Mr. Speaker, I move—

Mr. Speaker, it is essential that we should just have another look at the main standpoints adopted by hon. members opposite and by us in regard to this legislation. The hon. the Minister made much of the fact that the motives of some individuals in not going along with the provisions that appear in his legislation were to acquire information from the co-operatives and misuse it and this was supposedly contrary to the interests of the co-operative or its members. I want to tell the hon. the Minister that in my opinion his standpoint is quite wrong because the motives both of members of the public who have discussed this matter with us and members of co-operatives are just as sound as those of the hon. gentlemen or of anyone on either side of the House. The representations we on this side have received in regard to this legislation are therefore based on sound motives and have only one aim and that is to serve the best interests of co-operatives. Any remark concerning members of the public with an interest in this legislation to the effect that they have ulterior motives is not in the best interests of the co-operative movement and still less in the interests of our agricultural industry. I trust that the hon. the Minister will refrain from making remarks about the public at large and that he will also refrain from trying to create the impression that appeals addressed to us are motivated by considerations other than the best interests of our agricultural industry.

At the time the principal Act was passed in 1939, a member of a co-operative society was granted a questionable right to view and study the books of a co-operative. That right was related to a member’s responsibility and his accountability to that co-operative institution of which he was a member. In addition it was also certainly intended to allow such members as were interested to acquaint themselves with the degree of efficiency and efficient management and administration of the institution of which they were members. This right is undoubtedly necessary in order to make an intelligent evaluation of the activities of the co-operative and also to ensure an intelligent discussion when members of the society gathered to discuss their interests. In the normal course, who are those members who desire that right? I believe it is usually those members who are the leading figures on the local agricultural scene and who would like to ensure, in the first place, that they are getting the best service from that institution and, secondly, if it is also a society that markets their products, that the marketing will be the most advantageous for them. Where it is possible that uneconomic services are being rendered, inspection of the books is essential in order that proposals may be made to eliminate such uneconomic services. Furthermore, I believe that the members who usually show this interest would like to know that the society is based on democratic principles, too. There must be periodic changes, for example in the board of directors. It is also possible that it could be essential for such changes to occur. For those who want to make themselves available for such posts—after all, it is surely necessary that the best agricultural brains should serve on the board of directors of any co-operative—inspection of the books is necessary in order to acquire a sound background in regard to the policy that is being followed and also to stay well informed as to how the business is being managed. A specific group or clique must not be encouraged to retain control of an institution of this kind at all times. We know that the world is full of dictators at many levels and the rights of minorities must also be protected. It is often the intelligent group in one’s local community that can also make the best, and also a bigger, contribution. That is why I find the actions of the hon. members of the Reform and the Progressive Party in the Committee Stage to be strange and inexplicable. They always have so much to say about the rights of minorities but when they have to prove it in a tangible form, then their interest is merely academic. In this debate, too, they have once again shown that their arguments are based on insubstantial grounds and that they have thus far failed to make a detailed study of the co-operative society in South Africa.

Sir, I want to conclude by saying this: Whereas the Third Reading of this Bill will be passed, I want to make an appeal to our co-operative societies and their members not to store up trouble for themselves by means of this legislation; not to promote the formation of cliques; not to place unnecessary restrictions on themselves at the insistence as I believe will often occur, of certain office-holders in specific co-operatives, sow suspicion among their members. Sir, a co-operative that is well handled and acts in the interests of its members will have nothing to hide. Its activities should be such as to enable it to have all its cards on the table as far as all its members are concerned. I believe that a wise board of directors and a wise members’ meeting will always act in the interests of the members. I want to tell the hon. the Minister that we shall make another attempt in the Other Place to move a further amendment at the Committee Stage which will put it clearly that this side of the House is not opposed to the laying down of reasonable restrictions, but what we do not want either is the situation where one will have further court cases in the future. Our amendment will also attempt to ensure that when a member wants to acquire information which it is in his own interest or in the interests of his organization, to have, he will in fact be able to acquire that information but will not be able to abuse this by requesting information he does not require. It will also be clear from our amendment that we do not want to encourage people to go and pry into the position of individual members but that when someone wants information with the aim of using that information at a member’s meeting with a view to bringing about more effective control of the co-operative, that information should be made available to him.

Mr. Speaker, the hon. member for Newton Park is now trying to rectify matters. I am not going to get excited because that hon. member does not understand what is going on here. Three times, now, I have tried to explain the position to him. The hon. member refers to members of the public. I refer to members of a specific co-operative —the interested parties, the shareholders in that co-operative. Has the hon. member consulted the Co-operative Council? He states that he does not want to do anything that will harm the co-operatives. Sir, the chief body for all co-operatives comes along and asks that the Act be corrected to that the Afrikaans and the English versions may correspond. The Registrar of Co-operatives, who is there to protect the co-operatives, is requesting this amendment. Sir, the hon. member has put his foot in it and now he wants to retrieve the situation. He referred to a court case. We are dealing here with a specific co-operative. This co-operative is the only protection the ostrich farmer has; there is no control board for him. At one stage the ostrich farmer was forced to his knees when the ostrich feather market collapsed. What we are dealing with here is a co-operative with protective powers, but the hon. member refers to a clique. Does the hon. member want to tell me that the board of directors of a co-operative is a clique? Hon. members opposite are always so much in favour of democracy. If the directors of that co-operative are a clique, as the hon. member has just said …

They do not like Oudtshoorn.

Sir, these people were elected democratically. I told the hon. member yesterday that those members were free to elect a new board of directors at any time. Any member who attends an annual meeting may, according to the Act, ask to inspect certain of the books of the co-operative under certain conditions. Sir, I cannot see why the hon. member for Newton Park is so concerned about this matter. He now wants to rectify this matter by moving an amendment in the Other Place. I say that I have always pleaded for protection and do so specifically, in this instance, for the ostrich farmer. If the hon. member had only said nothing, there would have been no difficulty, but owing to information given to him suddenly acted here. After all, I saw the man here.

May I ask whether it would not have been much better if the ostrich farmers had their own co-operative?

The ostrich farmers have their own Little Karoo Co-operative that exercises control over their products, the processing of the skin. The farmers want nothing else. They are quite happy. I said yesterday that we should hold a referendum among the ostrich farmers and ask them, and then it would only be those two clients of the hon. member’s who would vote against them. However much I should like to co-operate I can do nothing in regard to this matter.

Motion agreed to.

Bill read a Third Time.

When I spoke on the Second Reading, I indicated that I would be moving an amendment in the Committee Stage to clarify the situation as far as the areas under the jurisdiction of the Natal Parks Board were concerned. I am referring now to clause 2(2) and wish to move the following amendments—

1. (1) On page 2, in line 37, after “administration” to insert:

, the National Parks Board or the Natal Parks Board

1. (2) on page 2, at the end of subsection (2), to add:

and with the agreement of the Board concerned.

The effect of these amendments, if adopted, will be to make subclause (2) read as follows—

The effect, I would say, is to limit the operation of the clause so that should at some time in the future a different Minister hold the portfolio which the hon. the Minister holds now and should the board wish to impinge upon the area of jurisdiction of either the National Parks Board or of the Natal Parks Board, then such move could be taken only after consultation with the Administrator of the province and with the consent of the board concerned. As I have indicated, in Natal there are many such lake areas, well and adequately served by the Natal Parks Board, which, has powers almost identical to those contained in this Bill, powers which are being exercised and used at the present time. Consequently, in its present form the Bill, as far as Natal is concerned, is superfluous and I wish, to ensure that the competent authority which administers those areas now will be entitled to administer those areas in future unless they consent for some reason to those areas being taken away from their control. You will notice, Sir, that I have included the National Parks Board. I do not have any detailed information as to the areas under the jurisdiction of the National Parks Board, but I do believe that it does control certain lake areas in the Cape and it may well be that there are lake areas under the jurisdiction of that board as well and consequently it, too needs to be protected in this manner. I do not believe that my amendment in any way goes against anything the hon. the Minister said in his introduction of the Second Reading. Nobody has spoken ill of any of our parks boards in South Africa, neither the National Parks Board nor the Natal Parks Board. Indeed, the hon. member for Eshowe, whose constituency embodies many of the most important lake areas in Natal, has, as I understood him yesterday, himself spoken of the good work which the Natal Parks Board has done in the areas under his jurisdiction. Accordingly I hope that the hon. the Minister will find it possible to accept this amendment because, as I say, it does not go against anything that he has said and I believe furthermore that it is within the spirit of what he intends in this Bill.

Mr. Chairman, we had discussions this morning following upon the hon. member for Umhlatuzana indicating yesterday that he would move these amendments. I would like to help the hon. member because I can see his problem. He is afraid that we may take away some of the powers of the Natal Parks Board. That is definitely not our intention. The legal advisers are of the opinion that we should not accept the hon. member’s amendments. The position is that if we want to proclaim a certain area to fall under the jurisdiction of the Lakes Board, the consent of the State President will have to be obtained. If the hon. member’s amendments are accepted, the effect will be that the State President’s decision may be overruled by the Administrator of a province.

Various other matters should also be considered. The Natal Parks Board, for instance, does not have the power to subdivide land. The Lakes Board will have the power to subdivide, in fact it will have more powers than any of the parks boards have at the moment. I can give the hon. member the assurance that we are not going to touch any of the functions which are at present being performed by the Natal Parks Board. The reason is that we do not have an organization such as the Natal Parks Board to do what that board is doing at St. Lucia. I visited that area several times in the company of Mr. Douglas Mitchell and I had a look at the work which is being done there. We want to have the same work done at George and Knysna and those lakes. According to what the legal advisers have told me it is not possible to accept these amendments. I want to repeat my assurance that we do not want to interfere with the Natal Parks Board. I understand the hon. member’s problem, because he may say that I can be fired tomorrow and then there will be another Minister of Agriculture perhaps with a different attitude.

Do you not feel that a board seeks to build an empire, and will try to expand its operations?

No, I cannot see such a likelihood, because even if it wants to expand it will take them a couple of years to rectify what is wrong in the present situation. There are many other places to which they can pay attention. Why should they, in any event, decide to interfere in Natal where such problems do not exist? I can show the hon. member various other places to which the board can pay its attention.

Mr. Chairman, the hon. the Minister made two points principally as to why the amendment is not acceptable. He says his legal advisers have advised him that if one inserts an amendment such as I have suggested, i.e. that these powers will only be exercised with the consent of the boards concerned—in other words, that there will be an invasion of the rights of a board with the consent of the board concerned—it will mean that the rights of the State President to assent to the legislation will be overridden. With great respect to whoever advised the hon. the Minister, if that is the legal advice, then he ought to get new advisers, because, with respect, there is no substance whatever in that statement. Over and over again in legislation you find provisions such as I have suggested, for example that something ought not to be done save with the consent of the Administrator-in-Executive of the province concerned. One comes across that time and again. Yet that is not an invasion of the right of the State President to approve of legislation. So, with respect, there is nothing in that.

The hon. gentleman also says that there are some powers, such as the power of subdivision, which are not held by the Natal Parks Board at the present time. That may well be the case and I do not dispute it, but if the Natal Parks Board requires a power such as that it only has to go to its parent body, the Natal Provincial Administration, to ask for that power and it will be given. The Natal Parks Board is a statutory body which operates under an ordinance and a set of regulations which were set up by the Natal Provincial Administration. If additional powers of that kind are required, such as are contained in this Bill, they can be obtained. That too, with respect to the hon. the Minister, is no reason at all for rejecting my amendment. I wish to emphasize that the power to subdivide, which is contained in this Bill, can only be exercised after the powers of the Natal Parks Board have been abrogated or done away with and substituted by the powers of this board. The powers of this Bill can only be exercised after this board has taken over from the Natal Parks Board. Consequently that argument also—and I say it with respect—does not carry the day.

Finally, let me say what has been pointed out by my friend sitting next to me. I accept the assurances of the hon. the Minister that it is not his intention to invade the areas of jurisdiction of the Natal Parks Board, but if that is not the intention, why take the power to do it? If there is no intention to exercise that power, let us limit the power. Let us get rid of it and then there will be no temptation to any subsequent incumbent of the hon. the Minister’s office to venture along that unhappy path. I want to urge the hon. the Minister to reconsider his decision in this regard. He can possibly consult other advisers with a view to considering, even at a later stage, the acceptance of an amendment of this kind.

Mr. Chairman, the hon. member said that I must get rid of my legal adviser. As far as I know he was born in Natal and is a supporter of the United Party.

That is no recommendation. [Interjections.]

What do you know about his politics?

I want to read his opinion on this amendment which unfortunately is in Afrikaans. It reads as follows:

That was the advice he gave me. Then he said:

That is so—

They are trying to do the same work—

So it will be possible. He writes further:

Under the present policy it is not possible for the Natal Parks Board to subdivide. I quote further:

When we drafted this legislation we never thought of Natal.

Typical.

The hon. the Minister of Defence raised this specific problem which occurs in his constituency, George. We never thought of Natal. I want to ask the hon. member to give me time to go to his suggestions. He has only just given me this amendment. We can amend the Bill in the Senate if necessary. I shall discuss the matter with the hon. member. I want to keep him completely happy because it seems to me that he does not trust me when it comes to Natal. I think the hon. member can rest assured that it was not our intention even to touch the Natal Parks Board. I want the hon. member to give me the opportunity to look at it. If necessary we can alter it in the Senate.

