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Canada's Medicare principles defended
Canada’s Medicare
principles defended
Health David says he plans to defend such fundamental principles of Canadian Medicare as universality and portability even if he has to bolster his enforcement powers under the Canada Health Act. But in signalling a tougher new federal line on Medicare, Dingwall also said he hopes the problematic areas of the health system, such as the ongoing federal-provincial dispute over private clinics charging patients user fees, can be alleviated
Ministernewly appointed anada’s Dingwall
through intergovernmental "cooperation" rather than legislative remedies. "I want to work cooperatively with the provinces. I want to seek their counsel. I think they’ll know my style fairly soon", Dingwall told reporters shortly after his appointment was announced.
Nevertheless, Dingwall stressed governing Liberal party will no erosions of the principles permit of Medicare. "They’re not negothat the
News in Brief
for violations of the Canada Health
Act, Dingwall replied: "I’m going
to
consider all of the options that I have. And there’s an option that as minister of national health I’d have to [consider]-and that’s put an amendment down to the Canada even Health Act to make it
stronger". Dingwall swapped posts on Jan 25 with Diane Marleau in a major cabinet shuffle aimed at shoring up the government’s Quebec front in the wake of a recent referendum in which the province nearly voted to secede. The Cape Breton lawyer enters the Health Ministry after a 2year sting as the nation’s Minister of Public Works (responsible for government advertising, polling, and major capital construction projects), during which time he developed a reputation as a patronage kingpin and became embroiled in a controversy involving the diversion of highway funds to build a tourist trail in his Nova Scotia riding.
tiable." Asked if he would consider
imposing
new
discretionary penalties
Wayne Kondro
São Paulo’s health assistance plan restored in Sao of the health for the poor has evolved from a political into a legal battle. The first phase of the project known as PAS (for Health Assistance Plan, in Portuguese) was started at the beginning of January. As proposed last year by the mayor of Sao Paulo, Paulo Maluf, groups of doctors would administer each of the city’s 14 hospitals and 166 health centres. To receive health-care assistance, have to register first would patients in these doctor-administered and centres, only residents in the area would be eligible to register. This procedure means that access to the service would be restricted, unlike access to other public health services in the country, which should be universal, as guaranteed by the Constitution. This breach of the Constitution is the main criticism made by major medical organisations, such as the Paulista Association of Medicine, Sao Paulo’s Regional Council of Medicine, and the doctors’ union. In addition, many critics believe that the plan is no more than the
The implementation plans Paulo
320
mayor’s personal political marketing device. Resistance by these and other medical organisations forced the Municipal Health Secretary to step down last November (see Lancet 1995; 346: 1418). The new secretary, Roberto Richter, is pushing the project forward and managed to implement it in one hospital in the Pirituba-region. Though the plan has been functioning since the beginning of January, the director of the Pirituba hospital said it is early to assess the plan’s efficiency. Late in January a request by the Paulista Association of Medicine, the National Federation of Doctors, and Sao Paulo’s doctors’ union resulted in a court decision that suspended the whole project. The the decision considered plan unconstitutional, and the mayor announced that he would appeal. However, a few days after the court decision, Richter announced that he will not interrupt the PAS in Pirituba. Moreover, he plans to extend it this month to other regions in the city. Clàudio Csillag
for Center Human Starr Genetics This centre has been set up at the Rockefeller University, New York, with a$US5 million grant from the Starr Foundation. It will be headed by Dr Jeffrey M Friedman, professor at Rockefeller and associate investigator at Howard Hughes Medical Institute. director for Walter and Eliza Hall Institute of Medical Research Prof Suzanne Cory, professor of molecular oncology at the institute, will succeed Prof Sir Gustav Nossal when he retires in June. She has also been appointed to the chair of medical biology at the University of Melbourne. New
Surpise appointment to head French cancer research charity Michel Lucas, former director of the General Inspectorate of Social Affairs (IGAS) is the new president of the Association la pour Recherche sur le Cancer (ARC), whose financial afairs were seriously questioned by the nation’s auditors recently (see Lancet Jan 13, p 107). Lucas had headed three IGAS inquiries into the charity. He has received authorisation from the ARC board to cooperate with the public prosecutor in legal inquiries into the charity. Gulf War syndrome investigation in UK The Ministry of Defence has ordered a full epidemiological investigation into illnesses and abnormalities congenital be to associatd with the alleged Gulf War. The investigation will be overseen by the Medical Research Council. Australian GPs unhappy The Australian National Centre for and Epidemiology Population Health has published a preliminary report of its survey of general practitioners (GPs). 35% of respondents strongly or partly agreed that they would leave general practise immediately if they thought there was anywhere to go. The main dissatisfactions were: not appreciated by government (94%), goverin ment interference clinical decisions (87%), concern over litigation (83%), practice administration (83%), long hours (81%), not appreciated by specialists and hospital doctors (80%), and not appreciated by the community (65%).
principles defended
Health David says he plans to defend such fundamental principles of Canadian Medicare as universality and portability even if he has to bolster his enforcement powers under the Canada Health Act. But in signalling a tougher new federal line on Medicare, Dingwall also said he hopes the problematic areas of the health system, such as the ongoing federal-provincial dispute over private clinics charging patients user fees, can be alleviated
Ministernewly appointed anada’s Dingwall
through intergovernmental "cooperation" rather than legislative remedies. "I want to work cooperatively with the provinces. I want to seek their counsel. I think they’ll know my style fairly soon", Dingwall told reporters shortly after his appointment was announced.
