Busy Schedule for National Group

Busy Schedule for National Group

Lindsay Roberts, FRCS FRACS

Chairman, Australian Day Surgery Council, 1990 – 2000

President Elect, International Association For Ambulatory Surgery 1999

Mr Lindsay Roberts has been elected as the Chairman of the National Day Surgery Committee.

A meeting of the expanded day surgery committee, consisting of surgical bodies, hospital representatives and health insurance leaders, met on June 2 this year to conduct an interim examination and assessment of overnight certification and banding of day surgery procedures which took effect from December last year. The new lists were a result of Federal Government legislation last year.

In summary, the major points of the meeting were:

• There was general agreement by the funds and private hospitals’ representatives that the changes had been introduced without much problem, although it seemed that the two official forms (certification and banding) were not being uniformly completed.
• A major problem was the multiplicity of claim and data forms.
• Overnight Certification. There had been a failure of communication that overnight certification applies only to band 1 procedures (recognising that very few such patients require overnight admission). All organisations should participate in communicating this fact to the medical profession and hospitals. The meeting was informed that the Government was to cease printing forms at the end of 1990, however there was strong support to encourage Government to continue printing the Overnight Certification Form – 1484 (8912).
• Banding. The banding form (which is optional) was not, in general, being completed. It seemed that the forms were being completed in public hospitals but not in private hospitals or free standing day surgery facilities.

There was a unanimous agreement that the four band system for day surgery procedures was inappropriate, confusing and cost ineffective. The National Day Surgery Committee has already expressed objection to lists of procedures in the various bands as prepared by the Commonwealth Department of Health and Community Services.

1. Informal Subcommittees (Funds, Private Hospitals, Free Standing Day Surgery Facilities) were formed to:-
   1. Prepare a comprehensive claim form including essential data information for universal use by Health Insurance Funds.
   2. Produce an alternative system of banding for day surgery procedures based upon the 15 band system which has been successfully introduced by Medibank Private and the Australian Private Hospitals Association. The great majority of day surgery procedures would be included In the first five bands of this system.

• The subject of contracting public patients to private day surgery in hospitals and free standing day surgery facilities was raised and there was strong, unanimous rejection of this principle. The meeting also unanimously rejected the discounting of facility fees for any such patients.
• Incentives for the expansion of day surgery. There was agreement that a paper should be prepared identifying incentives and the elimination of disincentives for the expansion of day surgery, applicable to all interested parties medical profession, private health insurance, hospitals and day surgery centres, government and general population (patients).
• National Seminar on Day Surgery. The Committee which had proposed this seminar at its last meeting agreed that this should be held with a lead time of approximately 12 months.
• Next meeting of the Expanded Committee will be held in mid-November to make its 12 month assessment of Day Surgery Certification and Banding.