Mr. Chairman, we want to indicate that we support the amendment put forward and, if the hon. the Minister will accept it either here or in the Senate, we would obviously approve. However, he said during the course of his reply that, at the very least, he would consult in the same way as he would consult the administrators concerned. If that is so, even if he does not accept the amendment of the hon. member for Umhlatuzana, he should at the very least insert in the Bill a provision that not only should the administrator be consulted but also any board which may be concerned. There could be no objection to that.

Not because I disagree with the amendment moved by the hon. member for Umhlatuzana, but merely to have the other alternative available as well, I wish to move the following amendments—

1. (1) On page 2, in line 37, after “administration” to insert:

1. (2) on page 2, in line 39, after “Administrator” to insert: or the Board.

You will see from this, Sir, that the first part of my amendment is identical to the amendment moved by the hon. member for Umhlatuzana and that the second part merely provides for consultation. I want to make it clear that I am putting this on the Order Paper as an alternative so that if the first is rejected, at least the second can be considered.

Mr. Chairman, I am grateful for the offer made by the hon. the Minister which, if I understood him correctly, was that there would be further consultation before this matter is discussed in the Other Place. I am quite happy to accept that offer to approach the hon. the Minister or his department or both for further discussions along these lines after which some agreement can perhaps be reached. In the light of that I am prepared to withdraw my amendment, with the leave of the House, to pursue the offer the hon. the Minister has made. I wish to express the hope that in those discussions some agreement along the lines of the amendment I have proposed, can be reached. On that basis I ask leave to withdraw my amendment.

I do not know what the hon. member for Yeoville’s attitude is, but I think that his amendment runs along a similar line of thought to the amendment I moved. Therefore it may be that he will consider withdrawing his amendment in the light of what the hon. the Minister has offered, but that, I suppose is for the hon. member to decide.

Amendments moved by Mr. R. M. Cadman, with leave, withdrawn.

Mr. Chairman, I see the merit of the approach of the hon. member for Umhlatuzana, but I think it is necessary that it should be on record in this House that these two amendments were in fact put before the House. Whether they are turned down or not, makes no difference because they can still be introduced in the Other Place. Nevertheless, concerning the matter of placing these amendments on record, I rather regret that the hon. member for Umhlatuzana has withdrawn his amendment.

It will appear in the Minutes of Proceedings in any case.

Yes, but it will not have been voted on in this House. If the hon. the Minister would undertake to give consideration to the hon. member for Umhlatuzana’s amendment, or at least to the lesser remedy being suggested by my amendment, I would withdraw the amendment on the same basis. However, I should like to hear from the hon. the Minister that he will at least give attention to the lesser remedy, because that is in accordance with what he said. According to his own words to the House, he could now accept the present amendment. All that I am concerned about is that if he accepts the present amendment, that acceptance might exclude the amendment which the hon. member for Umhlatuzana moved which is in fact an amendment I prefer. I therefore do not want to close the door by suggesting to the hon. the Minister that he should accept this amendment now. That is why I would be prepared to withdraw my amendment.

The hon. member for Yeoville has asked leave to withdraw his amendment. Any objection?

Mr. Chairman, I have asked the hon. the Minister to reply so that I could indicate thereafter whether I am prepared to withdraw my amendment or not.

Mr. Chairman, as I have told the hon. member for Umhlatuzana, I am prepared to consider his amendment. I am prepared to hold discussions with, him personally and to bring along the legal adviser and members of my department. With us all present we can see whether we can reach a solution to make everybody happy. An amendment can then be introduced in the Senate. In the present times in which we live, with the prevailing spirit of détente, I want to co-operate with hon. members.

Mr. Chairman, in these circumstances I shall withdraw the amendment and leave it to the hon. member for Umhlatuzana to put forward the case as a whole in the discussions.

Amendments, with leave, withdrawn.

Clause agreed to.

Clause 11:

Mr. Chairman, according to the hon. the Minister’s Second Reading speech, the object of this amending Bill was to rehabilitate and to restore the damage caused by injudicious actions on the part of individuals and bodies in the past. In clause 11 there are set out the many objects and powers of the board, but there is nothing in this clause which, states how one can rehabilitate and restore the lagoons, lakes and the estuaries which have been, shall we say, polluted by man-made constructions. There is nothing in this clause or anywhere else in the Bill in this connection, except in clause 15, perhaps, where I see something about the opening and closing of mouths subject to the approval of the Minister of Water Affairs. I shall also have something to say about that in due course. I would have liked to have seen much stronger wording here about the financing and the powers of the board in relation to other bodies that have caused damage to lakes, lagoons and river mouths to see whether something positive can be done. As I read this, there are references to subdividing, laying out, hypothecation, acquiring, leasing and entering into contract and all that sort of thing. What is absolutely necessary, however, according to what I read into the hon. the Minister’s Second Reading speech, is not contained in this clause. I am referring to the power to act and to make other bodies act. I should like to hear the hon. the Minister say something about this.

Mr. Chairman, I think the hon. member for Albany is most rightly referring to the Bushman’s River problem which he and I discussed several times. He needs help there. There is money involved in this. However, I think it is still possible in terms of this legislation to get the powers to do something about this Bushman’s River problem.

*It is said here that the jurisdiction of the board is restricted to the demarcation of lake areas. But all river-mouths and tidal areas, too, are the property of the State, and this problem may be included with those as part of the area of this board. I think I may reassure the hon. member that we should just like to launch this matter first. Then we shall be able to see what more we can do in terms of these statutory powers in the case of the Bushman’s River mouth. Up to now I have only given thought to the division of George. As yet we have not given thought to other problems which may arise in due course. Let us first launch this matter and then see what more can be done.

Clause agreed to.

Clause 15:

Mr. Chairman, I regret having to keep on worrying the hon. the Minister about my beloved river, the Bushmans River. Clause 15 deals with the opening and closing of the mouth of a tidal river. Something is lacking in this legislation, and that is the definition of the mouth of a river. The problem in respect of the Bushman’s River is not at the mouth of the river, in other words, where the river runs into the sea, but about a mile inland. If this legislation contained a definition of a certain stretch of a river which would be known as the mouth …

There is a definition here.

No, there is no clear definition. Such a definition must be phrased much more clearly. These are things which may be ironed out gradually by means of consultation and on the basis of experience, but I wish to express my ideas about this since this particular river— as well as other rivers—concerns me. In the Cape Province there is, for example, the Kowie River having a very long tidal stretch which runs through a township. The Minister knows that we also have problems with that river, because the river bed was relaid originally, in the old days, when a harbour was built. Therefore, it is necessary now to restore the banks that were made, while there is nobody who is really responsible for restoring those banks. Such a river may perhaps be included in such a definition. If there is no definition of a river mouth, we shall have problems with clause 15.

Mr. Chairman, the problem of the hon. member for Albany concerns the Bushman’s River. We can define a river mouth, but the mouth of the Bushman’s River is a very large one. It starts within 50 metres of the place where the new bridge was built. That particular bridge caused disruption as far as the natural flow is concerned. To rephrase this Bill so as to accommodate the case of the hon. member for Albany would be somewhat difficult.

Then it would be a tidal river.

Yes, the hon. Minister of Defence is right—then it would be a tidal river. The high and low water marks in that area fall within what is described as State land. If the river mouth is disturbed in that area, we have powers in terms of the old Act. As far as this specific problem is concerned, we have not gone into the matter. By this time I have a great deal of sympathy with the hon. member for Albany because, when I see him, I think of the Bushman’s River mouth. I can give the hon. member the assurance that we shall give attention to this problem even if we have to do so in terms of the Soil Conservation Act. The provincial council is not innocent in this respect either. Things such as roads are built by them. We can deal with this case separately, and I can give the hon. member the assurance that as far as this problem is concerned, I am far more sympathetic now, and that I shall consequently try to accommodate the hon. member.

Clause agreed to.

Clause 17:

Mr. Chairman, I am sorry to bother the hon. the Minister, but I would like to get his words on record as they are important to my people in the Eastern Cape as well as to the people all over the Republic as far as the tidal rivers in this country are concerned. In his reply to what I had to say on clause 15, the hon. the Minister stated—and we have been aware of it—that the beds of tidal rivers are the property of the Department of Agricultural Credit and Land Tenure and that they can now become the property of the board. My appeal to the hon. the Minister is that this board, wherever it has control of this part of State land, shall have the strictest possible control over that State land. I say this because of one thing I also find lacking in this Bill. There is no clause that says “notwithstanding anything in any other Act contained”. I want to ask the hon. the Minister what he would do in relation to this clause and the State land in the beds of rivers. If, for instance, the hon. the Minister of Railways were to introduce a clause in an Act which allowed him to alter the course of any river, stream or watercourse for the purpose of constructing and maintaining tunnels and bridges or to divert or alter, either temporarily or permanently, the course of any river, stream, watercourse or road or raise or sink the level thereof, how would this measure obviate such a measure being introduced for instance by the hon. the Minister of Railways? He would have a terrific problem and there should be something in this legislation stating that notwithstanding anything in any other Act contained, this board shall have the say over these areas. I can see it being included in clause 17 and I would like the hon. the Minister to give it consideration. Perhaps he can bring something like this in when he goes to the Other Place.

Mr. Chairman, I know of a specific river where the Railways built a bridge and the pillars of the bridge altered the flow of the river. I think the best solution is that the hon. member for Albany, the department and myself get together in order to devise an amendment in order to help the hon. member with his problem, if it is possible. You have got to work with the legal people to draw up legislation. I am only a maize farmer, but I know there are no two ways about drawing up an Act. So let us get together this afternoon or tomorrow morning to see whether we can make amendments to please the hon. member.

Clause agreed to.

House Resumed:

Bill reported without amendment.

Bill read a Third Time.

Mr. Speaker, I move—

This Bill seeks to bring certain amendments to an Act of the Natal Colonial Parliament, Act No. 9 of 1910. In order to understand the amendments which are contained in this somewhat technical Bill, it is necessary that I give some background briefly to the circumstances which necessitated the introduction of the Act of 1910.

What was the district of Natal, and which later became the Colony of Natal was originally from the ecclesiastical point of view part of the Bishopric of Cape Town. Bishop Robert Gray became the first Bishop of Cape Town and in that capacity was the registered proprietor in trust of certain properties in Natal which he held for the use of what was then known as the Church of England. Bishop Gray resigned as Bishop of Cape Town in October 1853, and in November of the same year the Colony of Natal became a separate diocese of the Anglican Church, known as the Bishopric of Natal. A certain John William Colenso became the first Bishop of Natal, and as Bishop he, in turn, was the registered owner in trust of certain properties in that colony, which he held for the use of the Church of England. The Church of England was described in various ways at that time. It was known variously as the Church of England, the English Church and the Anglican Communion, but its official description became the Church of the Province of South Africa, and it is necessary, Sir, in considering this ecclesiastical legislation that one appreciates that when one talks of a province one talks of the ecclesiastical province which included the whole of South Africa. The constitution of the Church of the Province was adopted provisionally in 1870 and was amended and then confirmed in 1876, and it is that constitution, with certain amendments, which governs the Church of the Province at the present time. The Church then, Sir, comprises various dioceses, and the Diocese of Natal is one of them. The government of the church is carried on at two main levels, firstly by a provincial syned, which deals with the broad issues of the province as a whole and those which affect the dioceses in their relationship with one another and, secondly, by a diocesan synod for each diocese. The rules created by the provincial synod are called Canons and those created by the diocesan synods are called Acts.

Returning to the historical side of this question, Bishop Colenso died in June 1883 and a problem then arose which concerned the appointment of a legal successor to Bishop Colenso. It is set out fully, Sir, in the preamble to the Act of 1910. Because by then Natal had acquired what were called legislative institutions—that is to say, it had achieved either representative or responsible government as a colony because that development had taken place in the constitutional government of Natal—the Crown refused to appoint a legal successor to the Bishopric of Natal. There was consequently a void, and there was consequently no legal owner of the properties of the Church of the Province which were situated in the Diocese of Natal. In addition to that void which existed—a legal void—the then existing system of administration of the church properties in terms of various trusts had proved to be costly and unsatisfactory, and in the result it was deemed desirable to appoint trustees and to alter and declare various of the trusts, in terms of which church properties were held, and all that was done by an Act, Act 9 of 1910, which was put through the Natal Colonial Parliament of that time. Sir, because we are dealing with amendments to that Act, it is necessary that I say a word or two in regard to the Act itself. That Act, Sir, contains complicated provisions relating to church properties, and they are complicated because various of the church properties were dealt with in different ways. In the first place, not all the properties of the church were brought within the Act, and provision was made for certain congregations to elect later, after the Act was enacted, to bring their properties within the operation of the Act; this is the first category. In the second place, in addition to immovable properties, i.e. land, there were certain specific funds vested in trustees for which provision had to be made in that act.

In the third place, because of certain differences in doctrine, points of view held by ministers of certain congregations and their congregations as opposed to others, it was necessary to provide in the Act that properties used by certain ministers and congregations should be administered solely for their benefit and to provide protection for them in regard to the doctrine required to be used in those particular church buildings which were erected on the properties concerned, and also in regard to the appointment of ministers for those particular congregations. There are historical reasons for that which it is not necessary for me to elaborate on here today.

In the fourth place, it was necessary to provide for particular properties to which particular trusts applied, to be dealt with in a specific manner. Now, the machinery which was devised to deal with this somewhat complicated set of properties and trusts was to link certain sections of the Act with particular schedules containing lists of properties. In this way it was made possible that certain provisions of the Act would apply to some of these schedules and some of the properties and not to the other. I might mention that there are four schedules listed in the Act.

