House of Assembly: Vol113 - TUESDAY 10 APRIL 1984

TUESDAY, 10 APRIL 1984 Prayers—14h15. LIQUOR AMENDMENT BILL (Third Reading) The MINISTER OF INDUSTRIES, COMMERCE AND TOURISM:

Mr Speaker, I move:

That the Bill be now read a Third Time.
Mr A B WIDMAN:

Mr Speaker, as indicated during Second Reading and during Committee Stage, our caucus has decided to allow every member of this party a free vote in respect of this Bill. This, of course, gives every individual member the opportunity of expressing freely his own opinion on this matter.

We have now reached the Third Reading stage of this amending Bill, and it is by now well known that as far as we in this party are concerned this is a matter in respect of which every hon member votes according to the dictates of his own conscience. I believe that this Parliament, as well as the public outside, should appreciate the real meaning of the system of a free vote. I believe it is very important that we exercise a free vote in this House from time to time because that allows hon members to express their own opinions and to vote according to their own conscience without being tied by caucus decisions taken prior to the debate on a measure in this House. Perhaps this occasion could serve as a precedent in future allowing us to exercise a free vote more often. That will allow us to debate many contentious matters in respect of which hon members have varying views. I do, however, want to express my regret about the fact that the governing party did not see their way clear to allow for the withdrawal of the Whips in this instance so that hon members of the NP could also have been allowed to express freely their own opinions in connection with this matter. I must admit though that we have had some brave speeches by certain hon members on the Government side, such as the hon member for Innesdal, for example. I am sure there are hon members on the Government side who do agree with what the hon member for Innesdal said in his speech and who might also have expressed their own honest points of view in connection with this measure if only they had been allowed to do so by the NP cacus.

Be that as it may, however, my personal point of view in this respect is well known by now. Quite frankly, Mr Speaker, neither the hon the Minister nor any other hon member of this House has been able to dissuade me to any degree whatsoever. My opinion on the question of the availability of alcoholic beverages and the possible implications thereof, particulary in so far as the influence of this factor on the youth of this country is concerned, remains unchanged. I do believe too, Mr Speaker, that every hon member of this House is duly concerned about the youth of South Africa. I do agree with one point made by the hon member for Constantia, however. That is his argument in connection with sparkling wines. It is quite probable, I believe, that sparkling wines are not quite as popular as other wines. Perhaps the reason for this is that sparkling wines are more expensive than other wines and therefore only the more affluent members of our society can really afford to buy it.

Furthermore there is one other point made by the hon the Minister to which I should like to refer as well. It seems as though certain points made by me during the Second Reading stage slipped the hon the Minister’s memory when he replied to that debate. That concerns the application of the proposed new section 32 of the principal Act. Section 32 of the principal Act, as it now stands, reads as follows, and I quote:

Prohibition of acquisition of licences by producers—
  1. (1) No licence, other than a wholesale liquor licence, a brewer’s licence, a wine farmer’s licence, a foreign liquor licence or an hotel liquor licence shall be granted or transferred under this Act to—

Once the new section 32 becomes operative it will of course include grocers’ wine licences as well. To whom will such licences be granted or transferred? The same section of the principal Act states as follows:

  1. (a) Any producer or his agent;
  2. (b) Any brewer or his agent;
  3. (c) Any person who has a financial interest in the business of such a producer or a brewer or the agent of such person;
  4. (d) any company in which shareholders having a financial interest in the business of a producer or a brewer together hold a controlling interest, or the agent of such company;
  5. (e) any company in which a company referred to in paragraph (d) holds a controlling interest, or the agent of such a company.

This of course also includes the broader aspect in respect of the Competitions Board, which, I believe, falls under the jurisdiction of this hon Minister as well. What is going to happen now is that grocers will be able to obtain liquor licences which will enable them to sell sparkling wines as well. There are brewers, however, who do not have this right. What is going to happen now is that breweries will obtain interests in companies that hold grocers’ wine licences. We are in other words opening the door for brewers of beer to take part in future in furthering the interests of the wine trade as well. As an example of this I may mention—and this is a well known fact—that SA Breweries took over OK Bazaars among other companies. In turn, JCI, Anglo Vaal and Liberty Life acquired a mutual interest of 34% in SA Breweries. That means that if OK Bazaars should apply for a grocers’ wine licence SA Breweries will indeed be holding an interest in all the wine outlets controlled by OK Bazaars. This is the one important aspect, I believe, with which the hon the Minister has not yet dealt. If by introducing this measure the hon the Minister now opens the door for practices of this nature, it is only fair and just, I believe, that the hon the Minister should say so to this House.

Having said that, Mr Speaker, I merely want to reiterate that I am opposed to this measure and that I will therefore record my vote against this measure being read a Third Time.

*Mr J H HEYNS:

Mr Speaker, I listened with interest to what the hon member for Hillbrow had to say. What really interested me was his reference in the plural form to the consciences of certain hon members of his party. I should like to know to whom he was referring when he used the plural form.

†The hon member further said he was very sorry that the NP did not allow a free vote in respect of this particular measure. I have replied to this point made by the hon member for Hillbrow already on a previous occasion. On this occasion, however, I do believe it is appropriate to remind the House of a previous occasion on which hon members of the PFP registered their vote here in the House in respect of a certain matter after they had already indicated by way of their signatures that they were of a completely opposite opinion. I am referring now to their sudden change of attitude when we were discussing the Toll Roads Bill here in the House last year. They were in fact compelled by a caucus decision to change the opinion to which they had already tied themselves in the Select Committee that had dealt with that measure prior to its introduction here. I believe I can state with certainty that hon members of the NP have never been compelled by their caucus in this dubious fashion to renounce a previously expressed point of view. Consequently …

*Mr S P BARNARD:

Rather tell us about Hennie van der Walt.

*Mr J H HEYNS:

You just keep your mouth shut now.

Later on you can again have some champagne with your breakfast. [Interjections.] The NP has never compelled its members in this House to renounce a standpoint they previously endorsed, and even confirmed with their signatures, and to adopt a certain standpoint which was diametrically opposed to their previous standpoint and which was contrary to the dictates of their conscience. For that reason alone—and the hon member for Hillbrow correctly pointed this out—it so happened that we heard speeches here in this House such as those by the hon member for Innesdal and others, who confirmed that because their consciences did not allow them to support this amending Bill, they were not going to participate in the voting. I believe that this in itself indicates adequate freedom of movement in this party. When reconsidering this, I think the hon member for Hillbrow should acknowledge that I am right when I say that the conduct of the NP and its caucus shows evidence of less coercion than that of the PFP. The extent of the coercion which the PFP caucus applies to its members was in fact most clearly demonstrated in the debate to which I have just referred, when hon members of that party were forced by their caucus to renounce standpoints they had previously endorsed with their signatures and in sharp contrast to those standpoints, to adopt a completely opposing standpoint here in the House. As far as this is concerned, I therefore do not think that that argument holds much water either.

I found it very interesting that the hon meber for Hillbrow said that the hon member for Constantia had raised a point which might have convinced him. This was the point in connection with sparkling wine. In this connection I just want to say in parentheses that it is probably a good thing that legislation has three readings and not four because if, at the Third Reading, a man has gone so far as to say “maybe”, he may, at the Fourth Reading, concede the point.

If we consider the effect of this legislation and we ask ourselves why some hon members opposed the legislation, then we also have to take the effect of the legislation in that particular connection into account. In reply to the argument of the hon member for Hillbrow and others in connection with the provision that grocers’ wine licences are now being extended to include the sale of sparkling wine, the hon the Minister told them repeatedly that if they opposed this amendment they should have the courage of their convictions to say that they were also opposed to the granting of further liquor licences, which would further increase the availability of liquor. If the hon member for Hillbrow is opposed to the extension of grocers’ wine licences in this connection, then the logical effect of this is that he is also opposed to the granting of further liquor licences in South Africa. None of those hon members were prepared to reply to that point or to concede it. This is not logical at all. This legislation does not entail the extension of liquor licences per se. It does not involve the immediate increase in the number of licences of the two groups mentioned here from 12 and 28 respectively, to 36. For each new licence required a separate application has to be made and the number of licences thus granted may not exceed 36. Applications have to be made on the prescribed form and in the prescribed manner to the prescribed board, and the consideration of the application will take place in the ordinary way and by means of the ordinary procedure according to ordinary norms for each individual case. Only then will it be decided whether or not the licence will be granted. As long as that argument applies, the conflicting opinions expressed by those hon members do not hold water at all. I therefore reject them, and I shall also support the Third Reading of this legislation.

*Mr S P BARNARD:

Mr Speaker, during the Third Reading of a Bill we deal with the effects of that legislation. The purpose of this legislation is to make sparkling wine more freely available in that it can now be sold under a grocers’ wine licence. I object to this effect, because it is important to note that the use and abuse of liquor increases as it becomes more freely available as is shown by reports we have received from Canada, which are at present being studied by our rehabilitation centres in South Africa.

The hon member for Hillbrow also indicated that a similar study was carried out in America at the time of the Nixon administration, and that that study proved beyond a shadow of a doubt that if liquor is more freely available it leads to greater abuse. I cannot imagine that it is our intention to promote the sale of alcoholic beverages in this country. I can see no advantage in this, and for that reason I oppose it. An hon member asked whether I was opposed to the extension of any further licences. I do not think that that is a good question because as a population grows there are certain deficiencies as far as such licences are concerned, and I have never said that within the framework of our existing legislation a person should not have the right, for example, to acquire a licence, but the more licences that are granted, the more intensive the sales promotion systems of the relevant sectors become.

Today we have the problem that it is believed—this is particularly the case in the rehabilitation centres—that an alcoholic is in reality a sick person. Is it right therefore to provide free drinks on an aircraft to a person who is addicted to alcohol, to a person who, if he takes a single drink, can fall back into one of his biggest problems? It is for that reason that I say that even on the SA Airways this matter should be looked into. [Interjections.] The hon member for Turffontein must please keep quiet.

*Mr A FOURIE:

But I did not say a word.

*Mr S P BARNARD:

In my life I have often worked with children suffering from brain damage. Their problem is that they are emotionally unstable. That is why, when they are grown up, one has to deal with them in that way.

*Mr SPEAKER:

Order! Is the hon member referring to the hon member for Turffontein now?

*Mr S P BARNARD:

No, Sir, I was referring to children I have taught.

*Mr A FOURIE:

Mr Speaker, on a point of order: Is the hon member entitled to say that I am emotionally unstable?

*Mr SPEAKER:

I asked the hon member to whom he was referring, and he said he was referring to children.

*Mr A FOURIE:

Sir, I heard exactly what the hon member for Langlaagte said, and I hope he has the “guts” to repeat what he said.

*Mr SPEAKER:

Order! The hon member for Langlaagte referred to emotionally unstable people. I immediately asked him to whom he was referring. In reply he said that he was referring to children who were emotionally unstable, but this is not a topic under discussion at the moment. The hon member for Langlaagte may proceed.

*Mr S P BARNARD:

Sir, the hon member is referring to me as a “fat cat” again. I have been living in the house he is referring to when he makes the allegation that I am a “fat cat” for 18 years now. If it will help him in any way, I can therefore assure him that I have been a “fat cat” for 18 years now. One should never allow oneself to be offended by people who are not worth taking offence at. [Interjections.] The hon member reminds me of a weathercock. Every change in the wind blowing on his tail causes him to point in a different direction in his political life.

I want to get back to the liquor question. On SATV unnecessary advertisements are shown at the expense of the taxpayer because the costs involved in such advertisements are partially covered by taxes the taxpayer has to cough up. There is for example an advertisement in which it is suggested that if a sportsman drinks a certain brand of beer, he will get to the top in that sport. In the first place that is not true, and in the second place if he had drunk that beer he would never have reached the heights he had in fact reached in that sport.

Clause 1 amends section 32 of the Liquor Act, 1977. This amendment means that SA Breweries is now gaining a real interest in the production of the wine industry. It is becoming part of this vertical integration, and for that reason we have to give serious consideration to this. If it is the intention of the hon the Minister to make more and more light wines available, I suppose there cannot be any objection to that, for as the hon the Minister said, it is the policy of the Government to make more and more alcoholic beverages available provided they are wines and light alcoholic beverages, which presumably include beer.

When we come to the matter of company take-overs, we find that Pick ’n Pay, which has adhered strictly to the Act, is being penalized for doing so. In contrast OK Bazaars, which did not adhere strictly to the law and which has been taken over by SA Breweries and Checkers, which has been taken over by Uniewyn, are benefiting in that in terms of this legislation they are going to be able to apply vertical integration. Let me give the House an easy example. Let us assume that SA Breweries takes over Checkers and Uniewyn, and they have the money to do so. Just ask me. I know. SA Breweries could easily go a step further and take over Pick ’n Pay as well. In that case it would have 108 distribution points in the retail industry and could totally control the distribution of liquor in the retail trade. I once said here that our dairy farmers would be ruined if margarine was made freely available on the market. That is precisely what happened. Beer is a substitute for wine. The production of beer can very easily be increased or decreased. On the other hand the wine industry is dependent on a time factor and in addition the problems besetting agriculture are an integral part of the industry.

*Mr L H FICK:

Mr Speaker, may I ask the hon member a question?

*Mr S P BARNARD:

No, Sir. That is the hon member who said South African farmers are lazy. I do not want to talk to such people.

My plea in this House today is that we should not expose our children to the greater availability of alcoholic beverages for the sake of an industry. This upsets me. I have here a copy of Springbok, the SA Airways publication. Ten pages in this magazine are devoted to liquor advertisements, one of which is a Johnnie Walker crossword. Is it necessary for the people who make use of our airways to be subjected to this kind of thing? When one travels by plane, one maintains a high level of concentration. Of course there are people who sit and sleep, and I know about that too. If we consider the availability of liquor in supermarkets, for example, I maintain that this is where young children accompanying their mothers first become acquainted with alcohol.

*The MINISTER OF TRANSPORT AFFAIRS:

Have you never had a drink on a aircraft?

*Mr S P BARNARD:

Mr Speaker, that hon Minister always asks questions which he himself could reply to and then he tries to implicate me in them. He should rather concentrate on the matter I referred to.

Let us consider the availability of liquor in supermarkets. The mother makes a list of her requirements. The child accompanies her to the supermarket. I am willing to bet that that housewife would not go into a bottle store to purchase liquor if it was not available at the supermarket. But now it is added to her groceries as part of her expenditure on food. It becomes a pattern of life to which I am opposed. My party as a whole is opposed to it. There are many good people among the members of the NP sitting opposite, and I know on the basis of conversations that I have had with them that they feel exactly the same way as we do about this matter. However, there is an element in that party which, when one talks about deviating from the traditional South African way of life, joins in the chorus. There is the example of the hon member for De Kuilen. He is a wonderful person and it is to the advantage of any party to have him as a member. However, one also finds a “galsiek” lamb climbing through the fence. I do not think the hon member I am referring to now should object, because then everyone will know who I am talking about.

*Mr SPEAKER:

Order! I shall not allow any hon member to be compared to a “galsiek” lamb.

*Mr S P BARNARD:

Mr Speaker, I withdraw it.

