Editorial: Callous cash perk ditched

19:49, Nov 15 2012

The hospital doctors' "cash for ash" perk is shameful.

A charge, so notional that it varies from $13 to $90, for the few minutes it takes a doctor to fill out a form certifying a body fit for cremation has, by shabby tradition, gone into junior doctors' social club events, parties, Sky TV in doctors' lounges, or just been pocketed by the medic concerned.

And all of this has been sanctioned by the district health boards (DHBs).

On what grounds? It's a special charge, spuriously levied for something that is plainly part of a doctor's normal duties, then generally spent indulgently.

Let nobody cast this as some sort of MASH-style venting, in which hardworking doctors necessarily blow off steam, because it's funded by distasteful and dishonourable means - hitting up freshly grieving families for no better reason than the sad fact that they've been able to get away with it.

The level of respect afforded those families is reflected in that jauntily applied name.


Look at the reaction now that reporters have winkled it out. An advisory message has gone out from the Resident Doctors' Association, effectively breaking the sorrowful news that the this little perk is coming to an end, not because of any change of heart about this starkly heartless practice, but because the media was about to haul it into the public arena and spoil everybody's fun.

The Southern DHB had not, at the time of writing, come clean about the amount its doctors were permitted to charge, and then individually retain.

At least other DHBs throughout the country fessed up, humiliating though they most must have found it. Why not our board? No, that won't do.

Some northern DHBs can take a little credit for having earlier discontinued the practice before it stood exposed. The Waikato DHB said it did so because to continue it "became inappropriate".

No, it didn't. It was always inappropriate.

The Nelson-Marlborough DHB allowed doctors to charge $90, although at least the lesser part of that went to recreation and the greater part to charity, but the $70 charges by MidCentral DHB doctors went to social events.

Now that this little lark is at last going to wither in the sunlight, doctors with an eye for their social kitty might have to look elsewhere to find ways to conjure up a special charge for plain-enough duties. They're smart people, so they'll doubtless come up with something.

Perhaps people showing up at accident and emergency departments for stitches might encounter a "cash for gash" no-dough, no-sew rule, or people might find they receive only the pain relief they're prepared to pay for under a "cash or gnash" system.

At the sexual health clinics, will there perhaps be a "coins for loins" deal?

If such wonderings are bad taste, and we're prepared to entertain the possibility that they are, they seem no less farcically objectionable than the shabby reality with which the public has been presented.

The Southland Times