National Health Act 1955 (Cth)

Case
No judgment structure available for this case.

NATIONAL HEALTH.

 

No. 88 of 1955.

An Act to amend the National Health Act 1953.

[Assented to 4th November, 1955.].

BE it enacted by the Queen’s Most Excellent Majesty, the Senate, and the House of Representatives of the Commonwealth of Australia, as follows:—

Short title and citation.

1.—(1.) This Act may be cited as the National Health Act 1955.

(2.) The National Health Act 1953 is in this Act referred to as the Principal Act.

(3.) The Principal Act, as amended by this Act, may be cited as the National Health Act 1953–1955.

Commencement.

2.—(1.) Except as provided by the succeeding provisions of this section, this Act shall come into operation on the day on which it receives the Royal Assent.

(2.) Section thirteen of this Act shall be deemed to have come into operation on the fourteenth day of April, One thousand nine hundred and fifty-four.

(3.) Sections twenty-two, twenty-four and twenty-eight of this Act shall be deemed to have come into operation on the twelfth day of May, One thousand nine hundred and fifty-four.

(4.) Sections twenty-three, twenty-five, twenty-six, twenty-seven, thirty-two and forty-four of this Act shall severally come into operation on dates to be fixed by Proclamation.

Parts.

3. Section three of the Principal Act is amended—

(a) by omitting the words “(Sections 31–37)” and inserting in their stead the words “(Sections 31–37a)” ; and

(b) by inserting after the words—

“Division 2.—Medical Services Committees of Inquiry (Sections 108–112).”

the words—

“Division 2a.—Medical and Hospital Benefits Committees of Inquiry (Sections 112a–112b).”.

 

Interpretation.

4. Section four of the Principal Act is amended—

(a) by inserting in sub-section (1.), after the definition of “dependant”, the following definition:—

“‘Director’ means—

(a) in relation to a State or to the Northern Territory of Australia—the officer for the time being holding the office or performing the duties of Commonwealth Director of Health for that State or Territory ; and

(b) in relation to the Australian Capital Territory—the Director-General ;” ;

(b) by omitting from sub-section (1.) the definition of “pensioner” and inserting in its stead the following definition:—

“‘pensioner’ means a person to whom, or in respect of whom, there is being paid—

(a) an age pension, an invalid pension or a widow’s pension under the Social Services Act 1947–1955 ;

(b) a service pension under the Repatriation Act 1920–1955: or

(c) an allowance under the Tuberculosis Act 1948,

but does not include a person to whom, or in respect of whom, a pension is granted to be paid from a date after the thirty-first day of October, One thousand nine hundred and fifty-five, and who, by reason of his income, would not have been eligible under the Social Services Consolidation Act 1947–1953, or the Repatriation Act 1920–1953, as in force on the thirty- first day of December, One thousand nine hundred and fifty-three, to receive the maximum rate of pension that would have been payable to him if the relevant Act had remained in force as on that date without amendment ;” ; and

(c) by omitting from sub-section (1.) the definition of “the Deputy Director”.

Delegation.

5. Section six of the Principal Act is amended by omitting from sub-section (4.) the words “a Deputy Director of Health” and inserting in their stead the words “a Commonwealth Director of Health for a State or for the Northern Territory”.

Commonwealth benefit payable in respect of professional services specified in Second Schedule.

6. Section fifteen of the Principal Act is amended by omitting sub-section (2.) and inserting in its stead the following sub-section:—

“(2.) If, on the date on which the professional service was rendered, the contributor had not paid all contributions due and owing by him to the organization, Commonwealth benefit is not payable unless—

(a) a fund benefit is paid by the organization in respect of the professional service ; or

 

(b) on that date the contributor was in receipt of unemployment benefit or sickness benefit under the Social Services Act 1947–1955.”.

7. Section twenty-six of the Principal Act is repealed and the following section inserted in its stead:—

Claims by organizations.

“26. Where a registered medical benefits organization desires to claim payment by the Commonwealth of Commonwealth benefits under this Part, it shall furnish to the Director-General, as soon as practicable after the end of a month or of such other period as the Director-General permits, a claim in respect of that month or other period, in the form authorized for the purpose of this section, together with such further information, and such vouchers, relating to the claim as are shown in the form to be required or as the Director- General requests, and payment by the Commonwealth of Commonwealth benefits under this Part to a registered medical benefits organization shall not be made except in respect of amounts included in such a claim duly made and in relation to which that information and those vouchers have been duly furnished.”.

8. Section, thirty-four of the Principal Act is repealed and the following section inserted in its stead:—

Disallowance of claims on report of Committee of Inquiry.

“34.—(1.) If a Committee of Inquiry established under Division 2 of Part VIII. of this Act reports that, in its opinion, in the circumstances of a particular case, a medical practitioner—

(а) should have been, or should be, paid an amount or a rate less than the amount or rate of fees or allowances prescribed by the regulations or fixed by or under an arrangement or agreement referred to in paragraph (b) of sub-section (2.) of section thirty-one of this Act, as the case may be ; or

(b) should not have been, or should not be, paid any amount,

in respect of medical services specified in the report, the Minister may, in accordance with that report, disallow, in whole or in part, a claim by that medical practitioner in respect of those services.

“(2.) Where, in pursuance of the last preceding sub-section, the Minister disallows a claim under which payment has been made by the Commonwealth to the medical practitioner, the medical practitioner, on receipt of notice of the disallowance and of the amount not payable as a result of the disallowance, shall repay that amount to the Commonwealth.

“(3.) An amount that a medical practitioner is liable to repay under the last preceding sub-section is recoverable as a debt due to the Commonwealth.”.

Termination of agreement following report of Committee of Inquiry.

9. Section thirty-five of the Principal Act is amended by omitting the words “for pensioners and their dependants” (wherever occurring).

Publication of notice of action taken.

10. Section thirty-six of the Principal Act is repealed.

 

Appeal from Minister’s decision.

11. Section thirty-seven of the Principal Act is amended by omitting the words “for pensioners and their dependants” (wherever occurring).

12. After section thirty-seven of the Principal Act the following section is inserted in Part IV.:—

Offences.

“37a. A medical practitioner shall not—

(a) make, either orally or in writing, a false or misleading statement in, in connexion with, or in support of, a claim for payment in respect of the rendering of medical services under this Part ; or

(b) claim or obtain payment in respect of a medical service that he has not rendered.

Penalty: One hundred pounds or imprisonment for six months.”.

Repeal and saving.

13. Section thirty-eight of the Principal Act is amended by omitting from paragraph (e) of sub-section (2.) the word “Hospitals” and inserting in its stead the word “Hospital

Hospital Benefits Committees.

14. Section forty-six of the Principal Act is amended by omitting the words “Deputy Director” (wherever occurring)’ and inserting in their stead the word “Director”.

Functions and powers of Committees.

15. Section forty-seven of the Principal Act is amended by omitting the words “Deputy Director” (wherever occurring) and inserting in their stead the word “Director”.

Application for approval of private hospitals.

16. Section forty-eight of the Principal Act is amended by omitting from sub-section (2.) the words “Deputy Director” and inserting in their stead the word “Director”.

Approval of applications.

17. Section forty-nine of the Principal Act is amended by omitting from sub-section (1.) the words “a Deputy Director” and inserting in their stead the words “the Director”.

18. Section sixty of the Principal Act is repealed and the following section inserted in its stead:—

Claims by organizations.

“60. Where a registered hospital benefits organization desires to claim payment by the Commonwealth of additional benefits under this Division, it shall furnish to the Director-General, as soon as practicable after the end of a month or of such other period as the Director-General permits, a claim in respect of that month or other period, in the form authorized for the purpose of this section, together with such further information, and such vouchers, relating to the claim as are shown in the form to be required or as the Director-General requests, and payment by the Commonwealth of additional benefits under this Division to a registered hospital benefits organization shall not be made except in respect of amounts included in such a claim duly made and in relation to which that information and those vouchers have been duly furnished.”.

Examination of records, books and accounts of registered organisations

19. Section seventy-five of the Principal Act is amended by omitting sub-section (6.) and inserting in its stead the following sub-section:—

“(6.) In this section, ‘registered organization’ includes—

(a) an organization the registration of which was cancelled under section seventy-nine of this Act within twelve months before the date of the authority under sub-section (1.), or the notice under sub-section (3.), of this section, as the case may be ; and

(b) an organization the registration of which is for the time being suspended under section seventy-nine of this Act.”.

