THE PRESS FRIDAY, MAY 18, 1984. A medical cheque-up

Press, 18 May 1984, Page 12

THE PRESS FRIDAY, MAY 18, 1984. A medical cheque-up

The Minister of Health, Mr Malcolm, provides food for thought in the figures that he presents against doctors’ claims for an increase in the fees that they charge patients. According to Mr Malcolm, the average general practitioner would gross an extra $272 a week from a $2 increase and an extra $4OB a week from a $3 increase, even after allowance has been made for a “free” service to one patient in five. The additional gross income from the increases would be more than many people earn in wages. At a time when the incomes of most other people in the work-force have been restricted to an increase of $8 a week, the rise in income of the average G.P., even after meeting practice costs that may have risen, and after tax, would be a generous dollop of jam on his — or her — bread and butter. Many people in the community — probably the majority — believe that they have some unsatisfied grievance brought about either by the freeze on incomes itself, or by the timing of its imposition. The same people are also likely to believe that arresting prices did them a good turn. Doctors’ fees used to be adjusted between June and September each year in the light of their accounts for the year to the previous March. Because of the timing of the start of the freeze, only a few doctors had raised fees in June, 1982, to take account of the high inflation in the previous year. If doctors alone had been caught by the timing of the freeze, some extra sympathy might be felt for their plight. As it was, many people were stopped from making or seeking what they regarded as fair increases in charges or incomes. Most industrial organisations, for instance, used to go to collective bargaining in the latter part of the year. Most award wage increases that might have been sought on the ground of inflation in the months before June, 1982, were also blocked by the freeze. Tax adjustments did much to compensate for employees’ being deprived of hoped-for pay increases. The changes in tax rates helped the medical profession as much as other people on similar or lesser incomes. Where real hardship has been caused by the

controls on incomes and prices, or where circumstances have changed significantly, grievances can be met by procedures to accommodate proven anomalies. Doctors also have recourse to these remedies. Like many other people, doctors have had to absorb increases in their costs caused by increased prices for imports during the freeze. The cost in New Zealand of imported medical equipment has been rising, and the rules can be used to take care of these rises. Doctors cannot expect to stand apart from all other sections of the community. They, like everyone else, can fairly be required to substantiate their entitlement to a compensatory increase in income. A blanket increase — which, according to Mr Malcolm, has been providing some doctors with as much as $6OO a week in extra income — is not in keeping with the principle of reimbursing justifiable, and justified, additional costs. Mr Malcolm’s rejoinders should not be seen to apply to all doctors. Such evidence as has been offered points mainly to increases sought or applied by doctors in Wellington and Auckland, and to doctors already charging high fees. Nevertheless, his argument is valid. If professional fees, for doctors or other groups, are simply allowed to catch up what is said to have been lost as a result of the freeze, everyone else will have a strengthened case for substantial claims. Taken to its logical conclusion, such a policy would mean that all wages and prices must leap forward as though the freeze had never been. No-one would be better off. Inflation would be uncorked again. Emerging from the freeze will be a long process, not without pain. Adjustments have been made to some incomes, not all due to the effect of higher costs. If all these adjustments were to be repaired, the freeze might as well not have been borne at all. Doctors are not being asked to bear the pain of the freeze alone; they are not being denied the chance to recover whatever is justifiable. Quite properly, they have been asked to submit their case for higher fees to the same scrutiny that applies to the claims of the rest of the community. The request is reasonable.