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FORM OF FEE-FOR-SERVICE CONTRACT
WITH PRACTICE COMPANY — RURAL DOCTOR PACKAGE HOSPITALS
THIS CONTRACT made the day of 20 , BETWEEN (insert the name of
relevant area health service) ("the Area Health Service") of the First Part AND (insert
name of the medical practitioner's practice company) ("the Company") of the Second
Part.
WHEREAS:
A. The Area Health Service has determined to appoint Dr (insert name of medical
practitioner) ("the Visiting Medical Officer") to provide services at the hospital or
hospitals specified in Schedule 1 hereto (the "specified hospital(s)") and the
Visiting Medical Officer agrees to render such services under a service contract
between the Area health Service and the Company, the terms and conditions of
which contract are hereunder.
B. The Company is to be remunerated for the services provided under the contract
on a fee-for-service basis in accordance with the rates and conditions
established under the Rural Doctors Settlement Package as defined in this
contract, relevant to the services rendered by the Visiting Medical Officer.
NOW IT IS HEREBY AGREED AS FOLLOWS:
1. APPOINTMENT
The Visiting Medical Officer is appointed on the terms and conditions set out
hereunder for the period specified in clause 2 of this contract.
2. TERM OF CONTRACT
2.1 This contract is to be for the period from ...........to.............. 20.. unless this contract
is properly terminated by either party in accordance with this contract.
2.2 The Visiting Medical Officer is, if otherwise qualified, eligible for but not entitled
to re-appointment upon the expiry of this contract. Satisfactory fulfilment by the
officer of the obligations under this contract shall be one of the considerations to
be taken into account in deciding whether to re-appoint the officer. In the event
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of re-appointment, a new service contract shall be made.
2.3 This contract shall not establish the relationship of employer and employee as
between the Visiting Medical Officer and the Area Health Service.
3. PROFESSIONAL RESPONSIBILITIES
3.1 The services provided by the Company under the contract are to be rendered by
the Visiting Medical Officer in accordance with the terms and conditions of the
officer's appointment which include the professional responsibilities specified in the
following sub-clauses.
3.2 The medical services rendered to public patients by the Visiting Medical Officer shall
be consistent with the clinical privileges granted to the officer under this contract
and the Company is to be remunerated for those services in accordance with the
rates and conditions established under the Rural Doctors Settlement Package.
3.3 The Visiting Medical Officer may participate in the teaching and training of
postgraduate medical officers where reasonably required and remunerated by the
Area Health Service in accordance with the hourly rate determined by the NSW
Department of Health.
3.4 The Visiting Medical Officer shall participate in committees expressly established or
authorised by the board of the Area Health Service and to which the officer is
appointed by such board, where reasonably required by the Area Health Service
for the proper and efficient functioning of the hospital concerned. The officer will be
remunerated for such participation in accordance with the Rural Doctors Settlement
Package.
3.5 The Visiting Medical Officer shall participate in an on-call roster for the provision of
medical services as may reasonably be required by the Area Health Service, and
when so rostered the officer shall be readily contactable at all times and be able
and prepared to attend the hospital concerned within a reasonable period of time.
To enable the officer to be readily contactable whilst he or she is on-call, the Area
Health Service will provide and maintain communications equipment (other than
normal telephone services) which is reasonably necessary in the circumstances.
The equipment will be provided on the condition that the officer will take reasonable
precautions to prevent damage to or loss or theft of the equipment. The officer will
be remunerated for such participation in accordance with the Rural Doctors
Settlement Package.
3.6 The Visiting Medical Officer:
3.6.1 shall be professionally responsible for the proper clinical management and
treatment of public patients under the officer's care in the hospital
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concerned and shall attend patients admitted under the officer's care at a
frequency appropriate to the patients' clinical needs;
3.6.2 shall take reasonable steps to ensure that the clinical records related to the
services provided by the officer, and those provided for patients under the
officer's care, are maintained adequately and that such completed records
include details of diagnosis, treatments and operations performed and a
discharge summary completed in the manner determined by the hospital
after consulting with the officer;
3.6.3 shall comply with rules and by-laws in force from time to time at the Area
Health Service, not being inconsistent with any of the rights and obligations
of the officer under this contract;
3.6.4 shall ensure that he or she complies with the statutory duty to report certain
criminal and disciplinary matters in writing to the chief executive officer of
the Public Health Organisation as required by section 99 of the Health
Services Act.