Now, it is necessary in order that the matter may be understood, so far as it is capable of being understood, that I refer briefly to the various sections which it is sought to amend. In terms of section 1, certain trustees known as “the trustees appointed under the Act” were appointed. These trustees were to be, in the first instance. Bishop Baines, then Bishop of Natal, and his successors, and the Diocesan trustees of the Diocese of Natal for the time being. The result of this was to appoint certain persons as trustees on behalf of the provincial trustees in respect of properties held by the church as a whole, and the same persons as special trustees in respect of the particular properties listed in the schedules to the Act. So, from time to time, when the Act came into operation the same body of persons comprised in their person, and operated as, two different sets of trustees, the one holding one set of properties and the same persons in a different capacity holding a second set of properties. Section 1 as I have said, names the trustees and identifies them and sets out the powers which the trustees appointed under the Act were to possess and the properties which they were to hold. Those are listed in Schedule A. All these properties that are referred to in section 1 were to be held and administered for the benefit of the Church of the Province of South Africa as a whole.

Section 2 provided that the trustees appointed under the Act were declared to be trustees of certain funds. They were to devote these to the uses originally intended by the donors of those funds in so far as they were not in conflict with the Act itself. Section 3 of the Act of 1910 laid down certain specific provisions concerning the properties listed in Schedule B. I will not go into all that, Sir, but those were the properties which were held in respect of particular congregations and particular ministers who held particular views on doctrine within the Anglican Church at the time. Section 4 dealt with properties listed in Schedule C. Those were the properties which would not come within the operation of the Act until the particular congregations at a later stage had agreed that that should happen, and had decided on the manner in which those decisions should be taken. Section 5 made provision for the properties in the final Schedule D, to be administered in terms of the specific trusts which had set them up.

I come now to the reason why it has become necessary to amend that somewhat complicated Act and which is the specific purpose of this Bill. The most pressing circumstance which has made it necessary for the Act to be amended is the urgent need for the erection of a new cathedral in Natal for the Diocese of Natal. The present Cathedral Church of St. Saviour’s is now much too small. It is a very old building, a not very attractive building and it is not feasible that this building be enlarged. It is not possible for a new cathedral to be built upon the property where the present cathedral stands. The property which the diocese and the church wish to use for the new cathedral is the old and historic site of the Cathedral Church of St. Peter’s which is a large site which runs between Church Street and Longmarket Street in Pietermaritzburg. It is not proposed to demolish the Church of St. Peter’s, which is both a beautiful and a historic building, but it is proposed to erect the new cathedral church next to the old Church of St. Peter’s. If I may interpose a personal note here, it gives me pleasure personally to have been asked to move this Bill because my grandfather was for some years the vicar of that old and historic Church if St. Peter’s and my late father bore the name of the late Bishop Colenso; so my family has a close association with these particular properties.

So where has the hon. member gone wrong?

As long ago as 1957 the congregation of St. Peter’s Church passed a resolution placing their property unreservedly at the disposal of the diocese for the purpose of the erection of a new cathedral. It was at this point where the difficulties of the existing Act came to the fore. That property consists of a number of subdivisions listed in Schedule B of the Act and it is consequently subject to the provisions of section 3. It will be clear, I hope, from what I have already said, that this property can be used for the purposes of the existing St. Peter’s Church and no other. Consequently it is the subject of a special trust, and amending legislation is required to enable the church to deal with its own property in the manner it wishes.

Opinions have been taken, I may say, from a number of senior counsel over the years and all the opinions are unanimous to the effect that it is not legally possible for the church to embark on what it proposes to do for the building of a cathedral without amending legislation such as we have before us at the present time. It was these opinions which initially motivated the church authorities to consider drawing up amending legislation.

In the light of the fact that it was necessary to amend the Act for the purpose of the new cathedral, consideration was then given to the other provisions of the Act, which for many years had caused administrative complications and difficulties. The future administration of church properties was also looked at so that any wrinkles in that regard could also be ironed out whilst amending legislation was going to be introduced. The differences in doctrine which existed in 1910 when the existing Act was passed no longer assume the importance today which attached to them then. It can be said that they have virtually disappeared. Just as the need has arisen for the use of the St. Peter’s property for expansion purposes, so it is expected that similar needs will develop in respect of the other properties in Schedule B which are the subjects of particular trusts, and more particularly in respect of the property of St. Paul’s Church in Durban, which is the major church in the Durban area. Apart from the need to remove restrictions which apply in respect of particular church properties, St. Peter’s and St. Paul’s in particular, the experience over the years of the working of the existing Act has shown that in some respects the powers given to the trustees are far too narrow. Furthermore, the necessity imposed by that Act for one set of persons to act as trustees in two separate capacities in respect of different properties, has made the administration of the church properties very cumbersome and very complicated. They have to be administered now in terms of the existing Act in a manner which is entirely unnecessary and undesirable. For these reasons it was decided to seek additional amendments designed to resolve the problem.

I wish to emphasize that it was throughout the resolve of the trustees appointed under the existing Act as well as the diocesan trustees that no amendment to the Act which affects particular congregations should be sought unless it was in accordance with the wishes of those congregations. Accordingly every congregation and its minister which were affected by any of the amendments to the legislation—I wish to emphasize that—were consulted and consented to the amendments which are contained in this Bill. As will appear more fully from what I have to say, there is also protection for such real rights as are concerned here, that is to say the rights of mortgagees and lessees. Where there interests are concerned in relation to any of the affected properties, protection by a special provision in this Bill has been provided. Therefore I can safely say that no existing vested rights have been affected or will be affected by this Bill save by consent and where there is no consent, there is a specific clause which preserves the rights of the persons concerned.

The complicated nature of the provisions of the Act naturally required a fairly complicated amending Bill. The reason why I have taken some time to elaborate on this speech, is that I realize that it is not easy, merely by a perusal of the Bill, to understand what is taking place. Indeed, had I been opposed to this measure and had it been proposed by a Minister of State, I would have been the first to ask for an explanatory memorandum to indicate what is taking place.

Before I deal with the remaining clauses, I should like to mention that in clause 1 of the Bill there is a small misprint which can be rectified administratively. That is that the words in lines 12, 13 and 14 which are reflected in square brackets, ought to have been in heavy type. Due to a misprint, however, they appear in normal type, but that will be rectified at an appropriate stage

Clause 1 of the amending Bill amends section 2 of the Act by removing from the control of the trustees appointed under the Act, moneys of the Dean and Chapter of the Cathedral Church of St. Peter. It does that to enable the building of a new cathedral, to which I have already referred. Clause 1 should be read with clause 6 of the Bill, which places those moneys under the care of the diocesan trustees instead of the special trustees as is the present position. They are given the power to deal with that money in accordance with the power vested in them in terms of the constitution and canons of the church and the particular Act of the diocese of Natal, and they are to be used for the benefit of that church. They are to apply these moneys for the uses originally intended by the donors in so far as they are not in conflict with the provisions of the Bill.

Clause 2 removes certain properties from the control of the trustees appointed under the Act and it does that by deleting from Schedule A the properties listed by number in clause 2. The reference there to clause 8(1) of the Bill preserves any right in any of these properties which are held by third parties. That is the protection given to parties as tenants or mortgagees, or persons in that category. The term “third party” is defined in clause 9 of the Bill. Clause 2 must also be read with clause 5. which substitutes the diocesan trustees in respect of the properties listed in the first Schedule to the Bill and gives such trustees power possessed by them from time to time in terms of the Constitution and Canons of the church. There is provision here that special conditions contained in the Deeds of Grant shall be observed in so far as they are not in conflict with the provisions of the Bill. Clause 5(2) is to the same effect, except that it relates to the proceeds of properties listed in Schedule A where such properties may have to be sold.

Clause 3 of the Bill deletes certain properties from Schedule B to which section 3 of the Act applies. It will be remembered that Schedule B is the one which lists the properties to which special trusts apply. As I have already indicated, the property of St. Peter’s is one of those. It is by means of deleting St. Peter’s property from Schedule B that the desired result of freeing this property from that special trust will be achieved.

Clause 4 deals with Schedule D and deletes an item from that Schedule. Section 5 of the Act applies to that.

I pass to clause 7 because I have already dealt with clauses 5 and 6. Clause 7 deals with the property of St. Paul’s Church in Durban which is at present one of those listed in Schedule B of the Act and to which section 3 of the original Act applies. That church property is subject to a special trust, to the effect that it be administered for the benefit of the minister and congregation of St. Paul’s Church. Unlike St. Peter’s in Pietermaritzburg, and certain other churches which have expressed the desire that their properties be deleted from Schedule B— those I have already referred to—and so be freed from the application of section 3 of the original Act, the minister and congregation of St. Paul’s have expressed the desire that the provision with regard to their property should be to the effect that it leaves it in schedule B for the time being, while allowing them at a later stage to elect to remove it from that schedule. To give effect to that desire of the congregation, is the purpose of clause 7.

Clause 9 is the definitions clause which speaks for itself, and I have already indicated that clause 8 is the clause which preserves the rights of third parties in relation to the properties I have dealt with.

That brings me to the end of my seriatim description of the clauses. I hope it will be apparent from what I have said that the purpose of this Bill is to alter and improve upon the existing Act which governs the administration through the medium of trustees of church properties of the Anglican Church in Natal. The amending Bill, which is in effect a consent measure, proposes to improve upon, make changes and add to the existing Act concerning the administration of the church and its properties. In order to bring that into effect, it is necessary that this Bill pass through, this House. I therefore invite the House to support this measure at Second Reading.

I must congratulate the hon. member for Umhlatuzana on the way in which he introduced this very technical Bill.

Mr. Speaker, Disraeli once said: “The Zulus are the only people who defeat our armies, change our Government and convert our bishops.” We are today dealing in this House with an issue of considerable historical importance to South Africa, particularly to its English-speaking people. The roots of the Bill which we have before us are an important part of the whole life of South Africa in the last century. We have heard a brief personal reference by the member for Umhlatuzana, but I wonder whether he is aware that his grandfather is turning in his grave to think that his grandson should be piloting this legislation through this House. I think it is sometimes common for us to smile indulgently about our ancestors’ feelings, attitudes and prejudices, but these things are indeed important. The very fact that the member for Umhlatuzana’s father has the name Colenso written into his family’s Christian names is an indication of the feelings at the time. Also on a personal note, it is interesting that the first time I ever met the member for Umhlatuzana I remember we had a discussion about this very point. Colenso was of course a colossus in the whole history of Natal. Shortly we shall be dealing with certain and consolidation proposals. It was, in fact, over the very issue which, affected some Zulu people in Natal that Colenso and Shepstone split in Pietermaritzburg and the whole society …

Order! The hon. member must not take that point too far.

On this issue the whole society of Pietermaritzburg was split and we know the grave history of the fight between Macrorie and Colenso in the town of Pietermaritzburg. This gave rise to the tremendous theological and doctrinal differences which existed between the men of St. Saviour’s and the men of St. Peter’s, which was, of course, a Colenso church and which is specifically mentioned in this Bill. It is on that site that the Church of the Province now wishes to erect its cathedral.

I believe that this Bill raises an even more important issue, however, in parliamentary terms. In this House those of us who are English-speaking will possibly have learnt that the longest word in the English language is anti-disestablishmentarianism. Of course, this is the very issue we are dealing with this afternoon in that a Bill has to come before this House to deal with a church matter of this type. I believe that it is seldom that we have such an historic event occurring in this House. Of course in South Africa, since 1910, we have stood in the tradition of anti-establishmentarianism. We have stood for disestablishment. This has been a great tradition of our churches in this country since 1910, not least of all the Dutch Reformed Church. I think it is important to remember that the Church of England has always stood in a tradition of erastianism in that the head of the Church of England has been the Queen of England. Theologically speaking, of course, this is nonsense. The Lord Jesus Christ alone can be head of his Church. It is interesting in this regard that in the Church of Scotland, which is an established church by law, the Queen of England,—the Queen of Scotland as she is when she is there—is not allowed on to the floor of the General Assembly of the Church of Scotland for fear that they should be accused of erastianism. However, she is allowed into a gallery on the side of the General Assembly floor. It was Andrew Melville, the great Scottish divine, who reminded King James I that he was God’s “sillie vassal” and was subject to God’s authority as well as to the authority of the people. I think it is not inappropriate for us to remember that the Rev. Andrew Murray, who has perhaps contributed most, spiritually speaking, to the Dutch Reformed Church in this country, was growing up at the time of the great disruption of the Scottish Church when Dr. Chalmers, in that great tradition of Scottish divines, with tremendous scholarship and yet firmly earthed in the people, led the disruption of the Church of Scotland on this issue of the erastianism of that church. I believe that in this Parliament we must retain that emphasis and be careful that we do not develop a de facto establishment Church. It is very interesting, for example, that the late Dr. Jan Hofmeyr, who died in 1948, although a Baptist, was buried from a Dutch Reformed Church. It is also interesting, in this regard, that the new State President is to be inaugurated in a Dutch Reformed Church on Saturday.

I believe that this is an important Bill for two reasons. One is because it takes us back into the great traditions of this country, it reminds us of the importance of Parliament, it reminds us of the fact that we are the people’s Parliament and it reminds us of the great battles which were relevant to our grandparents and older relatives and which are perhaps no longer of importance to us. It is also significant, I believe, because it reminds us of the importance of not having an established Church. I have great pleasure, therefore, in supporting the Second Reading of this Bill.

Mr. Speaker, we on this side of the House would also like to congratulate the hon. member for Umhlatuzana on the introduction of this Bill and the explanation he has given of a very technical matter. As I do not wish to indulge in a discussion on church history and theology I shall conclude by saying that we shall support the Bill.

