Maternity fee offer gives doctors $4 more

Press, 30 August 1985, Page 3

Maternity fee offer gives doctors $4 more

PA Wellington Doctors have been offered an almost $4 increase in the maternity benefit, under a proposed new fee scale. The Health Department told the Maternity Benefit Tribunal yesterday that it had worked out the proposed new scale on behalf of the Minister of Health, Dr Bassett. The proposed scale meant that doctors would receive $2O for the first antenatal (before birth) consultation, and for the nine antenatal consultations after that they would receive $lO a visit. At the moment the fee for all antenatal consultations except the first one is $6.18. The director of the department of clinical services, Dr John Phillips, said the total fee for all antenatal and post-natal consultations would come to $320.50.

However, there was a bonus payment of $29.50 for doctors who provided total care before and after birth, including the delivery. The delivery fee would be $l3O under the proposed scale, while doctors would get just over $BO for postnatal consultations. The total fee for doctors who did all maternity care would come to $350 a patient. Dr Phillips said the proposed new fee was 70 per cent of a $14.25 fee for an ordinary visit to the doctor. The tribunal, chaired by a Christchurch barrister, Mr Ralph Wylie, began in Wellington yesterday with evidence from the Health Department on Dr Bassett’s behalf.

Mr Tom Gault, Q.C., with Mr Grant Pearson, counsel for the Minister, said the tribunal had been convened because for only the second time in 40 years the Medical Association and the Minister of Health had failed to reach agreement on the level of the benefit.

The maternity benefit, which covers ante and postnatal doctors’ visits, is paid by the Government and means women receive free maternity care. The association had asked for an 80 per cent increase in the benefit. Mr Gault told the tribunal the new fees

scale was higher than if it had been linked to inflation, and was presented not as a progression from the past fee, but as an assessment of what was reasonable now.

It attempted to remove anomalies and areas of potential abuse in the present scale, Mr Gault said. It was proposed that any new scale of fees set by the department should be effective from August 1, each year. Dr Bassett had also proposed to lift restrictions on doctors claiming mileage fees for patient visits. Doctors cannot claim for mileage fees for journeys, between surgery and patient, of less than 13km. Because cost increases were likely to be significant, the rate of 41c a kilometre would remain.

Mr Gault said it would become apparent during the tribunal that an important reason for the failure of the parties to agree was the effect of the price freeze on the fee scale, and its revision.

He said that after the freeze difficult questions arose about the extent to which any of the increases in fees should include those agreed before the freeze. Mr Gault said that Dr Bassett readily accepted his responsibility to ensure that

maternity services of an adequate standard were available. This could only be done by providing a scale of fees for the services acceptable to doctors.

In evidence to the tribunal, the chief executive of the Health Department’s clinical services, Mr Kenneth Swann, said the Government had authorised a 9 per cent increase in the benefit, in addition to another 3 per cent that had already been negotiated in August last year.

“This represented a cash injection into the maternity benefits system of $1 million in a full year, and was extra and outside of adjustments being offered to other sectors,” said Mr Swann.

He said that the Medical Association had firmly rejected this offer in September last year, and had indicated it would seek the tribunal.

The tribunal has received 18 submissions from interested parties, but said it regards the Medical Association and the Health Department on behalf of the Minister as the main parties.

Counsel for the Medical Association is Mr Paul Temm, Q.C., with him Mr Bernard Hill.