20. Section seventy-eight of the Principal Act is repealed and the following section inserted in its stead:—

Changes of rules, &c., by registered organizations

“78.—(1.) If, after the registration of an organization under this Part, the registered organization changes—

(a) the constitution of the organization ;

(b) the articles of association or rules of the organization ;

(c) the benefits provided by the organization or the contributions for, and the amount of, those benefits ; or

(d) in the case of a registered medical benefits organization that provides professional services under a contract arrangement—the terms and conditions under which professional services are provided under the arrangement,

the registered organization shall, within seven days after the change is made, furnish to the Director-General notification in writing of the change.

Penalty: One hundred pounds.

“(2.) If such a change alters or affects—

(а) the benefits provided from the medical benefits fund or the hospital benefits fund of the organization or the contributions payable to the organization for such a fund ;

(b) the conditions relating to the provision of benefits by the organization from such a fund ; or

(c) the assets, the income, the expenditure, or the probable income or expenditure, of the organization in relation to such a fund,

the change is inoperative and has no legal effect unless and until the Minister’s approval of the change has been given in accordance with this section.

“(3.) The Director-General shall refer to the Committee, for examination and report to the Minister, a notification by a registered organization of a change in relation to which the last preceding sub-section applies.

“(4.) The Committee shall examine the effect of the change and, in its report, recommend to the Minister that his approval of the change be given or refused.

 

“(5.) If, after examining the effect of the change, the Committee considers that the change—

(а)imposes any unreasonable or inequitable condition affecting the rights of contributors to the medical benefits fund or the hospital benefits fund of the registered organization ; or

(b) adversely affects the financial stability of the medical benefits fund or the hospital benefits fund of the registered organization by providing for reduction or probable reduction of the assets of the organization, reduction or probable reduction of the income of the organization, increased expenditure by the organization, insufficient contributions or excessive benefits or otherwise,

the Committee shall state its opinion and the reasons for its opinion in its report to the Minister.

“(6.) As soon as practicable after his consideration of the report of the Committee, the Minister shall approve or refuse to approve of the change and give to the registered organization notification in writing of his decision.

“(7.) An approval of the Minister given in pursuance of the last preceding sub-section may be unconditional or given subject to variation, in pursuance of sub-section (6.) of section seventy-three of this Act, of the terms and conditions subject to which the organization is registered.”.

Offences.

21. Section eighty-two of the Principal Act is amended by omitting sub-section (7.).

Interpretation.

22. Section eighty-four of the Principal Act is amended by inserting in sub-section (1.), after the definition of “hospital authority”, the following definition:—

“‘pensioner’ includes a dependant of a pensioner ;”.

23. Section eighty-five of the Principal Act is repealed and the following section inserted in its stead:—

Pharmaceutical benefits.

“85.—(1.) The pharmaceutical benefits referred to in this Part are—

(a) drugs and medicinal preparations the names or formulae of which are prescribed and other particulars of which are determined by the Minister ; and

(b) in relation to a pensioner—

(i) except as determined by the Minister, drugs and medicinal preparations that are the subject of monographs in the British Pharmacopoeia ;

(ii) drugs and medicinal preparations, being drugs and medicinal preparations not referred to in the preceding provisions of this section, that are determined by the Minister to be available to pensioners ; and

 

(iii) except as determined by the Minister, medicinal compounds composed of two or more of the drugs and medicinal preparations referred to in sub-paragraphs (i) and (ii) of this paragraph.

“(2.) In determining particulars of a drug or medicinal preparation the Minister may specify a brand, a strength, a form and a maximum quantity or number of units, or any of those particulars, and the drug or medicinal preparation in accordance with those particulars is the pharmaceutical benefit that may be medically prescribed for supply, supplied and received for the purposes of this Part.

“(3.) A copy of each determination made by the Minister in pursuance of this section shall be published in the Gazette.”.

Eligibility for pharmaceutical benefits.

24. Section eighty-six of the Principal Act is amended by omitting from sub-section (2.) the words “or purpose” and inserting in their stead the words “or for a prescribed purpose”.

Prescribing of benefits by medical practitioner.

25. Section eighty-eight of the Principal Act is amended by omitting from sub-section (4.) the words “prescribed by the regulations” and inserting in their stead the words “determined by the Minister”.

26. Section eighty-nine of the Principal Act is repealed and the following section inserted in its stead:—

Pharmaceutical benefits to be supplied only on prescription. &c.

“89. A person is not entitled to receive a pharmaceutical benefit unless it is supplied—

(a) by an approved pharmaceutical chemist, on presentation of a prescription written by a medical practitioner in accordance with the regulations, at or from premises in respect of which the pharmaceutical chemist is for the time being approved ; or

(b) in accordance with the provisions of section ninety-two, section ninety-three or section ninety-four of this Act.”.

Supply of certain pharmaceutical benefits by medical practitioners.

27. Section ninety-three of the Principal Act is amended—

(a) by omitting from sub-section (1.) the words “as are prescribed for the purpose of this section” and inserting in their stead the words “as the Minister determines” ;

(b) by omitting from sub-section (2.) the words “the regulations may prescribe” and inserting in their stead the words “the Minister may determine” ; and

(c) by inserting after that sub-section the following sub-section:—

“(2a.) A copy of each determination made by the Minister in pursuance of this section shall be published in the Gazette.”.

 

Approved hospital authorities.

28. Section ninety-four of the Principal Act is amended by inserting in sub-section (2.), after the word “hospital”, the word “authority”.

Suspension or revocation of approval or authorization.

29. Section ninety-five of the Principal Act is amended—

(a) by inserting in sub-section (1.), after the word “writing,” (first occurring), the words “reprimand a medical practitioner or approved pharmaceutical chemist or” ; and

(b) by omitting from paragraph (d) of that sub-section the word “prescribed”.

Publication of notice of suspension or revocation.

30. Section ninety-six of the Principal Act is repealed.

Pharmaceutical Benefits Advisory Committee.

31. Section one hundred and one of the Principal Act is amended by omitting sub-section (4.) and inserting in its stead the following sub-section:—

“(4.) An addition to the general pharmaceutical benefits as prescribed under the National Health Act 1953 shall not be made unless that addition has been recommended by the Committee.”.

Offences.

32. Section one hundred and three of the Principal Act is amended by omitting paragraph (f) of sub-section (5.) and inserting in its stead the following paragraph:—

“(f) supply as a pharmaceutical benefit a drug or medicinal preparation that does not conform in form, brand, strength or standard of composition or purity with the particulars determined or the standards prescribed in respect of that pharmaceutical benefit ;”.

Powers of authorized persons.

33. Section one hundred and four of the Principal Act is amended by adding at the end thereof the following sub-section:—

“(3.) Upon inquiry by an authorized person, an approved pharmaceutical chemist shall not refuse or fail to disclose—

(a) the source from which he purchased or obtained drugs or medicinal preparations that are or have been pharmaceutical benefits ; or

(b) particulars of stocks in his possession of drugs or medicinal preparations that are or have been pharmaceutical benefits.

Penalty: One hundred pounds or imprisonment for six months.”.

Interpretation.

34. Section one hundred and seven of the Principal Act is amended by omitting from sub-section (1.) the words “for pensioners and their dependants” (first occurring).

Functions ofFederalCommittee.

35. Section one hundred and nine of the Principal Act is amended by omitting from paragraph (b) the words “for pensioners and their dependants”.

 

36.—(1.) Section one hundred and ten of the Principal Act is repealed and the following section inserted in its stead:—

Medical Services State Committees of Inquiry.

“110.—(1.) The Minister may establish in a State one or more Committees, each of which shall be called a Medical Services Committee of Inquiry for the State in which it is established.

“(2.) Each Committee shall consist of the Director and four medical practitioners appointed by the Minister from among medical practitioners nominated by the Council of the branch of the British Medical Association in the State.”.

(2.) The persons who, immediately before the commencement of this section, held office as members of the Medical Services Committee of Inquiry for a State shall continue to hold office as if they had been appointed under section one hundred and ten of the National Health Act 1953–1955.

Functions of State Committees.

37. Section one hundred and eleven of the Principal Act is amended—

(a) by omitting the word “State” (first occurring) ;

(b) by inserting in paragraph (a), after the word “State”, the words “in which the Committee is established” ; and

(c) by omitting paragraph(b) and inserting in its stead the following paragraph:—

“(b) the provision in the State in which the Committee is established of medical services under Part IV. of this Act or under the repealed Regulations.”.