*Mr SPEAKER:

We should all bear in mind that we are hon members of this House. Let us conduct our debates at that level.

*Mr S P BARNARD:

Last week the hon member concerned accused me of using and abusing the taxpayers’ money. He said that I was being dispossessed and repeated the allegation which he had made in this House outside. He is conversing with me and that is why I have to react to it. However, I shall abide by your ruling, Mr Speaker.

*Mr SPEAKER:

Order! I feel very strongly about this point. After all, we represent the people of South Africa. Let our conduct be worthy of this honour in every respect. We would be a far more effective House if we were to do this. I want to appeal to hon members to maintain a proper level of debate in all their speeches.

*Mr S P BARNARD:

The hon the Minister once said that the freer availability of liquor would not lead to greater abuse. However, if the hon the Minister were to bear the law of averages in mind, he would realize that it has to lead to increased consumption and abuse of liquor. If it does not lead to the increased consumption of liquor, why is there a law prohibiting the sale of liquor after hours? Where is the sense in this? Why are only 36 of these liquor licences being issued? Who made these representations to the Cabinet, and did the Cabinet decide accordingly? Is the Cabinet also concerned about the liquor abuse and did they decide that only 36 licences should be issued? Do they no longer trust the hon the Minister in this portfolio?

I do not want to quote too many figures. However, I do want to point out that surveys made by the CSIR indicated that alcohol played a role in 50% of all accidents involving motor vehicles. It also came to light that in 60% of all fatal motor vehicle accidents, alcohol played a role. During 1983 the total loss in man-hours, damage to motor vehicles, etc, was R1 823 925 700. At present liquor valued at R6,4 million is consumed every day in South Africa, which is an alarming phenomenon. There are certain factors such as people’s incomes which have to be taken into account when it comes to the use and abuse of liquor. It is a tragic day when a Bill such as this one is placed on the Order Paper. I do not want to anticipate things too much, but this Bill has to be studied carefully. There is also the flavouring of wine, and one asks oneself what quantity of alcohol the flavoured wine will contain.

Today I have a request to make to hon members in this House. When matters are being discussed which do not affect party politics, we should not debate so vehemently with each other. When a person adopts a moral standpoint on something, it is not necessary to argue with him about it.

*The MINISTER OF INTERNAL AFFAIRS:

Who was called to order because he became vehement?

*Mr S P BARNARD:

Mr Speaker did not call me to order. He called all hon members to order. It was the bad behaviour of hon members which forced Mr Speaker to talk to all the hon members. The hon the Minister has now given me an opportunity to raise a matter. When it comes to a moral issue, hon members should not malign one another.

I understand the standpoint of the hon member for Innesdal who wants to abstain from voting on this legislation. I do not hold it against him that he does not want to vote against the legislation. After all, the position is that an hon member is under the discipline of his Whip. For these reasons I do not hold it against the hon member at all that he is going to abstain from voting, although he spoke out against the legislation. This proves that the hon member also has moral objections to this legislation.

The fact that I am crossing swords with the hon the Minister now does not mean that I do not perceive the value of this legislation, particularly the importance of introducing a quota system according to a voters’ total. The fixing of the quota has become a problem. Could the hon the Minister not consult the hon the Minister of Health on the tremendous problems that are present in our rehabilitation centres? In centres such as Magaliesoord and elsewhere there are people for whom nothing can be done. All one can do is feel extremely sorry for them. It is very unlikely that these people will ever recover. One should think of introducing a levy on liquor which should then be paid over to rehabilitation centres, because the problems in those rehabilitation centres are caused by a commodity which is freely available.

*Mr J W H MEIRING:

Mr Speaker, during the Second Reading is was my dubious privilege to speak after the hon member for Langlaagte and now I have to do so again. I do not intend to descend to the same levels as the hon member did. What absolutely astounds me is how it came about that the hon member for Langlaagte is the spokesman of the Conservative Party on this matter. If I had to choose, I would have chosen the hon member for Meyerton, the hon member for Pietersburg or the hon member for Germiston District. I want to ask the hon member for Langlaagte …

*Mr H D K VAN DER MERWE:

You must say what you mean. Do not speak in riddles.

*Mr J W H MEIRING:

I shall tell the hon member exactly what I mean. The hon member for Langlaagte does not mean what he says. After all, the hon member for Langlaagte’s benchmate does not agree with what he says.

*Mr H D K VAN DER MERWE:

Mr Speaker, on a point of order: May an hon member say that another hon member does not mean what he says?

*Mr SPEAKER:

The hon member is entitled to say that if that is his opinion. It is not unparliamentary.

*Mr H D K VAN DER MERWE:

The hon member for Paarl does not mean what he says. He does not know what he is saying either. [Interjections.]

*Mr J W H MEIRING:

Sir, let me put it another way. The hon member for Langlaagte’s heart is not in what he is saying. Why the Conservative Party is constraining all its members to vote against this matter is beyond me. After all, they are the people who attend champagne breakfasts. However, I do not want to pursue that matter, because more than enough has already been said about it.

I would prefer to try to react to certain of the statements made by the hon member for Langlaagte. The first point he made was that as light alcoholic beverages such as wine, become more freely available, it leads to greater abuse. He quoted from a report on a study made in the USA to support his statement that the freer availability of wine leads to abuse. Sir, surely this is not true. Practice has in fact proved the opposite. I have not the slightest doubt that wine was abused when it was a scarce item, when it was an item which was difficult to obtain, when it was an item which one had to try to obtain in dark corners. We are discussing the oldest profession … [Interjections.] … the oldest agricultural profession in this country, a profession which is the backbone of the existence of many people in this country. Just consider how this profession has gone out of its way to normalize the consumption of its product.

*The DEPUTY MINISTER OF AGRICULTURE:

Call it an industry.

*Mr J W H MEIRING:

Very well, I shall call it an industry. [Interjections.] Just consider how this industry has gone out of its way to improve the circumstances surrounding this product, to create attractive premises, to establish neat shops and, above all, to teach people to use this product with food.

*Mr H E J VAN RENSBURG:

Simply in order to sell more.

*Mr J W H MEIRING:

One of the most attractive things one sees abroad are the grocers’ shops where people can purchase wine with their food. The hon member for Bryanston said: “simply in order to sell more” and the hon member for Langlaagte spoke about the poor housewife who was exposed to this terrible product. I ask myself: If the husband goes to an off-sales liquor store or if the wife purchase the same product in the grocer’s shop along with her food, who is going to buy more wisely? There is after all not the least doubt that all this goes hand-in-hand with the correct use of wine, that is, with food.

The hon member for Vasco spelled out the two principles contained in this Bill very clearly. I want to refer to one further effect and draw the attention of the hon the Minister to it again. The one effect of this legislation is that sparkling wine will now be available in grocers’ shops.

*The MINISTER OF CONSTITUTIONAL DEVELOPMENT AND PLANNING:

It is for breakfast.

*Mr J W H MEIRING:

Exactly. I am concerned that some grocers’ shops may abuse this opportunity to make imported champagne available as “loss-leaders” in their shops. I do not think this is the intention. In my Second Reading speech I asked the hon the Minister to go into this matter of imported products a little. I want to point out at once that I understand the hon the Minister’s problem in this connection and that one has to be very careful not to upset the balance. However, it is a fact that as far as wine and malt licences and wine-house licences are concerned, no imported products may be sold. I still feel that it would be worth our while to give very serious consideration to this matter. As far as grocers’ wine licences are concerned, consideration could be given to specifying that imported wines, including sparkling wines, may not be sold.

It gives me pleasure to support the Third Reading of this Bill.

*Mr C UYS:

Mr Speaker, allow me to say a few brief words. I shall not try to rise to the high level of the hon member for Paarl because that is impossible. I shall simply try to maintain my ordinary level.

I participated in the Second Reading debate on this Bill. Hon members on the Government side who participated in that debate, did not reply to a single argument I raised. In his reply the hon the Minister reacted to things I did not raise, but he did not reply at all to what I did, in fact, say.

On the PFP side I did hear one little voice suggesting that I was speaking with the voice of Moscow. If the day ever has to arrive in our country that one can be accused of speaking the language of Moscow when, as a public representative, one takes up the cudgels for the little man, then I think we are very close to the day when capitalism destroys itself in South Africa.

What were the arguments I advanced? I want to repeat them briefly. I am referring specifically to clause 1 of the Bill. I said this was ad hoc legislation which was being passed with only one object in mind, namely for the sake and on behalf of two big companies with ample means at their disposal. There is no other reason for it. The hon the Minister still has to convince me that any other reason exists for it. This is ad hoc legislation and it is being passed in conflict with a policy the Government have already accepted, namely that it is opposed to vertical integration in the liquor industry. Now this same Government, however, comes to this House and on behalf of SA Breweries and Natie Kirsch, that standpoint is simply thrown overboard for it is now being argued that because Pick ’n Pay, which is not controlled by the liquor trade, received 36 grocers’ wine licenses, OK Bazaars and Checkers, too, should each receive 36 grocers’ wine licenses.

This afternoon the hon member for Vasco said that these applications would be normally assessed and disposed of in the normal course of events. On the part of the executive of South Africa, however, it is now being said in advance here that because Pick ’n Pay has 36 grocers’ wine licences, OK Bazaars and Checkers should also receive 36 licences each, otherwise they are not competing on an equal footing. That is the implication. That is my objection to this legislation. I have never liked ad hoc legislation, least of all if that ad hoc legislation is introduced to overthrow an existing, healthy policy in opposition to vertical integration in the liquor industry.

*The MINISTER OF INDUSTRIES, COMMERCE AND TOURISM:

Mr Speaker, after our having thrashed out these two clauses very thoroughly during the past two days, there are very few arguments left to which I have not already replied. In the first place I want to come to the hon member for Hillbrow who again stated his standpoint today, as he also did yesterday during the Committee Stage.

†I respect the hon member and I also respect his point of view. As the hon member explained yesterday, he is against the availability of liquor, and if at all practically possible, he would really plead for the abolition of all the existing licenses. I respect his point of view but I return to it because I do not agree with him that availability leads to abuse. This was the central theme of his objection. I disagree with it, although I respect the hon member’s point of view. However, I did not like it when the hon member alleged that hon members on this side were not acting according to their conscience as far as this Bill was concerned. For a man who claims to judge these matters from a moral point of view, that was an unworthy suggestion. [Interjections.]

*The hon member is very well aware that hon members had an opportunity during the Second Reading debate and again now to decide according to their own convictions how to act in respect of this legislation. The hon member knows that no one is obliged to vote for this legislation. He was able to listen to an hon member on this side of the House who stated his point of view very clearly as to why he differed with us on the legislation before us. [Interjections.] But the hon member unfortunately adopts a point of view which we find so frequently among people who are opposed to a matter. They praise everyone who is also opposed to it, while they doubt the integrity and morality of those who are in favour of it. If We wish to differ with one another in a worthy manner, I do not think it behoves the hon member to adopt such a standpoint.

The hon member spoke about the separation which allegedly existed between wholesale and retail, and the separation which existed in earlier legislation in terms of section 32 and which was now being eliminated. The hon member for Langlaagte and the hon member for Barberton also referred to that. Consequently, let me briefly sketch the history of this separation again. For a long time now it has been the ideal in certain circles in the liquor industry that there should be separation between wholesaler and retailer, and that there should also be separation between the interests of brewers on the one hand and those of the wine and spirits industry on the other. It is against this background that the Competition Board instituted an extensive and thorough investigation into the liquor industry. The report of that board was presented to the Government at the beginning of last year, and it contained various proposals, which were offered as a package. The board also made it very clear that if the liquor industry was restructured, all their recommendations were to be regarded as a unit.

The Government went into all the proposals very thoroughly, and many of them were meritorious proposals. On 25 March last year the Government then announced its standpoint on the recommendations by way of a Press statement. Hon members should take the trouble to have another look at that statement. In it we indicated that owing to various historic and other reasons it was not possible to implement separation in the liquor industry and that we would simply have to be satisfied with a greater measure of integration. I know that it still remains the object to strive for a greater degree of rationalization in the industry, which might eventually enable us to reduce unnecessary group formation, to promote competition and to serve the interests of the producer, the wholesaler and the consumer in the best way. The fact of the matter is, however, that we have an integrated situation today. There is no separation. That is why the biggest brewery in this country—in fact the only brewery in the country—has an interest of 33,33% in the largest undertaking in the wine and spirits industry. On the strength of this interest it also, indirectly, has the right to acquire up to 300 retailers’ licences. Is that not integration? Consequently it is on account of this fact of integration that we are trying to bring about greater uniformity in regard to grocers’ wine licences so as to make the rules the same for everyone, and at least to make it possible then—because integration is a fact—for the respective groups and people to lay claim to fair uniform treatment; to make the rules of the game the same for everyone, as far as possible.

Consequently the issue here is not, as the hon member for Barberton is trying to allege, the interests of Pick ’n Pay or a single other group. If we should argue about the implications of this legislation as the hon member for Barberton did, the implication is simply that every applicant—whether it is a group or an individual—as far as grocers’ wine licences are concerned, can ultimately acquire a maximum of 36 such licences. Each of these licences—and this brings me to the hon member for Hillbrow again—is an independent licence, separate from the others, in the sense that an application has to be made for each one and that each application is subject to the position, the locality, the building and the plans submitted. The council decides about those applications, each one separately—in the way prescribed by the Act. In the same way objectors are also afforded an opportunity to submit their objections, and these are adjudicated upon by the Liquor Board by way of an open hearing.

Integration therefore exists, and it is wrong of hon members to allege that this measure is promoting integration, contrary to the standpoint of the Government. We are simply dealing with an inequality, a discrimination which exists, and are trying to get the rules uniform.

The hon member for Barberton also alleged that I had not replied fully to his argument that the small man was being prejudiced. If I inferred from his argument that he was actually opposed to the big groups—and this afternoon he again gave such an indication—I apologize to him. I said this the last time. But what is the present position of the small man? It was largely to protect the position of the small man that the Government did not see its way clear to accepting all the recommendations of the Competition Board. The Competition Board recommended that beer should be sold in grocers’ shops. That, as the hon members knows, would have meant the end of many retailers who have become established over the years. Consequently the Government is trying, within each industry, to further the position of the small businessman. There is a great deal of evidence to prove this. We can also discuss this aspect further when my Vote comes up for discussion. The same applies in the case of the liquor industry. The decision not to accept the recommendations of the Competition Board in their entirety was also taken with regard being had to the interests of the small man.

In the interests of the small man, and also to prevent unnecessary concentration in the industry, a limit was placed on the number of licences which a specific shareholder was able to acquire. I am referring now to the number of grocers’ wine licences. That is in fact why the limit of 36 was set. The hon member for Langlaagte wanted to know why 36. With all due respect, Mr Speaker, if the hon member for Langlaagte is only waking up and asking questions like this now, while this number of 36 was announced as long ago as March of last year, I do not know whether I should take any trouble at all to reply to the hon member.

*Mr S P BARNARD:

On what grounds was the number 36 decided upon?

*The MINISTER:

As has repeatedly been stated in this House—and also explained in this debate by the hon member for Stellenbosch—this was done because the government wished to counteract unnecessary concentration in the liquor industry, which could have a disruptive effect on the industry. Hence the limit of 36. That number, 36, was the number which the largest licensee already had.

