KEY POINTS:
The National Party plans to ditch limits on doctors' fee increases and instead rely on "trust" in GPs not to rip patients off, and competition in the marketplace to keep fees reasonable.
Health spokesman Tony Ryall said while universal subsidies for cheaper doctor's visits would stay, National would remove the limits which restrict by how much doctors can increase their fees.
Mr Ryall - who made the call during the release of National's health discussion paper yesterday - said a limit on fee increases was not needed because "competitive pressure" would ensure fees stayed at a reasonable level.
Labour introduced the limit on fee increases last year to ensure its increased subsidies for cheap doctor's visits - which have halved fees over the past seven years - were passed on to patients.
However, Mr Ryall said doctors needed flexibility to set their fees because of increasing costs, including the introduction of four weeks' annual leave and nurse pay increases.
"We think the Government's price control affects the long-term viability of general practice. So people can have the price control, but they might not have a GP. That's the reason we've indicated for a long time that we just don't think they should have this."
He said National would have a much more "trusting relationship and a relationship of mutual respect" with doctors, who had undertaken to pass on subsidies when they signed up for them.
Prime Minister Helen Clark said a visit to the doctor was not akin to a visit to an accountant or mechanic and without a cap, doctor fees would creep up and become unaffordable.
National leader John Key also said fees would be controlled by "the market". Asked what would stop rural doctors increasing their fees given they faced little competition, Mr Key said "country GPs aren't exactly known for being rip-off merchants".
Dropping the fee increase review won support from Dr Mark Peterson, chairman of the Medical Association's GP Council, who said the fees review process was "flawed".
"We don't believe it's necessary anyway because GPs have a very good record on passing subsidies to patients."
The issue effectively derailed a significant opportunity for National to outline its thinking on a key policy area, including its proposals for shrinking the waiting lists and provide more opportunities for health care through GPs and the private sector.
The document - titled Better, Sooner, More Convenient - did not include mention of the fee increase cap, which Mr Ryall mentioned during questioning by media.
Its omission in the document led Helen Clark to describe it as "grossly duplicitous" and "National's secret agenda for the health system".
However, Mr Ryall said it was no secret and he had assumed it was well known because he had mentioned it in public speeches.
Releasing the discussion document yesterday, National leader John Key ruled out any major restructuring of the health system.
While costings on final policies would not be done until next year, there would not be budget cuts to health.
However, he indicated the rate of spending would not increase at the pace it had under Labour, saying Labour did not have the results to show for its extra spending and the money could be used more effectively.
The document covered proposals for an increased role for the private sector in performing elective surgery, as well as letting GPs do more procedures in areas in which they had specialist skills.