38. After section one hundred and eleven of the Principal Act the following section is inserted:—

Medical consultants

“111a.—(1.) Where a matter referred to a Committee of Inquiry established under section one hundred and ten of this Act concerns the conduct of a medical practitioner in connexion with his provision of medical services under Part IV. of this Act or under the repealed Regulations, and a question arises before the Committee as to the necessity for treatment given to a pensioner or the dependant of a pensioner by the medical practitioner, the Committee may, subject to the Minister’s approval, employ a medical practitioner as consultant upon the matter.

“(2.) A medical practitioner employed under this section shall be paid such remuneration, in respect of his services as consultant, as the Minister determines.”.

39. After Division 2 of Part VIII. of the Principal Act the following Division is inserted:—

“Division 2a.—Medical and Hospital Benefits Committees of Inquiry.

Medical and Hospital Benefits State Committees of Inquiry.

“112a. The Minister may establish in each State a committee, called the Medical and Hospital Benefits Committee of Inquiry for the State in which it is established, which shall consist of the Director

and four medical practitioners appointed by the Minister from among medical practitioners nominated by the Council of the branch of the British Medical Association in the State.

Functions of State Committees.

“112b. A Committee of Inquiry established under the last preceding section shall inquire into and report to the Minister or the Director-General on any matter referred to the Committee by the Minister or the Director-General in respect of or arising out of the supply by a medical practitioner of evidence in support of a claim for payment of Commonwealth benefit under Part III. or Part V. of this Act.”.

Pharmaceutical Services State Committees of Inquiry.

40. Section one hundred and fifteen of the Principal Act is amended—

(a) by omitting from sub-section (1.) the words “the Deputy Director in the State” and inserting in their stead the words “the Director, an officer of the Commonwealth Department of Health who is a pharmacist” ; and

(b) by omitting from sub-section (2.) the word “Deputy”.

Effect of prosecution for offence.

41. Section one hundred and thirty-three of the Principal Act is amended—

(a) by omitting from paragraph (a) of sub-section (1.) the words “for pensioners” ;

(b) by inserting in sub-section (2.), after the word “may” (first occurring), the words “remove the suspension (if any) effected by the Director-General under the last preceding sub-section and” ; and

(c) by omitting from that sub-section the words “suspension or”.

42. After section one hundred and thirty-four of the Principal Act the following sections are inserted:—

Publication of notice of certain action taken under this Act.

“134a.—(1.) The Minister may, if he thinks fit, cause notice of action that he or the Director-General has taken under section thirty-four, section thirty-five, section ninety-five or section one hundred and thirty-three of this Act to be published in the Gazette.

“(2.) An action or proceeding, civil or criminal, does not he against a person for publishing in good faith a copy of, or a fair extract from, or a fair abstract of, a notice published in the Gazette in pursuance of the last preceding sub-section.

“(3.) A publication shall be deemed to be made in good faith if the person by whom it is made is not actuated by ill will to the person affected by the publication or by any other improper motive.

Time for commencing prosecutions.

“134b. A prosecution in respect of an offence against this Act or the regulations may be commenced at any time within three years after the commission of the offence.”.

 

43. After section one hundred and thirty-nine of the Principal Act the following section is inserted:—

Evidence.

“139a.—(1.) The Director-General may, by writing under his, hand, certify that, during a period or on a date specified in the certificate—

(a) a private hospital was or was not an approved private hospital for the purposes of Part V. of this Act ;

(b) an organization was or was not a registered medical benefits organization or a registered hospital benefits organization ;

(c) the registration of an organization was subject to terms and conditions stated in the certificate ;

(d) a medical practitioner was or was not authorized under section eighty-eight of this Act to write a prescription for the supply of pharmaceutical benefits or was or was not authorized under section ninety-three of this Act to supply pharmaceutical benefits specified in the certificate ;

(e) a pharmaceutical chemist was or was not approved under section ninety of this Act for the purpose of supplying pharmaceutical benefits at or from premises specified in the certificate ;

(f) a medical practitioner was or was not approved under section ninety-two of this Act for the purpose of supplying pharmaceutical benefits to persons in an area specified in the certificate ;

(g) a hospital authority was or was not approved under section ninety-four of this Act for the purpose of its supplying general pharmaceutical benefits to patients receiving treatment in or at a hospital specified in the certificate ; and

(h) a document annexed to the certificate is a true copy of a determination by the Minister under this Act or of any other document made or issued under this Act.

“(2.) In proceedings under this Act, in a prosecution for an offence against a law of the Commonwealth and in an investigation or inquiry conducted or made under this Act, a certificate purporting to have been given under this section—

(a) is evidence of the facts stated in the certificate ; and

(b) shall, unless the contrary is proved, be deemed to have been given by the person purporting to give the certificate.”.

The Schedules.

44. The Schedules to the Principal Act are repealed and the following Schedules inserted in their stead:—

THE SCHEDULES.

 

FIRST SCHEDULE. Section 14.

Commonwealth Benefits for Professional Services in Respect of which Fund Benefits are also Payable by Registered Medical Benefits Organizations.

Item No.

Professional Service.

Commonwealth Benefit.

Part 1.—Professional Attendances not covered by any Other Item or Sub-item in this Schedule or the Second Schedule to this Act.

£

s.

d.

1.

Professional attendance (including attendance at rooms, surgery, homo or hospital, but not including an attendance at which there is made an examination of a patient’s sight for the purpose of correcting errors of refraction by the prescription of spectacle lenses) by—

(1) A medical practitioner other than a specialist in the practice of his specialty—each attendance...........................................................................

6

0

(2) A specialist in the practice of his specialty—

(a) When patient referred by another medical practitioner—

(i) For the first attendance............................

1

0

0

(ii) For each subsequent attendance during the same course of treatment.................................................

10

0

(b) When patient not referred by another medical practitioner—each attendance..............................................................

6

0

Part 2.—Administration of Anaesthetics.

2.

Administration, whether by one or more than one medical practitioner, of general, intravenous, local or spinal anaesthetics (not covered by any other item or sub-item in this Schedule or the Second Schedule to this Act), including pre-medication and pre-operative examination in preparation for anaesthesia, in connexion with a professional service or a series or combination of professional services—

(1) For which the Commonwealth benefit payable does not exceed £3 

15

0

(2) For which the Commonwealth benefit payable exceeds £3 but does not exceed £7.....................................................................................................

1

2

6

(3) For which the Commonwealth benefit payable exceeds £7 but does not exceed £11 5s..........................................................................................

1

10

0

Part 3.—Operations.

Division 1.—Ear, Nose and Throat.

3.

Operations on tonsils and adenoids—

(1) Removal of tonsils, or tonsils and adenoids of—

(a) Persons under twelve years of age............................

1

17

6

(b) Persons twelve years of age or over.........................

3

0

0

(2) Removal of adenoids......................................................................

15

0

(3) Removal of lingual tonsil or lateral pharyngeal bands............

15

0

(4) Incision of peritonsillar abscess (quinsy)....................................

15

0

4.

Uvulotomy..........................................................................................................

15

0

5.

Paracentesis tympani, myringotomy, operation for acute otitis media, operation for abscess of middle ear.................................................................................................

1

2

6

6.

Operations on maxillary antrum—

(1) Proof puncture.................................................................................

15

0

(2) Lavage—each attendance.............................................................

7

6

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 3.—Operations—continued.

£

s.

d.

7.

Cortical mastoidectomy.....................................................................................................

5

12

6

8.

Intubation of larynx...........................................................................................................

1

17

6

9.

Tracheotomy......................................................................................................................

3

15

0

10.

Repair of tongue tie...........................................................................................................

15

0

Division 2.—General Surgical.

11.

Cholecystectomy................................................................................................................

11

5

0

12.

Cholecystostomy...............................................................................................................

5

12

6

13.

Suture of perforated gastric ulcer......................................................................................

7

10

0

14.

Appendicectomy................................................................................................................

5

12

6

15.

Drainage of appendiceal abscess, or for ruptured appendix or for peritonitis...................

5

12

6

16.

Splenectomy......................................................................................................................

11

5

0

17.

Repair of hernia, namely:—

(1) Umbilical—

(a) Persons under ten years of age....................................................

2

12

6

(b) Persons ten years of age or over..................................................

5

12

6

(2) Incisional or strangulated................................................................................

7

10

0

(3) Femoral, inguinal or ventral (not being incisional or strangulated hernia)

5

12

6

18.