The Government adopted the standpoint that it did not want to deprive people of their existing rights. That is why the number of licences which the largest group had was taken as the number which would also be the limit. Hence the number of 36 licences. Further restrictions have been imposed on the liquor industry, in the interests of the small man.

*Mr S P BARNARD:

May I please ask a question?

*The MINISTER:

I just want to complete my argument and then the hon member can put his question. Further restrictions were placed on concentration. There is also a provision that no group may acquire more than 12 retailers’ licences, and surely that was done to prevent further concentration in the industry as well as to afford the small group and the small man an opportunity to further their interests. The hon member may now put his question.

*Mr S P BARNARD:

I just want to ask the hon the Minister whether he intends embodying the limit of 36 licences in legislation?

*The MINISTER:

Mr Speaker, it is not necessary to embody it in legislation. The number of 36 can be maintained in that no further licences are granted. It is not necessary to introduce legislation for that purpose. I think that I have, with that, also replied to the question of the hon member for Hillbrow. The fact remains that integration already exists and that SAB, by means of its shareholding in Kaap Wyn, acquired an interest in the possible 300 retailers’ licences.

I wish to make a few more observations in respect of the hon member for Langlaagte. The hon member said that he was opposed to any extension of the availability of liquor. According to his view this legislation would make liquor more freely available and that was why he was opposed to it. The hon member says, however, that he is not opposed to the allocation of further licences, although he tried to qualify that statement by saying, under certain conditions. The fact remained, however, that he argued that this legislation entended the availability of liquor further. But liquor is already freely available in South Africa, and that was the point I tried to bring home to the hon member. Liquor is freely available. That hon member piously advocated here that we should vote against this legislation and that a further extension of the principle of the Liquor Act should be opposed and from there be digressed widely and discussed various matters which he could have raised far more profitably under the discussion of the Vote of the Minister of Health and Welfare or the hon the Minister of Foreign Affairs, under whom the SABC falls, and the hon the Minister of Transport Affairs. If he wishes to discuss SABC advertisements, which he has every right to do, then I recommend to him that the Vote under which he should discuss them is the Vote of the Minister of Foreign Affairs. The same principle applies to the availability of liquor as far as the SA Airways is concerned, and so on.

But the hon member said that he was also speaking on behalf of his party and that the CP, as party, was therefore voting against this legislation. They are not voting as individuals, but as a party. The hon member was opposed to the availability of liquor. He felt very strongly about that and he advocated that we should vote against this legislation. If this is the standpoint of the CP, then the ambiguous attitude which the CP adopts is doubly surprising. In Die Patriot of 15 July a large advertisement for an hotel in Silverton appeared. This is an hotel for farmers and sportmen. The hon member is vehemently opposed to sportsmen who consume liquor. As far as this hotel was concerned, people can obtain a 10% reduction over week-ends and there are two ladies bars in the hotel. How does the hon member for Langlaagte reconcile the standpoint which he adopts, even to SABC advertisements, with the fact that advertisements of this nature appeared in their party organ? [Interjections.]

When we talk about double standards, therefore, we should also read what happened in Die Patriot of 26 August. In it an advertisement appeared which stated that CP members were welcome at a certain restaurant in Windhoek which had a light liquor licence and at which people were welcome from Monday to Saturday. [Interjections.] If those hon members therefore adopt such a standpoint as a party against an extension which, to a slight extent, extends the existing grocers’ wine licences so that sparkling wine can also be available and which makes this rule uniform for grocers’ wine licences, how is it that this attitude can be adopted in their party organ? [Interjections.] Surely the issue here is not the principle of grocers’ wine licences—the hon member was in fact concerned about grocers’ wine licences—because this principle has already been agreed to. That principle exists and any applicant qualifying for such licences, may obtain further grocers’ wine licences.

The hon member also made inquiries about the position of SA Breweries and went on to argue that SA Breweries, with this interest, would also be able to take over other interests. I want to point out to the hon member that the Government has on several occasions expressed its concern over concentration, not only in the liquor industry, but in the South African economy. We established the Competition Board precisely in order to promote competition, and takeovers and mergers are watched very carefully by the board. In fact, it is necessary for companies and groups to discuss possible take-overs and mergers in advance with the board so that no decisions will be taken which will subsequently have to be undone, at great expense and after a great deal of trouble. I find it gratifying to be able to say that many groups are already adopting this procedure. The board is therefore proceeding, without making a great fuss about it, to promote competition in the South African economy as far as it is within its means to do so. It will therefore be possible, through the action of the board, to limit very effectively the dangers which the hon member saw on the horizon and which could possibly be dangerous.

I want to thank the hon members for Vasco and Paarl who made positive contributions and the replies which they gave on the misapprehensions which existed in regard to this legislation. I think that I replied during the Second Reading debate to the important, but sensitive matter raised by the hon member for Paarl, namely the question of imported liquor.

Finally I want to return to the hon member for Hillbrow and certain other hon members who, in the discussion of this Bill, repeatedly fell back on the argument that availability inevitably leads to abuse. The fact of the matter is that anything can be abused. Surely the abuse is not rooted in the thing itself; the abuse is not situated in the product, the abuse is situated in the human being. Money and goods can be abused. Is the hon member not aware of all the disputes, all the unhappiness and all the hatred and misery which money and the abuse of money have caused? If one wishes to take this argument to its logical conclusion, one arrives at an absurdity for to be consistent sex should also be prohibited. Surely there are many sex offenders and sexual perverts and rapists.

The problem of the hon member and many of the other hon members who adopt this standpoint is their negative outlook on life. They do not accept that a human being is a unique, ethical, free, religious responsible being.

*Mr H D K VAN DER MERWE:

Conceived and born in sin.

*The MINISTER:

For that very reason he is accountable and also has a responsibility. Human beings have a responsibility and are held accountable, religiously, ethically and politically. After all, one does not remain on the straight and narrow path simply because there are no wrong paths to follow, he remains on the right path because he acts in a responsible way, because he acts in a civilized way.

*Mr H D K VAN DER MERWE:

What are your views on drugs?

*The MINISTER:

What are my views on drugs? Let us take the question of civilization for a moment. Civilization is nothing but the way in which human beings deal with the world around them. As a person who has also studied the social sciences, the hon member ought to know very well that civilization is the way in which human beings have converted nature into a home for themselves. Civilization is the way in which human beings deal with nature outside themselves and with their own natures within them, the way in which human beings make the world liveable. Responsible use of liquor, use of liquor in accordance with civilized values, is as old as mankind itself. It goes back to time long before Biblical times. Responsible liquor consumption patterns were already established in the time of ancient Greek civilization. The drinking culture of the Greek civilization was a finely formulated culture. We advocate the responsible use of liquor. It is rooted in human culture and forms part of the way in which people associate with nature. In that way mankind elevates itself above the animal kingdom. The way in which he deals with liquor, makes of him a civilized creature or an animal. If he uses liquor within the pattern of sympathetic association with his fellow men or to an enhance the pleasure of the food he consumes or as an adjunct to pleasant company, then he is using liquor in a civilized way. On the other hand liquor, if he abuses it, changes a man into an animal, just as the abuse of sex changes a human being into an animal. But we must strive to educate human beings into a sense of responsibility so that they can live meaningful and joyful lives. That is why I should like to conclude this debate with a quotation from Death in the Afternoon by Ernest Hemingway:

Wine is one of the most civilized things in the world and one of the material things of the world that has been brought to the greatest perfection and which offers a greater range of enjoyment and appreciation than possibly any other sensory thing which may be purchased.

Question put.

Upon which the House divided:

Ayes—112: Alant, T G; Aronson, T; Badenhorst, P J; Ballot, G C; Bamford, B R; Bartlett, G S; Blanché, J P I; Botha, C J v R; Botha, P W; Botma, M C; Breytenbach, W N; Clase, P J; Coetsee, H J; Conradie, F D; Cronjé. P; Cunningham, J H; De Jager, A M v A; De Klerk, F W; Delport, W H; De Pontes, P; De Villiers, D J; Du Plessis, B J; Du Plessis, G C; Durr, K D S; Du Toit, J P; Fick, L H; Fouché, A F; Fourie, A; Gastrow, P H P; Geldenhuys, A; Geldenhuys, B L; Golden, S G A; Hardingham, R W; Hayward, S A S; Heine, W J; Heunis, J C; Heyns, J H; Hugo, P B B; Hulley, R R; Jordaan, A L; Kleynhans, J W; Koornhof, P G J; Kotzé, G J; Kotzé, S F; Landman, W J; Le Grange, L; Lemmer, W A; Le Roux, Z P; Ligthelm, N W; Lloyd, J J; Louw, E v d M; Louw, M H; Malcomess, D J N; Malherbe, G J; Marais, P G; Maree, M D; Meiring, J W H; Mentz, J H W; Meyer, W D; Miller, R B; Morrison, G de V; Myburgh, P A; Nel, D J L; Niemann, J J; Odendaal, W A; Olivier, P J S; Pieterse, J E; Poggenpoel, D J; Pretorius, N J; Pretorius, P H; Rabie, J; Rogers, P R C; Savage, A; Schoeman, H; Schoeman, W J; Schutte, D P A; Sive, R; Soal, P G; Steyn, D W; Streicher, D M; Swanepoel, K D; Tempel, H J; Terblanche, A J W P S; Terblanche, G P D; Thompson, A G; Ungerer, J H B; Van den Berg, J C; Van der Linde, G J; Van der Merwe, C V; Van Eeden, D S; Van Niekerk, A I; Van Rensburg, H M J (Mossel Bay); Van Rensburg, H M J (Rosettenville); Van Vuuren, L M J; Van Wyk, J A; Van Zyl, J G; Veldman, M H; Vermeulen, J A J; Vilonel, J J; Volker, V A; Watterson, D W; Weeber, A; Wentzel, J J G; Wessels, L; Wilkens, B H; Wright, A P.

Tellers: W J Cuyler, S J de Beer, W T Kritzinger, C J Ligthelm, R P Meyer and L van der Watt.

Noes—28: Barnard, M S; Barnard, S P; Boraine, A L; Burrows, R M; Cronjé, P C; Eglin, C W; Hartzenberg, F; Langley, T; Le Roux, F J; McIntosh, G B D; Moorcroft, E K; Scholtz, E M; Schwarz, H H; Slabbert, v Z; Snyman, W J; Swart, R A F; Theunissen, L M; Treurnicht, A P; Uys, C; Van der Merwe, S S; Van Heerden, R F; Van Rensburg, H E J; Van Staden, F A H; Van Zyl, J J B; Visagie, J H; Widman, AB.

Tellers: K M Andrew and H D K van der Merwe.

Question agreed to.

Bill read a Third Time.

MEDICAL, DENTAL AND SUPPLEMENTARY HEALTH SERVICE PROFESSIONS AMENDMENT BILL (Second Reading resumed) *The MINISTER OF HEALTH AND WELFARE:

Mr Speaker, when the House was adjourned last night I had already made considerable progress with my reply to the Second Reading debate. However, there are still certain matters I want to refer to.

The hon member for Parktown was not present yesterday and rendered his apologies. In his absence the hon member for Hillbrow expressed a different point of view to the one he had expressed. He shall, therefore, have to give him a talking to. The hon member for Parktown referred to the general situation “of total health care” as he called it. This is a situation we can more appropriately discuss with one another during the discussion of my vote. Furthermore, he declared himself in favour of the inspection introduced by the legislation. His point of departure is that this is an honourable profession and that it should remain so. He also agreed that there should be a register for dispensing doctors. He and the hon member for Hillbrow must sort the matter out between them.

*Dr M S BARNARD:

We have already.

*The MINISTER:

It seems to me that the two hon members have an appointment for this evening, when they are going to tackle each other.

*Dr W J SNYMAN:

Mr Speaker, yesterday the hon the Minister asked the hon member Dr Vilonel somewhat impatiently, whether the Medical Society had made representations to him about this legislation. Has the Medical Association stated, either in writing or verbally, that they are in favour of clause 6 of this Bill in which the right of a medical practitioner to dispense is affected?

*The MINISTER:

Yes, and I have already spelled it out to the hon member. In fact, I told him when they had their final meeting with me and when we reached a final agreement about this. On account of that I had a few amendments placed on the Order Paper. The hon member need not, therefore, be concerned about the Medical Association. For the past 18 months we have been negotiating with each other almost monthly.

The hon member for Witbank sketched the interesting history of the origin of the Medical Council. He agreed that the inspection should be carried out and that the register should be introduced. However, he objected to the way the legal advisers have of referring to a “thing”. I should prefer not to express an opinion in this House about “things”. I simply accept it if it is put to me in that way.

The hon member for Pietersburg spoke, in the first place, about the right of doctors to dispense. I do not disagree with him about that. I do not think that this legislation abolishes it. In fact—and I also mentioned this yesterday—all that is being added here is that the Medical Council now have the right to decide whether they want to introduce a register. If they do introduce a register they can exempt certain people or groups from it. However, then they are also obliged to recognize the existing rights and enter in the register the names of certain people who are already dispensing. The hon member also spoke about medicine prices and expressed his views on the subject, referring to newspaper reports. One has to be careful if one wants to express an opinion about medicine prices merely on the strength of newspaper reports.

I replied last night to the speech by the hon member for Worcester.

†The hon member for South Coast asked me a number of questions. Let me be candid: He asked me so many questions that I was not able to follow all of them. One thing he asked was what the definition is of “open shop”. As regards an open shop with reference to dispensing by doctors, I can say that for many, many decades that has already been included in the law. The expression “an open shop” as it appears in the proposed section 52(1)(a), to my mind means that a medical practitioner may not sell medicine to the general public. His right is therefore restricted to the sale of medicine to patients under his treatment and for the purpose of such treatment only.

The hon member also asked me whether the doctor will be allowed to continue as at present in terms of the proposed section 52(2) or whether his registration will be subject to the conditions provided for under the proposed section 52(1)(a). The position is that that section applies to all doctors. Consequently, all doctors will be subject to the conditions which the council may determine under this section. Subsection (2) of that section provides for a transitional periods of three months within which an existing doctor has to register. It also protects the rights of such doctors since the registrar is obliged to enter their names in the register.

The hon member also asked me whether there is any reason why doctors cannot be associated with pharmacists to supply medicines in terms of the proposed section 52(1)(a). He said this should be done in clinics in industrial areas. My answer to that is that, to my mind, there is no need for such an association between pharmacists and doctors. Provision already exists in terms of the Medicines and Related Substances Control Act, 1965 for a clinic to obtain a permit to acquire, possess and supply such medicines.

*If the hon member was referring to the proposed section 52A, I believe that that is irrelevant. It does not apply to doctors but simply means that under certain circumstances a doctor can obtain permission to appoint a nurse to supply medicines to his own patients. This will accordingly take place under his supervision and on his responsibility. This is not a new principle either. It is in fact an old principle. All that is being asked here is that instead of obtaining the permission of the Director-General, which is the case at the moment, permission should in future be obtained from the Medical and Dental Council.

