Chapter 8 - Relieving the Patient, Not the Doctor: the Hospital Benefits Act

Summary

As the central point of the system of health care and its single most expensive item, the integration of the hospitals into the new health service would be central to its success and cost. Nowhere were the limits that the Chifley government imposed upon its health policies so manifest.

The Commonwealth government was faced with the task of developing policies subtle enough to achieve the major objective of increased equity of access, while general enough to apply to each of the very different state systems without causing financial chaos. Two major options were canvassed during the wartime debates over policy. The NHMRC and JPCSS reports had advocated the direct involvement of the Commonwealth, using control of the public hospitals as the basis for an integrated national health service. This would require a massive injection of central funding to expand bed capacity and construct a centralized, hospital-based medical care system. It could be achieved either directly, by the constitutionally difficult road of a Commonwealth takeover of the state hospital systems, or by grants-in-aid to the states, with strict conditions on their use. The second possibility was to accept the prevailing structure of the health system as given and merely improve access to services, reducing the financial burdens of serious illness. This option of income support was adopted as the basis of the hospital benefits scheme.