Laparotomy, namely:—

(1) Exploratory......................................................................................................

5

12

6

(2) Involving operations on abdominal viscera not covered by any other item or sub-item in this Schedule...................................................................................................

7

10

0

19.

Removal of varicocoele.....................................................................................................

3

15

0

20.

Enterostomy or colostomy.................................................................................................

5

12

6

21.

Gastrostomy......................................................................................................................

5

12

6

22.

Closure of enterostomy or colostomy...............................................................................

1

2

6

23.

Treatment of intussusception, namely:—

(1) Reduction by fluid...........................................................................................

3

15

0

(2) Laparotomy and reduction..............................................................................

7

10

(3) Laparotomy and resection...............................................................................

11

5

0

24.

Reduction of volvulus.......................................................................................................

7

10

0

25.

Separation of peritoneal adhesions....................................................................................

5

12

6

26.

Paracentesis abdominis......................................................................................................

15

0

27.

Tapping of hydrocoele.......................................................................................................

15

0

28.

Removal of hydrocoele......................................................................................................

3

15

0

29.

Removal, ligation or cauterization of haemorrhoids.........................................................

4

10

0

30.

Excision of fistula in ano...................................................................................................

5

12

6

31.

Incision of ischio-rectal abscess or haemorrhoid..............................................................

1

17

0

32.

Excision of fissure in ano..................................................................................................

1

17

6

33.

Dilatation of anus..............................................................................................................

15

0

34.

Excision of rectal polypus.................................................................................................

1

17

6

35.

Orchidectomy-simple.........................................................................................................

4

10

0

36.

Transplantation of undescended testis or testes................................................................

5

12

6

37.

Operations on prepuce—

(1) Circumcision of—

(a) Persons aged less than twelve months.........................................

15

0

(b) Persons not less than one year but less than twelve years of age

1

2

6

(c) Persons twelve years of age or over............................................

1

17

6

(2) Reduction of paraphimosis under anaesthetic, with or without dorsal incision 

15

0

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 3.—Operations—continued.

£

s.

d.

38.

Suture of—

(1) One nerve trunk.....................................................................................

2

12

6

(2) Two or more nerve trunks.....................................................................

4

10

0

39.

Suture of tendons—

(1) Suture of tendo achillis or other large tendon.......................................

3

15

0

(2) Primary suture of—

(a) Flexor tendons of hand—

(i) One tendon..........................................................

2

12

6

(ii) Two or more tendons.........................................

3

15

0

(b) Extensor tendons of hand—

(i) One tendon..........................................................

1

17

6

(ii) Two or more tendons.........................................

2

12

6

(c) Tendons of foot—

(i) One tendon..........................................................

1

17

6

(ii) Two or more tendons.........................................

2

12

6

(3) Secondary suture of—

(a) Flexor tendons of hand—

(i) One tendon..........................................................

3

15

0

(ii) Two or more tendons.........................................

5

12

6

(b) Extensor tendons of hand—

(i) One tendon..........................................................

2

12

6

(ii) Two or more tendons.........................................

3

15

0

(c) Tendons of foot—

(i) One tendon..........................................................

2

12

6

(ii) Two or more tendons.........................................

3

15

0

40.

Excision of sinus.....................................................................................................

3

15

0

41.

Excision of ganglion of wrist..................................................................................

1

17

6

42.

Excision of bursa—

(1) Small......................................................................................................

1

17

6

(2) Large (including olecranon, calcanean or patellar)...............................

3

15

0

43.

Incision of bursa......................................................................................................

15

0

44.

Excision of exostosis...............................................................................................

1

17

6

45.

Incision with drainage of—

(1) Haematoma, furuncle, small abscess or similar lesion not requiring a general anaesthetic

7

6

(2) Large haematoma, abscess, carbuncle, cellulitis or similar lesion requiring a general anaesthetic......................................................................................

15

0

46.

Incision of tendon sheath or sub-cutaneous fascia..................................................

1

17

6

47.

Drainage of middle palmar, thenar or hypothenar spaces.......................................

1

17

6

48.

Removal of nail or incision of pulp space, paronychia or other acute infections of hands or feet, not covered by any other item or sub-item in this Schedule...................................

15

0

49.

Operations on blood vessels—

(1) Ligation of—

(a) Veins and small arteries.....................................................

15

0

(b) Medium arteries.................................................................

1

17

6

(c) High saphenous vein..........................................................

3

15

0

(d) Great vessels (including carotids and jugulars, subclavian, axillary, iliac or femoral vessels)..........................................................

5

12

6

(2) Excision of—

(a) Varicose veins of lower limb.............................................

2

12

6

(b) Varicose veins of lower limb with high ligation of saphenous vein

5

12

6

50.

Biopsy (including aspiration biopsy, excision of lymph gland or glands, biopsy of cervix or section of breast) not covered by any other item or sub-item in this Schedule.................

1

2

6

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Past 3.—Operations—continued.

£

s.

d.

51.

Removal of cysts, tumours or scars, namely:—

(1) Cyst, tumour or scar not covered by any other item or sub-item in this Schedule..............................................................................................................

15

0

(2) Cyst or simple tumour of breast (minor operation)...........................

1

17

6

(3) Deep tumour or cyst, malignant or non-malignant (not covered by any other item or sub-item in this Schedule) requiring wide excision...............

3

15

0

(4) Abrasive therapy to scars—each treatment........................................

2

12

6

52.

Paracentesis or aspiration of thoracic cavity—either or both.............................

15

0

53.

Operation for empyema—

(1) Intercostal drainage not involving resection of rib............................

1

17

6

(2) Radical operation involving resection of rib.......................................

3

15

0

54.

Amputation of breast—simple.................................................................................

5

12

6

55.

Operation for acute osteomyelitis, namely:—

(1) Of phalanx, metacarpal or metatarsal (one bone).............................

1

17

6

(2) Of sternum, tibia, ulna, clavicle, rib, tarsus, carpus, fibula or radius (one bone)

3

0

0

(3) Of humerus or femur (one bone)..........................................................

3

15

0

(4) Of any combination of bones specified in sub-item (1) or (2) of this item 

4

10

0

(5) Of any combination of bones specified in sub-item (3) of this item or in that sub-item and sub-item (1) or (2) of this item................................................

7

10

0

(6) Of mandible or maxilla (other than alveolar margins)......................

3

0

0

56.

Craniotomy, not covered by any other item or sub-item in this Schedule.......

11

5

0

57.

Lumbar puncture........................................................................................................

15

0

58.

Removal of foreign body not covered by any other item or sub-item in this Schedule or the Second Schedule to this Act—

(1) Superficial.................................................................................................

6

0

(2) Subcutaneous...........................................................................................

1

2

6

(3) Deep...........................................................................................................

2

12

6

(4) Plates and similar articles used in treating fractures.........................

2

12

6

Division 3.—Urological.

60.

Catheterization of bladder........................................................................................

15

0

61.

Passage of urethral sounds—dilatation of urethral stricture...............................

1

2

6

62.

Suprapubic cystostomy.............................................................................................

2

12

6

63.

Nephrectomy—complete or partial.........................................................................

11

5

0

64.

Drainage of perinephric abscess..............................................................................

5

12

6

65.

Repair of ruptured urethra or bladder.....................................................................

9

7

6

Division 4.—Gynaecological.

66.

Hysterectomy (other than vaginal)—

(1) Subtotal.....................................................................................................

7

10

0

(2) Total...........................................................................................................

11

5

0

(3) With plastic repair operations...............................................................

11

5

0

68.

Repair of cystocoele or rectocoele not covered by item 70 in this Schedule............

5

12

6

69.

Repair of cystocoele and rectocoele not covered by item 70 in this Schedule.........

7

10

0

70.

Colpoplasty, Donald-Fothergill or Manchester operation (operation for genital prolapse) 

9

7

6

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 3.—Operations—continued.

£

s.

d.

71.

Amputation or repair of cervix not covered by item 70 in this Schedule..............

3

15

0

72.

Cauterization, ionization, diathermy of, or removal of polyp from, cervix...........

1

17

6

73.

Curettage with or without dilatation..........................................................................

1

17

6

74.

Dilatation of cervix not covered by item 73 in this Schedule.................................

1

10

0

75.

Salpingectomy or salpingo-oophorectomy—

(1) Unilateral...................................................................................................

5

12

6

(2) Bilateral.....................................................................................................