Mr. Speaker, I should like to thank the two hon. gentlemen who have spoken and who have indicated their support for this Bill. Let me say that I was glad to hear at the end of the speech of the hon. member for Pinetown that he supported the Bill because until that moment I had grave doubts as to what his intention was! The hon. gentleman made a speech which I found interesting. I hope, however, that he will not consider me uncharitable when I say that the relevance of his speech, to the contents of this Bill was somewhat slight. He made a cryptic reference—I hope it will be cleared up at some stage—to the fact that my grandfather who was the Vicar of St. Peter’s, would turn in his grave were he to hear me supporting and indeed introducing this Bill here today. Once again it was not made clear to me why that predecessor of mine should be turning in his grave. I may say that it would be a difficult task because he rests under a cairn of stones in northern Natal where he fell on the battlefield during the Anglo-Boer War. His is a lone grave under that cairn of stones in northern Natal. I hope it will be made clear to me at some stage by the hon. gentleman why this contortion should be undergone by my late relative. I think he would have been very glad indeed to know that I was piloting a measure through this House which in effect confirms the coming together of the two sections of the Anglican Church in Natal which split apart during the last century. Indeed, I think that that is something to be desired.

Secondly, the hon. member for Pinetown dealt with the undesirability of an established church. If I understood him correctly he rather suggested that because legislation governed the properties of the Anglican Church, we had something here in the nature of an established church. Once again, with respect, I do not think he understands the position. The only reason why there is legislation in this regard is because the constitutional evolution of the colony of Natal to representative and responsible government prevented the Queen of England in the eyes of the law from appointing a successor to a deceased bishop. It is for that reason and for that reason alone that there is legislation governing this situation.

The final point he made was that the Queen of England is the head of the Anglican church. Here again he makes a proposition which I do not agree with. As I understand the constitutional position, the Queen of England is the Defender of the Faith which is an entirely different office from that of head of the church who, as I understand, is not the Queen of England.

I also wish, to congratulate the hon. member for Johannesburg West on what he said because he said nothing to which I can reply other than to say “thank you.”

Motion agreed to

Bill read a Second Time.

Mr. Chairman, duly authorized by the hon. member for Humansdorp, it is my privilege to move the amendment as it appears in his name on the Order Paper, viz.—

I shall give a brief explanation of the effect of the amendment in this connection. In terms of section 9(1) of Act No. 72 of 1968, no servitude or other right may be granted in respect of a State forest, except with the approval of both the House of Assembly and the Senate. This means that there is a prohibition. However, this prohibition does not apply to the granting of rights to State departments, as mentioned there, viz. the S.A. Railways, the Post Office, Provincial Administrations and local authorities. In clause 5 of this Bill, the National Transport Commission is added to the above-mentioned group of public bodies. In terms of sections 7 and 7A of Act No. 72 of 1968, nature reserves, protection forests and wilderness areas are established and it is provided that these areas must be preserved. They may not be damaged and no cutting is allowed either. These provisions one finds in section 7(2).

The very object of the proposed amendment is that these areas may not be encumbered by servitudes or other rights of this nature, except with the permission of both the House of Assembly and the Senate. I do this with a view to providing greater protection.

Mr. Chairman, I would like to support the amendment of the hon. member for Ermelo. In its fully amended form it will read as follows, if I understand it correctly—

1. (a) prohibiting, save in the case of an area set aside under sections 7 and 7A, the granting in accordance with the regulations of any right (whether of a permanent or temporary nature) in respect of any portion of a State forest to any department of State, the S.A. Railways and Harbours Administration, the Post Office Administration, the National Transport Commission, Provincial Administrations or any local authority for public purposes.

The areas set aside in section 7 and 7A are nature reserves and protected forests as well as wilderness areas. These areas are the small precious jewels of indigenous forest and exceptional natural scenery that we should protect for forthcoming generations. They are also areas set aside for special protection for water conservation and for other reasons. Normally the Wilderness areas are recommended by the National Monuments Council for preservation. We cannot allow these areas to be cut up and scarred without very careful consideration. We would certainly object to the cutting up of passages through these areas by Escom or the Post Office or the Railways and Harbours Administration or, for that matter, the National Transport Commission, for the purpose of constructing roads or erecting overhead telephone wires across these areas. Sir, I see the Minister as the custodian of these forests, and I believe that he has real concern for the forests under his control. I believe that he should insist on an ecological study of areas like this before he allows roads to cross these areas or pathways to be cut for the purpose of high tension wires erected by Escom or any other body. I feel, therefore, that we should not detract from the special protection given to these areas. These forests are ecological units in themselves, and any human disturbance can affect the habitat of plants growing there, or can even affect the animal life there. I know very well that even in the areas where the present Garden Route is under construction and where bulldozers cross the forest floor, enough disturbance is created on the infertile soil layer, with a very thin layer of leaf mould on top of that, to affect future germination—compaction— and to cause a disturbance which will leave its scars and marks for many years to come. I feel, therefore, that it is essential to support this amendment. As I read it, the Minister’s amendment will allow the national Transport Commission to put a national highway across nature reserves and protection forests and wilderness areas without seeking the approval of both Houses of Parliament, as set out in section 9 of the original Act. I feel that we should not detract in any way whatsoever from the right of the two Houses of Parliament to raise objections. Our forests, I believe, are a national heritage that should not be desecrated in any way without the full knowledge and consent of both Houses of Parliament.

Sir, I am prepared to accept this amendment. I listened to the like-minded arguments supporting the amendment, which came from both sides of this House. I accept the amendment for two reasons. The one is that the type of places that we have in mind here, in other words the wilderness areas or forest reserves, are, in any case, areas which have been selected in a way which makes it very unlikely that various bodies will ask for access to them. There are indeed such places where various bodies will ask for access, but it is very unlikely that this will happen in future. But for the sake of the few cases where it can happen and in view of the fact that this House feels so unanimous about this, I feel that it will be in everyone’s interests if this amendment is accepted. The second reason for my acceptance of the amendment, is that I should not like to see any dispute arising with regard to a matter such as this. One does not want to have a public dispute about things such as wilderness areas and forest reserves, and in view of the unanimity in this House about the amendment, about which we had a few minor misgoings at the time of drafting the Bill, I am prepared to accept the amendment.

Amendment agreed to.

Clause, as amended, agreed to.

Clause 10:

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

1. (1) on page 8, in line 53, after “fund” to insert “or otherwise”;
2. (2) on page 10, in line 30, to omit “(8)” and to substitute “(7)”;
3. (3) on page 10, in line 31, after “shall” to insert “as soon as practicable”; and
4. (4) on page 10, to omit subsection (5) of the proposed section 31E.

I refer firstly to page 8 of the Bill, line 52, where it reads—

The amendment is to insert “or otherwise” after the word “fund”. The reason why I am doing this, is because it appears that there is very great interest on the part of the public to make contributions. By inserting these words, we are simply opening the door to people or bodies who want to make such contributions, and here I am not thinking so much of the making of a road, but of overnight huts. That is why I am inserting those words.

Then I want to refer to the amendment inserting the words “as soon as practicable” on page 10, in line 51, after “shall”. I think this idea also arises in another amendment and I do not think we differ as far as our ideas in this regard are concerned. I think this is a better choice of words. For the protection of the department, I feel that the words “as soon as practicable” are actually better than the word “forthwith”. The word “forthwith” means one must do it immediately and I think it is more fair to say that one must do it “as soon as practicable”. From an administrative point of view, I think, this is more acceptable. Then I want to refer to the deletion of subsection (5). That is actually an accommodation arising from discussions which were held with hon. members on this side and members on the opposite side of the House, as well as with the South African Agricultural Union, after the introduction of the Bill. The whole spirit of that subsection which we are deleting, is that the intention, from the beginning, with the establishment of a hiking way, was that there should not be a dispute as to where it should be. For example, a route may run across private property. If it happens that one subsequently finds when one wants to create such a worthwhile facility as this, that it might cause fighting, one should rather not do it. For that reason I am deleting the subsection altogether, because as it stands here, it means that if there is a dispute, the Secretary may make a submission to the Minister and then the Minister may have the matter investigated and actually make a decision contrary to the wishes of people. If we delete this, we shall rather retain what remains, viz. that agreements be reached by means of negotiation. I think we are all satisfied that if we have negotiated about it, then it is unnecessary that the Minister forces his wish on unwilling people. I also held a discussion with the hon. member on the opposite side who is interested in this and also wants to move other amendments, and I think that he accepts it like this.

I should like to accept the hon. the Minister’s third amendment, and consequently withdraw the second amendment of which I have given notice. I think his wording, “as soon as practicable” is better than ours, which is “forthwith”. I agree with the Minister as far as that is concerned. Then in the light of the Minister’s fourth amendment, which is to omit subsection (5) of the proposed section 31E, my proposed fifth amendment falls away as well as my sixth and seventh amendments. I would like to say that I accept the withdrawal and I agree with the hon. the Minister, because I believe it would be extremely difficult to maintain a national hiking way across the property of an owner who was unwilling to agree to having this hiking way crossing his property. I can well visualize difficulties with fences, taps and gates and things of that nature. It would make it almost impossible to have a pleasurable hike across the property of a person who did not bear the goodwill necessary for maintaining it. Therefore I agree wholeheartedly with this particular amendment.

I therefore move the remaining amendments standing in my name on the Order Paper, as follows—

1. (1) On page 8, in line 36, after “Minister”, to insert:

1. (2) on page 10, in line 35, to omit “filed in his office”;
2. (3) on page 10, in lines 37 and 38, to omit “as soon as it may for any reason be lodged in his office”;
3. (4) on page 12, in lines 3 and 4, to omit “damage caused by them to private property on that land” and to substitute:

The first amendment refers to the proposed section 31B(2), which simply reads—

I feel it is essential that in order to maintain the goodwill of the people residing in the area one should give them the necessary notice of the intention to develop a national hiking way through that particular area. I believe that there should be a notice in the Gazette setting forth the proposed opening to inform the public in the area, first of ail, and together with such a notice in the Gazette there should also be a notice indicating that it is proposed to determine a national hiking way within a stated period. This period should end well in advance and not less than within six weeks hence from the date of appearance in the Gazette. Thirdly, the notice should invite objections or representations concerning the proposed opening so that the people in the area can also participate in the scheme and also bring their knowledge to bear. There are many interested people in communities of this nature and also organizations such as farming associations, ramblers’ and hiking clubs, as well as the South African Mountain Club, that would like to participate and make their special knowledge available to the Minister as far as the planning of some of these national hiking ways is concerned. There should be consideration for the farmers, the neighbours and the communities of an area near to such a national hiking way. I believe that they should be consulted and given the opportunity to participate. They could possibly advise on the hiking way’s better routing, past hidden springs of which the hon. the Minister and his department might not be aware. They might also know of special scenic areas and might also be able to assist by advising on the possibility of avoiding certain steep slopes with loose boulders and sagging and slipping ground and things of that nature. I believe that it is highly advisable that they should be allowed to participate. The motive is to promote and make a success of this excellent undertaking by the hon. the Minister and his department. I believe that this could be of great credit to South Africa, not only for its own citizens but also for tourists who visit South Africa. It will encourage the people of the area to cherish and protect the forests and the hiking ways in their particular area. To ensure their co-operation, they should be properly notified and consulted so that they become a part of the whole system.

I now turn to my amendments to the proposed section 31E(4) which reads—

I believe there are two phrases here which are unnecessary and I, therefore, ask for the deletion of the phrases “filed in his office” and “as soon as it may for any reason be lodged in his office”. It seems to be quite unnecessary to have those phrases.

My amendment concerning the proposed section 31E(8), concerns the possible damage caused to private land by hikers and in this regard I refer to page 12 lines 3 and 4. Surely, they could not be liable for accidental damage caused to any land without proof of negligence or wilful damage in any court of law. It is not deliberately starting a grass fire or leaving a gate open, but other kinds of damage which could be caused accidentally without any wilful intent by the casual hiker. Here I can think of an example like rock slides or landslides having been accidentally caused by a hiker. If any damage should be caused to property of a private owner below such a slope, that individual person will be held responsible in terms of this clause as I read it. I think that this will be grossly unfair, and I feel that the hon. the Minister of Forestry or his department should be responsible, or this special fund which he hopes to create for that purpose, should refund such damages. I should like to recommend that the hon. the Minister reconsiders this particular aspect.

Mr. Chairman, as far as the hon. member’s amendments are concerned, I want to say immediately that the first amendment is acceptable. I think that we agreed about the second amendment. The hon. member also intimated that this amendment was no longer necessary. As far as his amendment to the proposed section 31E(4) is concerned, the hon. member wants to delete the words on page 10 in line 35, “filed in his office”. He wants to have the title deed endorsed with particulars of the route. The hon. member wants to delete the words “filed in his office”. The department does not object to this, but it will bring about an enormous amount of work when correspondence has to be conducted and when the department is dealing with owners who do not always hand in their title deeds. For that reason, the Registrar of Deeds requested us to tell the hon. member that we should try to agree not to do this because it will cause an enormous amount of work. The fact remains that if it is noted in the register, for which provision is made in the legislation, it is sufficient as far as the Registrar of Deeds is concerned and also as far as the department it concerned. Therefore, unfortunately I cannot accept it.

