MEDICAL SERVICES

Otago Daily Times, Issue 27211, 14 October 1949, Page 8

MEDICAL SERVICES

AMENDMENT OF RULES BILL BEFORE PARLIAMENT ABOLITION OF REFUND SYSTEM PA WELLINGTON, Oct. 13. Doctors are to be prohibited from practising under a capitation system and a fee for service system at the same time. This is provided for in a clause in the Social Security Amendment Bill which was introduced and read a first time in the House of Representatives to-day.

The Bill is divided into three parts. Part 3 gives effect-, to the recommendations of the Medical Services Committee for the removal of abuses from the social security medical services scheme. The refund system which entitled a medical practitioner to recover fees from a patient and the patient to obtain a refund from the Social Security Fund is not to apply unless specially authorised. Fees may be recovered from a patient if the medical practitioner is authorised to do so .by the council of the New Zealand branch of the British Medical Association after consultation by the council with the Minister of Health.

Fees payable from the Social Security Fund for general medical services are fixed at “a reasonable fee not exceeding sever* shillings and sixpence.” The existing law provides for payment of a' fixed fee of seven shillings and sixpence” for such services. Power is cbntained in the Bill for payment of higher mileage fees than are at present allowed The basic mileage fee is at present Is 3d a mile. Regulations may be made to provide for specialist medical services and "for a scale of fees for such services. Such regulations may include provisions for official recognition of medical practitioners in any branch of medicine or surgery and for determination of disputes on whether a particular service is a specialist medical service. Recovery of Fees Medical practitioners or their personal representatives or assignees are authorised by the Bill to recover fees from patients at law for general medical services under the Social Security Act, but not until a month after an account signed by the doctor and showing particulars of the services provided has’ been delivered to the person concerned. A judge or magistrate may authorise an action to be taken earlier if there is reasonable cause to believe that a person owing an account is about to leave New Zealand or is about to do any other act

that would tend to prevent or delay a doctor from obtaining payment. . A patient may within one month after delivery of an account apply, to a divisional disciplinary committee for an examination of an account and lor its opinion as to what are reasonable Tees for the services for which the account is rendered, and the court may on its own motion or on the application of any party, also refer an account to a divisional disciplinary committee for its opinion, in any such case the court shall not complete tne hearing of an action until it has the opinion of the committee. . The court shall not give judgment for any amount exceeding that which is- considered by the committee to be reasonable without first affording the committee a reasonable opportunity of appearing by counsel and giving evidence.

Sections in Part 111 of the Bill are to come into force on a date fixed by the Minister of Health. They shall apply to medical services provided by a medical practitioner after commencement of the legislation, but shall not apply to any provided before that date.

Part 1 of the Bill gives legislative effect to the increases in social security benefits announced in the Budget. Monetary Benefits

Part 11 contains several miscellaneous provisions relating to monetary benefits. Provision is made for payment of part of the benefits where a wife or widow is in receipt of a war pension for her own disablement. The Social Security Commission may increase up to £26 a year the rates of benefits granted to parents of deceased members of the forces or mercantile marine.

Asked by the Leader of the Opposition, Mr Holland, if the Bill increased the allowable income of age beneficanes beyond £1 a week in view- of the fact that the purchasing power of the pound had fallen so greatly, the Minister of Social Security, Mr Parry, said the increases were basic increases, and not cost of living increases. The increases represented the natural development of the social security principle in accordance with the productivity of the country.