in the paramedical areas. I believe that the Bills before the Senate are not in the best interests of Australia. Therefore, I oppose them.
– Before I call on Senator Wheeldon to close the debate, I remind honourable senators that the Health Insurance Bill 1973 and the Health Insurance Commission Bill 1973 have been dealt with in a cognate debate. Unless otherwise ordered, after Senator Wheeldon has concluded his remarks, I will proceed to take votes on the measures separately.
– in reply- I did not agree with a great deal that Senator Hall had to say tonight. But there was one thing with which none of us could really disagree and that is that what is going on tonight is largely a symbolic discussion. We all know very well where we stand, whether we be new senators, old senators or middle-aged senators.
– I am not old.
– I was not suggesting that the honourable senator was old. I would classify the Leader of the Opposition (Senator Withers) as middle-aged. We have all heard the debate. It has been going on since 1968 when this proposal was first included in the policy of the Australian Labor Party. We debated it during the 1969 election campaign when we were defeated and the Liberal and Country Parties were re-elected. It was debated in 1 972 when we were elected. The people of Australia knew what it was that we were putting to them in that election. The matter was debated from the end of 1972 through to May 1974 when another election was held. The people of Australia knew very clearly what Labor was putting to them. They voted overwhelmingly for the policies of the ALP and our policies regarding a health insurance scheme which is the subject of the 2 Bills that are before us tonight.
I agree with Senator Button in what he so correctly said about every one of the 6 Bills which were the subject of the double dissolution. When each of the Bills comes before the Senate, an Opposition senator says that the Government does not have a mandate for that Bill. We are still waiting with bated breath to find out which is the Bill for which we have a mandate. Certainly, all of the 6 Bills which were the subject of the double dissolution were very clear to the people of Australia when they voted. They knew what the election was about and they returned Labor to government on the very question of whether those 6 Bills should become law. That is the matter upon which they voted. Now, we hear from the Opposition that we do not rely on an election, even if it was held only 2 months ago and even if it confirmed the result of an election which was held 1 8 months before that. What do we rely on? The Opposition tells us that we rely on gallup polls and some articles in the ‘Canberra News’ and the London ‘Times’ which have been presented to us by Senator Jessop. Apparently, this is the evidence.
We do not choose to rely on either the ‘Canberra News’, the London ‘Times’ or the gallup polls. We rely on the elections which were held in May when we presented these policies and when we won. We are here to carry out the policies of the Australian Labor Party and we are here to carry out the will of the Australian people who put the Australian Labor Party into government in order to carry out the policies for which they voted.
I think that it is rather curious that we should be told tonight of the dire fate which awaits us if we adopt a scheme of national health insurance. We are told about the appalling standards of medical practice, the dire distress, the anguish and the suffering of those unfortunate countries in which there is a scheme of health insurance. What are these sad, unfortunate lands about which we have heard so much? They include
Scandinavia, Finland, the Netherlands, France, West Germany, Austria, Great Britain, Canada and New Zealand. We are told that these are the sad countries where people are sick and miserable because they have the misfortune to live under a scheme of national compulsory health insurance.
Unfortunately, we have not been told about any of those countries where the people are thriving in radiant health because they do not have health insurance and because they rely on a completely free medical scheme. I am surprised that Senator Baume, Senator Townley or one of the other Opposition senators did not tell us about the wonders of medical services in the Philippines, Thailand, Uganda, the Central African Republic and those countries which have the sort of medical service which Opposition senators would like the Australian people to have- that is to say, no health insurance and medical services completely in the hands of private enterprise. I challenge the Opposition to compare the standards of health in those countries which have a national health insurance scheme with the standards in those countries which do not have a national health insurance scheme. I believe that the result is evident to us now without even making such a comparison. The standards of health in Scandinavia and Western Europe are infinitely superior to those in Uganda, the Central African Republic and the Philippines- those countries whose health schemes have gained such admiration from honourable senators opposite tonight.