As far as his amendment to section 31E (8) is concerned, we must understand how it is going to work in practice. Certain people will hike in an area and an accident or damage to property will occur. Such damage or accident can be the result of negligence or deliberate intent, but when negligence or deliberate intent has to be proved under any sort of circumstance, an enormous number of difficulties may eventually arise. Since the legislation was drafted, we have had a completely different idea, which I want to mention now. In the meantime, we have thought of the idea of leaving it just as it is and not going into that detail. The Government contributes to the fund and we are going to try not to make the fund liable for any incident, but to cover it by means of insurance. We have started negotiations about this matter and there are some insurance companies who are interested in doing it. If we keep it as it is, we hope to make the fund liable for that premium. Then the position will be, that every person on such a route, will be covered by the insurance which, has been taken out. Then it is not necessary to prosecute people or to look for the black sheep when there is trouble. Because this is a better plan in my opinion, because it is a better and a shorter way to do this, and because it will cause less difficulty for us, I want to tell the hon. member that I cannot accept his amendment. Our plan is a better plan, in my opinion.

Clause, as amended, agreed to.

House Resumed:

Bill reported with amendments.

Report Stage taken without debate.

Third Reading

Mr. Speaker, I move—

Mr. Speaker, it is now some time since the Bill was read a second time. In fact, it was done on 5 March. I think it may be appropriate at this stage to bring certain matters to the attention of the House, the first being that this Bill in providing a hiking-way system, is bringing about a profund change in recreation in South Africa. South Africans are traditionally outdoor people. We are people who love to get out-of-doors, to have a braaivleis over the weekend, to get out into the country, go to the seaside and so on. The State, specifically the Department of Forestry, is now providing an amenity on a mass scale and this amenity is going to mean a tremendous amount to the increasingly urbanized population of South Africa, I wish to point out that this is going to have a profound effect on private property. I think one should realize this and I think the farming community must realize that, although the hiking-way system will to a certain extent go through State land, the farming community is going to be expected —and I am sure it will meet that expectation—to co-operate to a high degree with the hon. the Minister in providing access to farms and other properties so that these hiking-ways can be laid out. This imposes very severe obligations on the farming community and also on the State to see that the rights of the owners of property are protected in view of the massive influx of people who come from urban areas and are therefore not always familiar with the ways of the countryside and the dangers to the countryside from fires and so on which may very seriously affect the properties of land-owners. Therefore I think the State has a very heavy obligation on it to see that farmers are not injuriously affected. One of the provisions of this Bill relates to the amendment of the provisions relating to honorary forest officers. The hon. the Minister himself stated during the Second Reading that he hoped that youth movements like the Boy Scouts, the Voortrekkers, as well as school organizations and universities would come forward and allow themselves to be appointed as honorary forest officers specifically for the purpose of helping in the business of controlling the activities of the public using these hiking-ways. I purposely do not use the word “policing” because I think it is far too severe a word. I would like to endorse what the hon. the Minister has said and to make an appeal to the public, particularly to youth organizations and others, to volunteer to be appointed to positions of this kind.

The Minister has said that he is investigating the possibility of insurance for any calamities or damages which may be caused. A fire on a farmer’s farm as a result of trippers and hikers going through the farm is nothing less than a calamity. I am very pleased indeed to hear that there is a possibility of insurance. As yet, it is nothing more than a possibility. At the same time it is incumbent on everyone, the State and the users of the hiking-way, to cut the possibility of any kind of damage down to an absolute minimum. I think that people who use the hiking system have an obligation to volunteer to help control the activities of the public using these hiking ways.

One of the problems the hon. the Minister is going to face is that of a mass influx. Let me just quote a figure I heard the other day. At the gate to Champagne Castle, which gives access to forest land, there were 300 people on one day during the past Easter Holidays wanting access. This was on a totally unorganized basis. There is no recognized hiking trail there and there is no system laid out I think we can imagine what the wear and tear to these trails is going to be. There will have to be some kind of limitation perhaps on the number of people who will be allowed to enter the higher areas from a point of view of safety to the public and from the point of view of the protection of the eco-systems in those areas. I am now speaking of my own personal knowledge of the Giant’s Castle area and the berg areas of Natal. There are what one might call defensible natural barriers, the different slopes and foothills beyond which the ordinary man in the street, the ordinary town dweller who is not a hiker or a mountaineer, cannot penetrate. I think we have to give a good deal of consideration to the safety of the public and the safety of the ecosystems, which one wants to protect in those particular areas. These natural barriers, the foothills and natural ridges in the berg areas, conform to recognized veld systems etc. We have to take careful cognizance of what a large influx of people into those fragile areas may do. When the hon. the Minister was replying in the Second Reading debate, he set out some of the objects which, the department hopes to achieve and some of the facilities it hopes to provide. He said, and I quote from Hansard (5 March, col. 1908)—

When the Minister mentioned separate sleeping facilities for men and women, I was just wondering what the position was going to be for those happy married couples who go upon the hiking-way together. I hope he will also make provision for facilities for married couples as well as facilities for those who are in a happy bachelor state.

Back to nature!

Mr. Speaker, we have great pleasure in supporting the Third Reading of this Bill.

Mr. Speaker, I am glad that the hon. member has reacted again at the end of this legislation. On the first point he made, i.e. that a completely new type of recreation is now being created in South Africa, I want to say that this is true. We will now have to see what happens in the future. I just want to give you an indication of what has happened up till now. Those parts that have been completed, are fully booked months in advance. As a matter of fact, there is such an influx of people that without control these parts would be completely overcrowded during weekends and that we would probably have the same position one finds in many parts of the world. It is said that on a pleasant day in the Tyrol area, the whole Austrian and German population can be found on the hiking-ways. One finds this tendency to an increasing extent in South Africa as well. It is therefore correct—we do not as yet have any idea of what the scope of it will be—but I have no doubt that it will eventually run into thousands of people during weekends when the entire population of South Africa can make use of the hiking-ways at the same time.

The second important aspect mentioned by the hon. member is the fact that there should be control, and from the nature of the case this is very important. There has to be control for many reasons. One does not want conflict among people because they go there in an uncontrolled way; neither does one want elements that do not belong there. Nor does one want people to arrive at places in an uncontrolled way in unfavourable weather circumstances which will cause them problems. In other words, absolute control must be exercised. The Department of Forestry will therefore take care of that as a State institution. The Act also provides that it will be the duty of the Council to take care of this and to make the necessary adjustments in future. As the National Parks Board is doing in its own sphere, this council will also be able to take steps. Therefore I have no doubt— with the goodwill that exist on all sides and the control we hope to have from the start —that we will be able to eliminate from the start that type of element the hon. member and I do not want to see there.

The hon. member also asked me what would happen when we have different people at one place on the same night, for instance married couples, old people, young people, children, males, girls, etc. I want to say to the hon. member that we are considering what happens in other parts of the world, and we have already devised such places where people can spend the night. We will start with the first two and then see how they function. Provision must however be made for different kinds of people and for different circumstances. After all, it will take a long time before the entire development will take place and initially one will simply have to feel one’s way. I have no doubt that we will soon have an indication of what the position will be.

Will it be possible for people to reserve accommodation to spend the night somewhere?

That is what should be done. You can appreciate what would happen if there is a place every 15 km where people can spend the night and there is a rush as a result of unfavourable weather conditions! Therefore there will be access at different points as well as proper control, as is the case at the Game Reserve where one enters through a gate. Reservations will have to be made in advance, so that every one on the hiking way will have a place to spend the night at the terminal point.

There will also have to be absolute control over the number of people, otherwise there would be chaos. We foresee that these things could happen and I just want to tell the hon. member that before we started on this scheme one of our officials who is greatly interested in this matter, was sent abroad for quite a long time to make a thorough study. In other words, we did not simply guess what had to be done. It is being done scientifically and we take note of what is being done in other parts of the world. We are trying to adapt overseas practices to South African conditions in order to prevent unnecessary chaos.

Motion agreed to.

Bill read a Third Time.

Mr. Speaker, I move—

The Water Research Commission was established by Act 34 of 1971 with the aim of promoting research in connection with water affairs.

The commission consists of the Secretary for Water Affairs, and seven other members appointed by the State President. One of the latter members is appointed by me to be chairman and chief executive official on a full-time basis.

In terms of Act 34 of 1971, the commission is empowered to appoint staff, at salary scales and with conditions of service determined by me, in consultation with the Minister of Finance, for the performance of its functions, and to carry out various other activities, for example the drafting and amending of research programmes, considering progress reports and liaising with other institutions.

Although the commission is active at the moment and making good progress, it is found in practice that its activities are hampered by a few factors which can be removed by making slight amendments to the Water Research Act, 1971. That is what we are doing now.

In the first place, section 3(1)(i) of the Water Research Act provides that I, the Minister, have to authorize all purchases or acquisitions of immovable or movable property which the commission may need in the performance of its duties. This authorization includes small purchases such as stationery or normal every-day administration costs, etc., which means in practice that a great deal of time is wasted in drawing up and keeping up to date statements which then have to be approved by me. The intention is now to amend the Act so that I shall only have to authorize the purchase or acquisition of immovable property, and for that provision is made in the proposed section 3(1)(i), while in terms of the proposed section 3(1)(i) the commission will be able to obtain small every-day requirements, which are necessary to allow its administration to run smoothly, without my approval.

In the second place, no provision is made in the commission’s constitution for the delegation of its powers to a sub-committee or to the chief executive official or another member or official. Such sub-committees, which could be charged with matters of a routine nature, would definitely contribute to a more effective functioning of the commission’s activities, and therefore provision is now being made in the Act, by the insertion of sections 10A and 10B, for the appointment and dissolution of committees consisting of members of the commission, to enable the commission where suitable to delegate powers which are conferred by the Act, in order to promote effectivity in the performance of the commission’s duties.

Therefore, all we are asking in this legislation is that it be made easier for the administration to run smoothly, so that the commission can act more effectively, so that it can divide itself into sub-committees and so that it can instruct officials to perform certain tasks on its behalf.

Mr. Speaker, we on this side of the House support this Bill. This Bill is a measure, as the hon. the Minister has said, which is aimed merely at making it easier for this vitally important water research commission to be able to function, to be able to adjust itself and adapt itself to ad hoc situations in any particular project which may arise and which may require specific research. I think that we can safely leave it in the hands of the commission to do that and to do it in the best interests of South Africa.

Motion agreed to.

Bill read a Second Time.

Committee Stage taken without debate.

Bill read a Third Time.

Mr. Speaker, I move—

Mr. Speaker, the Sale of Land on Instalments Act, 1971, which came into operation on 1 January 1972, had its origin in the need which arose over many years for legislation which would regulate the relations between parties interested in a transaction by means of which land was sold on instalments. Although the legislation was preceded by various investigations, it was not possible at that stage when it was put into operation to predict with any measure of certainty whether the legislation would in all respects serve its purpose.

Nevertheless the legislation concerned has, since its commencement, been the subject of intensive study by academics and persons involved in practice in its application. In responsible circles this attempt on the part of the Government to establish legislation in terms of which the ordinary citizen would be protected against any adversity he might encounter when he purchases land on instalments, has been welcomed with acclamation. More specifically mention has been made of the effect the Act is having in limiting the dangers involved in fraudulent practices by irresponsible township developers and estate agents, as well as in the insolvency of parties to a contract for the sale of land on instalments. However, in a memorandum submitted to my Department of Commerce the Association of Law Societies submits that although the legislation has in many respects succeeded in its purpose, there are various areas in which the Act is creating confusion, and that the possibility exists that if the Act is not suitably amended, its purpose may be defeated.

It is therefore clear that at present a need exists for the Act to be amended, and on this occasion I also want to thank the representatives of the Association of Law Societies for all the trouble they have gone to in being of assistance to my Department of Commerce with the preparation of the amendment Bill which is now before this House. I now want to discuss the principles of the most important proposed amendments to the Act which are included in the Bill— and I apologize for the fact that this is going to take a considerable length of time.

As is customary, section 1 of the Sale of Land on Instalments Act, 1971, contains a number of definitions. In clause 1 of the Bill it is now being proposed that certain definitions be added to the existing definitions, and that certain of the existing definitions be further defined. One of the existing definitions will be deleted as a result of the proposed amendments. The reason for this I shall explain in a moment. Sir, I want to point out in passing that certain amendments appear in my name on the Order Paper, amendments which are not really the result of my labour but of the labour of the hon. member for Pretoria West. I want to thank him for having contacted me in this regard in good time.

Because the definition of the concept “land” has a fundamental effect on the application of the Act in certain respects, this concept is probably one of the most important concents included in the Act. Of course the said definition should, as I shall subsequently indicate, also be read in conjunction with section 2 of the Act to determine in which cases the Act is or will in fact be applicable.

According to representations received by my Department of Commerce, uncertainty exists in regard to the application of the Act in respect of contracts for the sale on instalments of small holdings which form part of land which is not situated in the area of jurisdiction of a local authority. In order to eliminate this uncertainty, it is being proposed that the definition of “land” be amended in such a way that all land not exceeding twenty-three hectares in extent and forming part of an area referred to in section 2(a)(ii) of the Act is deemed to be land used mainly for residential purposes or intended to be used for such purposes, unless the contrary is proved.

There is also a lack of clarity in regard to the application of the Act in respect of contracts for the sale on instalments of an undivided share in land. I come now to the point made by the hon. member for Pretoria West, and I shall consequently move in the Committee Stage that all doubt which exists at present in this regard be eliminated by including an undivided share in land in the definition of “land”.

