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Specialist Referral System for Medical Benefits
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PRESS RELEASE BY THE MINISTER FOR HEALTH, DR» A.J. FORBES

SPECIALIST REFERRAL » « SYSTEM » FOR MEDICAL BENEFITS

People claiming the higher rate of medical benefits

for specialist treatment under the Health Benefits Plan will

soon have to provide their health insurance fund with an

official "notice of referral" form issued by their general

practitioner.

The Minister for Health» Dr, A.J, Forbes, said

today he had approved the introduction of the "notice of

referral" form following recommendations by a joint working

party of representatives of the Australian Medical Association,

the Commonwealth Department of Health and the four Royal

Colleges representing specialist and general medical practitioners

The form was part of an overall plan accepted by the

Australian Medical Association and approved by h im, for a more

formalised system of referrals of patients to specialists and

consultant physicians,

Dr. Forbes said this followed the extension of differ­

ential (or higher) benefits to a wider range of services under

the new Health Benefits Plan.

A higher Commonwealth medical benefit is paid for

each of about 300 services rendered by specialists and for

consultations by consultant physicians, provided the patient

has been referred by another doctor.

Dr. Forbes said that the target date for the introd­

uction of the new "notice of referral" form was November 1.

All private medical practitioners would be issued with

books of the forms, which would indicate whether they were

referring a patient to a specialist for an "opinion", "immediate

treatment" or "continuing management of present condition".

The patient would take the form with him when he went

to see the specialist. The specialist would note the referral

number on the patient's record and would attach the form to the

patient's account.

2 ο

The patient would then present both the account and

the form when claiming medical benefits for the first specialist

service.

The health insurance fund would retain the form, and

the specialist would quote the referral number on any subsequent

accounts covered by the initial general practitioner's referral„

Dr. Forbes said the "notice of referral" would also be

used by medical practitioners when referring patients to consul­

tant physicians. Common fees for consultations with consultant

physicians are higher than the common fees of specialists.

He said that the "notice of referral" would not specify

the period for which the referral was made, but administrative

procedures would be introduced whereby further notice of referral

would be required after a period of time had elapsed.

Dr. Forbes said he was confident that the new referral

method would have the support of the medical profession as a

whole. It was not just a system devised within the Government

but had been drawn up by a working party which included repres­

entatives of the Federal Executive of the Australian Medical

Association, the Royal Australasian College of Surgeons, the

Royal Australasian College of Physicians, the Australian Council

of the Royal College of Obstetricians and Gynaecologists, the

Royal Australian College of General Practitioners and the

Section of General Practice of the New South Wales Branch of the

Australian Medical Association. ,

A similar form would also be used by dentists when

referring patients to specialist medical practitioners and by

optometrists when referring patients to eye specialists

(ophthalmologists). This matter has been the subject of

discussions with the Australian Dental Association and the Australian

Optometrical Association. .

' Dr. Forbes also announced that Specialist Recognition

Advisory Committees had now been established in every State to

make recommendations to the Director-General of Health on the

eligibility of medical practitioners for recognition as specialists

or as consultant physicians for the purposes of the National Health

A c t . The committees comprised nominees of the Australian Medical

Association and the four Royal Colleges.

CANBERRA, September 3, « 1970 » Departmental No. 27