MEDICAL SERVICES

Marlborough Express, Volume LXXVI, Issue 251, 24 October 1942, Page 3

MEDICAL SERVICES

SPECIALISTS' FEES. SOCIAL SECURITY SCHEME. . When discussing the provision in the Finance Bill (No. 2) for the re- : fund of a portion of fees paid to medical practitioners for specialist services under the Social Security scheme, the Leader of the Opposition, Mr Holland, said it ralsed an important issue which the Opposition welcomed as it had relentlessly criticised the non-payment of specialist services in the past. "At last the Government is giving way to our representations," he added. Mr Lee (Democratic Labour, Grey Lynn) : Will you use your persuasion to get the doctors to give way? Mr Holland: The doctors have been reasonable throughout and ready to co-operate with the Government in the scheme they were prepared to work. Continuing. he said if we were prepared to recognise the specialist we should be prepared to pay a specialist's fee. The Minister for Health, Mr Nordmeyer, said the important part of the provision was that it was retrospective • to November 1, 1941, and refunds up to 7s 6d for services could be sought by patients. The medical profession itself found it exceedingly difficult to make up a list of specialists. There were varying standards of specialists, but just as soon as an opportunity presented itself the Government would provide for fuller specialist services than the present Bill provided. The Minister in Charge of Social Security, Mr Parry, said the Government was face to face with a position where in his opinion it was shown that claims to be a specialist were nothing more than a ramp to displace general practitioners. Mrs Dreaver (Government, Waitemata) said the clause was going to be progressive in solving New Zealand's problems on this question. "Our hospitals under the present system are providing training for those specialists and they are making their name there and going out and using it in their private practices," she continued. "These men are putting up their fees, and I feel the Minister will have to try to avoid it being turned into a racket." INCOME OF DOCTORS. A suggestion that the Minister should have lists posted showing the names of doctors prepared to accept the prescribed fee in full settlement was made by Mr Lee. He said he failed to understand why the House should persist in upholding the extension of the principle of racketeering. The Minister \Vas now in a position with the statistics of medical income to determine whether the fee from the State yielded a fair income. If it did not, increase the fee; if the yield exceeded a fair income, then fetch it down. Mr Polson (Opposition, Stratford) said that many of the ordinary practitioners would not like to go back to the old system and were well satisfied under Social Security. The public irritation was not against the ordinary practitioner. The State might have to do something further to see that the specialists' services

were made more accessible, for their charges were completely outside the range of the ordinary citizen. Mr Nordmeyer said that since the introduction of the Social Security scheme the services of obstetrical specialists were made available, and later radiological services. In addition, the services of specialists were readily available in all the major hospitals to those who required outpatient orin-patient attention. These facts should be borne in mind. It was tremendously difficult to fix a fee if fee-for-service was to prevail in the specialist field. It was likely that when the specialist service was introduced by the Government it Would be on the lines of providing a specialist and consultant service on a full -time basis for the public with the doctor remunerated on a salary basis. The clause was agreed to.