The word “contract” is many times in the Act, and consequently it is necessary for this word to be clearly defined. However, a number of problems have risen in practice in regard to this definition. Firstly it has been pointed out that the definition of “contract” refers to “the purchase price” payable in more than two instalments. It is argued that a purchase contract in respect of land, in which provision is made for a deposit payable upon the conclusion of the contract, as well as for payment of a number of instalments which consist only of interest, and for the payment of the balance of the purchase price against transfer, is not affected by the Act or covered by the Act. To clarify the position, I shall consequently move in the Committee Stage that the Act shall refer to “a contract under which the purchase price, interest or any other moneys are payable in more than two instalments”. Once again I want to express my gratitude to the hon. member for Pretoria West for his suggestion in this particular regard.

Secondly, the courts have ruled on more than one occasion that a contract for the purchase and sale of land, which is subject to suspensive or resolutive conditions, is under certain circumstances not binding on the parties. Therefore, it is now being proposed that 1he definition of “contract” be suitably amended in order to make it clear that the provisions of the Act are applicable to a contract, regardless of whether it is subject to a suspensive or resolutive condition.

Thirdly, there have been objection to the fact that a cession under which the purchaser has ceded, for the purposes of the Act, his right under a contract to claim transfer of land, is also included in the concept of “contract”. Therefore, it is now being proposed that the said section of the definition of “contract” be deleted, and that a new definition of “intermediate transaction” be inserted by clause 1(e) of the Bill after the definition of “interest” in section 1 of the Act. According to the existing provision of section 2(a) the Act is applicable to a contract under which the purchaser is a natural person or is the estate of the purchaser who has died or is insolvent. In view of this, doubt exists whether a juristic person, including a company, may be a cedent for the purposes of the Act as it is worded at present. In practice, however, it is possible that a company may purchase land on instalments from a township developer and that, before the former has taken transfer of the land, it may in turn sell that land on instalments to some other person. In fact, this happens quite frequently in practice.

In view of the abovementioned circumstances the definition of “intermediate transaction”, which will now be inserted in section 1 of the Act by clause 1(e) of the Bill, will distinguish between two kinds of transactions. Firstly, provision will be made for the transaction in accordance with which a natural person who has purchased land under a contract alienates that land under an agreement before that land has been transferred to him, and secondly, provision will also be made for the transaction in accordance with which any person, including a juristic person or company, sells land, in respect of which he has acquired the right under an agreement to claim transfer of that land to his name, under a contract before such land has been transferred to that person.

†It is also proposed that definitions of the words “agreement” and “intermediary” be inserted in section 1 of the Act by clauses 1(b) and 1(e), respectively, of the Bill.

The word “agreement” will cover any agreement for the sale, exchange, donation or other means of disposal of land, as well as a contract as defined by the Act; and, under the concept “intermediary” a distinction will be made between the natural person who purchased land under a contract on the one hand, and any person, including a juristic person or compay, who obtained the right to claim transfer of land under an agreement on the other, and who, as the case may be, sells or alienates such land under an intermediate transaction before the land is transferred to him.

The reason why these two words are given the widest possible connotation is that any person, including a juristic person or company, who obtains the right to claim transfer of land to himself may, before he takes transfer of the land, sell that land under a contract to someone else.

The proposed amendments to the definition of “purchaser” by clause 1(g), and to the definition of “interest” by clause 1(d), as well as the deletion of the definition of “cession” by clause 1(a) of the Bill, stem from the proposed amendments to sections 11 and 14 of the Act. The latter amendments are matters upon which I shall enlarge in due course.

However, at this stage, I should mention that section 2 of the Act could be construed in such a manner as to limit the application of the Act to certain transactions for the sale of land under which the purchaser is a natural person. I have already pointed out that a juristic person or company may, in its capacity as an intermediary, be both the purchaser and the seller of land under an intermediate transaction.

The proposed insertion of a reference to sections 11 and 14 in section 2(a) of the Act will make it clear that, by virtue of the fact that an intermediary is not always a natural person, the provisions of the Act will, in fact, in certain cases apply in respect of juristic persons.

In terms of the proposed amendment to section 4(1)(a) of the Act by clause 3(a) of the Bill, a reference to the territory of South West Africa will be inserted in the said section and certain words will be deleted from the section. Although the Act also applies in the territory of South West Africa, the section, as it is presently phrased, could be construed to require that the addresses of the purchaser and seller which have to be stated in a contract, shall be located in the Republic. It is, therefore, considered necessary that a reference to the territory of South West Africa be inserted in the section.

The deletion of certain words from the section results from certain proposed amendments to section 15 of the Act in terms of which the requirements relating to domicile will be shifted from section 4(1)(a) to section 16 of the Act where they more appropriately belong.

It is also proposed that three new paragraphs be insertel by clause 3(b) of the Bill in section 4(1) of the Act after paragraph (i).

Paragraph (iA) will require that a contract shall contain a reference to the right of the purchaser under section 10 of the Act to accelerate payments in terms of the contract and to claim transfer of the land against payment in full of the purchase price with interest and all other amounts owing in terms of the contract.

Paragraph (iB) will require that a contract shall contain a reference to the limitation, in terms of section 13 of the Act, upon the right of the seller to take action by reason of any failure by the purchaser to fulfil an obligation under the contract.

Paragraph (iC) will require that a contract shall contain a reference to the right of the purchaser under section 72 of Act 29 of 1926 to demand transfer of land after payment in instalments of not less than 50% of the purchase price, on condition of registration of a mortgage bond over the land.

It may well be asked why it is necessary that a reference to certain legal provisions be inserted in a contract. It is claimed that it often happens in practice that provisions which conflict with the legal provisions in question are inserted in a contract. If the contract does contain a reference to the said legal provisions, the possibility of the insertion in the contract of provisions conflicting with those legal provisions is reduced and the chances that the purchaser who reads the contract will become aware of his rights, are increased.

Clause 4 of the Bill contains a proposed amendment to section 5(1) of the Act which provides that the seller shall hand over or send a copy of the contract to the purchaser free of charge. In certain quarters it is alleged that, although the Act makes provision that the purchaser shall obtain a copy of the contract free of charge, the Act also contains provisions in terms of which the parties to a contract may agree that the purchaser shall be responsible for the costs involved in the drafting of the contract. According to those persons who hold this viewpoint it is difficult to reconcile the relevant conflicting provisions of the Act. In order to clarify the position, therefore, it is now proposed that the expression “free of charge” be deleted from section 5(1) of the Act and that a provision be added to the section in terms of which the seller will be prohibited from making a charge for the making of the copy of the contract which has to be supplied to the purchaser, or for complying with the provisions of the said section.

*Section 6(2) of the Act, as it is worded at present, provides that no seller may stipulate for, demand or receive interest with regard to a contract at a rate which is higher than the maximum rate which is men charged by any building society in respect of a loan secured by a first mortgage bond over land.

It is argued that it is difficult for a seller of land on instalments to determine what interest rates are being charged by building societies. Hon. members who are in practice will know that the interest rates frequently differ. This is particularly the case among smaller building societies. According to representations received by the Department of Commerce there is also a lack of clarity among sellers and their legal representatives in regard to the position which applies if the building societies alter their interest rates. Therefore, it is now being proposed that section 6(2) of the Act be amended by clause 5(2) of the Bill in order to provide that the Minister of Economic Affairs will be able to prescribe by regulation the maximum interest rate which may be stipulated for, demanded or received under a contract.

How are you going to do it.

I shall explain.

Section 6(1) of the Act provides that, when interest is payable under a contract, it may not be calculated more frequently than monthly and not less frequently than quarterly, on the outstanding balance which is then payable in terms of the contract. The position is that many township developers prefer to calculate interest quarterly in advance because this requires less labour than when interest is calculated monthly. Since the outstanding balance of the purchase price of a property may constitute a considerable sum, the interest over months on such balance could also be considerable. Various purchasers have complained to the Department of Commerce that township developers are unwilling to make an adjustment in the interest which is payable under the contract if the purchaser offers to pay the entire outstanding balance in one sum shortly after interest for an ensuing three months has been calculated in advance.

Therefore, it is now being proposed that a subsection (4) be added by clause 5(b) of the Bill to section 6 of the Act which will provide that, after the purchase price of the land together, with the interest and all other amounts which may be payable under the contract has been paid, no further interest will be payable under the contract. I believe that hon. members will also want to discuss this particular aspect with me.

It is also alleged that although section 7 of the Act, as it is worded at present, provides that certain provisions would be invalid if they were to be included in a contract, the provisions of the section do not prevent an unscrupulous seller from incorporating invalid stipulations in a contract in the hope that the purchaser is not, or will not become aware of his rights. In clause 6 of the Bill it is being proposed that a new section 7 be substituted for section 7 of the Act. The proposed section 7(1) of the Act will now provide that, subject to the provisions of subsection (2), a contract entered into after the commencement of the Sale of Land on Instalments Amendment Act, 1975, may not contain certain provisions mentioned in the Act.

Although subsection (1) of the proposed, section 7 also contains five paragraphs, as does the existing section 7 of the Act, the wording of paragraphs (b) and (d) of the proposed section differs from the wording of the corresponding paragraphs in the existing section. In the case of paragraph (b) it is provided at present that the purchaser shall, under certain prescribed circumstances, not forfeit any claim in respect of a useful improvement effected by him on the land. It is argued that the scope of the expression “useful improvement” is not very clearly demarcated in South African law. Hon. members who are in practice are aware of this, and also that it may be open to dispute or disagreement in the proposed 7(1)(b) of the Act the expression concerned is now being defined as necessary expenditure incurred by the purchaser, with or without the authority of the registered owner or seller of the land, in regard to the preservation of the land or any improvement thereon, as well as any improvement which enhances the market value of the land and was effected by the purchaser with, the consent, whether express or implied, of the registered owner or seller of the land. I think hon. members will readily agree with, me that this is an improvement on the existing position. The present paragraph (d) contains a proviso in terms of which the seller may bind himself to arrange for the purchaser a mortgage bond over land which, he has sold on instalments. According to certain standpoints it is not clear how this proviso, as it is worded at present, may be complied with. In order to clarify the requirements with which a seller may comply in terms of the proviso, it is being proposed that the proviso in paragraph (d) be deleted, and that a subsection (2) be added to section 7 of the Act which will make provisions for a suitable exception to the prohibition in the proposed section 8(1)(d).

†CIause 7 of the Bill will amend section 10 of the Act. Although this section of the Act confers upon a purchaser the right to accelerate payments in terms of the contract, it is not clear whether he has the right to claim that land, which he has purchased under a contract, shall be transferred upon his name if he fulfils his obligations under the contract. It is now proposed that the position be clarified by the insertion in the Act of a new section 10(1)(c) which provides that a purchaser shall at all times be entitled to claim transfer of land against payment in full of the purchase price with interest and all other amounts which may be owed in terms of the contract. The provision is, however, subject to the proviso that, when the contract refers to a date or event after which the seller will be able to give transfer, the purchaser may only claim transfer of the land sold after such date or event.

In terms of the proposed amendments contained in clause 7 of the Bill a subsection (2) will also be added to section 10 of the Act. The subsection provides that, when a contract makes provision that a seller shall give transfer against payment in full by the purchaser of the purchase price with interest and all other amounts owing in terms of the contract, a banker’s guarantee for payment of those amounts against transfer shall be deemed to be payment.

The problem encountered by purchasers of land on instalments is that a banker’s guarantee, payable at the time of occurrence of an event, cannot be considered to be payment in itself. When a contract makes provision that the seller shall give transfer after the purchaser has paid the purchase price, the seller is under no obligation to give transfer if he is offered a guarantee for payment of the purchase price against transfer. The law courts have also on more than one occasion decided that, in the aforementioned circumstances, the purchaser may claim transfer only if he has fulfilled his obligations under the contract, i.e. has in fact paid the seller.

A banker’s guarantee payable against transfer is normally accepted by a seller as payment because such acceptance allows the purchaser to make arrangements with a financial institution for the granting to him of a loan which will be secured by a mortgage bond over the land. The amount of the loan is only paid at the time of the registration of the mortgage bond. It follows that, when the seller insists that the purchaser shall first pay his debt before transfer is given, the purchaser will rarely be in a position to make arrangements for a loan, with the proceeds of which he will be able to pay off his indebtedness under the contract. Under these circumstances it is possible for a seller to exploit the inability of the purchaser to take transfer by or on an agreed date in terms of the contract, to the latter’s detriment. The proposed amendment will assist the purchasers concerned to escape from this very difficult position.

I now propose to deal with the principles involved in the amendments which will be effected by clause 8 of the Bill to section 11 of the Act. In a memorandum to my Department of Commerce on the Act, and suggested amendments thereto, the Association of Law Societies stated inter alia that

Under subsection (1) of section 11 of the Act as it is at present phrased, any person who has purchased or who purchases land under a contract and who has sold or who sells that land under a contract of purchase and sale before the land is transferred to him, is deemed to have ceded, or to cede, his right under that contract of purchase and sale to claim transfer of the land. I have already mentioned that, as a result of the proposed insertion in the Act of definitions for the concept “intermediary” and “intermediate transaction”, it is also proposed that the definition of “cession” should be deleted.

Whereas it is proposed that the expressions “cession” and “cedent”, as they are at present used in section 11 of the Act, shall be substituted by the concepts “intermediate transaction”, it should be borne in mind that these lastmentioned concepts cover a wider field because, as I have already explained, intermediaries will in future not be confined solely to natural persons.

The problems to which the Association of Law Societies refers in its memorandum result mainly from the existing provisions of section 11(2) of the Act in terms of which, despite the fact that the Deeds Registries Act requires transfers to be effected in the sequence of the preceding juristic acts or events, land in respect of which the right to claim transfer was obtained by a cession, is transferred directly from the registered owner to the cessionary if certain conditions are fulfilled. Although the provisions of the section in question were intended to be directory, it now appears that the section is phrased in such a manner that the provisions thereof are construed to be peremptory. In view of the considerations which I have just mentioned, it is proposed that the proposed section 11(1), which will be substituted for the existing section 11(1), shall provide that the purchaser of land under an intermediate transaction will, subject to the provisions of subsection (2) and provided that all the transfer duties have been paid, have the right to claim transfer directly from the registered owner to himself.