I would like to deal in detail with some of the matters that have been raised, particularly those raised by Senator Guilfoyle. Senator Guilfoyle represents the shadow Minister for Social Security in the Senate. She explained to us in some detail how iniquitous it is that there should be a form of compulsory -
– She did it very well, too.
-Yes, she did it very well I must say that she made the best of a very bad case. Senator Guilfoyle has told us how tragic it is that the rights of the Australian people should be taken away from them in order that they should engage in compulsory health insurance, ls she arguing that compulsory insurance in toto is to be condemned? Are Senator Guilfoyle and the Liberal Party saying that there should not be compulsory third party insurance, that there should not be compulsory workers compensation insurance? I do not know. I have never heard the Liberal Party advocating that. Why do not its members advocate that? Because the people of Australia are used to compulsory third party insurance. They know how compulsory third party insurance works, with all its faults, and they know how compulsory workers compensation insurance works, with all its faults. The people of Australia, knowing the ogre of compulsory insurance about which they have been told by our conservative opponents and having lived under it, would never dream of going back to a state of affairs in which there was voluntary third party insurance or voluntary workers compensation insurance. In the same way the people of Western and Northern Europe who have had the experience of national health insurance schemes would never dream of abandoning those schemes.
Has anyone ever heard of the Christian Democrats of West Germany saying at any stage that they would abandon their scheme of national health insurance? Of course they would notbecause the Christian Democrats, the conservative party in West Germany, introduced the compulsory national health insurance scheme. Did the Conservative Party in Great Britain or even Enoch Powell or the late Major Sir Henry LeggeBourke in their wildest moments ever say that the British health scheme should be dismantled? Of course they did not. Why does the Liberal Party in Australia take this position? It takes this position because, as we all know, it is so far to the right that it makes Enoch Powell look like a Trotskyite. There are at present living in Australia one million people who are not members of the voluntary health insurance schemes which exist in this country. There are a variety of reasons, no doubt, why they do not join the present voluntary health insurance scheme. Whatever the reasons may be, the Australian Labor Party believes it is a gross injustice to these people. It is a gross distortion of the social welfare of the country that approximately one-twelfth of our people should be deprived of the medical benefits which we believe are the right of every citizen. We do not deny that it is integral to the policy of our Party that the provision of adequate health services for all citizens and residents of this country is a right to which all those citizens and residents are entitled whether they have or have not joined some voluntary organisation or whether their parents or the people of whom they are dependants have joined such an organisation.
Conceding that, we believe that the only way and the fairest way in which such provision can be made for the health of the Australian people is a system of compulsory national health insurance. I am pleased that Senator Steele Hall, despite the remnants of his earlier days in the Liberal-Country League, at least has gone sufficiently far on this matter to acknowledge, unlike his more troglodytic colleagues on the Opposition benches, that it is essential that there should be a system of compulsory national health insurance.
-He is having two bob each way.
– I do not think that Senator Young should reflect on Senator Steele Hall in this way because up till now the Opposition has got his vote.
– No- the Government has.
-No, not on this measure. The Opposition has Senator Steele Hall’s vote on this.
– How did we get it?
– The honourable senator was not listening. I hope that Senator Steele Hall and all fair minded people will note that even though Senator Steele Hall is voting against us, I am the essence of politeness in my remarks while nothing but rudeness is coming from his former colleagues on the Opposition benches. However, I would like to deal with some of the specific matters raised by Senator Guilfoyle, as I think they warrant a reply. Senator Guilfoyle has asked for an undertaking that the provisions in clause 24 (3) would not deprive patients of private psychiatric hospital care and benefits for such care. The effect of the provision in clause 24 (3) (a), which states that certain premises used for the care or treatment of mentally ill or mentally defective persons shall not be approved as hospitals for the purposes of hospital payments, is the same as the provision in the definition of ‘hospital’ in section 4 of the existing National Health Act. The purpose of the provision in the National Health Act is to preclude State mental health institutions from being approved as hospitals and this is the purpose of the provision in clause 24 (3) of the Bill now before the Senate. Private psychiatric hospitals currently approved as hospitals under the National Health Act will be eligible for approval as hospitals under the provisions in the Bill before the Senate. The $16 occupied bed day payment will be made to all approved private hospitals, including private psychiatric hospitals and, where patients in these hospitals are privately insured, treatment in such hospitals will attract private insurance benefits. Private insurance contributions will continue to be allowable taxation concessional deductions.