4. CLINICAL PRIVILEGES
4.1 Subject to subclause 4.2 the Visiting Medical Officer's clinical privileges are as
specified in Schedule 1 of this contract.
4.2 The Area Health Service may review and vary the clinical privileges of the Visiting
Medical Officer at any time after advice from the appropriate credentials committee
in respect of the specified hospital/s in accordance with any applicable Act or
regulations, or by-laws in force at the specified hospital(s).
4.3 The medical services which the Visiting Medical Officer provides to patients at the
specified hospital(s) shall be consistent with the clinical privileges determined by
the Area Health Service in respect of the Visiting Medical Officer from time to time.
5. GST
5.1 To the extent that the Visiting Medical Officer is liable to pay GST in connection with
services supplied under this contract, the fees specified in the Rural Doctors
Settlement Package are exclusive of GST.
5.2 The Area Health Service agrees that should the Visiting Medical Officer be liable
for GST in connection with the services supplied that the fees specified should be
increased by an amount equivalent to the GST payable by the Visiting Medical
Officer on the supplies.
5.3 The Visiting Medical Officer shall be registered for GST purposes and shall have an
Australian Business ("ABN"). The Visiting Medical Officer shall provide such details
to the Area Health Service.
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5.4 The Visiting Medical Officer agrees that the Area Health Service will gross up
GST liable services in accordance with GST legislation. The Area Health
Service will create tax invoices on the Visiting Medical Officer's behalf (being
Recipient Created Tax Invoices). The Area Health Service shall provide the
Visiting Medical Officer with a copy of the Recipient Created Tax Invoices at the
time of payment of the service.
6. HOSPITAL FACILITIES
The Area health Service where reasonably practicable shall provide:
(i) all ancillary, medical, nursing and clerical assistance and facilities,
instruments and equipment reasonably necessary for the proper
performance of the services to be rendered by the Visiting Medical
Officer under this contract; and
(ii) to the Visiting Medical Officer upon request and free of charge, sufficient
suitable and serviceable outer uniforms and duty garments, which shall
remain the property of the Public Health Organisation and which shall be
laundered at the expense of the Public Health Organisation.
7. UNPAID LEAVE OF ABSENCE
7.1 The Visiting Medical Officer shall be entitled to unpaid leave of absence during
any period the officer is unable to render services due to illness or special
circumstances of an urgent or compassionate nature provided that the officer
shall notify the Area Health Service of such incapacity as soon as is reasonably
practicable.
7.2 The Visiting Medical Officer may have other periods of unpaid leave of
absence at times agreed between the officer and the Area Health Service.
The officer will give the Area Health Service reasonable written notice of
proposed periods of leave of absence. The Area Health Service will not
unreasonably withhold its agreement to proposed periods of leave of
absence and will take into account the reasonable needs of the officer for
reasons including professional development, continuing medical education
and holidays.
7.3 Upon the receipt of reasonable written notice and in accordance with clause
7.2, the Area Health Service is to organise such alternative arrangements for
the provision of medical services to public patients as the Area Health Service
requires whilst the Visiting Medical Officer is on a leave of absence under this
clause. At the request of the Area Health Service the officer will provide
reasonable assistance to the Area Health Service in organising such
arrangements.
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8. RECORD OF SERVICES
8.1 The Visiting Medical Officer shall maintain a record of services rendered by the
officer under the contract in accordance with the Rural Doctors Settlement
Package and in a form agreed with the Area Health Service.
8.2 The record referred to in subclause 8.1 shall be maintained for each calendar
month during which services are provided by the Company, and it shall be
submitted to the Area Health Service in accordance with the Rural Doctors
Settlement Package. Any claim made by the Company must be capable of being
verified by the Area Health Service from the records held by the Area Health
Service.
8.3 The record when so submitted pursuant to subclause 8.2 shall be accompanied by
(or be) an account for payment. The Area Health Service in making payment of an
account to the Company shall advise details of how the payment is made up as
between the various services rendered.
