FEE FOR SERVICE

Auckland Star, Volume LXXVI, Issue 237, 6 October 1945, Page 7

FEE FOR SERVICE

MEDICAL BENEFITS

ALLEGATIONS OF ABUSES

Parliamentary Reporter.

WELLINGTON, this day.

The Government was seriously considering whether the fee for service medical benefit under the social security scheme was to be continued because it had been abused, stated the Minister of Health, Mr. Nordmeyer, in the House of Representatives yesterday. He revealed that there would be discussions with the British Medical Association next week. That question and several others relating to medical services and prescriptions came up during the discussion yesterday of the Health Department's estimates.

Mr. Acland (Nat., Temuka) asked the Minister what action he was taking in respect to some of the misdemeanours taking place among doctors and patients. Cases were heard of, he said, of doctors making money from social security by going out on calls which were not essential and cases that were not genuine had been heard of.

The Minister replied that the question of disciplining doctors for overvisiting was difficult because it was tremendously hard to prove it. If a doctor said a patient required his services, it was difficult to prove that he was not justified. It was really a matter for the doctor's conscience.

Mr. Langstone (Goyt., Waimarino): If there was not 10/ or 7/6 attached they would not do it. ,

"I am bound to say," continued Mr. Nordmeyer, "that abuse of the fee for service medical benefit is causing the Government seriously to consider whether that system should be continued. Discussions are being held with the British Medical Association next week. There has been a disinclination to have discussions. Diplomatic relations were broken off but they have now been resumed."

The Leader of the Opposition, Mr. Holland: What was the cause of the breaking off?

The Minister: The doctors took up the attitude that the Government, in introducing the scheme in 1941, was doing .something inimical to their interests. Now they are taking a different view.

Renewal of Referring to suggestions that there had been over-prescribing of medicines, the Minister said that the doctors themselves were the only ones to decide whether a patient required certain prescriptions. If doctors, in the interests of their patients and in the public interest, told them they did not need medicine—

Mr. Acland: They would go to another doctor.

Mr. Poison (Nat., Stratford) remarked that patients who needed further prescriptions had to go to the doctor for a renewal and there was another fee.

The Minister replied that, on the other hand, it might be more costly if there was a renewal of prescriptions without medical authority. Some doctors, he added, did overprescribe and some prescribed unnecessarily expensive ingredients. Part of the increase in the drug expenditure was due to the widening of the pharmacy benefits and the introduction of proprietary lines in the hormone field. There had also been a general increase in the cost of drugs. The Health Department had been taking measures to deal with doctors whose prescriptions indicated that they were prescribing unnecessarily expensive ingredients, or over-prescribing, and an improvement had been effected in many cases.

Mr. Poison suggested that the wastage of funds was obviously causing concern to the Government, but it was not fair for the Minister to blame the doctors, who were endeavouring to administer the Act on the lines laid down by the Government. (Government members dissent.)

Mr. Thorn (Govt., Thames): They charge the fees and collect the money. Mr. Poison: Fees the Government prescribes. Mr. Clyde Carr (Govt., Timaru): They are . driving a coach and six through the Act. Mr. Poison suggested that when a service became free, a greater number took advantage of it.

Mr. Morton (Nat., Waitemata) entered a protest against any suggestion that the doctors were not doing their work to the best of their ability. Never before in New Zealand had the medical profession been so entirely and utterly overworked as at the present time.

Mr. Armstrong (Govt., Napier) said that from his experience in his electorate he thought the doctors were to be congratulated on the wonderful service they had given during the past five or six years. Mr. Nordmeyer said he agreed with Mr. Poison that there was too much hospitalisation. It had been the Government's objective to ensure that all people who could be treated at home were so treated, and it was thought that the fee for service system would encourage that, but that aim had not materialised.