7

10

0

76.

Oophorectomy, incision or excision of ovarian, parovarian, fimbrial or broad ligament cyst, not covered by any other item or sub-item in this Schedule..................................................

6

7

6

77.

Removal of ectopic gestation.....................................................................................

7

10

0

78.

Suspension or fixation of uterus, internal or external shortening of round ligaments 

5

12

6

79.

Myomectomy...............................................................................................................

5

12

6

80.

Operation on vagina—

(1) Colpotomy.................................................................................................

1

17

6

(2) Colporrhaphy (not covered by items 68, 69 or 70 in this Schedule)....

2

12

6

(3) Dilatation—each attendance....................................................................

7

6

81.

Suprapubic drainage of pelvic abscess......................................................................

5

12

6

82.

Excision of vaginal or Bartholin’s cyst.....................................................................

1

17

6

83.

Gynaecological examination under anaesthesia not performed in association with any other item in this Schedule or the Second Schedule to this Act.....................................................

15

0

84.

Removal of simple tumour of perineum or vulva....................................................

1

17

6

85.

Incision of Bartholin’s abscess..................................................................................

1

2

6

86.

Removal of calculus from Skene’s duct....................................................................

1

17

6

87.

Excision of, or cautery to, urethral caruncle.............................................................

1

17

6

Division 5.—Ophthalmological.

88.

Extirpation of tarsal cyst.............................................................................................

15

0

89.

Removal of foreign body from cornea or sclera.......................................................

7

6

90.

Enucleation of eye.......................................................................................................

5

12

6

Division 6.—Amputations and Disarticulations of Limbs.

91.

Amputation or disarticulation—

(1) Finger or fingers, thumb or thumbs—

(a) One finger or thumb..............................................................

1

10

0

(b) Each additional finger or thumb...........................................

7

6

(2) Through metacarpals................................................................................

3

15

0

(3) Hand...........................................................................................................

5

12

6

(4) Forearm.....................................................................................................

5

12

6

(5) Through arm..............................................................................................

6

12

6

(6) At shoulder................................................................................................

9

7

6

(7) Toe or toes—

(a) One toe (or great toe).............................................................

1

17

6

(b) Each additional toe (or great toe).........................................

7

6

(8) Foot............................................................................................................

7

10

0

(9) Through leg................................................................................................

7

10

0

(10) At knee.....................................................................................................

7

10

0

(11) Through thigh..........................................................................................

9

7

6

(12) At hip........................................................................................................

11

5

0

 

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 3.—Opérations—continued.

£

s.

d.

Division 7.—Miscellaneous.

92.

Assisting at operation—In respect of not more than one medical practitioner (not being the anaesthetist) who assists at any operation or series or combination of operations performed on the same patient on the same occasion—

(1) For which the Commonwealth benefit payable does not exceed £3 

7

6

(2) For which the Commonwealth benefit payable exceeds £3 but does not exceed £7...........................................................................................................

15

0

(3) For which the Commonwealth benefit payable exceeds £7 but does not exceed £11 5s............................................................................................................

1

2

6

93.

Collection intravenously of blood specimen for pathological test..................

7

6

94.

Injection intravenously of saline and glucose.....................................................

15

0

95.

Blood transfusion—

(1) Collection from donor and transfusion.............................................

2

5

0

(2) Transfusion, using pooled blood or blood already collected.........

1

10

0

(3) Collection of blood for purposes of transfusion..............................

1

2

6

(4) Transfusion with venesection and complete replacement of blood—

(a) Including collection from donor.....................................

3

0

0

(b) Using pooled blood or blood already collected............

2

5

0

96.

Venesection—each attendance at which venesection is performed................

7

6

Part 4.—Midwifery.

Division 1.—General.

97.

Ante-natal care (excluding any service or services covered by item 101, 103, 104 or 105 in this Schedule)—

(1) Where attendances do not exceed seven—each attendance.........

6

0

(2) Where attendances exceed seven.......................................................

2

2

0

98.

Confinement and post-natal care for nine days (excluding any service or services covered by item 102, 103, 106, 107 or 108 in this Schedule) where the medical practitioner has not given the ante-natal care....................................................................................................

2

5

0

99.

Ante-natal care, confinement and post-natal care for nine days, excluding any service or services covered by items 101 to 108 (inclusive) in this Schedule...........

3

15

0

100.

Caesarean section and post-natal care for nine days..........................................

7

10

0

Division 2.—Special Services.

101.

Toxaemia of pregnancy, eclampsia or ante-partum haemorrhage—each attendance 

6

0

102.

Post-partum haemorrhage requiring special procedures such as packing

1

2

6

103.

Surgical induction of labour...................................................................................

1

2

6

104.

External version under anaesthesia......................................................................

1

2

6

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 4.—Midwifery—continued.

£

s.

d.

105.

Internal version under anaesthesia..............................................................

1

2

6

106.

Repair of third degree tear............................................................................

1

2

6

107.

Evacuation by manual removal of the products of conception such as retained foetus, placenta, membranes or mole................................................................

1

2

6

108.

Decapitation, craniotomy, cleidotomy or evisceration of foetus or any two or more of those services.......................................................................................................

5

12

0

Part 5.—Injections and Vaccinations.

109.

Local infiltration around nerve or in muscle with alcohol, Novocaine or similar preparation—each attendance at which one or more injections are given..............

7

6

110.

Injection of varicose veins or haemorrhoids—each attendance at which one or more injections are given..................................................................................

7

6

Part 6.—Treatment of Dislocations.

Division 1.—Not Requiring Open Operation.

115.

Treatment of dislocation of—

(1) Mandible—

(a) First or second dislocation......................................

15

0

(b) Third or subsequent dislocation.............................

7

6

(2) Clavicle..........................................................................................

2

5

0

(3) Shoulder—

(a) First or second dislocation......................................

1

17

6

(b) Third or subsequent dislocation—

(i) Requiring anaesthesia..............................

1

17

6

(ii) Not requiring anaesthesia......................

15

0

(4) Elbow.............................................................................................

2

5

0

(5) Carnal bone..................................................................................

1

10

0

(6) Carpus on radius and ulna.........................................................

3

15

0

(7) Finger.............................................................................................

15

0

(8) Metacarpo-phalangeal joint of thumb.....................................

1

17

6

(9) Hip..................................................................................................

5

12

6

(10) Knee.............................................................................................

4

10

0

(11) Patella..........................................................................................

1

10

0

(12) Ankle...........................................................................................

2

12

6

(13) Toe...............................................................................................

15

0

(14) Tarsus or tarsal bone.................................................................

1

17

6

Division 2.—Requiring Open Operation

116. Treatment of a dislocation referred to in item 115 in this Schedule, or in item 701 in the Second Schedule to this Act, which requires ail open operation—the amount specified in the relevant item for the treatment of that dislocation if an open operation had not been required, plus one-half of that amount.

 

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 7.—Treatment of Fractures.

£

s

d.

Division 1.—Simple and Uncomplicated Fractures not requiring Open Operation.

117.

Treatment of fracture of—

(1) Terminal phalanx of—

(a) Finger or thumb..................................................................................

15

0

(b) More than one finger, or of thumb and one or more fingers..............

1

2

6

(2) Proximal phalanx of—

(a) Finger or thumb..................................................................................

1

17

6

(b) More than one finger or of thumb and one or more fingers...............

2

12

6

(3) Middle phalanx of—

(a) Finger..................................................................................................

1

2

6

(b) More than one finger..........................................................................

1

17

6

(4) One or more metacarpals not involving first carpometacarpal joint.....................

1

17

6

(5) One or more metacarpals involving the first carpometacarpal joint (Bennett’s fracture) 

2

12

6

(6) Carpal bone (excluding navicular).........................................................................

1

10

0

(7) Navicular or carpal scaphoid.................................................................................

3

15

0

(8) Radius....................................................................................................................

2

5

0

(9) Ulna.......................................................................................................................

1

17

6

(10) Both shafts of forearm.........................................................................................

4

10

0

(11) Wrist—

(a) Colles’ fracture...................................................................................

2

12

6

(b) Distal end of radius............................................................................

2

12

6

(c) Distal end of ulna................................................................................

2

12

6

(12) Humerus..............................................................................................................

4

10

0

(13) Clavicle................................................................................................................

1

17

6

(14) Scapula.................................................................................................................

2

12

6

(15) Sternum................................................................................................................

1

17

6

(16) One or more ribs..................................................................................................