9. SUSPENSION OF CONTRACT
9.1 Subject to Chapter 8 of the Health Services Act 1997, the Area Health Service may
suspend the appointment of the Visiting Medical Officer in accordance with any
applicable by-laws where it is necessary in the interests of the hospital to which the
officer is appointed.
9.2 Where the Visiting Medical Officer is so suspended, the respective rights and
obligations of the parties under the contract shall be suspended for the duration of
that suspension.
10.TERMINATION OF CONTRACT
10.1 The contract and the Visiting Medical Officer's corresponding appointment shall be
terminated:
(i) upon the expiry of the period specified in clause 2 or on such earlier date as
may be agreed between the Company and the Area Health Service;
(ii) by three months' notice in writing given by either the Visiting Medical Officer
or the Area Health Service;
(iii) if the Visiting Medical Officer ceases to be registered as a medical
practitioner;
(v) if a condition is placed on the Visiting Medical Officer's registration as a
medical practitioner by the New South Wales Medical Board which in the
opinion of the Area Health Service precludes the officer from providing any
services of a kind or in a manner that is required under the contract;
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(vi) if the Visiting Medical Officer becomes permanently mentally or physically
incapable of rendering services under the contract;
(vii) if the Visiting Medical Officer commits serious and wilful misconduct; or
(viii) if the Visiting Medical Officer's appointment is terminated by operation of
any Act or regulation.
10.2 On the termination of the contract, any amount due and payable to the Company
pursuant to the contract shall be paid at the time of such termination or as soon
thereafter as reasonably practicable.
10.3 Nothing in this clause affects any right of appeal the Visiting Medical Officer may
have under Chapter 8 of the Health Services Act 1997.
11. PROFESSIONAL INDEMNITY AND PUBLIC LIABILITY INSURANCE
11.1 The Company shall maintain medical indemnity insurance and public liability
insurance to the levels approved by the Director-General from time to time under
section 85(2) of the Health Services Act 1997, to cover the liabilities arising from
the performance of this contract by the Company or in respect of the Visiting
Medical Officer's practice as a medical practitioner under his or her appointment
with the Area Health Service.
11.2 The Company shall provide the Area Health Service at least annually with
documentary evidence, satisfactory to the Area Health Service, of the insurance
coverage required under sub-clause 11.1 and shall immediately notify the Area
Health Service, in writing, of any changes to such insurance coverage, including
changes concerning the insurer, the maximum amount payable per claim or any
exemption in relation to the medical practice or other activities of the Visiting
Medical Officer.
11.3 The Company shall indemnify the Area Health Service against any cost, claim,
demand or expense (including the cost of funding or settling any action, claim or
demand) made, sustained, brought or prosecuted in any manner based upon,
occasioned by or attributable to any injury to any person (including death) or any
damage to any property which may arise from any action, event or omission by the
Company, its employees or agents, or the Visiting Medical Officer, during the
performance of the contract but only to the extent that the claim or demand has not
arisen from any negligent act or omission by the Area Health Service or its
employees.
12. DISPUTE RESOLUTION PROCEDURE
12.1 The objective of each stage of this procedure is to achieve a result which is fair and
equitable in the circumstances. It is expected that both the Visiting Medical Officer
on behalf of the Company and the Area Health Service will be prepared
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at all times to take part in bona fide negotiations to agree on such a result in any
dispute between them without the necessity of taking it to a Liaison Committee
for determination under subclause 12.8.
Stage 1 - Consultation
12.2 In the event of a dispute arising, the Visiting Medical Officer or the Area Health
Service may give notice in writing to the other party identifying the matter or
matters the subject of dispute.
12.3 As soon as practicable after the giving of notice under subclause 12.2 the parties
shall meet to discuss the dispute and attempt to resolve it by a mutually agreed
method.
Stage 2 - Hospital level
12.4 If the dispute is not resolved within 14 days after the giving of notice under
subclause 12.2 or such further time as the parties may agree in writing, the
hospital administration shall at the earliest practicable time and in any event
within a further 14 days convene a meeting of the following participants:
(i) the Visiting Medical Officer;
(ii) the clinical head responsible for the Department or Unit in which the officer
performs his or her duties (if such a position exists), otherwise a medical
practitioner nominated by the executive officer/manager (however called)
for the hospital at which the officer performs his or her duties;
(iii) the executive officer/manager (however called) for the hospital at which
the officer performs his or her duties or the nominee of the executive
officer/manager;
(iv) at the option of the Visiting Medical Officer, a representative of the Rural
Doctors Association (NSW) Inc or an independent person of the officer's
choice, not being a legal practitioner; and
(v) such other persons as may be agreed by the parties to the dispute.
