U—3lb

31. The Committee appreciated that all of the classes of specialist services listed above are the subject of full benefit when provided by specialist staffs of Hospital Boards and all are the subject of the provisions made in section 12 of the Finance Act (No. 2), 1942, whereby .a person paying fees for specialist services may obtain from the Fund a refund, of 7s. 6d. for every occasion on which the services have been provided. So far as private specialist services are concerned, substantial benefits have thus far been provided only in respect of radiology and pathology under the Social Security (X-ray Diagnostic) Regulations 1941 and the Social Security (Laboratory Diagnostic Services) Regulations 1946 respectively. Further brief reference is made to these two classes of services in paragraph 45. Reference is also made to obstetric specialist services in paragraph 42 under the heading of " maternity benefits." 32. Payment of Benefits. —For those private specialist services not already the subject of substantial benefit the Committee agreed that the method which was likely to receive the most general approval would be one by which the specialist should be required to claim on the Fund on behalf of the patient the appropriate amount payable from the Fund for the service and apply that amount in full or part settlement of his charge for the service, with the right to recover any balance from the patient in the manner suggested in respect of General Medical Services. 33. Recognition of Specialists. —The Committee considered that, in general, the requirements for recognition as a specialist would be — (1) An adequate training in the specialty under reeognized teachers ; (2) The possession of a higher qualification (if such exists) in that specialty ; (3) The holding of or having held hospital or other public appointment in the specialty; and {4) A general recognition by the applicant's colleagues of his special skill and experience. Some specialists might be recognized as such under more than one of the classes listed in paragraph 30. 34. The Committee -did not consider that, under the conditions governing practice jn New Zealand at the present time, there should, or ordinarily could be, a requirement that the specialist devote his practice exclusively to his specialty. This requirement could at the best be fulfilled only in certain specialties, but more often conditions will dictate that a practitioner should practise his specialty along with the general practice of medicine or surgery. The Committee considered, however, that there should be no differentiation in the requirements for recognition as between the full-time specialist and the part-time specialist. 35. In order to provide machinery for the recognition of specialists the Committee contemplates legislation modelled upon section 14 of the Social Security Amendment Act, 1939, which would incorporate the requirements set out in paragraph 33 above. No doubt the Association would set up a special committee which would report and make recommendations to the Minister in respect of every application for recognition as a specialist referred to the Association under a provision corresponding to section 14 (3) of the Social Security Amendment Act, 1939. 36. It should be made clear that the recognition or non-recognition of practitioners as specialists would in no way affect the right of the particular practitioner to practise a specialty, but would merely affect the right of the practitioner to receive the specialist benefits from the Fund on behalf of his patients. Moreover, special provision would require to be made enabling recognition to be afforded, pursuant to the provisions suggested in the preceding paragraph, in the case of those practitioners already practising a specialty at the time of the initiation of the specialist benefits who do not hold a higher academic qualification, but otherwise possess the necessary qualifications. Further, provision should be made for the discretionary allowance of specialist benefits in respect of specialist services rendered in an emergency or under like exceptional circumstances.

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