Page 1131 - Week 04 - Thursday, 21 April 1994
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MS ELLIS (11.51): The Public Accounts Committee inquiry into the Auditor-General's report No. 5 of 1993, Visiting Medical Officers, has proven timely but also difficult, given recent events in this area and the complexity of the issues involved. Whilst acknowledging that the aim of the audit was "to review the management and control of payments to Visiting Medical Officers (VMOs) in the ACT public hospital system and to examine the terms and conditions under which the payments were made", I also note the comments by the Auditor-General in paragraph 1.2 of his report. He says:
As well, it -
the audit -
reviewed the contractual arrangements under which VMOs provide services and compared rates of payment with the amounts paid under Medicare and the rates paid by other States.
The committee, guided by the chairman, attempted or, should I say, determined not to involve itself in the debate or process still under way - that is, the negotiations for contract renewals between ACT Health and the VMOs. I have, with other committee members, endorsed this report of the PAC. However, I believe it appropriate to note here today the difficulty that I believe some committee members faced in deliberating this way. Many of the Auditor-General's comments could have easily and appropriately led us down broader paths. Nevertheless, there are some comments in the Auditor-General's report and within our report which I believe warrant some additional consideration.
The chapter in the committee report referring to fee-for-service arrangements outlines some interesting findings by the Auditor-General. In it we report the Auditor-General's comments as follows:
. payment to fee-for-service VMOs of up to $1.3m per annum cannot be proved to relate to services actually provided by doctors.
. fee-for-service rates were above national rates. If payments were similar to national rates, the annual payment to VMOs would be lessened by at least $1m.
The Auditor-General also comments on the record keeping within ACT Health and appropriately points out areas for improvement. The AMA, to their credit, indicated a willingness to attempt to address the VMOs' side of the record keeping requirements, although they doubted the level of misdemeanour on the part of their members. The committee states at paragraph 3.16:
The Committee nevertheless formally recommends that ACT Health ensure that claims made by VMOs for payment for the provision of services are verified and properly documented.
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