12.5 The meeting will consider the dispute with the objective of assisting the parties
to resolve the dispute in a fair and equitable manner. With the consent of the
parties the meeting may be continued on adjourned dates.
Stage 3 - Area Health Service level
12.6 If the dispute is not resolved within 14 days after the convening of the meeting
under subclause 12.4 or such further time as the parties may agree in writing,
the Area Health Service shall at the earliest practicable time and in any event
within a further 14 days convene a meeting of the following participants:
(i) the Visiting Medical Officer;
(ii) an appropriate clinical head nominated by the relevant chief executive
officer (however called) of the Area Health Service;
(iii) an executive of the Area Health Service nominated by the relevant chief
executive officer (however called) of the Area Health Service;
(iv) at the option of the Visiting Medical Officer, a representative of the Rural
Doctors Association (NSW) Inc or an independent person of the Visiting
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Medical Officer's choice, not being a legal practitioner.
(v) such other persons as may be agreed by the parties to the dispute.
12.7 The meeting will consider the dispute with the objective of assisting the parties to
resolve the dispute in a fair and equitable manner. With the consent of the parties
the meeting may be continued on adjourned dates.
Stage 4— Mediation by Disputes Committee
12.8 If the dispute is not resolved within 14 days after the convening of the meeting under
sub-clause 12.6 or such other time as the parties may agree in writing, then the
Visiting Medical Officer or the Area Health Service may serve a further notice in
writing on the other referring the dispute to a Disputes Committee for mediation.
Such dispute shall thereupon be and is hereby referred to a Disputes Committee
for mediation.
12.9 A Disputes Committee will have a total of not more than six members of which there
will be an equal number of nominees of the Rural Doctors Association
(NSVV) Inc and the Director-General of the NSW Department of Health.
12.10 A Disputes Committee may call on expert advice as and when necessary.
12.11 The cost of a Disputes Committee will be shared equally between the Company
and the Area Health Service unless otherwise ordered by a Disputes Committee.
12.12 In any proceedings before a Disputes Committee, the Visiting Medical Officer and
the Area Health Service shall have the right to appear in person or with the leave of
a Disputes Committee be represented by an agent. However, no party is to be
represented by a legal practitioner except with the consent of all parties and by
leave of the Disputes Committee.
12.13 It is agreed between the parties that a Disputes Committee shall determine all
questions arising for determination by reference to considerations of general justice
and fairness.
Stage 5 — Arbitration
12.14 If the dispute is not resolved within 14 days after the appointment of the mediator or
such other time as the parties may agree in writing, then the Officer or the Area
Health Service may serve a further notice in writing on the other referring the dispute
to arbitration. Such dispute shall thereupon be and is hereby referred to arbitration
by a single arbitrator to be agreed upon by the Visiting Medical Officer and the Area
Health Service or, in the absence of agreement, to be appointed by the President
or other most senior bearer of the Council of the Law Society of New South Wales
or its successor.
12.15 The arbitrator's fee shall be negotiated on the appointment of the arbitrator and
shall be shared equally between the Company and the Area Health Service, unless
otherwise ordered by the arbitrator.
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12.16 The Visiting Medical Officer and the Area Health Service shall each appoint an
assessor to sit with the arbitrator in a consultative capacity, but the determination
shall be made solely by the arbitrator.
12.17 The Visiting Medical Officer and the Area Health Service shall have the right to
appear before the arbitrator and may be represented by a barrister or by a solicitor
or, with the leave of the arbitrator, by an agent.
12.18 At the request of the Visiting Medical Officer, the Rural Doctors Association (NSW
Branch) shall be entitled to appear and be represented in the arbitration.
12.19 At the request of the Area Health Service, the NSW Department of Health shall be
entitled to appear and be represented in the arbitration.
