MOTION SICKNESS

have joined in the chorus asking that something be done about it. But doing something really effective about it is difficult and thorny. Certainly it cannot be done overnight. Nobody nowadays is surprised when the cost of delivery of health and medical services is found to be rising steadily. That seems to be the experience in most parts of the world and is shared in varying degrees by all community services. But figuressuch as those published by the AMA Gazette for increases in medical benefitspaid for pathology indicate a deeper problem. They were, as the Gazette states, before the Federal Council at its meeting in January of this year and were there viewed with grave concern. But while, seen in the cold in this way, they evoke dismay, they cannot occasion surprise. As the Minister pointed out in his statement, the Government in April, 1976, moved to establish a working party under the chairmanship of Dr Sidney Sax, with wide-ranging terms of reference. Its broad task, as reported to the AMA Federal Council by the President," was to review the Schedule fees and benefits for pathology serviceson both a short and a long term basis. It was made up of representatives of the Commonwealth Department of Health, the State Health Authorities, the Australian Medical Association, the Royal Col1ege of Pathologists of Australia and the Society of Pathologists in Private Practice. Its activities at that stage and indeed since were, understandably, confidentialuntil releasedby the Minister. The Minister in his press statement has lifted the veil on measures recommended by the Committee "to stop these rip-offs and abuses" -measures to be adopted in the short term to lessen the opportunities for abuse. The first was a new and more restrictive schedule of fee benefits which the Government brought into operation on October 1,1976,and which, according to the Minister's statement, will probably reduce costs by at least $8 million in a full year. The second was an approved provider scheme which imposes a code of conduct on practitioners. Such a code of conduct, the Minister states, which must be agreed to by practitioners, will prohibit fee-splitting and other malpractices. It wil1 also ensure that the pathologists bill the patients or the health insurance funds direct and not the referring doctors. The Government was unable to draft legislation in time to introduce the approved provider scheme to operate from January I, 1977. It is now aiming for July I. A further report from the working party is still awaited. "As soon as this report is to hand, the Government willgivedue consideration to its recommendations", the Minister states-and concludes on a very resolute note: "The Government is determined to put an end to some of the quite outrageous practices going on in the pathology area which are being conducted at great expense to the taxpayers general1y. " The Government has, the Minister assures us, the ful1 support of the Australian Medical Association, the Royal College of Pathologists of Australia and the Society of Pathologists in Private Practice. That is scarcely surprising in view of the aspects of cost to the community and al1eged shady dealing already mentioned and also the way in which the situation has tended, without warrant, to reflect adversely on the medical profession as a whole.