MEDICAL CARE

Gisborne Herald, Volume LXVIII, Issue 20486, 21 February 1941, Page 6

MEDICAL CARE

FAMILY SERVICE STATE BENEFITS SCHEME OUTLINED VOLUNTARY ACCEPTANCE I 5,/- A HEAD FOR DOCTORS MILEAGE LIMIT FIXED (Per Press Association.! WELLINGTON, this day. The Social Security Medical Benefits Regulations, 1941, were gazetted last p isn't and come into force to-day. The regulations generally set out the scope of the medical benefits to be provided, that is, the medical services which can be provided by the ordinary general practitioner. They do not include maternity benefits, which are already provided, for the administration of anaesthetics, for which a separate fee may be charged, nor specialist services. These specialist services, defined as those which involve the application of special skill and experience of a degree or a kind 'hat the general medical practitionersas a class cannot reasonably be expected to possess. Before a general practitioner who claims to be a specialist in certain branches of medicine may charge his patient, for services which he renders, he must first inform the patient that he proposes to charge for those services, and,, secondly, obtain the patient’s consent. Further, he cannot claim any specialist fee unless he complies with at least one of three conditions: (1) That he held hospital or other appointments affording SDecial opportunities for acquiring special skill and experience of the kind required for the oerformance of the specialist services in question, and has had actual recent experience in the performance of service of a similar kind; (2) he has had special academic or post-graduate study of a subject that comprises specialist services rendered, and had actual recent experience in performing services of a similar kind; or (3) thathe is generally recognised by other oractitioners who have a direct personal knowledge of his work as having special oroficiency and experience in the subject or subjects that comprise the specialist services rendered by him. Service By Agreement A patient who desires to.take advantage of the services must first procure an application card which he will complete and take to the doctor of his choice. If the doctor is willing he will countersign the card and be responsible for sending it to the local medical officer of health. The signing of the card by the practitioner constitutes an agreement by him to attend and care for the patient, and he is responsible for the free treatment of that patient from that date. In the case of children a separate card is to be filled in for each child on a special children’s card. The patient is required to notify the medical officer of health of any change in address, and, if he fails to do so, may be charged such amount as has been wrongly paid to the doctor on whose list his name appeared. Practitioners who are prepared to work under the scheme are required to provide and maintain a suitable surgery and waiting room accommodation, to be in attendance for consultation and treatment of patients at his surgery or elsewhere at regular times, to visit any patient whose condition of health is such that it is impossible or inexpedient for him to visit the practitioner’s surgery, to visit any of his patients in hospital where the rules of hospital permit and where a parent requires the service of which the general practitioner is capable of affording, to prescribe such drugs and appliances as may be required for the treatment of any patient, to issue free of charge medical certificates or recommendations required for the purposes of the Social Security Act, to keep clinical records of the history of his patients and his treatment of them and to answer all reasonable inquiries made by the medical officer of health with respect to any prescriptions, certificates or recommendations which he has issued.

Supply of Drugs

Provision is also made that a doctor shall supply a patient in a case of emergency with such drugs as may be required and, in this connection, he is entitled to claim the cost from the patient until pharmaceutical benefits have been provided in which case he is to be paid from the social security fund.

The regulations detail the provisions which have to be made where a practitioner, who has agreed to accept patients under the scheme, employs an assistant or engages a partner. Generally, the obligation is upon a practitioner to give personally such benefits as he has undertaken to do “except where he is prevented from doing so by urgency or other professional duties, temporary absence from home or other reasonable cause.”

A medical practitioner is also obliged to make all the necessary arrangements for securing the proper treatment of his patients in cases where he is unable to give treatment personally. If he has any standing arrangement in this matter, he is required to notify the medical officer of health. A doctor agreeing to care for a patient who engages any deputy or assistant is responsible for compliance by that deputy with the requirements of the regulations. Where two or more medical practitioners are in partnership, treatment may, at any time, be given by one or other of the partners to any patient on the list Of the practitioner, instead of by the practitioner in person if reasonable steps are taken to secure continuity of treatment. Transfer of Patients The regulations also detail the procedure where a patient desires to shift from one doctor’s list to another, where a patient removes from one place of residence to another, where a doctor himself desires to have the patient removed from his list and where a doctor desires to terminate all his agreements under the Act. In the latter case he must give three months’ notice of his intention to do so.

The regulations also make special provision for dealing with the case of doctors who are serving with His Majesty’s forces, either within New Zealand or overseas. Provision is made here for a simpler method of

transfer of patients from the list to a practitioner who is attending them to that of a doctor who returns to his practice. They also provide that where any person entitled to receive medical benefits desires to make a complaint about the service rendered by the practitioner of his choice, the complaint must be made in writing to the medical officer of health who may dismiss it as trivial or submit it for decision to a special committee to be set up by the Minister. * Capitation Fee

With the prior consent of medical practitioners, the Minister may at any time publish a list or lists of names of medical practitioners who have entered into agreements under the regulations. Every medical practitioner who agrees to provide medical benefits in accordance with the regulations is entitled to reteive from the social security fund for every person on his patients’ list a capitation fee of 15s per annum. This applies to every person on his list, including children. He is required to give all the necessary medical care to those persons living within three miles of his surgery in consideration of the receipt of this sum. Regarding mileage arrangements, instead of paying the doctor special mileage for each visit, the regulations provide that the doctor is entitled to an annual amount of 2s for each mile beyond three that the patient’s residence is distant from the doctor’s surgery. In no case will mileage be paid beyond 20 miles from the siu gery.

It is further provided that in cases where a doctor is required to travel more than 20 miles, he may charge a mileage fee, from the 20-mile limit to the patient’s home and this is recoverable from the patient. It is expressly set out that nothing in the regulations affects the Minister’s power to make special arrangements in connection with certain areas or certain classes of persons conferred upon him by the Social Security and Finance Acts.