The hon member Dr Vilonel had many reservations, not about the principle of the legislation as such, but about its wording. To motivate his point he quoted from acts relating to criminal law. I want to say to him that in my opinion there are two things that are dangerous for a doctor to do. The first is when he starts interpreting acts against the advice of others who know the acts. That is a very dangerous thing for a doctor to do. The other dangerous thing a doctor can do is to ask the Minister to protect him against the Medical Council, which is in any case responsible for his registration. When he does that he is skating on thin ice. Personally I have never regarded the Medical Council as a threat. In fact, it has always afforded me protection. Therefore, I agree with the hon member for Witbank that the task of the Medical Council is twofold. Firstly, it is its task to protect the public by seeing to it that the public receives a medical service from people who are properly qualified. Secondly, it is the task of the Medical Council—and it performs this task very well and efficiently— to protect those people who practise according to the ethical rules of the profession.

As far as the hon member for Hillbrow is concerned I think I have already replied sufficiently to his remarks. I must say to him, however, that he has gone so far as to hold a brief in this House for the Sacos of the medical profession.

Mr A B WIDMAN:

Mr Speaker, I should like to ask the hon the Minister whether he rejects the memorandum submitted by the National Medical and Dental Association because of its merits or because he does not like some other connotation about the association.

*The MINISTER:

For a great many years now the Medical Association of South Africa has been the body recognized by the Government and this is also embodied in legislation. I am not prepared to listen to representations by splinter groups of the Medical Association that are not well-disposed towards the medical profession in South Africa.

Mr A B WIDMAN:

Irrespective of the merits?

The MINISTER:

Yes. I do not agree with their merits. They disagree with the Medical Association and I agree with the Medical Association. Therefore I do not accept their situation.

*The position is that the Government recognizes the Medical Association of South Africa as the body which is representative of the private practitioners as well as a large percentage of medical practitioners in the service of the State. It is treated as such, and we accept that body as such. Just as the Government, when it comes to agricultural matters, will not listen to a body other than the South African Agricultural Union, we shall not do so in this instance either.

Mr A G THOMPSON:

Mr Speaker, I should like to ask the hon the Minister to reply to a matter which I raised yesterday in respect of what a reasonable distance is.

*The MINISTER:

The hon member’s question basically concerns section 52A. The section as such is not being changed. Basically, the issue here is that it is an existing right of practitioners who have large practices and are very busy and have already received the necessary permission to employ a nurse to dispense certain medicines to their own patients. The right to grant that permission will now be transferred from the Director-General: Health and Welfare to the Medical Council. That is the only change effected in the section concerned.

Question agreed to.

Bill read a Second Time.

MEDICAL SCHEMES AMENDMENT BILL (Committee Stage)

Clause 1:

Dr M S BARNARD:

Mr Chairman, I think it is very important that in discussing the Committee Stage of this Bill, we start off by making quite sure in whose interests we are speaking. As far as the Medical Association of South Africa, or any other association or council or Minister or political party is concerned, when I discuss this Bill—and this also applies to the next Bill on the Order Paper—my first interest is that of the patient. We have to judge these Bills in the interests of the patients.

Clause 1 deals with definitions and, when reading these definitions, one really comes to the heart of the Bill. “Service” and “scale of benefits” are now being defined and there is the deletion of the definition of “tariff of fees”. To refresh hon members’ memories on the discussion that took place during the Second Reading debate of this Bill, I should like to remind them that we on this side of the House suggested to the hon the Minister that he should appoint a select committee to go into the provisions of this Bill to see how we could try—and I repeat the word “try”— to improve this Bill.

We know that one of the functions of the Browne Commission is to investigate medical schemes to ascertain how they are managed and how they benefit patients. Therefore, we found it surprising that this amending Bill was introduced before that commission’s final report was tabled. The hon the Minister said that one could amend Bills but I should still like to hear from him why this Bill was introduced at this stage. I should like to hear the hon the Minister’s explanation as I have not had a satisfactory answer from him on that score.

The hon the Minister said that many groups had complained about some of the provisions of the Medical Schemes Act. Let us examine what the Act provides for at present. We have the various associations trying to come to an agreement with RAMS in regard to the determining of fees. All suggestions are eventually placed before a tariff committee which gathers information and, when a decision is made on a tariff, which is statutory, they refer it to the Minister for his approval.

In this Bill we have in the first place the deletion of the tariff of fees. This means that there will no longer be a statutory tariff of fees. Secondly, the new definition of “scale of benefits” means that the medical schemes can now have their own scale of benefits which can either be agreed to or not by the various associations providing the service. If they agree to the benefits suggested, the scheme will work; if not, there is no arbitration and then everyone will go his own merry way. That is what in fact is going to happen if this Bill becomes law, and that is where we have problems with this Bill.

That is why we believe that this measure will not succeed. Hon members on the Government side have argued—and I respect their point of view—about the goodwill that still exists. Since 1967, however, it has been proved that agreement could never be reached irrespective of what ways and means were employed. Now, with all possible ways of reaching agreement being jettisoned, I believe that the Representative Association of Medical Schemes and all the other associations in the field of medical services will sooner of later fail to reach agreement. When this happens, who will then have to bear the costs? Will it be the doctors? Will it be the Representative Association of Medical Services? Who will it be? I submit that it will be the patient, and only the patient, who will have to bear the cost. I say this because I believe that in terms of this amending measure medical schemes and suppliers of medicines and other medical services will go by the board. Ultimately the victim of this whole new dispensation envisaged in terms of this measure, will be the patient and no one else. The subject of this measure is the medical treatment of patients and the payment for such treatment by medical aid schemes. That is what this Bill is all about. I believe that unless some way of arbitration is provided and that unless someone has a final say, this measure will result in a total collapse of all medical schemes as they exist and function today. I only have to refer to what has been said by other hon members during the previous discussions of this Act to realize that this is indeed what is going to happen. Some hon members in the previous debate during 1980 pointed out that if it did not become operative it will lead to chaos. I should like to know from the hon member for Rustenburg, who, I am sure, is going to speak later, why the Minister’s say in the matter has to be terminated now. He should tell us why the abolition of the tariff committees will not lead to chaos. If I remember correctly, Mr Chairman, it was argued earlier by hon members opposite in 1980 that that was indeed what would happen should the tariff committees be abolished. What has caused them to change their opinion in this respect? I should like the hon member for Rustenburg or any other hon member on the Government side to tell us that.

For a patient who is already ill, or even one of his next of kin, to bear the stress of having to pay doctors’ and hospital bills and medicine bills as well, I believe, is indeed a heavy burden to bear. We who are in medical practice know this from our own experience. Should this be allowed to become common practice in the medical field, I believe, we in this House will be party to depriving ill patients in this country of one of the most important and most basic rights to which they have always had a claim. What will happen then? The hon the Minister complains—and with justification—of the high cost of medicines today. People in this country who cannot afford to bear the costs of medicines and medical treatment will now be compelled to seek help from provincial hospitals. That will increase medical costs even further; the very costs about which the hon the Minister himself is so concerned.

I want to put it to the hon the Minister that I have spoken to representatives of most of these medical associations. On the whole not one of them is satisfied with this measure as it stands at the moment. They are satisfied with most of the provisions contained in this Bill, but they have grave reservations about certain provisions. We on this side of the House believe that the hon the Minister has never received any complaints from the private patients in respect of the legislation as it currently applies. We also believe that employers, who actually bear the bulk of the costs involved in sustaining medical schemes, have not complained to the hon the Minister about the current legislation. Therefore I believe it is our duty to see to it that the patient and the employers who foots the bill, are recognized and protected.

*Dr W J SNYMAN:

Mr Chairman, we in this party are also of the opinion that the present legislation does not offer a solution to a problem that has existed for many years; nor is it a solution to the definition contained in clause 1, inter alia, the definition concerning the determination of a statutory tariff that will satisfy medical schemes, as well as medical practitioners, whilst at the same time affording the assurance that patients will not be adversely affected.

We argued about this during the Second Reading as well. I should also like to associate myself with what the hon member for Parktown had to say. They suggested that the legislation be referred to a select committee, and we proposed that a method of arbitration be established by means of which medical practitioners can also be given a direct say in the fixing of the so-called scale of benefits being proposed here. The hon the Minister reiterated this afternoon that medical practitioners should not try to interpret legislation, and he also said that medical practitioners would not know what “in consultation” or “after consultation” means. I just want to tell the hon the Minister that medical practitioners are not really so stupid. As the legislation stands at present, medical practitioners are going to have no say in that regard, since provision is only made that, after consultation, they must accept a one-sided, statutory announcement in the Gazette, which will then constitute the scale of benefits.

With regard to the terminology being used here, I move the following amendment to this clause printed in my name on the Order Paper:

  1. 1. On page 5, from line 5, to omit paragraph (c) and to substitute:
(c) by the insertion after the definition of “rules” of the following definition: “ ‘scale of remuneration’ means a scale of remuneration determined in terms of section 29;”

The reason for our moving this amendment is because there could be confusion in the legislation in respect of the term “benefits”, since clause 13 speaks of benefits for which provision is made in respect of members of medical schemes. I do not think a medical practitioner works for any benefits. He works for remuneration. It must therefore either be a tariff or remuneration. We are therefore moving this amendment with regard to the terminology to the effect that “scale of benefits” be omitted and that “scale of remuneration” be substituted.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, the hon member for Parktown put the same question to me he has put before, and that is why we do not wait until the report of the Browne Commission has been submitted. As regards this specific matter, the Browne Commission has submitted a provisional report to me. About a month ago the Browne Commission submitted a second report to me which dealt specifically with this subject, and it corresponded precisely with the first report. They also proposed the introduction of an arbitration commission. I therefore want to ask the hon member what he would have done if he were in my position. When the Medical Schemes Act came into operation in 1967 it stated that negotiations had to take place in order to fix a tariff. The legislation of that time further provided that if agreement could not be reached in this regard the dispute should be referred to the Central Council for Medical Schemes, which would then act as arbiter. In October of the same year the Central Council for Medical Schemes, after it had appointed certain committees on which members of the suppliers on the one hand, and members of the schemes on the other, plus an impartial chairman, served, then decided that there were problems with the scheme and that it would not be a success. They tried the scheme, but it was not a success.

Another attempt was made after that. A remuneration commission, with a judge as chairman was then appointed. Serving on this commission was a representative of the schemes, as well as a representative of either the doctors or the dentists, depending on the nature of the case before the commission. That did not work either.

We then went further and the Act was amended once again. It was decided that someone else should be appointed to fix the tariffs. The Medical and Dental Council was then asked to put the case. People were not satisfied with that either.

The Act was altered again to read as it does at present. The position is that the Medical and Dentral Council has to fix the tariffs. After having received representations from everyone, they have to decide. They are therefore the arbiter now. After they have approved the tariffs, the Minister must make the final decision.

As far as I am concerned, various kinds of arbitration committees have been considered, and none of them has worked. How can the hon member expect me to appoint a committee that has not worked in the past?

*Dr M S BARNARD:

Mr Chairman, may I ask the hon the Minister, seeing that he is repeatedly saying that it did not work, for whom it did not work? Did it not work for the patient? Let us forget about the doctors and the medical schemes and confine ourselves to the patient. My question is whether, as matters stand now, it did not work for the patient.

*The MINISTER:

Not one of those situations can work. If the people who provide the services—that is the doctors, the dentists and the other people who provide services— are not satisfied, it will not work. That is in the first instance. Secondly, we come to the people who receive the services, and they are the patients. If they are not satisfied, it will not work either. No one has been satisfied. Recently everyone has been angry. The person with whom they were angry was usually the person in the middle, the person who had merely been given the task to decide, and no one was satisfied with his decision. One person says it is too little, and the other says it is too much. The situation is that arbitration has never worked in the past, and it will not work in the future either. That is why we have the proposal before us at present.

This is concerned with eliminating chaos. For the first time all the supplies have the right to fix their own tariff structure. The Act prohibits the schemes from altering that tariff structure. All they can say is that they are prepared to pay so much of the tariff structure and that they are prepared to fully cover that which they are prepared to pay. The dentist, medical practitioner, or whoever is prepared to impose the tariff the medical schemes are prepared to pay, are compensated directly by the medical schemes.

*Dr M S BARNARD:

And who is going to pay the rest?

*The MINISTER:

It works just as it does at present. If someone wishes to contract out, you pay the rest.

*Dr M S BARNARD:

No, that is not the way it is.

*The MINISTER:

Of course.

*Dr M S BARNARD:

No, it does not work like that.

*The MINISTER:

How can the hon member tell me that it does not work like that? For every doctor that is contracted out at this stage, the medical schemes pay a portion, and the rest is paid by the patient.

*Dr M S BARNARD:

No, it will not work like that.

*The MINISTER:

Of course it is as I say. Can the hon member not understand that?

*Dr M S BARNARD:

I shall reply to that in a moment.

*The MINISTER:

As far as the hon member for Pietersburg is concerned, if he reads the clause carefully, he will see that it is concerned with a service, the obtaining of benefits by a scheme for its members. A scheme does not provide a service to its members, but it obtains benefits for its members. For that reason, what the scheme pays will be a scale of benefits according to what it is prepared to pay. The tariffs fixed by medical practitioners, dentists, or other professional people is their tariff structure. The issue is therefore not that a doctor does not work for benefits, since he works for a fixed tariff. For the benefit the supplier, viz the medical practitioner or the dentist, has that his money is being guaranteed, they are prepared to give discount. A free market mechanism will be in operation here. There are the suppliers of services on the one hand, and the receivers of services, who are united in an association, on the other, who have to negotiate with one another. I want to warn that the moment it is determined that it must take place “in consultation”, in other words, that people must agree with one another before something happens, one is creating chaos. However, if one of them has his tariff and the patient has his scale of benefits, the patient has the right to go to whomever he wishes, the doctor has the right to charge what he wishes, and the scheme, which is basically an insurance scheme in terms of which each person pays on the basis of the benefits he obtains, will pay according to what it has undertaken to pay on behalf of its members. If there is a difference between the two, the patient who receives the service must pay in the difference, just as is the case at present. The only difference is that the doctor can now decide completely independently whether he wants to be contracted in or contracted out, and that he does not have to notify some body or another of his decision. He simply carries on with his practice. The account he renders his patient is sufficient proof to decide whether the medical scheme will pay it in full, or whether the patient will have to contribute a portion.

Dr M S BARNARD:

Mr Chairman, I am very surprised at the hon the Minister. I would like to read to him the following definition:

“service” means any medical, psychological, paramedical, nursing, surgical or dental treatment, and includes the supply of medicines or of medical, surgical, dental or optical requirements or appliances, or of accommodation in a hospital or maternity or nursing home.

The hon the Minister—I noticed that the hon the Deputy Minister of Internal Affairs also got very excited about it—only talks about the doctor. However, a doctor often requires the use of a hospital to be able to render his service.

*The hon the Minister says the situation remains exactly the same. That is not, however, the case with private hospitals. Does the hon the Minister know what happens to a patient who goes to a private hospital?

*The MINISTER OF HEALTH AND WELFARE:

I know.