12.20 In the event of either the Rural Doctors Association (NSW Branch) or the NSW
Department of Health appearing in the arbitration pursuant to a request under
subclause 9.18 or 9.19, the other organisation shall be entitled to appear and be
represented as of right.
12.21 It is agreed between the parties that the arbitrator shall determine all questions
arising for determination in the course of the arbitration by reference to
considerations of general justice and fairness.
12.22 The determination of the arbitrator shall be final and binding upon the Visiting
Medical Officer and the Area Health Service.
Definitions
12.23 In this clause:
12.23.1"dispute" means any dispute arising between the Visiting Medical Officer
and the Area Health Service at any time as to any matter or thing of
whatsoever nature arising under the contract or in connection herewith;
including but not limited to matters relating to clinical privileges, but
excluding a matter relating to the non-reappointment, suspension or
termination of appointment of the Visiting Medical Officer;
12.23.2"local hospital" means a health facility conducted by the Area Health
Service at which the Visiting Medical Officer provides services under the
contract.
1 3 . NO T IC E S
Any notice required by the contract to be given in writing shall be properly served if
delivered by hand to the addressees personally or if sent by prepaid registered mail,
facsimile or telex transmission to the addressee at the address furnished in writing
to the addressor, and shall be deemed to have been received by the
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addressee on the date of hand delivery or on the date the facsimile or telex
transmission was recorded or seven days after the date of posting.
14. DEFINITIONS
In this contract:
"appointment" means appointment as a visiting medical officer and includes
reappointment, and appointed and re-appointed have a corresponding meaning;
"area health service" means an area health service as defined in the Health
Services Act 1997;
"board" means a board of a public health organisation as defined in the Health
Services Act 1997;
"chief executive officer" means the chief executive officer of the Area Health
Service or his or her nominee.
"clinical privileges" means the clinical privileges as defined in the Part 4 of
Chapter 8 of the Health Services Act 1997;
"fee-for-service contract" means fee-for-service contract as defined in the Health
Services Act;
"GST" means Goods and Services Tax imposed in accordance with the A New
Tax System (Goods and Services Tax) Act 1999, related Acts and Regulations;
"GST legislation" means the A New Tax System (Goods and Services Tax) Act
1999, and related Acts and Regulations;
"hospital" means a hospital as defined in the Health Services Act;
"medical practitioner" means a person registered for the time being under the
Medical Practice Act 1992;
"officer" means the visiting medical officer;
"on-call" means rostered to be available to attend public patients pursuant to an
on-call roster prepared by a hospital or an area health service, as the case may
be in consultation with the relevant hospital.
"practice company" means a corporation (however incorporated) that is controlled
or conducted by the visiting medical officer and by means of which the officer
conducts his or her medical practice;
"public patient" means a patient in respect of whom the hospital or area health
service, as the case may be, provides comprehensive care, including all
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necessary medical, nursing and diagnostic services, by means of its own staff or
by other agreed arrangements;
"Rural Doctors Settlement Package" means the rates on a fee-for-service basis of
remuneration, agreed between the NSW Department of Health and the Rural
Doctors Association (NSW) Inc and specified in Departmental instructions from
time to time, in respect of certain services provided by visiting medical officers
under modified fee-for-service contracts;
"service contract" means a service contract as defined in the Health Services Act;
"services" means medical services provided to a public patient by the visiting
medical officer under a fee-for-service contract, including teaching, training and
participation on committees, but excluding attendance at meetings of a medical
staff council (howsoever called);
"visiting medical officer" means a visiting medical officer as defined in the Health
Services Act who performs the said work under a fee-for-service contract, but
excluding a pathologist and a radiologist; and
"visiting practitioner" means a visiting practitioner as defined in the Health
Services Act
NOTE
Other conditions of appointment
Any other conditions to which the Visiting Medical Officer's appointment is subject are
required to be specified in the service contract if they are to have effect.
SIGNED for and on behalf of)
the Area Health Service)
SIGNED for and on behalf of)
the Company)
Visiting Medical Officer as the
duly authorised officer
of the Company
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SCHEDULE 1
Name and Address of Hospital Clinical privileges granted to the Visiting Medical
Officer in respect of specified hospital
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SCHEDULE 2
Medical services to be provided to public patients
(under clause 3.1 of the contract)