1

10

0

(17) Maxilla.................................................................................................................

3

15

0

(18) Mandible..............................................................................................................

4

10

0

(19) Zygoma................................................................................................................

1

17

6

(20) Pelvis (excluding symphysis pubis)....................................................................

4

10

0

(21) Symphysis pubis..................................................................................................

3

15

0

(22) Femur...................................................................................................................

7

10

0

(23) Patella...................................................................................................................

1

17

6

(24) Tibia.....................................................................................................................

3

15

0

(25) Fibula...................................................................................................................

1

17

6

(26) Both shafts of leg.................................................................................................

5

12

6

(27) Ankle (Pott’s fracture) with or without dislocation of ankle...............................

5

12

6

(28) Tarsal bone (excepting os calcis or os talus).......................................................

1

17

6

(29) Os calcis (calcaneus)............................................................................................

3

15

0

 

The Schedules—continued.

First Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Past 7.—Treatment of Fractures—continued.

£

s.

d.

(30) Os talus........................................................................................

3

15

0

(31) One or more metatarsals..........................................................

1

17

6

(32) Phalanx of toe (other than of great toe).................................

15

0

(33) More than one phalanx of toe (other than of great toe)......

1

2

6

(34) Distal phalanx of great toe.......................................................

1

2

6

(35) Proximal phalanx of great toe.................................................

1

10

0

(36) Skull.............................................................................................

3

15

0

(37) Nasal bones—

(a) Not requiring reduction...........................................

15

0

(b) Requiring reduction.................................................

1

17

6

(38) Spine—

(a) Transverse process or bone other than vertebral body, not requiring immobilization in plaster..................................

1

17

6

(b) Transverse process or bone other than vertebral body, requiring immobilization in Plaster..................................

4

10

0

(c) Fracture of vertebral bodies—

(i) Without involvement of cord..................

7

10

0

(ii) With involvement of cord.......................

11

5

0

Division 2.—Simple and Uncomplicated Fractures requiring Open Operation.

118. Treatment of a simple and uncomplicated fracture of a part referred to in item 117 in this Schedule requiring an open operation—the amount specified for the treatment of that fracture in that item if an open operation had not been required, plus one-third of that amount or an amount of Eleven pounds five shillings, whichever is the less.

Division 4.—Compound Fractures requiring Open Operation.

120 Treatment of a compound fracture of a part referred to in item 117 in this Schedule requiring an open operation—the amount specified in that item for the treatment of that fracture if the fracture was a simple and uncomplicated one and did not require an open operation, plus one-half of that amount or an amount of Eleven pounds five shillings, whichever is the less.

Division 5.—Complicated Fractures involving Viscera, Blood Vessels or Nerves and requiring Open Operation.

121 Treatment of a complicated fracture of a part referred to in item 117 in this Schedule involving viscera, blood vessels or nerves and requiring an open operation—the amount specified in that item for the treatment of that fracture if the fracture had been simple and uncomplicated and had not required an open operation, plus three-quarters of that amount or an amount of Eleven pounds five shillings, whichever is the less.

The Schedules—continued.

SECOND SCHEDULE Section 15.

Commonwealth Benefits for Additional Professional Services.

Item No.

Professional Service.

Commonwealth Benefit.

Part 1.—Pathological Services.

£.

s.

d.

Division 1.—Blood.

201.

Pathological services in relation to blood, namely :—

(1) Examination of blood film..............................................................................

6

0

(2) Red cell count.................................................................................................

6

0

(3) Red cell count and estimation of haemoglobin...............................................

7

6

(4) White cell count..............................................................................................

6

0

(5) White cell count and differential leucocyte count..........................................

7

6

(6) Red cell count, white cell count, estimation of haemoglobin and examination of blood film 

15

0

(7) Platelet count...................................................................................................

6

0

(8) Reticulocyte count..........................................................................................

6

0

(9) Haemoglobin estimation (when patient referred by another medical practitioner) 

6

0

(10) Estimation of coagulation time.....................................................................

6

0

(11) Estimation of prothrombin time....................................................................

6

0

(12) Estimation of bleeding time..........................................................................

6

0

(13) Blood sedimentation rate..............................................................................

6

0

(14) Determination of fragility of red blood cells................................................

6

0

(15) Haematocrit estimations................................................................................

7

6

(16) Estimation of mean diameter of red blood cells...........................................

15

0

(17) Blood grouping, namely :—

(a) A.B.O..........................................................................................

6

0

(b) A.B.O. and compatibility test......................................................

7

6

(c) A.B.O. and either M.N. or Rh typing..........................................

15

0

(18) Examination of serum for Anti-Rh or other blood group antibodies............

15

0

(19) Coombs’ test.................................................................................................

7

6

(20) Determination and titration of cold agglutinins in blood..............................

7

6

(21) Examination of blood for malarial, filarial and other parasites....................

7

6

(22) Paul-Bunnell reaction....................................................................................

7

6

(23) Paul-Bunnell reaction with white cell count and differential white cell count 

15

0

(24) Blood culture.................................................................................................

15

0

(25) Blood sugar estimation—initial or repeated..................................................

7

6

(26) Glucose tolerance test...................................................................................

15

0

(27) Estimation of urea, chloride, creatinine, cholesterol, phosphatase and similar blood chemistry—

(a) One item.......................................................................................

15

0

(b) Two items....................................................................................

1

10

0

(c) Three or more items.....................................................................

2

5

0

(28) Estimation of total protein (by gravimetric methods)...................................

6

0

(29) Estimation of lead (quantitative analysis).....................................................

15

0

(30) Examination of specimen obtained by sternal puncture or biopsy...............

15

0

(31) Van den Bergh reaction—

(a) Qualitative....................................................................................

7

6

(b) Quantitative..................................................................................

15

0

(32) Spectroscopic tests for blood and blood derivatives.....................................

15

0

(33) Estimation of alcohol in blood......................................................................

15

0

(34) Carbon dioxide combining power

15

0

 

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 1.—Pathological Services—continued.

£

s.

d.

Division 2.—Urine.

202.

Pathological services in relation to urine, namely :—

(1) Microscopical and cultural examination for microorganisms—

(a) Not including animal inoculation...................................

7

6

(b) Including animal inoculation...........................................

15

0

(2) Microscopical examination of centrifugalized deposit (when patient referred by another medical practitioner)........................................................

6

0

(3) Quantitative chemical estimation of sugar, albumin, urea, phosphates and similar urine chemistry—

(a) One item..............................................................................

15

0

(b) Two items............................................................................

1

10

0

(c) Three or more items............................................................

2

5

0

(4) Estimation of 17 keto-steroids............................................................

15

0

(5) Estimation of hippuric acid.................................................................

15

0

(6) Estimation of lead (quantitative analysis)........................................

15

0

(7) General examination for reaction, specific gravity, blood, albumin and sugar, with microscopical examination of centrifugalized deposit with or without qualitative tests for urobilin, acetone or indican (when patient referred by another medical practitioner).....................................................................................

7

6

(8) Urea concentration test........................................................................

15

0

(9) Urea clearance test................................................................................

15

0

(10) Assay of ascorbic acid excretion......................................................

15

0

(11) Water elimination teat.......................................................................

15

0

(12) Mosenthal kidney function test........................................................

15

0

Division 3.—Pus, Exudations and other Morbid Fluids.

203.

Pathological services in relation to pus, exudations and other morbid fluids, namely :—

(1) Microscopical examination of smear for cellular content and micro-organisms 

6

0

(2) Cultural examination for, and identification of, aerobic micro-organisms 

7

6

(3) Cultural examination for, and identification of, Cl. tetani and other anaerobes 

15

0

(4) Microscopical examination of vaginal and cervical discharge.....

6

0

(5) Microscopical and cultural examination of vaginal discharge......

7

6

(6) Serological typing of streptococci including Str. Pneumoniae.....

15

0

(7) Serological grouping (Lancefield) of streptococci..........................

15

0

(8) Examination of vaginal discharge for T. vaginalis.........................

6

0

(9) Microscopical and cultural examination and animal inoculation in connexion with the pathological examination of pus, exudations and other morbid fluids 

15

0

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 1.— Pathological Services—continued.

£

s.

d.

Division 4.—Serological Tests.

204.

Agglutination test, including agglutination tests for enteric fever and Brucella infection 

7

6

205.

Complement fixation test for syphilis (qualitative or quantitative)..................................

7

6

206.

Complement fixation test for gonorrhea..........................................................................