*Dr M S BARNARD:

The hospital ascertains to what medical scheme the patient belongs and what his membership number is. It puts through a telephone call to that medical fund, asks whether the patient is a member of the fund and what the tariff is that the fund pays. Now that is something of the past, because it is no longer going to be the procedure. It is possible that a patient who has suffered a stroke could be admitted to such a hospital during the night. Where is the hospital going to obtain those particulars? The patient or his family is only going to find out next morning that the hospital and the medical fund cannot reach agreement. Where are they then going to obtain the necessary money for the patient’s treatment? This Bill concerns the patient. The hon the Minister and the people who drafted this Bill did not consider the patient. It cannot be said that the situation will now still be the same.

This Bill has a further effect that hon members have not even thought of yet. Doctors in the cities do not have a chance to work in provincial hospitals and must therefore work in private hospitals. This Bill does suit the doctors in the rural areas, because they work in the provincial hospitals where the fees are much lower. This Bill therefore discriminates to a certain degree against doctors in the cities and against patients in the cities who become ill. We can argue this point, but time will tell who was right. I want to stop this legislation, because it is going to cause chaos, and the patients are the ones who are going to suffer. Ministers of Health do not last long in this Parliament. I should like to help the hon the Minister, because I do not want him to be known as the hon Minister who caused medical schemes in private practices to end up in a state of chaos.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, on each and every occasion I have told the hon member “and other suppliers”. The procedure for a private hospital is exactly the same as that for other suppliers. Even the Representative Association of Private Hospitals—Die Verteenwoordigende Vereniging van Privaathospitale—will negotiate with RAMS in the same way. How can the hon member now tell me it is not so?

*Dr M S BARNARD:

I am not arguing about that; I agree.

*The MINISTER:

Then a daily tariff will be determined, as is done now. In fact, if they cannot agree, the existing tariff remains in force. How can the member say it is a different story? If the hon member is worried about the medical funds not being able to afford private hospitals tariffs, I agree with him.

*Dr M S BARNARD:

It is the patient who cannot afford them.

*The MINISTER:

The patient too. I want to refer the hon member to certain private hospitals. Recently I saw the medicine account of a certain private hospital covering a one-month period. It amounted to R40 000.

*Mr H D K VAN DER MERWE:

For just one patient?

*The MINISTER:

Yes, for one patient. Can the hon member now understand the situation, and how can he say that the present Act cares for the patient? I also have accounts for medicines for a patient who, in two days, received 106 Omnipon injections. Does the hon member think it is possible for a patient to receive 106 Omnipon injections in two days? The patient, however, did receive an account for the injections from a private hospital. Those are not little angels we are dealing with. I realize what the hon member’s problem is.

*Dr M S BARNARD:

Is this legislation going to prevent it?

*The MINISTER:

No, I am not saying it will prevent it, but surely the hon member does not think that the present system prevents it. The free market mechanism must now be given a chance so that people can negotiate with one another. Is the hon member opposed to the free market mechanism?

*Dr M S BARNARD:

You are playing around with illness.

*The MINISTER:

I am not playing around with illness. I am afraid the hon member does not know what is going on because he is just thinking of private hospitals. The hon member speaks about patients, but they are patients in private hospitals.

Amendment 1 negatived (Conservative Party dissenting).

Clause put and the Committee divided:

Ayes—103: Alant, T G; Aronson, T; Badenhorst, P J; Ballot, G C; Bartlett, G S; Blanché, J P I; Botha, C J v R; Botha, P W; Botma, M C; Breytenbach, W N; Clase, P J; Coetsee, H J; Conradie, F D; Cunningham, J H; De Jager, A M V A; De Klerk, F W; Delport, W H; De Pontes, P; De Villiers, D J; Du Plessis, G C; Du Plessis, P T C; Durr, K D S; Du Toit, J P; Fouché, A F; Fourie, A; Geldenhuys, A; Geldenhuys, B L; Golden, SG A; Hardingham, R W; Hayward, S A S; Hefer, W J; Heine, W J; Heyns, J H; Hugo, P B B; Jordaan, A L; Kleynhans, J W; Koornhof, P G J; Kotzé, G J; Kotzé, S F; Landman, W J; Le Grange, L; Lemmer, W A; Le Roux, Z P; Ligthelm, N W; Lloyd, J J; Louw, E v d M; Louw, M H; Malherbe, G J; Marais, P G; Maree, M D; Meiring, J W H; Mentz, J H W; Meyer, W D; Miller, R B; Morrison, G de V; Niemann, J J; Odendaal, W A; Olivier, P J S; Page, B W B; Pieterse, J E; Poggenpoel, D J; Pretorius, N J; Pretorius, P H; Rabie, J; Rogers, P R C; Schoeman, H; Schoeman, W J; Schutte, D P A; Scott, D B; Steyn, D W; Streicher, D M; Swanepoel, K D; Tempel, H J; Terblanche, A J W P S; Terblanche, G P D; Thompson, A G; Ungerer, J H B; Van den Berg, J C; Van der Linde, G J; Van der Merwe, C V; Van Eeden, D S; Van Niekerk, A I; Van Rensburg, H M J (Mossel Bay); Van Rensburg, H M J (Rosettenville); Van Vuuren, L M J; Van Wyk, J A; Van Zyl, J G; Veldman, M H; Vermeulen, J A J; Viljoen, G V N; Vlok, A J; Watterson, D W; Weeber, A; Wentzel, J J G; Wessels, L; Wilkens, B H; Wright, A P.

Tellers: W J Cuyler, S J de Beer, W T Kritzinger, C J Ligthelm, R P Meyer and L van der Watt.

Noes—36: Andrew, K M; Bamford, B R; Barnard, M S; Boraine, A L; Burrows, R M; Cronjé, P C; Dalling, D J; Gastrow, P H P; Goodall, B B; Hartzenberg, F; Langley, T; Le Roux, F J; Malcomess, D J N; Moorcroft, E K; Myburgh, P A; Olivier, N J J; Savage, A; Scholtz, E M; Schwarz, H H; Slabbert, F v Z; Snyman, W J; Soal, P G; Suzman, H; Swart, R A F; Tarr, M A; Treurnicht, A P; Uys, C; Van der Merwe, H D K; Van der Merwe, S S; Van Heerden, R F; Van Rensburg, H E J; Van Staden, F A H; Van Zyl, J J B; Visagie, J H.

Tellers: G B D McIntosh and A B Widman.

Clause agreed to.

Clause 9:

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, I should like to move the amendments printed in my name on the Order Paper, as follows:

  1. 1. On page 9, in line 39, to omit “ and”.
  2. 2. On page 9, after line 39, to insert:
the registrar shall, by notice served by registered post, furnish the party complained against with full particulars of the complaint, and request such party to furnish him for the information of the council with his comments thereon in writing before a date specified in the notice, not being a date earlier than thirty days after the date of the notice.”; and

Basically this does not involve any change in the Act. In the process of printing a portion of the clause was unfortunately omitted. That is why it is now being inserted again. It is therefore in no way an amendment to the Act. Basically it involves maintaining the wording in its present form.

Dr M S BARNARD:

Clause 9 refers to section 28 of the principal Act. In terms of clause 9(b) subsections (4), (5), (6) and (7) are deleted. The Act as it stands now contains a review mechanism to investigate and report on complaints against suppliers of services, but all references to this have been deleted. That is being done through the deletion of subsections (4), (5), (6) and (7), leaving the final decision in all matters to the Central Council for Medical Schemes, and any such decisions shall be binding on all parties concerned. Where the Central Council for Medical Schemes comes into this I should like to ask the hon the Minister why these subsections were deleted. In which way will it benefit medical practitioners or patients?

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, if the hon member had read this properly he would have seen that the obligation which section 29, placed on the suppliers of services who were contracted in, no longer claim, in terms of the specific exceptions, more than a statutory tariff from members of a scheme, is now being deleted. In the new dispensation suppliers have a choice of remaining within the scale of benefits, if there is one, or to ignore the scale.

*Dr M S BARNARD:

Is that clause 9?

*The MINISTER:

Yes, that is clause 9. Payment takes place in terms of the provisions of clause 12. So there is no longer any reason to regulate complaints concerning the collection of fees in the Act. There is no longer any question of contracting in or contracting out.

Amendments 1 and 2 agreed to.

Clause, as amended, agreed to.

Clause 10:

Dr M S BARNARD:

Mr Chairman, I do not think that we need to spend much time on this clause. This is the clause that we disagree with and which we discussed in great detail during the Second Reading and also during the discussion on the tariffs under clause 1. The clause deals with the tariff of fees and with contracting in and contracting out in respect of persons registered in terms of the Medical, Dental and Supplementary Health Service Professions Act, 1974.

Section 29 is being repealed and replaced by a new section 29 which allows the Representative Association of Medical Schemes to determine a scale of benefits, in consultation with a professional association, which will become the basis on which all registered medical schemes will grant benefits. The benefit schedule will be reviewed whenever the association sees fit or the Central Council of Medical Schemes will be requested to do so and may amend the schedule thereafter. There is no mention of any supervisory body higher than the central council to request or demand tariff reviews, and in this there is possibly an inherent danger.

The representative association is also a statutory body in terms of the Medical Schemes Act, which means that whatever bias they may have is carried through to the supervisory body—about that there is no doubt—where there is a preponderance of members who in turn have a strong bias in favour of the point of view subscribed to by the members of the Representative Association.

It is obvious that with the same people serving on and largely controlling both the supervisory and subsidiary bodies, no safeguard exists for the review of the benefit schedules.

A rider has been added to the effect that whatever tariffs are in force at the time that the amending Bill becomes law, will remain in force until such time as a scale of benefits has been determined. That is all very well but although the profession and other suppliers of service have been freed of the commitment of having either to be contracted in or out, there is no compulsion upon RAMS to do more than consult with then before setting their benefit schedule. The suppliers of services have thus been effectively divorced from any voice in the determination of the tariffs. That is the problem, Mr Chairman. They will set their own fees, RAMS will determine its benefit schedules and the gap between supplier and scheme will become ever wider. I should like the hon the Minister to tell me whether this will not happen, that is, that this gap will become wider.

This is not a satisfactory state of affairs, especially for the individual members of schemes and their employers, those without whose vast monetary assistance there would be no medical aid movement such as we currently enjoy. I must warn the hon the Minister that I see this as a great danger. These people are yet to be canvassed as to what they wish to be done, and it is certainly not in their interests, to incur a breakdown in the highly important area of medical aid facilities, which would no doubt happen within a comparatively short time after the inevitable rift between the medical aid movement and the suppliers of services occurs, especially as there is no longer any arbitrary body in the event of a breakdown.

I appeal to the hon the Minister to pay attention to my remarks regarding this clause because I can assure him that the acceptance of this clause will lead exactly to the position I have just described.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, I move the two amendments printed in my name on the Order Paper, as follows:

  1. 1. On page 9, in line 45, after “may” to insert:
, subject to such conditions as the Minister may prescribe by regulation with regard to a tariff of fees determined under section 12(1)(b) of the Dental Technicians Act, 1979 (Act No 19 of 1979),
  1. 7. On page 11, from line 6, to omit subsection (2) and to substitute:
(2) The Association shall within three months after the fixing of a guide to fees referred to in subsection (1)(d) or when it deems it necessary or when it is requested by the council to do so, review any scale of benefits, or any provision thereof, and may amend it.

I believe the first amendment to be necessary because the tariffs of dental technicians are determined in terms of the Dental Technicians Act. As far as I am concerned, that is unsatisfactory. It is done, however, in terms of an Act which is still in force at this stage. For that very reason provision has to be made for that, and that is what I wish to do by my way of my first amendment. I trust that in future agreement will also be reached in this regard so that the Minister’s decision can also be withdrawn.

As far as my second amendment is concerned—that is amendment No 7 on the Order Paper—I consider its wording to be better than the present wording. It will prove more satisfactory than the present wording. I therefore propose that this be accepted as such.

Mr A B WIDMAN:

Mr Chairman, I strongly support the arguments put forward by the hon member for Parktown. I do not know how we can really solve the difficulty which exists in terms of this clause, to wit the resolution of a difference of opinion between the Representative Association of Medical Schemes and the various other associations. For this reason of course we will have to vote against clause 10.

Be that as it may, however, if the hon the Minister is not prepared to withdraw this clause, which unfortunately forms the root of the whole problem, I may perhaps mention two points in this connection which worry me. The first of these is in respect of the proposed new section 29(1)(a) which reads as follows:

The Representative Association of Medical Schemes (hereinafter referred to as the Association) may by notice in the Gazette determine a scale of benefits in respect of any service to a member of a medical scheme or a dependant of such a member.

What causes me concern here, Mr Chairman, is the use of the word “may”. The only way in which, I believe, this problem can be solved will be by substituting “shall” for “may”, and I accordingly move the following amendment:

8. On page 9, in line 45, to omit “may” and to substitute “shall”.

I move this amendment because, as I see it, “shall” is mandatory while “may” is not indicative of any obligation. That means that they may publish it in the Gazette if they want to, or they may not publish it if they do not want to. “Shall” will make it obligatory for them to publish it in the Gazette. They will then have no discretion because publication will be mandatory. I suggest that this amendment will improve the measures.

My second problem is in connection with the proposed new section 29(1)(c), which reads as follows:

Before the Association determines a scale of benefits in respect of any service supplied by a particular profession or professions, it shall consult the professional association (if any) which in its opinion represents the majority of those persons practising such profession or professions.

The hon the Minister will note that “shall” is used in this instance, making such consultation mandatory. I did raise this point during the Second Reading debate, and I said then that I would come back to it at Committee Stage. In my opinion there could be two interpretations of the words “it shall consult the professional association” in lines 55 and 56 on page 9. The word “shall” is mandatory and so it means that there be consultation with professional associations in this regard. I should like to know the intention of the hon the Minister with these words. Does the hon the Minister intend that RAMS should merely tell, for example, the Medical Association or the Private Hospitals Associations that the tariff is a certain amount and that that amount will be gazetted, or does it mean that the agreement of the Medical Association or any other professional association has also to be obtained? Having spoken to some of the doctors who are members of the Medical Association, I am under the impression that they were told that they would sit around a table and come to an agreement with RAMS. However, with the greatest respect, that is not the way I interpret it because it does not say “by agreement with”. It merely makes provision for consultation. I can consult the hon the Minister and he can tell me what he proposes and I can say that I do not agree with it. However, irrespective of that, having consulted me, the hon the Minister can still publish it in the Gazette. He does not have to have my agreement, and this is where the problem arises. Therefore, I think the hon the Minister should state clearly whether this is to be done either by agreement or by consultation.

Irrespective, however, of what the hon the Minister says in this regard, I must also say that it is not going to cure the inherent ill which has been pointed out by the hon member for Parktown, namely that if no agreement can be reached, who is going to solve the problem? Although the amendments moved to this clause by the hon the Minister will be an improvement as far as the wording of this provision is concerned, they still do not meet the problem that has been pointed out from these benches, namely who the final arbiter will be and what will happen in the event of disagreement.

The MINISTER OF HEALTH AND WELFARE:

May I ask the hon member a question? There was a final arbiter in the past. Was that successful? That is the reason why we are effecting these amendments. It did not work.

Dr M S BARNARD:

For the patient it did.

