Editorial: Doctors' double-dipping can't be justified

18:50, Nov 18 2012

The sums of money many district health boards allow hospital doctors to keep for signing cremation certificates are not large, but that does not detract from the important principle at play. Professionals paid from the public purse to perform a service should not double-dip by taking a private fee for that same service.

Signing cremation certificates is something doctors do during their normal working hours. It is a prescribed part of their work and, in most cases, does not require them to leave the hospital. In other words, when doctors complete cremation certificates, they are simply doing their jobs.

There is a case to be made for DHBs levying charges to recover the cost of providing extra services, but when it comes to cremation certificates, there seems to be no reason for any charge at all. In days gone by, when doctors often had to visit homes to confirm deaths and they were more likely to deal with patients whose histories they did not know, the process was obviously more time-consuming and charging could be more easily justified.

But now, two-thirds of deaths occur in care, and processing the certificates takes about 10 minutes. The insignificance of the work required is reflected in the fact that many DHBs provide the certificates for free, while Christchurch Hospital charges just $5.75. Residents in the Nelson-Marlborough DHB's catchment should be asking hospital managers there why they feel the need to charge $90 for a service others provide for nothing.

Deborah Powell, national secretary of the Resident Doctors' Association, says physicians in DHBs which allow the fees to be kept by staff should be congratulated for using the cash for ''the collective good'', instead of simply banking it.

She misses the point. Whether the money is pooled and spent on social-club functions or furniture and Sky TV for doctors' lounges, as in many DHBs, is irrelevant. The issue is that filling out the forms is part of a doctor's stated duties, and as such, they have already been paid for doing it.


Many doctors have taken umbrage at this newspaper's exposure of the practice, insisting that it is no different from undertakers charging for burial services. That argument also does not bear scrutiny. Undertakers are private businesses and have to be paid. The fairest and most practical way is for them to charge those who use their services. Doctors, on the other hand, are paid a salary from the public purse to perform a range of stated tasks.

Nobody is arguing that junior doctors do not work hard in often stressful situations. They provide a valuable service and deserve to be well rewarded for their efforts. In their early careers, the hours are long and the rate of pay for the amount of time they work is relatively low, given their skills and responsibilities.

However, the studies and training that allow them to eventually enjoy lucrative positions are heavily subsidised.

Taxpayers also pay the salaries of doctors working in the public health system. They have a right to expect that when they get handed a bill for a service, it is not from someone who was just doing his or her job.

The Dominion Post