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Wednesday, 13 October 1971
Page: 2292

Dr EVERINGHAM (Capricornia) - 1 would like to bring the attention of the Minister to a few items under clause 7 which refers to a schedule of the Act. There are some items which are not actually listed in this schedule but which are in the principal Act and which I think are well overdue for reform and should have been introduced into this schedule. I refer to items 971 and 976, the items relating to the pricing of anaesthetics and to the specialist consultations which are not referred. The points that I wish to make are firstly that it is over a year since I and the surgeons involved in Queensland referred to more than one of the previous Ministers for Health these items 971 and 976 which are not performed under that name in Queensland and are certainly not charged for in Queensland at the rate set out. This schedule purports to set down the most common fee for a State. It is not a most common fee because nobody charges anything like that fee for that item and nobody could possibly do it at that charge. This matter has been brought up again and again with the Minister for Health but all we are told is that it has been referred back to the committee. The committee has had 2 or 3 meetings since and 1 think it is fair to say that the committee should be able to decide in 2 minutes whether it is or is not a common fee as is alleged, lt is not a common fee because nobody charges anywhere near that fee.

The other point is that the fee for an anaesthetic is based on the common fee for other services performed at the same time - in other words, the services performed by the surgeon and his assistant. The wording is ambiguous and it should be altered. 1 have asked the Minister to alter it but he declined to do so because he felt it was unambiguous. If it was unambiguous doctors would not be charging according to a strict interpretation which is made under these items. In other words, where it says the fee for an anaesthetic should be based on the value of services performed at the same time, it means the services performed by the surgeon and his assistant. The Commonwealth does not accept this interpretation and therefore it should change the wording. It should read excluding the services of the assistant'. It is all very well to say that exactly the same service is performed by the surgeon whether he has an assistant or not. If the Government is going to use that argument, it should recognise that exactly the same service is performed whether it is done by a specialist or by a general practitioner, but the fee for the anaesthetist is varied according to whether a specialist does the operation or a general practitioner does the operation. If it is legitimate to charge a patient more when there is a second doctor present to assist the surgeon then surely there is an argument that this should attract an extra anaesthetic fee just as much as an extra anaesthetic fee is attracted when a specialist does the operation and not a general practitioner. If the Government does not want to interpret it in that way then 1 suggest that it should alter the wording so that it is no longer ambiguous and patients will not have to meet a charge when they will not get the benefit of the common fee based on the wording as it exists.

My final point is that where a patient goes to a specialist without being referred he gets only the benefit of a general practitioner consultation. 1 think that here again it ought to be spelt out and made clear that either the Government will give the benefit on the basis of the common fee or it will not. The plain fact of life is that it is not a common fee that surgeons charge. When a surgeon gets a patient unreferred he does not charge the general practitioner fee, so it is not the common fee. That is perhaps the one that is the least objectionable because most people realise the position. Nevertheless I think it should be spelt out and made clear in the pamphlets which are circulated claiming that the Government will rebate a percentage of the common fee.

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