Mr A B WIDMAN:

Apparently, Sir, it did work for the patient. However, if, as the hon the Minister says, it was unsuccessful, what was the reason? In his reply to the Second Reading debate I think the hon the Minister stated that it could take up to 10 months before the Minister was able to make a final decision, and that the amendment was being affected to avoid delays of that nature. If that is the reason then I do not accept it as being reason enough to amend the provision. Why did the hon the Minister take 10 months to make a decision? Why could he not have decided within a few weeks? Why did he have to take 10 months to decide? Was it necessary for him to take so long to decide? If that is his reason then I am afraid that I cannot accept it as a reason for amending this provision because I am sure he could have arrived at a decision much sooner. If there was no agreement and the hon the Minister’s decision was required, he could have given it earlier. As the hon member for Parktown and the hon member for Rustenburg have said, it will lead to chaos unless the Minister can decide. What is the hon the Minister doing now? He is reverting to a position of chaos.

As I say, our problem with this clause is that there is no final arbiter and, although I have suggested a small improvement for what it is worth, the provision as it stands will not cure the ills that are bound to arise.

*Dr W J SNYMAN:

Mr Chairman, as far as we in the CP are concerned, clause 10 constitutes the very heart of this legislation, and that is specifically why we voted against the principle at Second Reading.

What is involved here is the major problem of determining the scale of benefits. I cannot follow the hon Minister’s argument. He told us that previously arbitration did not prove successful and that it would not be successful in this case either. What must not be lost sight of is that arbitration previously took place in completely different circumstances. At the time there was a so-called preferential tariff on the medical side which was taken as the norm instead of the previously existing guideline. That is where the point of departure went wrong.

If the hon the Minister is telling me that arbitration, as we propose it here, cannot work, well then I do not know. We proposed three representatives of the Representative Association of Medical Schemes, three representatives of the professional association and three representatives of the SA Medical and Dental Council. All we are asking is for these people to reach consensus. They elect their own chairman and they must achieve consensus. If the hon the Minister does not see it succeeding, then we ask him how on earth he thinks consensus will ever be reached in the general, broad political and constitutional field.

We are asking, for a very good reason, that consensus be reached between the representatives of the profession, the statutory body and the schemes. Our reason for doing so is that we do not want the guideline laid down by medical practitioners and the statutory tariff to drift further and further apart until eventually there is such a wide gap that the whole scheme collapses. Then there would only be one last remaining alternative and that would be a State medical health scheme. That is why, in the interests of the patients and the medical practitioners of South Africa, we are very strongly opposed to this legislation, and specifically this clause.

The last amendment we moved has, to a certain extent, been anticipated by the hon the Minister’s amendment in terms of which the danger, which exists by virtue of medical schemes not having a time-limit and being able to delay matters for a very long time before determining new tariffs, is resolved. For that reason we shall not be going into this any further.

The clause we are now dealing with forms the essence of the legislation. We foresee the danger of total failure as far as this is concerned, with the country eventually being saddled with a State medical health scheme.

*Dr J J VILONEL:

Mr Chairman, I should like to make a few remarks to the hon members for Pietersburg and Parktown. Before I come to that, however, there is something else I want to say. I think the hon the Minister is the hon member with the best sense of humour in this House, I think he would appreciate my telling him that I enjoy speaking about a Bill with which I am in agreement.

The Medical Association of South Africa held discussions with the Representative Association of Medical Schemes, or RAMS as it is known. The minutes of those discussions are available. The question of arbitration or non-arbitration was specifically discussed at that meeting. The Medical Association was in favour of arbitration, but the other people were not. They then agreed on certain points, and one of the important points was the decision that the RAMS would independently determine a scale. As soon as one says they must independently determine a scale, one cannot introduce a system of arbitration at a later stage, because the two principles are in conflict. At that meeting the following resolution was then adopted by the Medical Association and the RAMS, which I quote as follows from the minutes:

Dat ’n skedule van voordele nie laer as die statutêre tarief van krag tydens die instelling van die nuwe bedeling deur die VVMS bepaal sal word in oorleg met die MVSA. Indien onderhandelings misluk …

This is the point I want to make:

… sal die VVMS onafhanklik verantwoordelik wees vir die vasstelling van die tarief. Betaling van dienste deur die geneeshere gelewer teen die tarief in hierdie skedule sal gewaarborg wees.

The point I therefore want to make is that in spite of the fact that the Medical Association would have liked to have arbitration, they agreed under the circumstances to say that that was what had been agreed to and that one should simply see how it worked out. A further point I want to make is that we must implement the new dispensation. If any errors creep in—there will be problems, because there will be clashes—one can take matters further. We do know, do we not, that all the previous efforts failed.

I read the hon member for Pietersburg’s speech made last year during the Budget debate. He said that our present system was totally unjust. I have a copy of his speech available, and those were more or less the words he used. It said the present system was totally unjust and should be done away with. That is exactly what the hon the Minister is doing. He is now putting the free-market mechanism into operation. Let us leave the matter at that, as those people agreed. Let us put the system into operation and then, by way of legislation, iron out the problems that crop up, if possible.

*Dr M S BARNARD:

Mr Chairman, I cannot agree with the hon member Dr Vilonel that we should simply make the free-market system applicable to sickness. In my opinion that is being irresponsible. When a patient has to undergo a major operation in a hospital, that is not the same as buying canned food.

*Dr J J VILONEL:

What was the situation prior to 1967 when there was, as yet, no Medical Schemes Act? Who protected the patient then?

*Dr M S BARNARD:

That has nothing to do with this clause. The hon member can come and discuss that with me in private. We are aware of the problems that many patients had at the time. I grew up in a mission station manse and know how my father struggled to have patients treated because they could not afford doctors.

I think the hon the Minister is beginning to realize that it is wrong to proceed with this Bill. It is slowly but surely beginning to counter his own arguments. He is a very clever Minister, but I do not think he fully realizes what this legislation is going to do to patients. He has not yet told me what is wrong with the present legislation. I do not care, first and foremost, about the problems of the medical profession in South Africa. Nor do I care, first and foremost, about the problems of private hospitals. I do, however, care about patients. At the moment medical schemes are looking to the interests of patients. If the hon the Minister can prove to me that the present system has not worked to the benefit of the patient, I will accept it. The present system, in terms of which the supplier of the service, the medical scheme and the patient co-operated with one another, benefitted the patient. Before being admitted to a private hospital, the patient knew that his medical scheme would pay. If a doctor was contracted in, he knew that his medical costs would be covered. What system could function more effectively?

The question of contracting in an contracting out, and the direct payment to patients if doctors’ tariffs do not comply with the requirements of medical schemes, causes a great problem. Particularly if someone is finding it hard to make ends meet and, let us say, receives R500 from a medical scheme, it is only human for him to want to put such an amount into his own pocket. The fact of the matter is, however, that the more money the patient puts into his own pocket, the more must the medical association, the hospitals, medical practitioners and dentists protect themselves. This would give rise to further problems and tariff increases.

I find the hon member for Pietersburg’s argument problematic. Although I want arbitration and an arbitration committee, I do nevertheless foresee problems. As the hon member Dr Vilonel has previously said, when this proposal was put to the various groups, the medical schemes were dissatisfied. I cannot imagine that the suppliers of so important a service not being able to agree with one another. I believe that if we were given the chance, we could work out a system that would do justice to the patient. I want to go so far as to say that such a system need not differ very greatly from the present one.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, to a large extent hon members repeated what had previously been said.

The hon member for Parktown said he thought I was now gaining a new perspective as far as this legislation was concerned. I am glad he said he thought so, because as usual he is wrong in his thinking.

One cannot simply go on explaining, but I shall try again. I have been negotiating with these people for 18 months now, that is to say with the representatives of the patients, the medical schemes. There is no way to negotiate other than with the representative body.

Let me begin at the very beginning. What is a medical scheme? It is an organization in which a number of people with the same interests get together, for example Parmed. A medical scheme is then established, with members having to make regular contributions. In some cases the members alone contribute; in others the employers also contribute, the only object being to purchase insurance against illness. The facilities and benefits a scheme offers its members depend on the contributions that members make. There are certain minimum benefits prescribed by the Council for Medical Schemes before a scheme can be registered. If those minimum requirements are met, the scheme is registered. It is, however, the task of the members of that scheme to decide, for example, whether the scheme should pay the full costs of hospitalization. It remains their task. That is why annual general meetings are held and why a committee is appointed to administer the scheme. The benefits a scheme offers to its members are thus in no way encroached upon. There must more or less be some agreement about what a hospital or a doctor may charge.

That is why the various schemes belong to one joint scheme, ie the RAMS—VVMS: die Verteenwoordigende Vereniging van Mediese Skemas. This organization negotiates on behalf of the members of the various schemes. In the case of medical doctors they negotiate with the Medical Association, in the case of dentists the Dental Association and in the case of hospitals with the Representative Association of Private Hospitals. They get together round a table and negotiate with one another. The moment I were to indicate, in this legislation, that they have to reach agreement, the result would be a clash, a deadlock, which would be impossible to resolve unless someone from outside were brought in to determine the tariffs. The medical profession has very serious objections to people from outside determining their tariffs for them. The legal profession likewise objects to people from outside having to determine their tariffs. That is why one cannot do it that way. As I have said, the medical profession has very serious objections to an arbitrator from outside being brought in to determine tariffs. In fact, the medical profession continually reproaches us with the fact that this disrupts the doctor-patient relationship. That is why we are now removing it.

What would be the subject of the agreement reached by the people sitting round that table—the Medical Association and the other associations, depending on what is involved? They would reach agreement on tariffs, because it is in the interests of both parties. It is in the interests of both parties to reach agreement, not to be engaged in an altercation. Doctors are not children. Those people know what to do. They also have an interest in their patients. They do not merely want to exploit them. The medical schemes, on the other hand, also have a responsibility towards their members. If they were to agree to tariffs that were too high, it would mean only one thing, ie tariff increases. There would be no other way out. After all, there is no question of additional money being available. Here it is surely not a question of the patient having to pay in if the tariff were too low. If the doctor’s tariffs were too high, on the other hand, the patient would in any case have to pay, regardless of whether he paid the scheme or paid personally.

The people are going to reach agreement because it is in their interests to do so. For the first time in 15 years they are now being left to their own devices to negotiate with each other. They also acknowledge that it is in both their interests to reach agreement.

*Mr A B WIDMAN:

What if they do not reach agreement?

*The MINISTER:

If they do not reach agreement, the doctor determines his tariff and the medical scheme determines its scale of benefits. Every medical practitioner is then free to send his account and charge what he wants to. If he sticks to the medical scheme tariff, he is paid directly. If he is not prepared to stick to that tariff, to work at the tariff proposed by the medical scheme, he determines his own tariff and the patient has to pay the difference.

*Dr M S BARNARD:

It is a good thing that you acknowledge that fact.

*The MINISTER:

Of course, but that is also the present position. If a doctor is contracted out and is not working in accordance with the medical scheme tariffs, the patient now also has to pay in the difference. All I am saying is that if a medical practitioner does not want to work in accordance with that tariff, there will be no placard hung around his neck or pasted on the wall saying that he is not working in accordance with that tariff. He submits his account and that is the end of it. We must just leave the people alone to negotiate with each other, and what I am saying is that they are going to reach agreement because it is in everyone’s interest to reach agreement. For that reason I am not prepared to accept the proposal of an arbitrator.

What procedure must be adopted in the case of arbitration? There is only one way in which it can be done. One appoints a representative of the Medical Association and a representative of the medical schemes, and then an impartial chairman. We had a representative of the medical schemes, we had a representative of the Medical Association, and we appointed a judge as chairman. Today they are still all cursing. Surely it is no use continuing on that basis.

*Dr M S BARNARD:

I can now clearly see that you are wrong.

*The MINISTER:

I am glad it is clear to the hon member that I disagree with him. I disagree with him because he did not spend 18 months negotiating with the different parties. Nor does the hon member have any experience of general private practice. Since he became a Prog he is, for the first time, involved on a part-time basis, flying to Johannesburg, as he does, about once a week. That is why he now talks only about private practice and nothing else.

*The MINISTER OF JUSTICE:

Does he only pull out toenails?

*The MINISTER OF HEALTH AND WELFARE:

Yes, that is all. I am not prepared to accept the amendments.

Mr A B WIDMAN:

Mr Chairman, I am sorry that the hon the Minister finds himself in such a corner that he has to resort to personal attacks upon such a distinguished medical man of whom South Africa can be well proud. France has seen fit to grant him a merit award for his services in South Africa.

HON MEMBERS:

Hear, hear!

Mr A B WIDMAN:

The hon the Minister obviously finds himself in a corner and is therefore touchy.

I asked the hon the Minister what his intention was with this clause. He has replied that what he intends with this clause is that RAMS will have its own set of fees and that the various associations will have their own set of fees, or scale of remuneration, or whatever one wants to call it. Does the hon the Minister not visualize that when there is no agreement and when it is not likely that there will be agreement, the gap between the tariffs laid down by RAMS and those laid down by the various medical, dental, pharmaceutical, private hospital and paramedical associations will widen?

The MINISTER OF HEALTH AND WELFARE:

Why will it widen? Why will it not become narrower?

Mr A B WIDMAN:

I say that because various interests will compete. Doctors have their expenses and paramedical also have their expenses, and unfortunately these expenses grow. As the hon the Minister knows well—he gave an example in this regard just now—the use of medicine has grown astronomically over the years. That part is therefore going to grow increasingly. On the other hand the various medical schemes in South Africa perhaps are not as affluent and cannot match the higher tariffs that may be set by these associations, and they will tend to keep tariffs down according to their income. In this regard I can mention as an example our own Panned Association where we had to increase contributions by 10%. The hon member for Parktown and I, as well as other hon members, serve on its executive committee. We have had to increase the contributions. Why? To meet the expenses that have occurred. Those medical aid schemes are going to govern their tariffs according to their income. They will not go broke. They have an obligation to all their members and they will therefore tend to keep their tariffs down. That is why I submit, with great respect, that the gap is going to grow and grow. The patient is now going to suffer because he is now going to fork out of his pocket more and more, which he may not be able to afford. That is the tragedy which is being enacted here.

The hon the Minister has indicated that he is not prepared to accept any amendments. Does he also reject my amendment in respect of the fact that if RAMS does not want to publish in the Government Gazette, it need not do so? By saying that it may publish in the Government Gazette one is actually saying that if it does not want to do so it may not do so and that nobody will know. All I am asking is that it should be published in the Gazette. Does the hon the Minister reject that as well?

The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, as far as I see the meaning of the word “may”, RAMS is empowered to publish it in the Government Gazette. I will accept that.

Mr A B WIDMAN:

You should rather stick to medicine.

The MINISTER:

The hon member should keep out of medicine. He knows nothing about it.

As far as the hon member for Parktown is concerned, when I want to talk to him about surgery I shall call him Marius but in this House he is the hon member for Parktown and I must say that he is a rather hopeless member. [Interjections.]

*Dr W J SNYMAN:

Mr Chairman, it is clear to me from the hon the Minister’s reply that he anticipates that there will be problems between the schemes and the medical practitioners from the outset. So everyone will simply have to determine his own tariff, as he says. The one that is published will then be the statutory tariff. The medical practitioners will then determine their own tariffs.

