NEW MEDICAL SCHEME

Southland Times, Issue 24533, 6 September 1941, Page 6

NEW MEDICAL SCHEME

BILL FIXES FEES OF DOCTORS 5/- ,FOR CONSULTATION IN TOWN (Special) WELLINGTON, September 5. “Generally this measure fixes as from the first of next month practising fees so far as they relate to the ordinary general practitioner s services of every doctor in New Zealand,” said the Minister of Health (the Hon. A. H. Nordmeyer) when the Social Security Amendment Bill was introduced shortly before the House of Representatives rose for the week-end adjournment today. A barrage of questions from Opposition members interrupted Mr Nordmeycr’s explanation. Some of them were not answered, but the Bill was read a second time pro forma and referred to the Public Health Committee without discussion when the Minister had completed his remarks. “This Bill fixes the fees for the consulting room, for visits to the homes in cities or boroughs and for visits to homes elsewhere in the country, Mr Nordmeyer said. The Leader of the Opposition (Mr S. G. Holland): Regardless of the service given? Mr Nordmeyer: The service is presumed always to be the best service a doctor can give. Mr Holland: The one fee for all services? . . Mr Nordmeyer: Yes. . Provision is taken for the introduction of regulations which may allow for higher fees for more special services, either in respect to all doctors or to certain doctors. The additional fee will be fixed by regulation, but the basic fee will be fixed in this Bill.

COERCION SUGGESTED Mr F. W. Doidge (Nat., Tauranga): Coercion of the doctors. Mr Nordmeyer expressed regret that the word “coercion” had been used. Mr H. S. S. Kyle (Nat., Riccarton): Would the Price Tribunal have to look at the fees? Mr Nordmeyer: There is no need to. Mr Holland: Is this the penalty for the doctors not coming into the scheme? Mr Nordmeyer: So far from being a penalty I think it is a concession. Mr Holland: What is the doctors’ reaction? Are they in agreement? Mr Nordmeyer: That will depend on their reaction. As the Bill is only before the House I cannot tell you.

An Opposition member: You have been a week in conference with them. In answer to a question the Minister said the general principles of the Bill had been referred to the doctors, but certain items of detail of necessity had had to be withheld until the Bill was before the House. Mr Holland: What do you think the reaction will be? Mr Nordmeyer: I can imagine some doctors will be enthusiastically in favour and I can imagine some will not be so enthusiastic. An Opposition member: Will the public have to pay? PAYMENT FROM FUND The Minister: The fee will be fixed and it will be claimed from the Social Security Fund. If, however, a patient for political, religious or any other reasons does not wish to make a claim on the fund, there is nothing to prevent him or her paying a doctor, but the amount will be that set out in the Bill. Mr Doidge: If a doctor refuses to be dragooned, what happens to him? The Minister: I cannot imagine any doctor refusing. Mr Nordmeyer said the fee for consultation at a surgery was 5/-, for a city or borough visit 6/6 and for a visit tr a person in the country 5/- plus 1/3 for each mile actually travelled, calculated both ways. Any fraction of a mile was calculated as for a mile. It was presumed that as most of the town doctors would live within close distance, 1/6 extra for their city visits would pay for their time and service.

The Minister said he felt a doctor would continue to give them the good service he had been giving. He would receive 5/- for every consultation, which was more than he got at present in a great many cases. He now gave much free service and had many bad debts.

Mr Holland: What is the estimated total cost a year? Mr Nordmeyer: It is impossible to assess it accurately. The amount we have given all the doctors is calculated to give them the same amount as under the capitation scheme at 15/-, and that scheme would cost £1,200,000, presuming every person was on the list. PROVISIONS OF BILL The Bill is a short one of only 11 clauses and becomes operative from October 1. For the purposes of the Bill general medical services are taken as the proper and necessary services of registered medical practitioners provided for persons entitled to any of the benefits covered by Part 3 of the main Act, but do not include medical services involving special skill and experience not reasonably expected of general practitioners, the administration by doctors of anaesthetics acting in collaboration with other doctors or dentists, medical services in relation to maternity benefits or services that would originally be free. The Bill provides that every doctor who gives general services for any patient after October 1 is entitled to receive fees from the Social Security Fund. In cases of visits more than 20 miles from a doctor’s surgery or home no account is to be taken of the distance travelled beyond 20 miles, but mileage fees at 1/3 a mile may be recovered by a doctor from his patient in respect of that part of the journey. CERTIFICATE FROM PATIENT Where a doctor supplies pharmaceutical requirements for treating a patient before they can conveniently be obtained elsewhere he shall be entitled to receive a payment from the fund. All claims by any doctor for payments from the fund are to be made to the medical officer of health in the district in which the doctor lives and are to be accompanied by a certificate from the patient that the services have been given. The sums paid to a doctor from the fund are to be accepted in full satisfaction of his claims. Except with the Minister’s consent, no doctor shall demand or be entitled to sue for any fees for services provided, and for which payment may be made under the Bill, unless the patient refuses to sign a certificate that he has had treatment. Should a patient refuse to sign a certificate the doctor shall not, except with the Minister’s consent, demand or sue for any fees in excess of the amounts payable from the fund plus mileage fees. The Minister is empowered to make special arrangements for the provision of adequate services where necessary. The last clause provides a fine of £lOO or 12 months’ imprisonment for any person who makes a false statement with a view to obtaining payment from the fund.