It is also proposed that, in the proposed subsection (2) of the Act, it shall be clearly stated that no land shall be transferred direct from the registered owner to the purchaser of land under an intermediate transaction except in those cases where, firstly, the purchaser to whom transfer is to be effected has fulfilled his obligations under the relevant intermediate transaction, and secondly where a final order of sequestration or liquidation has been given in respect of the estate of any intermediary entitled to claim transfer before the land is transferred to the said purchaser, or where the circumstances contemplated in section 14(3) and (4) exist, that is to say, the creditors of the registered owner of the land have attached the land for the purpose of selling it in execution.

*It has also become necessary to relieve the Deeds Registry of the obligation to verify the accuracy of the statements made for the purposes of the Act in deeds of transfer. To comply with this requirement it is being proposed that section 11(3) of the Act will provide that, if relevant facts with regard to the matters specified in subsection (2) are included in a deed of transfer and such facts are certified to be correct by a conveyancer, those facts are deemed to be correct, unless the contrary is proved. In this connection I want to observe at once that this is in any case the current practice in the ordinary course of the registration of deeds of transfer and mortgage bonds.

The existing provisions of section 11(3), (4), (5), (6) and (7) of the Act will, with the necessary adjustments, be retained in respect of the concepts of “intermediate transaction” and “intermediary”, which I have already mentioned, which are being substituted for the expressions “cession” and “cessionary”. However, the complaint has in fact been received that the Act did not contain an adequate sanction against non-compliance with the existing provisions of section 11(6) of the Act. Therefore, it is now being proposed that it will be clearly stated in the proposed section 11(7) of the Act that any person who sells or alienates land in terms of an intermediate transaction shall furnish the purchaser concerned with all the necessary transfer duty receipts. Furthermore, a subsection (8) is being added to the existing section in which provision will be made by means of suitable provisos that, if the seller of land in terms of an intermediate transaction does not furnish the purchaser with the transfer duty receipts, as required by the proposed subsection (7), he forfeits interest in terms of the transaction concerned in respect of the period from the conclusion of such transaction until those receipts are in fact furnished. Moreover, it is being proposed that a provision be added to the proposed subsection (9) of section 11 of the Act which will authorize a purchaser, if he pays transfer duties payable by an intermediary or any predecessor of the intermediary in order to obtain transfer of land, to sign all the necessary documents in regard to the transfer duty or transfer on behalf of such intermediary or predecessor.

Section 12(1) of the Act provides inter alia, that if a seller, with the consent of the purchaser, cedes and assigns his rights and obligations under a contract, that cession and assignment shall be deemed to be a power of attorney to the assignee concerned to transfer the land to the purhcaser in accordance with the conditions of the contract. It is alleged that there are certain township developers who insert a provision in their contract for the sale of land on instalments in terms of which the purchaser consents to the township developer ceding and assigning his rights and obligations under the contract, but the person to whom the rights and obligations will be ceded and assigned, is not mentioned in the contract.

It is alleged that if the assignee is not designated in the document in terms of which the purchaser grants consent in accordance with the provisions of section 12(1), the purchaser could in fact assign his obligations under a contract to a person who is not able to comply with those obligations. It is therefore being proposed that a subsection (1A) be added to section 12 of the Act by clause 9 of the Bill which will provide that no consent as contemplated, except with specific reference to a specific assignee, may be granted.

This proposed provision will afford a purchaser the opportunity of considering whether the person to whom the seller proposes to assign his obligations under the contract is a competent person who will comply with those obligations.

It is also being proposed that two amendments will be effected by clause 10 of the Bill to section 13(1) of the Act, which imposes a restriction on the right of a seller to take action owing to the failure of a purchaser to comply with obligations under a contract.

Every contract for the sale of land on instalments contains a provision which confers upon the seller the right to claim the full purchase price of the land from the purchaser if he should fail to pay an instalment on the due date. There are very sound reasons for this provision being included in such contracts.

Although the common law does not require a seller to send the purchaser a reminder before he exercises the right concerned, it is nevertheless regarded as fair and reasonable that a seller does in fact send the purchaser a reminder and allow him a reasonable time to rectify his failure. At present the Act only places a restriction on the right of the seller to cancel the contract without having sent a reminder. However, it is alleged that when a purchaser fails to comply with his obligations under a contract, the seller concerned in many cases sends the purchaser a letter of demand which creates the impression that the purchaser will forfeit all the payments which he made under the contract if he does not pay the entire outstanding balance under the contract immediately upon receipt of such letter of demand.

In view of the fact that the legal position in the abovementioned circumstances is not clear, it is being proposed that section 13(1) of the Act be amended in such a way that no doubt will exist that a seller shall in fact send the purchaser a reminder before he demands the accelerated payment of any instalments of the purchase price under a contract.

At present the Act allows sellers to send the said reminder to the address which, as far as is known, is the purchaser’s last known residential or business address. According to complaints received the position is being exploited by sellers in that contracts are being cancelled on the grounds of reminders which never reached the seller. Section 4(1)(a) of the Act requires inter alia that the address of the purchaser be stated in the contract. I have already mentioned that the Bill contains certain proposed amendments in respect of the said address, and I shall subsequently have more to say about this matter. At this stage, however, I just want to mention that it is now being proposed that section 13(1) of the Act be suitably amended so that the sellers will be required to send their reminders, as prescribed by this section, to the address of the purchaser stated in the contract, or to a changed address of which notice has been given.

Although it is being proposed in clause 11 of the Bill that a new section be substituted for section 14 of the Act, most of the proposed amendments to the existing provisions of section 14 of the Act result from certain other proposed amendments to the Act. I have already referred to the fact that it is being proposed that the concepts of “intermediate transaction” and “intermediary” should be used in the Act instead of the expressions “cession” and “cessionary”. I have also pointed out already that the concept “intermediate transaction” covers a far wider field than the expression “cession”.

Furthermore I must also point out that a conflict exists between the Afrikaans and English versions of section 14(1) of the Act. It is argued that the interpretation of the section concerned is, for the abovementioned and other reasons, giving rise to many problems in practice. Land which has been sold on instalments, is an asset in the estate of the person in whose name that land is registered. It is therefore possible for the creditors of the registered owner of land sold on instalments to attach that land and to sell it. In terms of the existing section 14(1) of the Act the purchaser, if he is unable to take transfer of land which he has bought on instalments from the registered owner of such land when the creditors of that owner attach the land, is granted a claim against the proceeds of the land if it is sold by or on behalf of the creditors. This claim ranks in preference prior to the claims of the concurrent creditors of the registered owner of the land but subsequent to any claim secured by a mortgage loan over the land.

At present the Act also provides that the said claim will only apply if the land is sold in execution. It is now being proposed that the section be suitably amended to state clearly that the purchaser will also have the claim referred to in that section if the land is sold by the trustee or liquidator of the insolvent estate of the registered owner.

In addition the existing section 14(1) of the Act grants the aforesaid claim only to a purchaser who purchased the land directly from the registered owner under a contract. I have already mentioned that certain township developers sell land in townships which they are developing to a company on instalments, and that the company in turn sells that land on instalments to natural persons. If the creditors of the township developer were to attach the land registered in the name of the township developer and were the sell it in execution, the natural person who purchased land on instalments under a contract from the company to which I have referred would, in terms of the existing provisions of section 14(1) of the Act, not have a claim in terms of that section against the proceeds of the land because he did not make his purchase directly from the registered owner, and the company would not have such a claim because it is not a natural person.

In addition I have already referred to the proposed insertion in the Act of a definition of the concept of “agreement” which will include any alienation of land, as well as a contract. It is now being proposed that section 14(1) of the Act should also be amended in such a way that the claim referred to in that section shall be granted to any person who has obtained the right to claim transfer of land in terms of an agreement, or to the insolvent or deceased estate of such person, provided the land has at some stage or other been sold in a series of transactions under a contract and is sold by or on behalf of the creditors of the registered owner of the land, or the trustee or liquidator of his insolvent estate. It is also argued that the reference in the existing section 14(2) of the Act to subsection (1) is causing confusion In order to clarify the position, it is now being proposed that the said reference be deleted, and that a provision be added at the end of the section which will provide that, if land which has been sold on instalments, is sold by or on behalf of the creditors of the registered owner of the land, the sale shall take place subject to the claim referred to in subsection (1).

Because the person to whom the claim referred to in the proposed section 14(1) of the Act is granted, may also be an intermediary, it is also being proposed that section 14(2) of the Act will be amended in such a way that provision will also be made for such an intermediary to be called upon to take transfer of land which is to be sold, if the address of the intermediary is known.

The proposed subsections (3), (4) and (5) contain for the most part proposed amendments which arise from other proposed amendments. However I must point out that the existing section 14(4) of the Act provides that, if a person decides to take transfer after having been called upon to do so in terms of section 14(2) of the Act, he shall in certain cases pay the outstanding balance of a mortgage bond over the land plus interest up to the date of registration of the transfer. However, there are certain claims in respect of costs which rank in preference prior to a mortgage bond. The Act, as it is worded at present, makes no mention of these costs. I may also mention that building societies have a fundamental interest in this matter, and that it has already come to my attention that a certain building society was prejudiced as a result of the deficiency which exists in this Act. It is therefore being proposed that section 14(4) of the Act be suitably amended to make provision, too, for the payment of the costs concerned by the person who takes transfer.

†I now turn to the proposed amendment to the Act to which I have already referred previously in passing. It is proposed that section 16 of the Act, relating to the addresses of the purchaser and the seller which shall be stated in a contract, be amended by clause 12 of the Bill. Section 16 of the Act presently merely provides that any party to a contract shall give by registered post written notice to the other party of a change in his address. It is proposed that the requirements in respect of domicile in the existing section 4(1) of the Act to which I have already referred be incorporated in section 16 of the Act because those requirements will more appropriately fit into this section.

In order to enhance the effectiveness of the proposed amendment to the existing section 13 of the Act, it is now proposed that a provision be added to section 16 of the Act which will provide that, when a party to a contract has given notice of a changed address, such changed address shall, after such notice, serve as domicilium citandi et cxecutandi for the party who gives the notice.

In conclusion, I want to deal with one further matter. The most outstanding objection raised against the Act in its present form is the fact that it does not make provision for adequate sanctions. The Association of Law Societies, among other things, had the following to say about this matter—

*In regard to the foregoing opinions of the Association of Law Societies I should like to point out that it has also been brought to my attention that there are sellers who do not want to comply with the provisions of section 3 of the Act. To those sellers I want to say that, if the amendments to the Act which I have proposed in the Bill and which is now before this House do not have the desirable effect on the sellers concerned. I shall have to give consideration, although I am reluctant to do so, to proposing that penal sanctions also be inserted for non-compliance with section 3 of the Act. However, to give more force to the existing statutory provisions, it is now being proposed that section 17 of the Act be amended by clause 13 of the Bill.

It is also being proposed that the court in whose area of jurisdiction the land which is being sold on instalments is situated, be empowered, upon non-compliance with any of the provisions of sections 3, 4, 6, 7(1), 10, 12 or 13 of the Act, provided the purchaser institutes suitable proceedings within two years after the date of conclusion of the contract—

1. (a) to reduce the interest payable by the purchaser under the contract, with due consideration for the circumstances, to such a rate as it deems fair and just; or
2. (b) grant an order for rectification of the contract; or
3. (c) declare the contract null and void from the start; or
4. (d) grant any other remedy as it may see fit.

It is also being proposed that the proposed powers be granted to magistrates’ courts as well. The proposed provision will enable the courts to evince their dissatisfaction in a tangible manner, with contracts which do not comply with the provisions of the Act.

Since this Bill is reasonably complicated, and I should very much like to afford hon. members the opportunity to study it, I move—

This was an exceptionally long Second Reading speech lasting almost an hour, but I want to reassure the hon. the Minister that he did not break the record of the late Gen. Smuts who, in 1914, when he moved the Second Reading of the Indemnity Bill, spoke for 6½ consecutive hours.

Motion agreed to.

Debate adjourned.

Mr. Speaker, I move—

As everyone is aware, a great deal of dissatisfaction has arisen since 1972 in regard to certain provisions of the Medical Schemes Act, 1967. As a result of a comprehensive legislative programme, I indicated that the provisions of the Act would be revised after July 1974. With the introduction of this Bill, I am fulfilling my promise.

The dissatisfaction in regard to the provisions of the Act may be summarized as follows:

1. (a) The allegation is being made that the Act is aimed at and is being used to control the medical profession.
2. (b) Arising out of this purely professional matters are being encroached upon and the bodies concerned are under no obligation to consult the professions in cases of a purely professional nature.
3. (c) As a result of the inflexible provisions relating to the Remuneration Commission, medical practitioners and dentists are being financially prejudiced.
4. (d) The functioning of the Remuneration Commission entails tremendously high costs for all the bodies concerned, and the Dental Association in particular is no longer able to afford them.
5. (e) The present Act requires schemes to be registered in terms of the Medical Schemes Act, 1957, and in terms of the Friendly Societies Act, 1956. As a result of the differences between medical schemes and friendly societies, the application of the requirements in respect of friendly societies, which are not neceisarily applicable to medical schemes, is causing problems for medical schemes.
6. (f) Originally there was only one association representing medical aid schemes. At present there are four such associations which are recognized by law. This situation not only obstructs negotiations between the interested parties, but is in fact contributing to an increase in expenditure.