Another point on which Senator Guilfoyle asked for an explanation related to clause 33 of the Bill. Senator Guilfoyle gave the opinion that the effect of clause 33 would be to cause all private hospitals to become financially unviable. Clause 33 provides for an Australian Government payment to all approved private hospitals of $16 per occupied bed day. As this matter has been raised by Senator Guilfoyle, I think it is appropriate that we should look at the record of the previous Government in which, unfortunately, Senator Guilfoyle was not a Minister. That Government possibly would have survived longer had she been a Minister. However, she was a back bencher. The previous Government’s record with regard to payment to private hospitals, if I may give this recent summary of its history, is that on 1 January 1958 Commonwealth hospital benefits for insured patients were last increased and this was to the existing amountthe amount which exists right up to this very day- of $2 a day. At that time public ward fees in public hospitals were approximately $3.60 a day.
By September 1972 public ward fees had risen to about $15 a day, but the previous LiberalCountry Party Government retained Australian Government assistance at $2 a day. In 1958 private ward fees varied as between States, but if I can take the examples of the most populous States of New South Wales and Victoria, in New South Wales the fee in public hospitals was $7.20, and in Victoria it ranged from $6.50 to $9. By September 1972 these fees had risen to $26.30 in New South Wales and $30 in Victoria. Again, the Commonwealth benefit provided by the Liberal-Country Party Government, the remnants of whose supporters are sitting opposite, was $2 a day, the same as it had been in 1958. Under the health insurance program of this Government- the Government of the Australian Labor Party- this payment of $2 a day which lasted from 1958 to 1972 under the Liberals and the Country Party will be increased to $16 a day. One of the effects of this increase in the rate of the Australian Government payment -
– What are the costs?
-What are the costs? Senator Guilfoyle says that we are not raising the payment; I say we are raising it; and now Senator Baume says: ‘What are the costs?’ This is the catch 22. First, the Opposition says that we are not giving enough and then when we say ‘We are giving more than you gave’, Senator Baume says That is wrong. What are the costs?’. Apparently, according to the analysis that Senator Baume is offering us, whatever we do is wrong. If we do not increase the payment, it would be too low; but when we do increase it the honourable senator asks: ‘What are the costs? Where is the money coming from?’ It is going to come from the same place which, as Senator Poyser reminds me, the money came to send conscripted Australians to Vietnam. That is where the money is going to come from- from exactly the same place. I find is so terribly interesting. I am glad that honourable senators opposite have reminded me of it. Those honourable senators opposite who are so opposed to conscription say, in effect: ‘What a shocking thing conscription is. Imagine conscripting these doctors’.
– What about the communist states?
-Senator Webster has reminded us of the communists too. We have not heard him on that for a long while. (Honourable senators interjecting) -
– Order! The Minister must be heard in silence.
-Thank you, Mr President. It is gladdening to see that in a changing and impermanent world some things never change- and one of them is Senator Webster’s interjections. One of the effects of the increase in the rate of the Australian Government payment will be that the rates of benefit for which people will be required to insure privately will be markedly lower than those for which they would need to insure if the existing payment of $2 a day were to continue. I fail to see, and I think we would all fail to see, how this action could endanger the financial viability of private hospitals. The argument is, as I understand it from what was said by Senator Guilfoyle, that somehow the financial viability of private hospitals is endangered by our scheme. Yet it is our proposal to increase the amount paid from $2 to $16. If that is how you damage someone’s financial viability I only wish that my own financial viability could be endangered in such a way.
