DETAILS OF PLAN

New Zealand Herald, Volume LXXV, Issue 23121, 20 August 1938, Page 18

DETAILS OF PLAN

OUTLINE BY MINISTER RIGHTS OF DOCTORS NUMEROUS SAFEGUARDS FIXING REMUNERATION [ 11Y TRLKGIIA I'll —SI'I'.CIAT. REPORTER 1 WELLINGTON, Friday .Details of the Government's plan for Administering the national health service under the social security scheme were made public to-day by the Minister of Health, the Hon. P. Fraser. who issued to the press a copy of a letter containing them and written by him to the president of the New Zealand branch of the British Medical Association, l)r. J. P. S. Jamieson, 011 August 11. The m'-ain principles of tho plan are outlined as follows: 1. Medical Benefits. —This is to comprise general practitioner services. Tho range of service is intended to be somewhat similar to that of the British scheme, i.e., services of medical practitioners other than those involving the application of special skill and experience of ;i degree or kind that general practitioners as a class cannot reasonably be expected to possess. Medical attendance in maternity is included under maternity benefits.

The Capitation Rate 2. Remuneration. —This is a matter upon which tho Government is willing to enter into immediate discussion. It is recognised that in the interests of the service the aggregate professional remuneration of practitioners as a whole should under the scheme bo something better than it is under present conditions. The proposal is to determine "a basic capitation fee," i.e., the average amount per, person that is represented by the aggregate remuneration (including mileage), of the doctors for (a) general practitioner services and (b) attendance on maternity cases. Subject to a reasonably cquitablo distribution and practicability from an administration viewpoint, it is proposed to allow the profession itself to decide the methods of distributing the remuneration. Consultation with Profession 3. Administration.—ln the course of preparing the present legislation, careful regard has been given to the various conditions put forward, by the profession, nVid it is now possible as regards some of these conditions, to give a definite indication as to the extent to which the legislation and the arrangements generally are likely to give'them practical recognition. The following principles have been put forward in the course of discussions with representatives of the profession:—

. (1). —That medical practitioners should have the right to bo consulted by the Government or its nominees, before any regulations are promulgated that can in any .-way affect them. The Government proposes to take every possible step to ensure the fullest consultation with the profession before any regulations affecting it nre gazetted. The bill provides for tho appointment of consultative bodies and the formal recognition for consultation purposes of, to quote tho bill, "any committee or other representative body for the time being constituted to promote or safeguard tho interests of the members of any profession affected by tho operation of this part of the Act." Rights of Practitioners (2). —That medical practitioners -should have the right to be adequately represented on any controlling body and that they should have the right to approach tho responsible Minister directly through . .their representatives. The form of control proposed is by three commissioners, one of whom is to be the Director-General of Health. Advisory bodies are, however, to be set up tp assist both tho central and district' administration. Particular reference is made to the constitution and functions of these advisory bodies later. (3). —The statutory right of every registered medical practitioner to undertake national health insurance service. This right is provided for in tho bill. > (-1). —Free choice as between doctor and patient, subject to the right of the doctor to refuse to accept a particular patient. (Any regulations affecting this must be nuost "carefully drawn. Tho present British regulations seem quite fair to all parties and work well). Separate Administration Specific provision to givo effect to this principle is mado in the bill. The procedure and arrangements generally for the exercise of tho right of selection and also for the assignment of patients who have failed to make a selection or who have been refused by tho doctor they have selected will be very similar to the provisions under the British scheme.

(5). —Administration of medical benefit to bo separated from tho administration of the cash benefits, and to bo through a body having representation of the practising profession. The bill provides for medical and other treatment benefits to bo placed under tho Minister of Health and tho Health Department. Administration on tho technical side will be by the Director-General of Health and district medical officers under his control. Tho general administration apart from the technical and professional side; will, as already indicated, bo in tho hands of three commissioners, one of whom will bo the Director-General of Health. (6). —Professional discipline to bo maintained by tribunals, mainly professional in constitution, as in the British system. This principle'is recognised in tho bill.' (7). —The relations between specialists and general practitioners to be adjusted bv a Central Medical . Authority set up by the professiou. This is understood to mean tho determination. of questions whether a particular professional service rendered or to be rendered by a particular practitioner falls within or outside the scope of general practitioner service. This procedure will be determined on the recommendation of the Central Medical Committee or a committee nominated by it. - MEETING AT TE AROHA PROFESSOR A T,CUE'S ADDRESS [IIY TELKCIIAPH—OWN COTUIKSI'ONDRNT] TE AROHA, Friday 'Another address on aspects of tho Social Security Bill was given by Pro feasor It. M. Algie, organiser of the Auckland Provincial Freedom Association, when speaking at To Aroha last night.. There was an attendance of over ■7UU in tho Majestic Tlieatro and the speaker was given a very attentive hearing. The chairman was Mr. W. C. Kennedy. After the address a vote of thanks was accorded Professor Algie.