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Wednesday, 27 May 1987
Page: 3448


Dr BLEWETT (Minister for Health) —There has not been, as is usual in such debates, one single new argument introduced by the Opposition, apart from warts and keratoses which I will deal with in a moment. We have had the same cliches repeated again and again. I look forward to a much wider assize than this body making the decision in the next few weeks. I am confident that it will be in support of the Medicare system-the system which is more fairly funded than any yet introduced in this country and to which the Opposition's only alternative is a flat rate insurance system which will impact most adversely in payment terms on the less well off in this society.

Taking up the one new point that was managed to be introduced by the Opposition in the whole two hours of the debate-that is, the issue of warts and keratoses-the reasons for removing the five items, and they will remain removed, is that the operation has become an extremely simple procedure. It is carried out mostly by general practitioners-in fact, three-quarters of them are carried out by general practitioners-in their own rooms in consultation times. We do not want to leave the incentive to have extra payments for those procedures which can now be done quickly and efficiently and mostly by general practitioners. Doctors will continue to be paid the consultation fee. Usually they do these procedures in consultation times because generally it takes a very short time to do them. There will not be built into the system an incentive to develop a rort and a quite unnecessary form of medicine by bringing people back for those procedures. We believe that it is a much better way of organising the system. However, that is not to say that doctors will not be paid. They will be paid their consultation fees for doing these simple procedures which they are able to do very quickly. The other point that I would make, because it is quite contrary to some of the nonsense talked by some self-interested specialists in this area, is that the decision does not affect skin cancers and their removal; it relates simply to the removal of warts and keratoses.

Question put:

That the words proposed to be omitted (Mr Porter's amendment) stand part of the question.