GOVERNMENT PLAN

Ashburton Guardian, Volume 61, Issue 112, 21 February 1941, Page 3

GOVERNMENT PLAN

TO OPERATE FROM MARCH 1. REGULATIONS GAZETTED. INDIVIDUAL CONTRACTS. (Per Pres 3 Association). WELLINGTON, February 20. The Social Security Medical Benefits Regulations, 1941, were gazetted to-night. Benefits under the general practitioner scheme will be available from March 1. The regulations generally set out the scope of medical benefits to be provided—that is, medical services which can be provided by the ordinary practitioner. They do not include maternity benefits, which are already provided for, the administration of anaesthetics, for which a separate fee may be charged, or specialist/ services s Specialist services are defined as those which involve the application of special skill and experience of a degree or kind that general medical practitioners as a class cannot reasonably be expected to possess.. Before a general practitioner who claims to be a specialist in certain branches of medicine may charge his patient for the services which he .renders, he must first inform the patient that he proposes to charge' for those services, and, second, obtain the patient’s consent. Further, he cannot claim any specialist fee unless he complies with at least one of three conditions: (1) That he has held hospital or other appointments affording a special opportunity for acquiring special skill and experience of the kind required for the performance of the specialist services in question, and has had actual recent experience in the performance of service of a similar kind; (2) he has had special academic or post-graduate study of the subject that comprises the specialist services rendered, and has had actual recent experience in performing services of a similar kind; or (3) that he is generally recognised by other practitioners, who have direct personal knowledge of his work, as having special proficiency and experience in the subject or subjects that comprise the specialist services rendered by him. Procedure to be Followed. A patient who desires to take advantage of a doctor’s services must first procure an application card which he will complete and take to the doctor of his choice. If the doctor is willing, he will countersign the card and be responsible for sending it to the local. Medical Officer of Health. The signing of the card by the practitioner constitutes an agreement by him to attend arid care for the patient, and he is responsible for the free treatment of that patient from that date. In the case of children *a separate Pfltd is to be filled ill for each child on ft special children’s card The patient is required to notify the Medical Officei of Health of any change of address, and if he fails to do so he may be chained such amount as has been wrongly paid-to the doctor on whose lilt his name appeared. Practitioners who are prepared to

work under the scheme are required, to provide and maintain suitable surgery and waiting-room accommodation; to be in attendance for the consultation aiql treatment; of patients at his surgery or elsewhere at regular times to visit any' patient whose condition or health is such that it is impossible or inexpedient for him to visit the practitioner’s surgery; to visit anj. of his patients in hospital where the rules of the hospital permit and where the patient requires service which a general practitioner is capable of affording; to prescribe sijch drugs and appliances as may be required for the treatment of any patient; to issue free of charge medical certificates or recommendations required for the purposes of the Social Security Act; to keep clinical records of the history of his patients and his treatment of them; to answer all reasonable inquiries made by the Medical Officer of Health with respect to any prescriptions, certificates, or recommendations Avhich ho has issued. Supply of Drugs. Provision is also made that a doctor shall supply to the patient, in ease of emergency, such drugs as may be required, and in this connection he is entitled to claim the cost from the patient until pharmaceutical benefits have been provided, in which case lie will be paid from the Social Security Fund. The regulations detail the provisions which have to be made where a practitioner who has agreed to accept patients under the scheme employs an assistant or engages a-partner. Generally an obligation is upon a practitioner to give personally such benefits as lie has undertaken to do, “except where he is prevented from doing so by urgency or other professional duties, temporary absence from home, or other reasonable cause.” A medical practitioner is also, obliged to make all necessary arrangements foi securing the proper treatment of his patients in cases where li& is unable to give treatment personally. If he has any standing arrangement in this matter ’lie is- required to notify the Medical Officer of Health. A' doctor agreeing to care for a patient, who engages any deputy or assistant, is responsible for the compliance by that deputy with the iequireiiients of the regulations. Where two or more medical practitioners aie in partnership, treatment may at ary time be given by one or other of the partners to any patient on the list of the practitioner instead of by the practitioner in person, if reasonable steps are taken to secure continuity of treatment. Changing Doctors. The regulations also detail the procedure where a patient desires to shift from one doctor’s list to another, where a patient removes from one place of residence to another, or where a doctor desires to terminate all bis agreements under the act. In the latter case he must give three months’ notice of his intentions to do so. The regulations also make special provision for dealing with the case of doctors who are serving with His Majesty’s forces, either within -Now Zealand or overseas. Provision is made bore for a simpler method of transfer of patients from the list of the practitioner who is attending them to that of the doctor who returns to his practice. They also provide that where any person entitled to receive medical benefits desires to make complaint about the service rendered by tne practitioner of bis choice, the com-

plaint must be made in writing to the Medical Officer of Health, wlio may dismiss it as trivial, or submit it for decision to a special committee to be set up by the Minister. With the priftr consent of medical practitioners, the Minister may at any time publish a list or lists of names of medical practitioners who have entered into agreements under the regulations. Amount of Payment. pvery medical practitioner who agrees to provide medical benefits in accordance with the regulations is entitled to receive from the Social Security Fund for every person on his patient's list a capitation fee of 15s a year .This applies to every person on his list, including children. He is iequired to give all necessary medical care to those persons living within three miles ol‘ his surgery in consideration of the receipt of this sum. Arrangements are made for mileage. Instead of paying the doctor special mileage for each visit, the regulations provide that a doctor is entitled to an annual amount of 2s for each mile beyond three that a patient’s residence is distant from the doctor’s surgery. In no case will mileage be paid beyond 20 miles from a surgery. It is further provided that in cases where a doctor is required to travel more than 20 miles he may charge a mileage fee from the 20-mile limit to the patient’s home, and this is recoverable from Ihe patient. It is expressly set out that nothing in the regulations affects the Minister’s power, conferred on him by the Social Security and Finance Acts, to make special arrangements in connection with certain areas or certain classes of persons.