WHO PAYS ?

Auckland Star, Volume LXX, Issue 107, 9 May 1939, Page 10

WHO PAYS ?

MATERNITY FEES. SERVICE CONTRACTS. LIST BEING PREPARED. BONUS SYSTEM STRESSED. While thp Brit i*h Medical Association officially maintains its absolute refusal to recommend i members t'> enter into contracts with tho < iovernnient. to give medical services in relation to maternity benefits under thp Social Security Act, the Minister of Health, the Hon. P. Frascr, ii nnoiiiii'i'il in Wellington yesterday th.it, maternity benefits would be avnilnbh Monday. 'lot h the o Ulcers of the British Medical Association in Auckland and the maternity hospital licensees declared today tli.it they knew nothing of any new arrangement, hut, it was learned from a reliable source that a list of niodical practitioners and proprietor* of maternity hospitals who had signed the contractu, was now being prepired and would he published later in tne week. According to a I'ress Association telegram from Wellington received to-day, the Minister of Health anuoiinced that arrangements for the completion of contract* with licensees of private hospitals, medical practitioners and obstetric nnines ha<l progressed sufficiently for him to determine the date on and after which maternity benefits would bo available. "This commencing ilato is Monday, May 15," added Mr. F raser. Carrying On. From several sources it was learned that whilo the maternity doctors were not signing contracts, they had agreed to carry out the medical services required under the Act, and thin is in harmony with the official announcement ] of the R.M.A. when it was decided not to accept contracts with the Government. This raises the question of how payment in to be made to tho medical practitioners for tho ecrviecs they render. On the one hand, the fee for the service rendered will bo a legal debt; on tho other hand, if the maternity benefit becomes operative as from next Monday tho patient must reap tho benefit, an<l is not likely to think herself concerned with the question of payment. The doctors will have to look to the Social Security Fund for their fees and not to tho patient, unless there is an alteration to tho law later on, giving tho patient tho right to collect from the Government and the doctor the right to collect from the patient. A family- doctor with an extensive practice said to-day that lie could only interpret tho Minister's statement that tho maternity benefit would come into operation next Monday as meaning that the CiovCrnment was falling into line with tho views of the U.M.A., and that the fees would bo paid to the patient, who would bo freo to make her own medical arrangements. '"I can see no other meaning to his words," he added. "If he is about to lssu«f A list of medical practitioner* and ho4f>ltals which will sign the contracts it will bo an exceedingly meagre one, and will not fill the bill a* far as maternity services are concerned." Maternity Bona* Other doctor* endorsed this view. They are of the opinion that the payments out of the Social Security Fund should be paid in cash to the parents of the child and regarded as a maternity bonus. This would leav* the patient free to choose the doctor. It was explained, however, that the Government fee would not necessarily be the total sum collected from the patient, the medical attendant being left free to charge an additional amount according to the circumstance*. One doctor said that in some instances a second opinion was required and there was no provision tinder the Act for the additional payment which would have to come out of the pocket of the doctor who consulted him, or arrangements would have to be made with the patient for the amount. "The system of maternity bonuses in vogue in Anetralia works simply and there is no friction," said another practitioner. "Something on those lines should be attempted here Instead of tho compulsory system that the Government is endeavouring, to foist on to an unwilling medical service." Auckland Health District. The health district of which Auckland ta the centre extends to within a few miles of Whangarei in the north and to Mercer in tho south. In this area the number of births registered for tho year ended February 28 last numbered approximately fIOOO. Tho district contains 28 private maternity hospitals with 137 beds. At the Auckland Hospital about 100 complicated and emergency cases are treated annually. For the year under review 740 birth* were recorded at St. Helen* Hospital and 104 at the Auckland Hospital Board's cottage hospitals at Warkworth and Waiiikii. At the Salvation Army Home at Grey Lynn for unmarried mothers over 200 birth* were recorded for the year. By far the greatest number of birth* j takes place in private hom«s. I fn the district there are 231 medical practitioners, and of these 100 reside in the metropolitan area. I