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One Voice: Pharmaceutical Benefits Scheme

The first clash between them subsumed whatever debate had been taking place over the NHMRC and Joint Committee reports, and it had profoundly significant consequences, setting off huge problems for the Government that it never resolved before it was defeated six years later.

It was fought over the Pharmaceutical Benefits Scheme. This proposed that medicines would be provided free at the point of service on a doctor’s prescription. It also proposed a number of close instructions for doctors using the scheme, including that they must use the prescription forms provided by the Government. The Government was reported to be confident that the legislation it would present to set up the scheme would not have any constitutional problems.

The BMA did not disagree in principle with provision of free prescribed medicines but it maintained that it was not the Government’s responsibility to decide which medicines should be included on free lists or how doctors should write out prescriptions. Sir Henry Newland said that the scheme would inhibit doctors in prescribing what they judged to be the most suitable medication for their patients. The BMA also challenged the advice by Attorney-General Bert Evatt that the legislation was constitutionally sound. Notwithstanding the BMA’s reaction and advice, the enabling legislation was passed by the Parliament in April 1944.

It was immediately rejected by Federal Council. The arrangements for it had been clearly well organised before the doctors who would run the scheme, or indeed anybody outside the Government, had seen any of its detail. The formulary of medicines for which it provided was discriminatory. Doctors would not be able to prescribe medicines that were the most suitable for their patients. Not only that but it was also identified as the Labor Party’s first legislated step towards a socialised and nationalised health service, as foreshadowed by Senator Fraser.