Another aspect of the provisions of the Bill which relates to private hospitals, which was raised by Senator Guilfoyle, is that clause 34 of the Bill will cause a loss of autonomy for religious, charitable and community hospitals. It is in the area of the provision of hospital treatment by private, religious, charitable and community hospitals that the Government has, most clearly of all, expressed its appreciation of the very important contribution which has been made by the private sector. The Government has no intention of endangering the role played by such hospitals or of interfering with their autonomy of management and of administration.
What the Bill before the Senate does offer to these hospitals is the opportunity to participate in the program by accepting patients for free accommodation and treatment in return for which the Government will make additional payments designed to take account of fees lost and any additional expenses incurred. I have to repeat that a decision by a hospital to participate in the special arrangements would be completely at the discretion of the hospital itself, and throughout the currency of such arrangements the individual hospitals would retain absolute autonomy over all management and policy matters such as the policies it adopts towards admission and treatment.
- Senator Webster has not read the Bill.
– I do not think he has. The aim of the provisions contained in clause 34 of the Health Insurance Bill is to provide a continuing and in some respects expanded role for the religious, charitable and community hospitals, and to ensure that the contributions made by the dedicated staff of these hospitals is not lost.
Senator Guilfoyle addressed herself to some other clauses of the Bill. She said that clauses 30 to 32 of the Health Insurance Bill had the effect of placing State hospitals under the direct control of the Australian Government. Clauses 30 to 32 of the Bill relate to State governments entering into agreements with the Australian Government and the heads of these agreements are spelt out in schedule 2 of the Health Insurance Bill, which is one of the Bills which are now before us. Under these agreements the Australian Government will meet 50 per cent of the net operating costs of public hospitals, and the $16 per occupied bed day payment will form part of this 50 per cent. This cost-sharing arrangement will considerably improve the financial position of State public hospital systems and will place the financing of these systems on a stable basis.
It is true that certain objectives of the Australian Government will also be achieved through these agreements. For example, the agreements will enable free standard bed treatment to be made available to all people regardless of means with medical services being provided to standard bed patients by doctors paid on a salaried sessional basis. However, the provisions of the Health Insurance Bill and the agreements cannot be construed to mean that the Australian Government will be placing State hospitals under the direct control of the Australian Government.
Senator Guilfoyle has quoted to us; and this matter has already been dealt with very largely by Senator Button- the report by a firm of actuaries in Melbourne on the estimated costing of the proposed national health insurance scheme. I do not want to dwell on this matter because it seems to me to be rather profitless in debates like this to discuss reports made by actuaries. But there are a couple of things I would like to say about this matter. With very becoming modesty Senator Guilfoyle did not name the firm of actuaries which prepared this report. Nor did she tell us who commissioned the report. As it happens we know that the report was prepared, as Senator Button has told us, by E. S. Knight and Co. of Melbourne, and it was commissioned by the Australian Medical Association. The document which was previously published, I think last year, and which was referred to this afternoon by Senator Guilfoyle is part of a much larger report. I think that is all I want to say about this actuarial report. I could argue that it would seem from the information that we have that to a great extent the alleged facts, the data which were given to the actuaries in making their assessment, were inaccurate or incomplete. As I have said, I believe it would be pointless for the Senate to debate an actuaries ‘ report. However, I would challenge the Government to produce at some stage the whole of the report and not just the document which is an extract from that report.
– You mean the Opposition, not the Government.
– You make a few mistakes, Mr Minister, but not too many.
– I said the Government did 1. 1 beg your pardon. We do not have the report to produce. I would ask the Opposition to produce the whole report and include in the report the data which was given to the actuaries, because having little bits and pieces and a few snippets which appear in a document like this, without knowing the data and without knowing the basis of calculation, it is completely useless to make any sort of assessment on a serious matter of this kind. But as the matter has been raised and some sort of extrapolation has been done, in a rather crude way if I may say so, by Senator Sheil, and in a somewhat more sophisticated way by Senator Guilfoyle, of the estimated increases in costs of the National Health Insurance Bill which is now before the Parliament and which the Australian Labor Party hopes will be adopted, I think it may be salutary to look at some of the increases which have taken place in hospital charges under the existing scheme. I am not referring to the new scheme but just to the same old scheme we have always had.