7

6

207.

Complement fixation test for hydatid..............................................................................

7

6

208.

Flocculation tests for syphilis, including Kline, Kahn, Eagle and similar tests—each test 

6

0

Division 5.—Faeces.

209.

Pathological services in relation to faeces, namely :—

(1) Cultural examination for S. typhi, dysentery bacilli and other intestinal pathogens—

(a) Without full fermentation reaction, serological or other investigation for purpose of identification........................................................................

7

6

(b) With full fermentation reaction, serological and other investigation for purpose of identification........................................................................

15

0

(2) Chemical examination, including chemical examination for occult blood and urobilin 

6

0

(3) General microscopical examination for M. tuberculosis including microscopical and cultural examinations—

(a) Without animal inoculation........................................................

7

6

(b) With animal inoculation.............................................................

15

0

(4) Microscopical examination for—

(a) Pus cells......................................................................................

6

0

(b) Helminthic infestation, worms and ova (all or any of them)......

7

6

(c) Amoebae, flagellates, vegetative forms and cysts (all or any of them) 

7

6

(5) Estimation of lead..........................................................................................

15

0

(6) Estimation of fat............................................................................................

7

6

Division 6.—Skin Sensitivity Tests.

210.

Skin sensitivity tests (not being mass or group tests), namely :—

(1) Skin sensitivity tests for allergens, including skin sensitivity tests for hay fever, asthma and other allergic conditions—..............................................................................

(a) Scratch tests—

(i) Less than four reagents................................................

6

0

(ii) Four or more reagents................................................

15

0

(b) Intradermal tests—

(i) Less than four injections..............................................

0

0

(ii) Four or more injections..............................................

15

0

(2) Casoni reaction for hydatid infestation..........................................................

6

0

(3) Mantoux test..................................................................................................

6

0

(4) Von Pirquet reaction......................................................................................

6

0

(5) Vollmer patch test..........................................................................................

6

0

(6) Frei antigen test.............................................................................................

6

0

(7) Schick test......................................................................................................

6

0

Division 7.—Autogenous Vaccines.

211.

Preparation of autogenous vaccines.................................................................................

15

0

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 1.—Pathological Services—continued.

£

s.

d.

Division 8.—Milk.

212.

Chemical analysis of human......................................................................................

15

0

Division 9.—Examinations for Special Pathogens.

213.

Examination for actinomyces—

(1) Microscopical examination.....................................................................

6

0

(2) Microscopical examination with culture aerobic and anaerobic—

(a) Without animal inoculation..................................................

15

0

(b) With animal inoculation.......................................................

1

2

6

214.

Examination for anthrax bacilli—

(1) Microscopical examination.....................................................................

6

0

(2) Microscopical examination with cultural examination......................

15

0

(3) Microscopical examination with cultural examination and animal inoculation 

1

2

6

216.

Examination for diphtheria bacilli—

(1) Microscopical examination of smear....................................................

6

0

(2) Microscopical examination, cultural examination and biochemical Reactions 

7

6

(3) Microscopical examination, cultural examination, biochemical reactions and virulence tests........................................................................................................

15

0

(4) Microscopical examination, cultural examination, biochemical reactions, virulence tests and typing of strains...........................................................................

1

2

6

216.

Dark ground examination for T. pallidum...............................................................

6

0

Division 10.—Calculi, Faecal Concretions and Gallstones.

217.

Qualitative examination of calculi, faecal concretions or gallstones..................

6

0

Division 11.—Gastric Contents and Examination of Vomitus.

218.

Pathological services in relation to gastric contents and vomitus, namely :—

(1) General chemical and microscopical examination.............................

7

6

(2) Fractional test meal...................................................................................

15

0

(3) Microscopical and cultural examination for M. tuberculosis—

(a) Without animal inoculation..................................................

7

6

(b) With animal inoculation.......................................................

(a) Partial...............................................................................................

7

10

0

(b) Complete..........................................................................................

11

5

0

(3) Cleft palate and hare-lip......................................................................................

11

5

0

(4) Hypospadias or epispadias—

(a) Preliminary plastic...........................................................................

4

10

0

(b) Urethral reconstruction....................................................................

9

7

6

(5) Syndactyly—each stage......................................................................................

4

10

0

(6) Lymphangiectasis of a limb (Milroy’s disease)—

(a) Each injection...................................................................................

7

6

(b) Excision...........................................................................................

7

10

0

(7) Macrocheilia........................................................................................................

9

7

6

(8) Macroglossia.......................................................................................................

9

7

6

(9) Macrostomia........................................................................................................

9

7

6

(10) Angiomata—

(a) Each injection...................................................................................

7

6

(b) Cautery.............................................................................................

15

0

(c) Excision, namely :—

(i) Simple...............................................................................

2

5

0

(ii) Complicated or large (localized)......................................

4

10

0

(iii) Complicated or large (diffused).....................................

7

10

0

(11) Torticollis..........................................................................................................

5

12

6

(12) Bat ears.............................................................................................................

9

7

6

(13) Reconstruction of ears, nose and other parts of the face, not covered by any other item or sub-item in this Schedule or the First Schedule to this Act........................................

11

5

0

516.

Operation for acquired conditions, namely :—

(1) Portal hypertension—

(a) Laparotomy......................................................................................

4

10

0

(b) Lieno-renal anastomosis..................................................................

11

5

0

(c) Eek’s fistula.....................................................................................

11

5

0

(2) Prolapsed rectum—

(a) Injection...........................................................................................

15

0

(b) Resection—plastic operation ..........................................................

5

12

6

(3) Megacolon—colectomy.......................................................................................

11

5

0

(4) Manipulations and plaster work for correction of epiphysitis—

(a) Perthes’ (Calve’s)—

(i) Manipulation.....................................................................

15

0

(ii) Manipulation and plaster.................................................

1

17

6

(b) Sever’s—

(i) Manipulation.....................................................................

15

0

(ii) Manipulation and plaster.................................................

1

2

6

(c) Kohler’s—

(i) Manipulation.....................................................................

15

0

(ii) Manipulation and plaster.................................................

1

2

6

(d) Kienboch’s—

(i) Manipulation.....................................................................

15

0

(ii) Manipulation and plaster.................................................

1

2

6

 

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Past 5.—Operations—continued.

£

s.

d.

(e) Schlatter’s—

(i) Manipulation...................................................................

15

0

(ii) Manipulation and plaster...............................................

1

2

6

(f) Scheuermann’s—

(i) Manipulation...................................................................

1

2

6

(ii) Manipulation and plaster...............................................

2

12

6

Division 10.—General Surgical.

517.

Gastrectomy, partial or complete........................................................................................

11

5

0

518.

Partial gastrectomy and gastro-jejunostomy.......................................................................

11

5

0

519.

Operation for perforated duodenal ulcer............................................................................

9

7

6

520.

Caecostomy........................................................................................................................

5

12

6

521.

Anastomosis of bowel........................................................................................................

11

5

0

522.

Removal of Meckel’s diverticulum....................................................................................

9

7

6

523.

Choledochotomy (with or without cholecystectomy).........................................................

11

5

0

524.

Reconstruction of bile duct including choledochoduodenostomy, cholecystoduodenostomy, choledochoenterostomy, choledochogastrostomy, cholecystogastrostomy or cholecystenterostomy 

11

5

0

525.

Resection of bowel or viscera for neoplasm or chronic inflammation...............................

11

5

0

526.

Repair or removal of ruptured viscus (including liver, spleen bowel) ..............................

11

5

0

527.

Operation for hydatid of liver, peritoneum or viscus.........................................................

11

5

0

528.

Abdomino-perineal resection.............................................................................................

11

5

0

529.

Gastro-enterostomy............................................................................................................

11

5

0

530.

Entero-enterostomy.............................................................................................................

11

5

0

531.

Entero-colostomy................................................................................................................

11

5

0

532.

Amputation of breast (radical)............................................................................................

11

5

0

533.

Excision of tuberculous or neoplastic glands of neck or axilla—

(1) Limited...............................................................................................................

7

10

0

(2) Radical...............................................................................................................

11

5

0

534.

Thyroidectomy....................................................................................................................

11

5

0

535.

Excision of localized thyroid tumour.................................................................................

6

7

6

536.

Removal of parathyroid tumour.........................................................................................

11

5

0

537.

Radical operation for prolapse of rectum in an adult.........................................................

7

10

0

538.

