There are few loftier perches in society than that upon which doctors sit. Few begrudge the medical profession its status, privilege and earnings. Most view the acclaim as fair reward for skills that save lives and make living a great deal easier. That bounteous goodwill has, however, taken something of a battering lately with the airing of cases of medical negligence or carelessness. It suffers anew with the Herald's disclosure of details of the ACC account set up to compensate the victims of misadventure.
Extraordinarily, doctors, who are protected from lawsuits over medical blunders, have managed to avoid paying premiums into the misadventure account. Instead, the $18 million fund is financed by taxes and levies on salary-earners. Effectively, doctors are making no contribution to their own safety net.
This grossly unfair situation is not directly the fault of doctors. The 1992 Accident Rehabilitation and Compensation Insurance Act allowed for medical professionals to be levied. The Government and ACC are to blame if no money was ever collected from that source, and doctors were able to escape financial responsibility for mishaps. Sir William Birch, the architect of the legislation, says it was intended to collect the levy, but "the medical profession itself did not support it." That opposition must surely have been predicated on the hoi polloi being unaware that it had been passed the baton for funding the ACC account.
Equally unconvincingly, Sir William suggests the system of collecting levies is complex in terms of who is levied and how much. Premiums, however, merely reflect safety records and work practices. It is difficult to see how the system could be more difficult than that applied to a multitude of small businesses. And it was Dr Pippa MacKay, who chairs the Medical Association, who suggested recently that general practitioners were "in effect, small business people."
It is inevitable that questions will be asked about pressure that the association, the biggest doctors' organisation, might have applied to convince the Government that its members should not be levied. It comes as little surprise that the association now suggests that doctors would be willing to pay premiums. It is more pertinent that no such offer was made when the issue was shielded from the light. The association now has little option, given the justifiable anger of those who fund the medical misadventure account.
Doctors may now try to deflect that ire by pointing out that they will pay high premiums because of their small number, and that this expense will evidence itself as an extra cost for patients. That will do nothing to ease the disquiet. Doctors may observe an ethic besides profit, yet they have never been particularly reluctant to minimise charges for their services. They have also been noticeably loath to surrender the right to sell services at a fee they can set.
Now it transpires that not only are they shielded from their mistakes by the accident compensation scheme but they have paid for not one strand of the safety net. Our leniency to medical malpractice has already left many patients with a deep sense of injustice. The financing of the ACC's medical misadventure account over the past eight years leaves all taxpayers with a bitter pill to swallow.
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