Nevertheless, Dingwall stressed governing Liberal party will no erosions of the principles permit of Medicare. "They’re not negothat the
News in Brief
for violations of the Canada Health
Act, Dingwall replied: "I’m going
to
consider all of the options that I have. And there’s an option that as minister of national health I’d have to [consider]-and that’s put an amendment down to the Canada even Health Act to make it
stronger". Dingwall swapped posts on Jan 25 with Diane Marleau in a major cabinet shuffle aimed at shoring up the government’s Quebec front in the wake of a recent referendum in which the province nearly voted to secede. The Cape Breton lawyer enters the Health Ministry after a 2year sting as the nation’s Minister of Public Works (responsible for government advertising, polling, and major capital construction projects), during which time he developed a reputation as a patronage kingpin and became embroiled in a controversy involving the diversion of highway funds to build a tourist trail in his Nova Scotia riding.
tiable." Asked if he would consider
imposing
new
discretionary penalties
Wayne Kondro
São Paulo’s health assistance plan restored in Sao of the health for the poor has evolved from a political into a legal battle. The first phase of the project known as PAS (for Health Assistance Plan, in Portuguese) was started at the beginning of January. As proposed last year by the mayor of Sao Paulo, Paulo Maluf, groups of doctors would administer each of the city’s 14 hospitals and 166 health centres. To receive health-care assistance, have to register first would patients in these doctor-administered and centres, only residents in the area would be eligible to register. This procedure means that access to the service would be restricted, unlike access to other public health services in the country, which should be universal, as guaranteed by the Constitution. This breach of the Constitution is the main criticism made by major medical organisations, such as the Paulista Association of Medicine, Sao Paulo’s Regional Council of Medicine, and the doctors’ union. In addition, many critics believe that the plan is no more than the
The implementation plans Paulo
320
mayor’s personal political marketing device. Resistance by these and other medical organisations forced the Municipal Health Secretary to step down last November (see Lancet 1995; 346: 1418). The new secretary, Roberto Richter, is pushing the project forward and managed to implement it in one hospital in the Pirituba-region. Though the plan has been functioning since the beginning of January, the director of the Pirituba hospital said it is early to assess the plan’s efficiency. Late in January a request by the Paulista Association of Medicine, the National Federation of Doctors, and Sao Paulo’s doctors’ union resulted in a court decision that suspended the whole project. The the decision considered plan unconstitutional, and the mayor announced that he would appeal. However, a few days after the court decision, Richter announced that he will not interrupt the PAS in Pirituba. Moreover, he plans to extend it this month to other regions in the city. Clàudio Csillag
for Center Human Starr Genetics This centre has been set up at the Rockefeller University, New York, with a$US5 million grant from the Starr Foundation. It will be headed by Dr Jeffrey M Friedman, professor at Rockefeller and associate investigator at Howard Hughes Medical Institute. director for Walter and Eliza Hall Institute of Medical Research Prof Suzanne Cory, professor of molecular oncology at the institute, will succeed Prof Sir Gustav Nossal when he retires in June. She has also been appointed to the chair of medical biology at the University of Melbourne. New
Surpise appointment to head French cancer research charity Michel Lucas, former director of the General Inspectorate of Social Affairs (IGAS) is the new president of the Association la pour Recherche sur le Cancer (ARC), whose financial afairs were seriously questioned by the nation’s auditors recently (see Lancet Jan 13, p 107). Lucas had headed three IGAS inquiries into the charity. He has received authorisation from the ARC board to cooperate with the public prosecutor in legal inquiries into the charity. Gulf War syndrome investigation in UK The Ministry of Defence has ordered a full epidemiological investigation into illnesses and abnormalities congenital be to associatd with the alleged Gulf War. The investigation will be overseen by the Medical Research Council. Australian GPs unhappy The Australian National Centre for and Epidemiology Population Health has published a preliminary report of its survey of general practitioners (GPs). 35% of respondents strongly or partly agreed that they would leave general practise immediately if they thought there was anywhere to go. The main dissatisfactions were: not appreciated by government (94%), goverin ment interference clinical decisions (87%), concern over litigation (83%), practice administration (83%), long hours (81%), not appreciated by specialists and hospital doctors (80%), and not appreciated by the community (65%).