Sigmoidoscopic examination (sigmoidoscopy).................................................................

1

2

6

539.

Operation of acute osteomyelitis, namely :—

(1) Of spine, pelvic bones or skull (one bone)........................................................

5

12

6

(2) Of any combination of bones specified in sub-item (1) of this item and sub-item (1), (2) or (3) of item 55 in the First Schedule to tin's Act...........................................................

7

10

0

540.

Operation (with or without sequestrectomy) for chronic osteomyelitis—

(1) Of scapula, sternum, phalanx, tibia, metacarpal, metatarsal, fibula, radius, ulna, carpus, clavicle, rib or tarsus (one bone)........................................................................................

5

12

6

(2) Of humerus or femur (one bone).......................................................................

7

10

0

(3) Of spine, pelvic bones or skull (one bone)........................................................

11

5

0

(4) Of any combination of bones specified in sub-item (1) of this item.................

7

10

0

(5) Of any combination of bones not covered by sub-item (4) of this item............

11

5

0

(6) Mandible or maxilla (other than alveolar margins)...........................................

5

12

6

 

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 5.—Operations—continued.

£

s.

d.

541.

Operation for cure of hypertrophic pyloric stenosis (Ramstedt’s operation)........

6

7

6

542.

Vagotomy..............................................................................................................

6

7

6

543.

Gastroscopy...........................................................................................................

3

15

0

544.

Removal of tumour of liver...................................................................................

11

5

0

545.

Drainage of liver abscess, namely :—

(1) Abdominal...........................................................................................

4

10

0

(2) Trans-pleural........................................................................................

6

7

6

546.

Portal vein anastomosis for portal obstruction......................................................

11

5

0

547.

Partial excision of pancreas...................................................................................

11

5

0

548.

Drainage of pancreas.............................................................................................

5

12

6

549.

Repair of diaphragmatic hernia.............................................................................

11

5

0

550.

Drainage of subphrenic abscess............................................................................

5

12

6

551.

Removal of branchial cyst or branchial fistula......................................................

6

7

6

552.

Removal of cystic hygroma...................................................................................

6

7

6

553.

Removal of ranula..................................................................................................

3

15

0

555.

Excision of innocent bone tumour.........................................................................

6

7

6

556.

Resection of upper jaw, lower jaw or both jaws...................................................

11

5

0

557.

Excision of tongue.................................................................................................

11

5

0

558.

Operations on salivary glands—

(1) Total extirpation of any one gland......................................................

11

5

0

(2) Incision of any one gland....................................................................

2

5

0

(3) Removal of calculus from gland.........................................................

4

10

0

(4) Dilatation or diathermy of duct...........................................................

1

2

6

(5) Removal of calculus from duct...........................................................

1

10

0

(6) Repair of cutaneous fistula..................................................................

2

5

0

559.

Cisternal puncture..................................................................................................

1

10

0

560.

Removal of styloid process of temporal bone (Eagle’s operation)........................

7

10

0

561.

Excision of coccyx.................................................................................................

4

10

0

562.

Excision of pilonidal cyst or sinus........................................................................

4

10

0

563.

Excision of diverticulum of pharynx or larynx.....................................................

9

7

6

564.

Removal of thyroglossal cyst................................................................................

6

7

6

565.

Removal of thyroglossal fistula.............................................................................

6

7

6

566.

Repair of cut throat—

(1) Involving skin and muscle...................................................................

1

17

6

(2) Involving vessels or nerves, or both....................................................

3

15

0

(3) Involving vessels and nerves and oesophagus or trachea....................

7

10

0

567.

Removal of malignant tumour of neck..................................................................

11

5

0

568.

Scalenotomy...........................................................................................................

4

10

0

569.

Removal of cervical rib.........................................................................................

9

7

6

570.

Thymectomy..........................................................................................................

9

7

6

571.

Removal of retroperitoneal tumour.......................................................................

11

5

0

572.

Drainage of retroperitoneal abscess......................................................................

5

12

6

573.

Peritoneoscopy.......................................................................................................

2

5

0

574.

Operation for malignant tumours requiring wide excision and dissection of glands or involving muscle, bone or viscera not covered by any other item or sub-item in this Schedule or the First Schedule to this Act............................................................................................................

11

5

0

Division 11.—Plastic and Reconstructive.

575.

Free graft, namely :—

(1) Pinch grafts..........................................................................................

2

5

0

(2) Split grafts—

(a) Limited.............................................................................

2

5

0

(b) Extensive..........................................................................

4

10

0

(3) Full thickness grafts............................................................................

3

0

0

 

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 5.—Operations—continued.

£

s.

d.

576.

Indirect flap or pedicle repair—each stage....................................................

2

12

6

577.

Cross leg, abdominal or other direct flap repair—each stage....................

2

12

6

578.

Local flap repair—

(1) Transposition or rotation...............................................................

3

0

0

(2) Pedicle or “Z” plastic......................................................................

3

15

0

579.

Plastic restoration of eye socket......................................................................

7

10

0

580.

Total reconstruction of eye socket—each stage...........................................

2

12

6

581.

Restoration of eyebrows....................................................................................

4

10

0

582.

Grafting for Symblepharon..............................................................................

7

10

0

583.

Restoration of eyelids—each stage.................................................................

2

12

6

584.

Correction of ptosis............................................................................................

7

10

0

585.

Correction of humped or long nose................................................................

7

10

0

586.

Correction of deflected or twisted nose.........................................................

7

10

0

587.

Reconstruction of syphilitic nose—each stage.............................................

2

12

6

588.

Local nasal reconstruction not covered by any other item or sub-item in this Schedule or the First Schedule to this Act...........................................................................

7

10

0

589.

Forehead flap or pedicle reconstruction of nose—each stage....................

2

12

6

590.

Removal of rhinophyma...................................................................................

7

10

0

591.

Ear reconstruction, total or partial—each stage...........................................

2

12

6

592.

Total lip and mouth reconstruction—each stage..........................................

2

12

6

593.

Facial slings for facial paralysis......................................................................

7

10

0

594.

Cosmetic meloplasty.........................................................................................

7

10

0

595.

Excision of moles and melanomata, and repair, not covered by any other item or sub-item in this Schedule.................................................................................................

3

15

0

596.

Excision of carcinomata, and repair, not covered by any other item in this Schedule or the First Schedule to this Act...........................................................................

3

15

0

597.

Correction of prognathism or retrogiathism..................................................

11

5

0

598.

Plastic reconstruction operations (not covered by any other item or sub-item in this Schedule or the First Schedule to this Act) for—

(1) Fracture of mandible......................................................................

7

10

0

(2) Fracture of maxilla..........................................................................

7

10

0

(3) Fracture of malar-maxillary compound......................................

7

10

0

(4) Fracture of nose...............................................................................

7

10

0

(5) Condylectomy—

(a) Single..............................................................................

4

10

0

(b) Double...........................................................................

5

12

6

(6) Finger reconstruction......................................................................

3

15

0

(7) Correction of epicanthus...............................................................

1

17

6

599.

Repair of neck contractures—each stage......................................................

2

12

6

600.

Correction of cicatricial flexion contractures of joints................................

4

10

0

601.

Mammaplasty.....................................................................................................

4

10

0

602.

Major grafting of hands—each stage.............................................................

2

12

6

603.

Penile reconstruction—each stage..................................................................

2

12

6

604.

Vaginal reconstruction in congenital absence..............................................

11

5

0

Division 12.—Miscellaneous.

605.

Hormone or living tissue implantation—

(1) By incision........................................................................................

1

2

6

(2) By cannula.......................................................................................

15

0

 

The Schedules—continued.

Second Schedule—continued.

Item No.

Professional Service.

Commonwealth Benefit.

Part 6.—Treatment of Dislocations.

£

s.

d.

701.

Treatment, not requiring an open operation, of dislocation of spine—

(1) Cervical (without fracture)............................................................

2

12

6

(2) Lumbar (without fracture).............................................................

3

15

0

(3) Associated with fracture of—

(a) Transverse process or bone other than vertebral body, not requiring immobilization in plaster.....................................

1

17

6

(b) Transverse process or bone other than vertebral body, requiring immobilization in plaster.....................................

4

10

0

(c) Vertebral bodies—

7

10

0

(i) Without involvement of cord.....................

(ii) With involvement of cord...........................

11

5

0

Actions
Download as PDF Download as Word Document
Cases Citing This Decision

0

Cases Cited

0

Statutory Material Cited

0