If we take New South Wales as an example we find that in public wards the fee was fixed on 1 August 1971 at $15. On 1 August 1974, 3 years later, it was fixed at $22.50. This is an increase of 50 per cent in 3 years. In the case of Tasmania, which Senator Townley misrepresents in this chamber, we find that on 1 January 1973 the fee was fixed at $18 and on 1 October 1974-1 year and 9 months later- it was fixed at $30 which is an increase of 67 per cent. Therefore under the existing scheme there has been an increase in Tasmania of 67 per cent in a little over a year and a half. One can well imagine what the Opposition and its tame actuaries would be saying to us if they were able to justify with all of their extrapolations and all of the figures that they have been plucking out of the air and giving to us tonight that there was going to be an increase of anything of the order of 67 per cent in hospital costs in a period of 18 months under our scheme. Yet this is what has happened under the existing scheme.
We have debated this Bill at very considerable length. The people of Australia are familiar with the issues which are involved in it. The people have been asked on 3 occasions what they thought about this Bill. On the first occasion in 1969 they rejected the Australian Labor Party and elected, as they soon found to their cost, a Government composed of the Liberal-Country Parties. In 1972 and 1974 they elected the Australian Labor Party. The elected us here to carry out our policies We have our policies. We are not here merely to sit on this side of the President’s chair. We are here to make substantial changes in the society, to the benefit of the people whom we represent and to the benefit of all of the Australian people. We are a Party of major social change. That is what we are proud of. That is why the Australian Labor Party came into existence. That is why we are introducing these Bills. The Bills that are before us at present are modest Bills. They are Bills which have the support of the Christian Democrats of western Europe and the Conservatives of Great Britain. The Bills very closely approximate to the national health insurance scheme in New Zealand. That country’s own conservative party, the National Party, never would have dreamed of dismantling that scheme.
All that we are doing tonight is introducing the sort of measure which any half-enlightened twentieth century conservative party would have introduced 30 years ago. We are saying tonight that we are determined that the people of Australia, in order to suit the interests of any group with vested interests, will not be denied the good health and the health service to which they are entitled and which the Australian Labor Party is determined to see that they will have. I commend the Bill to the Senate.
That the Bill be now read a second time.
The Senate divided. (The President- Senator the Hon. Justin O’Byrne)
Question so resolved in the negative.
Consideration resumed from 11 July (vide page 104), on motion by Senator Wheeldon:
That the Bill be now read a second time.
The Senate divided. (The President- Senator the Hon. Justin O ‘Byrne)
Question so resolved in the negative.
Debate resumed from 11 July (vide page 107), on motion by Senator Wriedt:
That the Bill be now read a second time.
-This Bill is now before the Senate for the third time. As the Minister for Agriculture (Senator Wriedt) pointed out in his second reading speech, the Bill has been presented to the Senate on this occasion because, in the opinion of the Government, it is one of the Bills on which the Government sought and obtained a double dissolution of the previous Parliament. If this Bill is rejected by the Senate on this occasion, the Government will seek a joint sitting of the 2 Houses of the Parliament to deal with it and the other Bills we have debated this week.
This Bill was introduced, and debate commenced on it in the Senate, on 1 3 December last year. On that occasion I spoke on behalf of the Opposition and stated our major objections to the principles of the Bill. Those objections remain, the Bill being in exactly the same form as it was at that time.
In the course of my remarks on this Bill I propose to restate those objections and also to deal with some of the newer arguments which were presented by the Minister in his second reading speech. Before I do that, Mr President, I wish to place on record on behalf of the Opposition our very grave objections to this Bill being introduced into the Senate or indeed, into the Parliament, in the manner it has been introduced and for the purpose for which it is being introduced. The Government, having presented the Bill and advised the Governor-General that it was the basis for a double dissolution of Parliament, now presents it again. If it is rejected, as I trust it will be, the Government will claim that that rejection is a ground for a joint sitting and that the Bill should be presented at a joint sitting.