However, I want to come back to what the hon member Dr Vilonel said. He quoted what the Medical Association of South Africa had said about this legislation after consultations with the Representative Association of Medical Schemes. I quote from his Second Reading speech, where he quoted the following from the resolution of RAMS (Hansard, col 3965):

… the introduction of the new dispensation will be determined by RAMS in consultation with the MASA.

“That is precisely what the legislation provides for,” the hon member added. But this is not what the legislation provides for. Nowhere in the legislation is there any mention of “in consultation”; only “after consultation” with the Medical Association can the statutory body determine the tariff. Later on in his speech, the hon member Dr Vilonel went on to say:

Furthermore, they say that “if negotiations failed, RAMS would be independently responsible for the determination of the tariff”.

He went on to say:

This includes the question of arbitration, of course, which may provide a solution at a later stage.

The hon member himself foresees that we may have to make use of arbitration if this system fails. The hon member went on to say:

In the same way, I could refer to many other joint decisions that have already been taken. Surely this is an example of the consensus politics which everyone is talking about.

However, it is very clear that this consensus will not be achieved and that as a result, the whole system will eventually collapse. Therefore I move amendments Nos 5 and 6 that are printed in my name on the Order Paper as follows:

5. On page 9, from line 59, to omit paragraph (d) and to substitute:
  1. (d) If the Association and the professional association referred to in paragraph (c) cannot come to an agreement as to the scale of benefits, the dispute shall be referred to an arbitration committee referred to in paragraph (e), which shall make its decision known within 30 days.
  2. (e) When a dispute referred to in paragraph (d) arises the Minister shall appoint an arbitration committee consisting of—
    1. (i) three representatives of the Association;
    2. (ii) three representatives of the professional association referred to in paragraph (c); and
    3. (iii) three representatives of the South African Medical and Dental Council.
  3. (f) The chairman of an arbitration referred to in paragraph (e) shall be elected from among its members.
6. On page 11, from line 6, to omit subsection (2) and to substitute:
  1. (2) The Association shall annually or when it is requested by the council to do so, review any scale of benefits or any provision thereof, and may amend it.
*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, I just want to tell hon members once again that I have personally been negotiating with all the parties involved in the legislation for the past 18 months. All these parties have now reached the stage where they are satisfied with the present legislation, and that is about as close as one can get to consensus. The way I interpret it, an undertaking has been given by the Association of Medical Schemes as well as by the suppliers that they will try in this way to provide the people of South Africa with a proper medical service. More than that we cannot expect. If hon members expect me to say today that there will never be any problems, my reply to them is that there is nothing under the sun which never creates problems. Among those people, of course, there may be attorneys who wish to talk about medicine, something which often happens in this House. In the same way, there are doctors, of course, who talk about the interpretation of statutes. This could lead to chaos, of course. [Interjections.] Therefore I accept it. For the first time, however, I am able to make the firm statement here that as far as I am able to bring this about and as far as I know, all parties involved are satisfied with this measure and would like it to be implemented.

*Mr A B WIDMAN:

Mr Chairman, this is my third and therefore my last turn to speak on this clause. I want to address a final appeal to the hon the Minister to indicate to us whether there is in fact a difference between the word “may” and the word “shall”. Do these words have the same meaning, or is there a difference between them? This is the simple question I should like to put to the hon the Minister, Mr Chairman.

Dr M S BARNARD:

Mr Chairman, I have listened with great interest to the hon the Minister explaining his interpretation of this clause and of the benefits contained herein. I should like, however, to refer the hon the Minister to what has reputedly been said by the chairman of the Representative Association of Medical Schemes in connection with this clause. He says, and I quote:

Medical schemes will be able to determine benefit scales according to the suggested tariffs. If a doctor charges according to a benefit scale the account will be paid directly by the medical scheme; if not, the patient will be responsible for payment. This will improve patient-doctor relationships. A doctor can take more notice of his patient’s personal circumstances and charge him accordingly.

It almost appears as though this spokesman has the bank balance of the prospective patient in mind. According to him a doctor charges not in relation to the treatment afforded the patient but in relation to the patient’s personal circumstances. The chairman of the Representative Association of Medical Schemes went on to say, and I quote him again:

The new Bill would enable medical schemes to determine what level of benefit they wanted to provide for their members.

Now we come to the crux of his interpretation of this clause, and I quote him again:

Now we will be able to aim at better health care instead of paying for illness.

That is how he sees the matter. I quote him further:

This will mean that if a patient seldom claims he or she will be entitled to a type of no-claim bonus.

He equates this with motor vehicle insurance, in terms of which people who never claim are entitled to a no-claim bonus. This is exactly the way in which he views the situation. He goes on to say, and I quote him again:

Patients will learn not to take every cough and cold to a doctor.

What this man says, Mr Chairman, is quite mind-boggling. He happens to be one of the people with whom the hon the Minister has reached agreement. This man suggests that for instance the mother of a child that has a cold should not take that child to a doctor. That mother is therefore threatened as it were to stay away from a doctor in order to safeguard her medical no-claim bonus. I submit that the patient should always have the right to approach his doctor whenever he considers it necessary. No medical scheme and no Minister should, in terms of any legislation or other rules and regulations, be entitled to stop patients from consulting a doctor. What the chairman of the Representative Association of Medical Schemes has to say in this report from which I have quoted, I believe, points to a very real danger inherent in this clause.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, I do not understand a word the hon member for Parktown is saying. He must please show me where it states in this clause that a patient is not allowed to see his doctor when he wishes. He read out something that someone wrote in a newspaper and claimed that that was what was stated in the clause concerned. What he read out here has got nothing whatsoever to do with the contents of this clause, Mr Chairman. How the hon member can therefore relate the two, I do not know. Mr Chairman, I regret that I have absolutely nothing more to say about the matter.

Amendment 1 agreed to.

Amendments 5 and 6 negatived (Conservative Party dissenting).

Amendment 7 agreed to.

Amendment 8 negatived (Official Opposition dissenting).

Clause, as amended, agreed to (Official Opposition dissenting).

Clause 11 agreed to (Official Opposition dissenting).

Clause 12:

Mr A B WIDMAN:

Mr Chairman, I should just like to ask the hon the Minister to clarify a point for me in respect of clause 12. The first part of the clause provides that the supplier of a service must render an account to the medical aid scheme. Previously, the period within which the account had to be rendered was 30 days. This period now falls away and this has now to be done “in the prescribed manner”. We find the same thing occurring again in lines 43 to 46 on page 11 where it is provided:

… may within the prescribed period and in the prescribed manner, if the amount due has not been paid, send a copy of that account or statement to the medical scheme in question.

I presume that the prescribed manner will be laid down in the regulations but I should just like to know what the hon the Minister has in mind in this regard. Is the hon the Minister going to lengthen or shorten the period? Are the doctors now going to have to wait longer for their money or is the rendering and payment of accounts going to be speeded up? How does the hon the Minister see the situation in terms of this new provision?

The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, the whole idea is to speed up payments. The present situation in regard to the rendering and settling of accounts has not proved satisfactory and it has become necessary to try to find some method by means of which the position can be improved. We have therefore opted for regulations so that if payment is not made as promptly as we would like it to be made then the regulations can be amended without ti being necessary to introduce amending legislation into Parliament. The whole idea is to try to bring about agreement among all the various associations as well as RAMS in terms of which accounts can be settled as promptly as possible. We want this to be incorporated in the regulations and that is the reason why the provision is worded in this way. I have asked the associations as well as RAMS to furnish me with their proposals in regard to the best way in which this can be done, and that is why I have opted for regulations to be issued by the Minister.

*Dr W J SNYMAN:

Mr Chairman, I shall not move the proposed amendments to this clause printed in my name, since the principle in this regard has already been rejected in previous clauses.

Since the hon the Minister has indicated that the whole intention of this clause is to expedite the time between a service rendered and the payment of the account for the service, I would suggest that the hon the Minister should bear the provisions of clause 12(b) in mind. Inter alia, the proposed section 32(2) reads as follows:

A supplier of service who in terms of subsection (1) has furnished an account or statement for the rendering of a service—
  1. (a) …
  2. (b) for which fees have not been determined in terms of a scale of benefits, but in circumstances and on conditions prescribed by the Minister,
may within the prescribed period and in the prescribed manner, if the amount due has not been paid, send a copy of that account or statement to the medical scheme in question.

I would suggest that since we have proof from all medical practitioners that up to five months elapse before their accounts are paid and this is creating tremendous problems for then, one should consider the possibility that such a supplier of service, after he has supplied the service, can send a copy of the account directly to the medical fund and that the funds, as soon as it has obtained an endorsement from its patient, can pay that account from the medical practitioner in order to shorten the period of waiting and to make matters easier for the medical practitioners.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, I accept the suggestion of the hon member for Pietersburg. In fact, I want to tell him that if he has any suggestions as to how to facilitate these matters and eliminate problems, I shall accept them with pleasure. We would do anything to expedite this, since it is one of the points that is causing a great deal of dissatisfaction.

One of the major problems over the past 18 months or two years has arisen as a result of organizational problems. When Transmed changed over from a benefit fund to a benevolent fund, they had to provide a completely new organization for a few hundred thousand patients. This gave many people a great deal of problems, but the position is improving rapidly. I think those problems will be eliminated shortly.

If the hon member has any suggestions in this regard, I should be pleased to listen to them. In fact, I would be pleased if we could eventually reach the stage when every patient has a card, so that he can also pay by way of credit cards. I would be very happy with something of that nature, but I cannot see how it can work.

Dr M S BARNARD:

Mr Chairman, I should like to come back to the question which the hon member for Hillbrow asked. This concerns the rendering of accounts and the prescribed period of time and manner in which accounts should be rendered. From the reply of the hon the Minister I gather that there will be some kind of arbitration amongst the different groups. The hon the Minister will listen to the proposals of the various associations and by means of some kind of arbitration he will arrive at a decision as to the period of time and the manner in which accounts should be rendered. Am I understanding the hon the Minister correctly?

The MINISTER OF HEALTH AND WELFARE:

No, I did not speak about arbitration. I shall promulgate the regulations after I have listened to everybody.

Dr M S BARNARD:

If I understand him correctly, in this matter the hon the Minister will use his authority to decide. Unlike as what will happen as to the matters which we have discussed before, when it comes to the regulations, the hon the Minister will use his authority.

The MINISTER OF HEALTH AND WELFARE:

That is correct.

Dr M S BARNARD:

After what we have heard during previous discussions, I find this really surprising.

Clause agreed to.

Clause 14:

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, I move the amendment printed in my name on the Order Paper, as follows:

  1. 1. In the Afrikaans text, on page 12, to omit line 35 and to substitute:
skandelik is, moet die raad die aangeleentheid rap-

It was simply the printer’s gremlin that got into the Afrikaans text and caused two lines to be reprinted.

Amendment 1 agreed to.

Clause, as amended, agreed to.

Clause 15:

*Dr M S BARNARD:

Mr Chairman, this clause is really aimed at the transition stage, and in this regard I should like to put a direct question to the hon the Minister. As the hon the Minister is aware, a request was addressed to him by the Medical Association of South Africa and the tariff committee for an increase in medical tariffs. The question I want to put to the hon the Minister, I am putting to him at the request of some of my colleagues who say that the hon the Minister has promised—I am not aware of this—to make a tariff adjustment before this Bill comes into operation. I should like to hear from him whether he still stands by that, and if that is, in fact, going to be the case.

*The MINISTER OF HEALTH AND WELFARE:

Mr Chairman, it is always a privilege for me to keep my promises. In this case I did make such a promise, and this legislation will not come into operation before that adjustment has been made.

Clause agreed to.

House Resumed:

Bill, as amended, reported.

ADMISSION OF ADVOCATES AMENDMENT BILL (Second Reading resumed) *The MINISTER OF JUSTICE:

Mr Speaker, I shall not react to the arguments of hon members who have supported the Bill. That is not necessary. However, I thank them for their support.

The hon member for Sandton made quite a number of statements and asked a number of questions which I have to deal with for the sake of the record.

†The hon member said that clause 2 contained an element of Government cynicism and that somewhere along the line the principle had been lost and had been superseded by political and ideological considerations. The allegation that the principle has been lost and has been superseded by political considerations would in fact appear to be in tune with the amendment the hon member for Sandton proposes to move in the Committee Stage. He spoke out in favour of a measure which would prevent citizens of, for example, the TBVC countries, from being removed from the roll of advocates as a result of their loss of South African citizenship. However, his proposed amendment to clause 2 will have the opposite effect, namely that they will be unprotected. Once they do not have citizenship, they will be liable to be removed from the roll. That is why clause 2 is being introduced. Clause 1, which provides for the recognition of certain foreign qualifications, will be incomplete if steps are not also taken to prevent persons with such qualifications from being removed from the roll of advocates merely because they have lost South African citizenship.

Mr D J DALLING:

We are not moving an amendment to that provision of clause 2.

The MINISTER:

But the effect of the hon member’s proposed amendment to clause 2 is to omit one of our amendments to section 7 of the principal Act. Once that provision is omitted, these people will be left without any protection.

Mr D J DALLING:

I think you are under a misunderstanding.

The MINISTER:

We can discuss this matter again during the Committee Stage but I want to tell him now that I am not prepared to accept the hon member’s proposed amendment.

The hon member also said that it was ironical in the extreme that if this Bill is passed, an English graduate from Oxford may not practice as an advocate in this country unless he becomes a citizen of the Republic, whilst a graduate of the University of Bophuthatswana, or of Transkei, who was probably born in this country, may practice in South Africa only if he does not become a citizen. An Oxford graduate can in the first place only be admitted as an advocate in the RSA if a university in the Republic certifies that his legal qualifications equal the local qualifications in regard to both the syllabus and the standard of training. Such an individual will obviously have problems because he did not study Roman Dutch law, and he will need to negotiate with a university to have certain of his courses accepted and recognized. They may for instance concede one or two years of education, but he will nevertheless still need to comply with the requirements to pass a degree equal to the baccalaureus legum or the baccalaureus legum itself before he can be admitted, should such a person become a South African citizen, there would be no basis for disbarment at all because in terms of section 3 of the Act the very qualification of citizenship entitles him to be admitted as an advocate. A British subject who has a qualification from one of the TBVC countries would, depending upon the definition of the category mentioned in clause 2(b), still have to comply with the requirement to be naturalized whilst a TBVC subject. On the other hand, he can only be exempted from this provision if he becomes naturalized.

The hon member for Sandton also argued that the effect of clause 2(b) will be that a person who is admitted in terms of existing measures may be disbarred as soon as he ceases to belong to a category of persons or to comply with the conditions determined by the Minister. I gather that the hon member is rather wary of the powers granted to the Minister in terms of the legislation. However, regarding the possibility of subsequent change in the conditions determined by the Minister, it should be noted that both section 7(1)(c) of the Admission of Advocates Act and section 22 of the Attorneys’ Act, which deal with the disbarment of certain foreign advocates and attorneys, provide for the withdrawal of a designated country. This action may be taken by the Minister. However, according to the record, the hon member did not object to that provision.

Mr D J DALLING:

Mr Speaker, may I ask the hon the Minister a question?

