Govt, doctors to talk

Press, 3 July 1985, Page 1

Govt, doctors to talk

By

PATRICIA HERBERT

in Wellington The Government can “talk legislation” when it meets the Medical Association to negotiate a new child benefit structure, according to the Minister of Health, Dr Bassett. The old scheme, introduced on February 1 and put in abeyance when the High Court ruled it invalid last Friday, gave doctors the option of joining or not joining but had a potential universality of application. It was this aspect that Mr Justice Vautier took issue with. He ruled that Dr Bassett had exceeded his authority under the legislation used, section 117 of the

Social Security Act. This provision would not apply were a separate law to be enacted. The Cabinet, on the advice of the Attorney-Gen-eral, Mr Palmer, has decided that Mr Justice Vautier’s decision is not correct and has lodged an appeal against it. Until that is heard, however, it will respect the ruling and has signed a special temporary arrangement to protect the 487 doctors and 200,000 children covered by the original and now defunct deal. Dr Bassett announced the details at a press conference yesterday and said the new conditions took account

of Mr Justice Vautier’s finding and that he believed they would “hold” legally. The important difference is that the schedule for the interim scheme applies only to the 487 doctors who were party to the first one. Their names are listed, forms will be sent to them this week and they can sign up.

Dr Bassett said it was within his power to add new names to the list but that the subsidies would be paid out only to those listed. They would not be available to the medical profession at large. He emphasised that the new scheme should not be confused with the old and itemisbd the points of departure. They were: • That it was directed to a specific group; at present the 487 doctors, many of whom practised in needy areas such as the West Coast of the South Island. • That it had nothing to do with the general medical services benefit and did not attempt to alter the Social Security Act. • That no committees would be established to adjudicate fees. • That the payment rates were higher. The State benefit had been raised from $9.50 to $10.25 on top of which the doctor could charge $4 instead of $3, the previous maximum. The

new figures were announced in the Budget and were to have been effective from August 1 but have now been brought forward. • That participating doctors would not be required to post their fee structures on the waiting room wall. But these measures are intended only as a stop-gap solution. Dr Bassett said the Government thought it important that parents could afford to take their children to the doctor as and when it was necessary and that he would this week meet representatives of the Medical Association to negotiate a new scheme for all doctors. Until that was achieved, the subsidies would not be available to all parents, he said. The sticking point to agreement last time was that Dr Bassett wanted some form of guarantee that doctors would not raise their charges so that the benefit to the public was “gobbled up.” He said yesterday that the Cabinet was firmly behind him in pushing for a guideline on fees and indicated that he would again insist on it in his negotiations. “In the last analysis, if the Government is paying a very significant amount of money for a particular purpose it has a responsibility to the taxpayers to see that

the social purpose behind that spending is achieved,” he said. “That is really all we are asking for ... but it is taking some time before doctors concede the point that he who pays the piper calls at least some of the tune and has the right so to do.” Dr Bassett said the State would pay about 75 per cent of child consultation fees if a new scheme was negotiated and that this would represent $5O million a year, compared with $36 million at present. Asked if he expected toachieve agreement with the medical profession this time, Dr Bassett said he hoped so and indicated that he did not want to resort to compulsion. “One of the reasons 1 came unstuck is that we made it (the original scheme) available to doctors to join if they wanted or not. We provided an option and, in the event, 75 per cent decided not to join,” he said. “We could have deemed under legislation that that was the situation and they would join. We did not want to do that and we still do not want to do that, and that is why I will meet the Medical Association on Friday to see if we can come to a mutually agreeable arrangement,” Dr Bassett said.