Our objections to this procedure on the part of the Government are based on our very firm belief that the way in which this Bill was dealt with in the Senate on previous occasions gave no ground whatsoever for the advice which the Prime Minister (Mr Whitlam) apparently gave to the Governor-General when he sought a double dissolution. Apparently the Prime Minister intends to repeat that advice in regard to a joint sitting. We believe that the way in which the Government has treated this Bill, the way it has treated the Senate and the way it proposes to treat the Senate in relation to this Bill, raises matters of the highest constitutional importance. In order to put on record the views of the Opposition in regard to these matters of great constitutional importance I move the following amendment to the motion for the second reading:
Leave out all words after’That’, insert:
1 ) ‘this Bill should be withdrawn and redrafted as a new Bill, because the Senate is of the opinion that it should not have been submitted to the GovernorGeneral by the Prime Minister as a ground for the double dissolution of Parliament on 11 April 1974 and should not now be introduced into the Parliament as the possible basis for advice to the Governor-General that he should convene a joint sitting of the Senate and the House of Representatives, for the following reasons:
On 13 December 1973 the Bill was introduced into the Senate and read a first time.
On the same day, which was known to the Senate at the time to be the last sitting day in 1973, the motion was moved for the second reading of the Bill, the debate was adjourned and the resumption of the debate made an order of the day for a later hour of the day.
Later on the same day, during the second reading debate, a non-Government senator, Senator
Byrne, for reasons referred to in his speech, successfully moved that the debate on the motion for the second reading be adjourned and that the resumption of the debate be an order of the day for the first sitting day in February 1974- the next anticipated sitting day of the Senate.
Approximately one and a half hours after that event, on the motion of the Leader of the Government in the Senate, the Senate adjourned to a day and hour to be fixed by the Presidentexpected to be a day and hour in February 1 974.
On 14 February 1974 His Excellency the Governor-General, acting upon the advice of the Government, prorogued the Parliament until 28 February 1974, by which action all Bills on the Senate notice paper lapsed.
The Standing Orders of both Houses provide for Bills which have lapsed as a consequence of prorogation to be proceeded with in the subsequent session, and if a Bill is in the possession of the House in which it did not originate it can be restored to the notice paper at the stage which it had reached at the date of prorogation, provided a message has been received from the House in which it originated requesting that its consideration be resumed.
On 12 March 1974, the fifth sitting day of the new session, a message was received by the Senate from the House of Representatives requesting the Senate to resume its consideration of the Bill.
Upon receipt of the message, the Leader of the Government in the Senate moved that the request be complied with, to which the Senate agreed, without debate or dissent, on 1 3 March.
On 19 March the Senate resumed the debate on the motion for the second reading of the Bill and, on 2 April, the motion was defeated.
On 8 April 1974-3 sitting days after the defeat of the Bill on 2 April- the Bill was again received by the Senate from the House of Representatives and the Senate deferred the Bill for 6 months on 10 April 1974.
The events in (i) to (x) above reveal that the relevant requirements in section 57 of the Constitutionthat the Senate should reject or fail to pass a proposed law on 2 occasions, separated by a period of 3 months- have not been met in either respect, particularly in view of the Government’s specific request, on 12 March 1974, for the Senate to resume its consideration of the Bill at the state it had reached on 13 December 1973- the debate on the motion for the second reading of the Bill; and
The terms of this resolution be forwarded by the President to His Excellency the Governor-General forthwith.
– In conformity with the sessional order relating to the adjournment of the Senate, I formally put the question:
That the Senate do now adjourn.
Question resolved in the affirmative.
Senate adjourned at 10.31 p.m.
Cite as: Australia, Senate, Debates, 18 July 1974, viewed 22 October 2017, <http://historichansard.net/senate/1974/19740718_senate_29_s60/>.