The MINISTER:

Hold your question for a moment.

Another argument advanced by the hon member for Sandton was that a person could be struck off the roll should he cease to belong to a category of persons or to comply with the conditions but that there was nothing in the Act or the Bill which required him to belong to that category or comply with those requirements. The admission requirements in relation to languages, citizenship and residence are not affected by the Bill. Clause 1 only deals with persons who already comply with those requirements. In clause 2 an exemption is created to the effect that the existing grounds for the disbarment of an advocate shall not apply as long as the person in question belongs to a category and complies with requirements determined by the Minister. It is clear that the contemplated category and conditions will be of such a nature that the persons concerned will necessarily form part of the relevant category and will have to comply with the relevant conditions in order to be admitted as an advocate.

A last matter with which I want to deal was a very straightforward question from the hon member for Sandton. He asked me to indicate whether I am satisfied that, notwithstanding the decision in the Moseneke case, the relevant persons do have permanent residence in the Republic and therefore qualify to be admitted as advocates. This is a very important question, and I therefore asked the law advisers to give me a very clear exposition of their views.

*They say that the legislation in terms of which the TBVC citizens, for example, lost their South African citizenship, namely the Status Acts concerned—in the case of Moseneke it was the Status Act relating to Bophuthatswana—and other similar provisions expressly provide that apart from citizenship, no citizen of any of the TBVC countries who was resident in the Republic at the time of the commencement of the relevant Status Act would lose any existing rights, privileges or benefits merely on the basis of the provisions of that Act. In Moseneke’s case, it was ruled that such citizens had retained the right of permanent residence in the Republic in this way. In the light of these provisions of the Status Acts in question, the reference in section 7(1)(a)(i) of the Admission of Advocates Act to persons who may be removed from the roll of advocates because they have ceased to be South African citizens can only relate to persons who have lost their citizenship in a way other than in terms of the Status Act, for example, by voluntary renunciation of their citizenship, or actually of their right of residence. The retention of the rights of citizens of the TBVC countries, which included the right to practise as an advocate, for example, has already been regulated by law, so section 7 can only be interpreted as a reference to persons who have lost their South African citizenship of their own volition, for example, or through their own fault.

It is very clear, and I hope the hon member will accept it, therefore, that apart from the fact that we base our standpoint on Moseneke’s case, we have also taken legal advice to this effect. Furthermore, the Government declares it to be its firm intention that this should be the legal position. If any situation were to arise which might point to the contrary, the Government would obviously be obliged to rectify the matter.

Mr D J DALLING:

Mr Speaker, may I now ask the hon the Minister please just to explain to us precisely what he intends with paragraph (b) of clause 2? It relates to the question of a category of persons. What does he really mean by that? Secondly, what sort of conditions is he really referring to? What is this all about?

The MINISTER:

I was coming to that very point. I think I can best explain it by dealing with a few hypothetical cases or, as the Romans would call it, a few casus. A first case in point is a South African citizen who, on one of the national states becoming independent, becomes a citizen of that independent country and proceeds to study at one of the universities of that country and obtains his LLB there. In order to be admitted as an advocate in the Republic in terms of the Act as we are amending it now, he will qualify through the application of section 3(1)(c) of the Act, namely that he has been lawfully admitted to the Republic for permanent residence, that he has the right to be resident here and that he is ordinarily resident in the Republic. Therefore the judgment in the case of Moseneke would apply to him completely. That judgment, as I have indicated, makes it abundantly clear that such a person does not forfeit any existing rights, privileges or benefits save as regards citizenship. In this way he retains, amongst others, the right of permanent residence. Being already normally resident in the Republic, he therefore qualifies for admission as an advocate.

However, he still has to meet certain academic qualifications as now prescribed in the legislation. He will have to comply with certain standards: A university in the Republic with a law faculty will have to certify that the syllabus and standard of education are equal or superior to those required for the degree of baccalaureus legum of a university in the Republic. That is his position. The question is how his disbarment, his removal from the roll of advocates, will be dealt with. In terms of section 7 his suspension from practice as an advocate will be dealt with through the new section 7(1)(a)(iii). That is the section which the hon member has in mind. This subparagraph provides for a person to be removed from the roll for reasons other than through the loss of citizenship or failure to obtain citizenship after the expiry of six years. Is that clear to the hon member? That is the purpose of this subparagraph, namely to afford the necessary protection.

I want now to deal with the second possible casus, and the hon member will understand the difference. In the second case a person retains permanent residence and is ordinarily resident in the Republic. If he acquires the necessary academic standard, not at a university situated in one of these countries but at a university in South Africa, what is his position? This very question was posed by the hon member for Green Point. It is a very valid question, and it actually triggered some further questions in this regard. I am therefore of the opinion that as the clause now stands we may have a situation where a person who has studied at a South African university may find himself in a position where he may be removed from the roll under certain circumstances, which is not the objective of this Bill. Therefore I feel this amendment should be further revised. We should narrow it down to a citizen of a country which was formerly part of South Africa. That will make the position clear and define the category in such a way that we will all be happy with the fact that the objectives of the Bill have been properly attained. I want to thank the hon member for Green Point for bringing this matter to our attention. It was not an oversight, but I think we are now making it very clear that a foreigner who has studied at one of these universities will still have to qualify as a citizen and that he may be disbarred and removed from the role if he ceases to be a citizen. The same will not apply to a citizen of one of the countries that were formerly part of South Africa.

Under the circumstances I think I have made it abundantly clear that there is need for an amendment to this particular clause, and therefore I intend moving at the Committee Stage that it be suitably further amended as follows:

On page 5, from line 11, to omit “and who was admitted to practise as an advocate by virtue of a qualification contemplated in section 3(2)(a)(iii)” and to substitute: but who is a citizen of a state the territory of which formerly formed part of the Republic

I think this will deal amply and suitably with all the problems which the Opposition may have, and it will also assist us in attaining our objectives.

Question agreed to.

Bill read a Second Time.

SMALL CLAIMS COURTS BILL (Second Reading) *The MINISTER OF JUSTICE:

Mr Speaker, I move:

That the Bill be now read a Second Time.

The Bill arises out of the fourth interim report of the Commission of Inquiry into the Structure and Functioning of the Courts— hereinafter referred to as the Hoexter Commission—in which the establishment of courts for the adjudication of small civil claims is proposed.

A draft bill based on this report was published in the Gazette on 9 December 1983 for general information and comment. I may mention for the information of hon members that the principles of the Bill before the House enjoyed the support of all who commented. Accessibility to the courts of law is one of the most essential characteristics of effective administration of justice. Even if legal practitioners were able to provide their services at low cost there are a large number of civil cases of such limited scope that the costs of litigation they would entail would be out of proportion to the claim. Litigation on these claims in the ordinary courts is simply not a paying proposition. As a result many people with valid claims do not resort to the courts. This state of affairs affects everyone, rich and poor. The declining value of money has caused the spectrum of claims falling into this category to widen rapidly over the past number of years. As far as the enforcement of contracts for the purchase of consumer items is concerned the cost of litigation has increased to such an extent in comparison with the value of the subject of litigation that the consumer, who, in the nature of the matter, may not take the law into his own hands—a consumer cannot, for example, walk into a shop and remedy his problem with his fists—has often, when faced with an injustice, simply had to grin and bear it.

The most important factors contributing to this expensive process of uneconomic litigation is the complex and technical court proceedings that are characteristic of our adversarial system of litigation.

†The result, and I quote from the Hoexter Report, is—

That … the rights of ordinary people often remain symbolic. The challenge is to create forums that will be so attractive to individuals, not only economically but also physically and psychologically, that they will feel comfortable and confident in using them, despite the resources and sophistication of those they tend to oppose.

This, indeed, is the challenge the Government has accepted by introducing this Bill, which provides for the establishment of separate courts for the adjudication of small civil claims.

The concept of small claims courts is new to South Africa. Costs and lapse of time in civil litigation are defended on the grounds that they are unavoidable, if not indispensable, in an effort to attain absolute justice. They also, however, give rise to certain questions. For whose benefit does our system of justice work? Is justice served by a system that offers protection for the few and nothing at all for the many? The objective of this Bill is to create access to justice by, among other things, eliminating the need for costly legal representation in small civil claims and the elimination of time-consuming adversary procedures before and during the trial of these claims. Apart from minor court fees, no costs may be awarded in small claims courts. In clause 45 of the Bill it is provided that no appeal shall lie from a decision of such a court. Clause 23 provides for the cessation of actions in cases of complex questions of law or fact.

It is also hoped that the introduction of these courts will contribute to an awareness among consumers of their legal rights and remedies in everyday trade and transactions. To assist the lay public the Department of Justice will endeavour to publicize as much information as possible about the procedures and benefits of these courts.

*The fact that legal representation for the litigating parties is not permitted, is compensated for in three ways. In the first place, in the place of the customary complicated civil process of law which makes legal assistance essential, a simple and easy-to-understand procedure is being introduced which will make it possible for litigants to present their own cases. In the second place, the expertise of the trained presiding judicial officer will be at the disposal of both parties. Accordingly a special responsibility will be borne by those who preside over these courts. Indeed, with the aid of the inquisitorial procedure they will have to look after the interests of both claimant and defendant. Therefore they will have to take a far more active part in court proceedings, in contrast to the adversary system in which it has more or less become tradition that the presiding officer sits back while the litigating parties, with their legal assistance, dominate the scene, as it were. Therefore it will be expected of this presiding officer to display considerable wisdom in looking after the interests of both parties. He will have to try to get at the truth by asking questions.

However, the professional lawyers of the country have already, in their comments on the Bill, made it known that they accept this challenge. We thank them for this. It should be mentioned that they have offered their services free of charge as presiding officers in these courts. This gesture attests to a sensitivity to the needs of the public which can be noted with appreciation.

In the third place, provision is made in clause 11 of the Bill for the appointment of legal assistants who will provide assistance to litigants in regard to the drawing up of summonses and other documents and the granting of legal advice in this regard.

Hon members must beware of the entertainment value attached to a related type of court in California by a recent television series creating the mistaken impression that the purpose of small claims courts may be anything other than the administration of justice. I want to confirm that the proceedings in these small claims courts will at all times be dignified, that these courts will continue to reflect the true character of courts of law and these courts will not be permitted to acquire the image of being anything other than courts of law. The presiding judicial officer will only perform his duties after having taken an oath identical to that taken by judges and magistrates. Although the strict rules of our law of evidence will not have to be applied in the small claims courts, and special rules of procedure will apply there, the system of justice that will be applied will still be that which has developed from our Roman Dutch legal heritage.

In its different reports the Hoexter Commission laid special stress on the principle of the maximum independence of judicial officers in all the courts. These principles will be applied in the small claims courts in particular, in that these courts will be manned by judicial officers who will not be linked in any way with the Executive.

†Mr Speaker, small claims courts are in the first instance intended to serve primarily the interests of the individual claimant, and are also intended to be courts of dispute and not courts for purposes of mere debt collecting. Special steps have therefore been taken in order to ensure that these courts do not become dominated by debt collecting agencies and businesses to the detriment of the individual litigants. That is why the courts will be restricted to plaintiffs who are natural persons as provided for in terms of clause 7(1) of the Bill. It is also with this object in mind that clause 14(4) provides that the courts shall not have jurisdiction in actions based upon a cession. Furthermore, a plaintiff will, in terms of clause 35(1), be required to prove the defendant’s liability and the quantum of the claim. In this regard I wish to emphasize that I do not accept without qualification the Hoexter Commission’s recommendation that consideration should again be given to the extension of the range of plaintiffs after the results obtained from the operation of the pilot projects have become apparent.

*I have already pointed out that this will for the most part be a consumer court. Therefore what it amounts to is a court of dispute. Indeed, this was an important factor that was borne in mind when the jurisdiction of this type of court was being considered. The proposal of the Hoexter Commission was that the limit of jurisdiction of these courts be set at R750. However, the report in question was signed in May 1982; almost two years ago. Proposals for a limit of jurisdiction in comment on the Bill varied from R1 000 to R5 000. Taking into account the erosion of the value of money since 1982 and the proposals received it was initially decided that a limit of R1 500 would provide for litigation in the case of the majority of everyday consumer goods. However, since the publication of the Bill I have received strong representations to the effect that the amount of R1 500 is too high since it infringes upon the significance of the increased monetary jurisdiction, of magistrates’ courts that has just been granted. In the light of this I am inclined to set the jurisdiction at R1 000 on condition that a mechanism will be considered to adjust the said jurisdiction regularly in accordance with the inflation rate and/or according to need. With a view to this I want to move an appropriate amendment in the Committee Stage relating to the reduction of the limit of jurisdiction from R1 500 to R1 000. It is proposed that the same mechanism to monitor the jurisdiction will also apply in the case of the increase in jurisdiction of magistrate’s courts.

I should like to point out to hon members that the jurisdiction of magistrates’ courts is not being excluded from claims with a value of up to R1 500. In such instances prospective plaintiffs have a choice of appearing either in a small claims court or in a magistrate’s court.

†Mr Speaker, one of the most salient features of litigation in the proposed small claims court is found in clause 26 of the Bill, the clause which deals with evidence. The existing rules of evidence need not be applied in these courts and the court may in fact ascertain any fact or matter in the manner it deems fit. To illustrate the radical departure from the traditional adversary system which is called for in small claims courts, the Hoexter Commission quoted the following words of a Canadian lawyer, Professor Terence G Ison:

… almost every principle that a common lawyer has cherished must be abandoned. The adversary system, the rules of evidence, the dignity of the court room, the concept of the trial; all must go.

Hon members who are lawyers will be forgiven if they are startled by this illustration. The adversary system, however, is one of the most important contributory factors to the high cost of litigation. On the other hand, an inquisitorial system of litigation is recognized the world over as the most effective antipode for the cost of litigating in small claims. Such a system will be available to the South African consumer public if the Bill is approved by Parliament.

A last important feature of the proposed small claims procedure I wish to accentuate is the manner of the execution of judgments of the court. There will be little advantage in a procedure facilitating an easy and cheap means of obtaining judgment in small claims if what is gained thereby is lost in a costly and time consuming execution process. Clause 41 therefore provides for a summary inquiry after judgment into the financial position of the judgment debtor who shall pay directly to the judgment creditor. Should, for some reason, the judgment debt not be discharged, a simplified execution procedure will be available.

*To sum up, Mr Speaker, what we are striving to achieve is a process of adjudication whereby the man in the street can settle his smaller civil disputes simply, promptly and inexpensively. I believe that the Bill before this House embodies these characteristics and that it will enable the individual once again to turn with confidence to the courts to settle this category of dispute.

While I have just spent a quarter of an hour explaining this matter, I am convinced that it will be possible to settle many of these small claims in a shorter time, since the procedure will be so much shorter.

Mr D J DALLING:

Mr Speaker, we have listened with interest to the hon the Minister’s introduction to this Bill, and I think now is an appropriate time to move:

That the debate be now adjourned.

Agreed to.

ADJOURNMENT OF HOUSE (Motion) The LEADER OF THE HOUSE:

Mr Speaker, I move:

That the House do now adjourn.

Agreed to.

The House adjourned at 17h59.