Doctor's fees

Having read Eddy Privitera's letter on the contents of my speech in Parliament (February 21) regarding doctors' fees, it never ceases to amaze me how there are some who are able to see the grand design in life together with the small print, while there are others who are forever only able to see the small print of life, leaving them forever falling short of their objectives.

In the Registers of the Medical Council there are, as all doctors should know, actually general notes for the guidance of medical practitioners. Point 32 states:

"It shall be unlawful for any practitioner to charge a fee less than that established in the official Tariff of Fees. It is advisable that one should not charge any fee if the practitioner is satisfied that the patient or the client cannot afford one. It would not be unethical in special cases to grant a discount of not more than 10 per cent for the bills of Lm30 and over."

In the same publication under "Ethics of the Medical Profession", point 14 (iv) states:

"It shall be unlawful for any practitioner to charge a fee less than an official one. If the doctor is satisfied that the patient cannot afford the fee, no fee shall be charged."

So as Mr Privitera can see there is a case for the publication of minimum tariffs and a note for an exception in a doctor's fee for the cases he mentions. What occurs most often however is that for some doctors who abuse this rule, the exception is the rule, because they are usually getting a free ride over their colleagues' backs. Many doctors do not wait for the official tariffs which have not been published by the government since 1939, to charge what they believe to be a fair fee.

My query in Parliament dealt with the fact that notwithstanding the several times that the Medical Council has asked the government to publish new tariffs that it has suggested, nothing has ever been done. This is not the case with the other professions such as those for lawyers and architects. This notwithstanding that the medical fees apply for a private medical consultation, while there is an excellent free service available for everyone, the NHS, which is one of the best in the world. On the contrary there is hardly any comparable free service by lawyers and architects to mention a few, who nonetheless have their tariffs published regularly.

This is my third intervention in Parliament over the matter, and hope springs eternal. However I like to bring the subject up when some politicians rightfully start to charge some doctors with corrupt practices. It is then incumbent upon the regulator to realise that the regulator is partly responsible for what is happening because of the regulator's inertia and/or lack of interest.

"God and the Doctor we alike adore,

But only when in danger, not before;

The danger o'er, both are alike requited,

God is forgotten, and the Doctor slighted".