In dealing with the provisions of the Bill I shall explain as I go along what methods are being contemplated to overcome these problems. At this stage, however, I think it would be a good thing if I were to pause for a moment at the allegation which is being made that the Act seeks, and is being used, to control the professions.

As is apparent from a letter from the former chairman of the Federal Council of the Medical Association, which appeared in the S. A. Medical Journal of 22 March 1975, this allegation is based primarily on the provisions of section 29 of the Act, viz. the so-called “contracting in and contracting out provision”. The argument is based on the fact that initially all medical practitioners are regarded as having contracted in, until formal notice is given of their contracting out. This provision was included in the 1967 Act. This method was adopted at the time because it was expected that most medical practitioners would in fact remain contracted in, and this would consequently facilitate the administrative functions considerably. This expectation was subsequently realized. In view of this objective, this argument therefore has no substance.

Far from exercising control over the provisions, section 29 contains certain contractual provisions. The provisions entail the following:

1. (a) Each medical practitioner is free to decide for himself whether or not the he wishes to render services in terms of the provisions of the Act. In view of this I really cannot see on what grounds the profession could be controlled in terms of this provision. In addition, we have gone out of our way to make this position very clear and in this regard I should like to refer you to the provisions of sections 28 and 42 of the Act, and the new section 40(2) which is included in clause 28.
2. (b) If the individual medical practitioner should decide to render services in terms of the provisions of the Act, he is required with regard to the charging of fees to accord equal treatment to all patients who are members of medical schemes.
3. (c) As consideration medical schemes are required, within the provisions of their rules, to make direct payment of the accounts of medical practitioners who have contracted in.

In other words, in terms of this provision a contract is being concluded, and this is all that this entails. This contract entails reciprocal benefits, inter alia that the medical practioner is assured of the payment of his accounts, as a result of which, the administrative costs of the scheme are restricted, but it is still aimed at promoting the interests of the patient, for under the circumstances the patient is assured of treatment equal to that accorded to other patients who are members of a scheme.

The advocates of the abolition of the system frequently allege that this provision affects the doctor/patient relationship, and that they are no longer able to negotiate with one another over fees. I have the utmost respect for these individuals and their ethical views on the matter, but we are living in a changing world and apart from that the demand for services is so great that the demand greatly exceeds the supply. The result is that the practices of most medical practitioners are so overloaded that the patient is only too pleased to be able to obtain the services of a medical practitioner. However, the question arises whether a person who is in distress is really expected to want to negotiate on financial matters. But the matter has another implication as well, which is that it seems to be the idea that if a patient and a medical practitioner cannot reach an agreement on the fees, such a patient could then go to another medical practitioner. As a result of the shortage of medical practitioners anything of this nature is virtually impossible. But apart from that, is it now being considered desirable, to take the extreme view, that a patient should call for tenders from a medical practitioner before deciding to which medical practitioner he is able to go as a result of costs?

In view of the above I can in no way agree with the allegation which is being made. In my opinion this system ought in fact to further the relationship between medical practitioner and patient, because both now know under what conditions the service is being rendered, and because the question of quibbling over prices is being excluded from the relationship. I want to emphasize this once again, so that there can be no illusions about this. This Act is intended to control medical schemes, and since the medical profession renders services to patients, the medical practitioner is only a voluntary contracting party. I would be failing in my duty if I were to omit to state the alternative. As I see the matter the alternative to the present system is that sections 29 and 32 be deleted entirely and the profession consequently excluded entirely from the provisions of the Act. Under these circumstances another method would have to be devised in terms of which the tariffs at which benefits are paid to members will be calculated. But under those circumstances it would only be a question of measures dealing with the position of member and scheme, and the medical practitioner would be unable to make any claim whatsoever to direct and guarantee payment of accounts by schemes, even if a medical practitioner were to charge the tariffs on which the benefits of members of schemes are calculated, for schemes will not allow any discrimination among member, and no method will exist in terms of which it would be possible to ensure that this did not happen.

At present this section comprises the entire basis of the relationship between member, scheme and medical practitioner, and unfortunately I cannot agree to its being deleted. On the contrary. I am of the opinion that with a little understanding, with a little co-operation and with a little goodwill, there need be no insurmountable problems.

Clause 1 contains the definitions, and I should like to draw your attention to the definition of “schedule of relative unit value”. In this schedule the various services rendered by an occupation or profession, are set out, as is at present being done in the tariff of fees, in respect of the medical profession where all the procedures and methods are set out by the various disciplines. A value, calculated as a percentage and expressed in points, is allocated to each individual item so that the values of the various items are reflected in relation to one another. In this way points are allocated, for example, to the unit value of an appendectomy, a tonsillectomy or an ordinary consultation, to be able in this way to compare them. This definition is of particular importance in relation to the contemplated amendments to section 30.

Clause 2 effects a change in—

1. (a) the constitution of the Central Council for Medical Schemes; and
2. (b) the requirements for appointment to which members of the council shall comply.

As regards the latter, the Act requires that the chairman, in the opinion of the Minister, shall have knowledge or experience of medical schemes. We were in the fortunate position that the present chairman has since 1960 been intimately concerned with medical schemes. Consequently there were no problems in this regard. From the nature of the case, however, the present chairman cannot remain chairman ad infinitum, and since this requirement might cause problems in the consideration of a person suitable for appointment, it is being deleted.

Medical schemes make provision for benefits to members in respect of supplementary health service professions. Consequently persons with knowledge of these professions should be appointed to the council. However, it would be possible to nominate a person who has knowledge of all these professions— there may soon be 28 —to the council from among the members of the professions. Under the circumstances it has been decided to adopt the same method as was adopted in regard to the S.A. Medical and Dental Council and to nominate an additional medical practitioner with a view to this medical practitioner, who is very intimately associated with the professions, bringing the required knowledge to the council. The council also exercises control over financial institutions. Consequently it is essential that there ought to be at least one person on the council with a knowledge of financial and business techniques. For the same reason at least one member of the council ought to have a knowledge of private hospitals and unattached operating-theatre units.

As a result of the abovementioned amendments, it will be necessary to increase the number of members of the council from seven to nine.

In clause 3 additional provision is being made to enable the Minister to remove a member of the council from his office if he deems this to be in the public interest. The present provisions do not provide for all eventualities in this regard and situations could arise in regard to which it would be essential that action be taken.

At present the Act provides for the payment of remuneration only to the chairman and vice-chairman of the council. The opinion is held that in the present circumstances a person cannot be expected to sacrifice his time to the activities of the council free of charge, and consequently clause 4 provides for a member or a member of a committee who does not receive remuneration from an employer to be remunerated for his services.

Clause 5 provides for the establishment of a committee to make recommendations to the council on the interpretation of the tariff of fees, the addition of new items to the tariff of fees and the adjustment of anomalies appearing in the tariff of fees. These matters are primarily of a professional nature. In terms of the present Act the council is empowered to interpret the tariff of fees, but it is not empowered to add new items to the tariff of fees during the period between Remuneration Commissions. The medical and dental professions expressed serious criticism of the fact that no mechanism exists in terms of which consultation of the professions in the matters concerned is compulsory. In all fairness I have to inform you that I was told that the council intended appointing a committee of this nature. Councils change, however, and there is no assurance that such a committee will continue to exist in terms of the present provisions. These provisions have been inserted in order to promote sound relations among the interested parties and to ensure that the professions are consulted on those matters which affect them intimately. The committee will consist of a chairman who is a member of the council, two representatives nominated by the suppliers of services, of whom one will be a full-time member and one will vary according to the discipline within the profession concerned, and two representatives who will be nominated by the Representative Association of Medical Schemes, of whom one shall be a person practising the profession concerned. In this way representation of the interested parties will be equal, but persons having knowledge of the discipline concerned will be in the majority so that it is being ensured that decisions on professional matters will not be taken by outsiders. In this way suppliers will consequently be very closely involved in decisions in respect of matters which affect them intimately. The final decision rests with the council.

As a result of the proposed abolition of the Appeal Board, the allocation of disciplinary powers to the council and the attendant change in the status of the council, and as a result of the powers which the proposed amendments confer upon the registrar, it has become necessary to revise the position of the registrar vis-à-vis the council. In view of the amendments the registrar will in fact occupy an executive position, and consequently this amendment is being-proposed in clause 6. To ensure continuity in the performance of the functions of the registrar, further provision is being made for the appointment of an assistant registrar.

In clause 7 the registrar, for obvious reasons, is being empowered to prevent confusion arising in regard to the names of schemes, or to prevent the registration of a scheme which cannot be financially viable.

Section 16 of the Act deals with provisional registration of schemes which existed at the commencement of this Act. All the schemes have already been registered, and consequently this provision is being adjusted in clause 8 so that it applies only to new schemes.

Section 17 or the Act requires medical schemes to be registered in terms of that Act, and also as a pension fund or friendly society in terms of the appropriate Act. Clause 9 provides for registration of schemes in terms of the Medical Schemes Act only, and the provisions have been taken over primarily from section 7 of the Friendly Societies Act, 1956. In terms of these provisions corporate status is being conferred upon a scheme, and measures pertaining to the assets, rights, liabilities and obligations of the scheme are being laid down, provision is being made for alterations at a deeds registry to any deeds in favour of a scheme shall be made free of charge, the maintenance of books of account and that the scheme shall have a registered office in the Republic is being required, and the serving of process is be-ins regulated. These provisions are essential to regulate the matters concerned pertaining to schemes.

The only new principle which is being inserted in section 18 by clause 10 is the proposed new section 18(2)(a) which empowers the registrar, if after investigation he is of the opinion that the registration of a scheme should be cancelled or suspended, to apply to the council for such cancellation or suspension. This is similar to the provisions of section 36(2)(b) of the Friendly Societies Act, except that in the latter case, where no council exists, the application has to be addressed to the court. As a result of maladministration it might be desirable or in the interests of members that the activities of the scheme be cancelled, and this could only be done if the registrar has been empowered to do so.

The provisions of clauses 11, 12, 14(d), 15 and 20 relate to formal directions which exist in the Friendly Societies Act 1956, and which are also applicable to medical schemes. With the abolition of dual registration the adoption of these provisions into the Medical Schemes Act is essential

Section 19A of the Act prescribes what a scheme shall do with contributions made by members. However, no directions exist in regard to the contributions by employers on behalf of members, and consequently this deficiency is being supplied in clause 13.

Section 20 of the Act provides for matters for which the rules of the scheme shall make provision, and clause 14 effects an amendment to these provisions. Clause 14(a) requires a medical scheme to make provision for maximum benefits as well. The object of this is—

1. (a) to bring the provision into line with the equirements which may be laid down by regulation; and
2. (b) if directions in respect of maximum benefits should be cancelled, to prevent this from degenerating into benefits in excess of 100%.

As regards the maximum benefits which may be prescribed by regulation I indicated at the time that the matter would be reconsidered after two years. The two year period expires on 30 June, after which this matter will receive attention.

Clause 14(b) merely clarifies the original intention that provision should be made for the continuation of membership in those cases where the member has no control over the termination of his employment.

As far as clause 14(c) is concerned, the council was of the opinion that this provision ought to be amended to deprive a scheme of the right to refuse to accept such persons as members. This is in fact what the present provision requires. But as a result of that the situation arises that employee groups may break away from the scheme and either establish a new scheme or join another scheme. The result would then be that such a scheme, from which the break-away occurred, could then be left with the pension, widow and orphan members. If this were to happen on a large scale it would be impossible for such a scheme to exist financially. Consequently the amendments in clause 14(c) and (e) are being proposed to provide for such a contingency.

Section 21(3) falls away as a result of the elimination of dual registration schemes. The provisions of clause 16 are, however, being inserted in its place to ensure that preference is not given to the application of rules of a scheme over the provisions of the Act and the regulations, in order to circumvent the latter in this way.

The requirements laid down in clause 17 exist in the Friendly Societies Act. As a result of the contemplated abolition of dual registration, it is essential that the provisions be included in the Medical Schemes Act.

At present there are four associations which represent medical schemes. From the nature of the case this is an obstructive factor in the general course of events, as I have already indicated. In clause 18 provision is being made for the establishment of one association of medical schemes. The basis of membership is approved by the associations. The associations which represent schemes, function in the interest of schemes in general, and incur tremendous costs to further the interests of schemes and members. However, there are a considerable number of schemes which are not members of associations and which silently reap the benefits and enjoy the advantages for which the associations exert themselves. I am of the opinion that it is unfair that the cost should be borne and the efforts made by some of the schemes only, while the others that are not members of associations, contribute nothing. Consequently it is being provided that every scheme is required to become a member of an association.

As a result of the abolition of the dual registration of schemes, clause 19 provides that the registrar may also exercise the powers in terms of the Inspection of Financial Institutions Act, 1962. In terms of the provisions of that Act inspectors may be appointed to inspect the financial affairs of schemes. It is not the intention to build up a separate inspectorate. Such inspectors have already been appointed under the Act concerned by the office of the Registrar of Friendly Societies, and since medical schemes form only a small part of their functions, they will continue to administer the provisions concerned. A further essential consequential amendment to implement this idea is included in clause 33.

Clause 22 amends section 29 of the Act, namely the so-called contracting in and contracting out provision. In the first place it is being provided that all persons registered in terms of the Medical Dental and Supplementary Health Service Professions Act, 1974, fall under these provisions. This step is necessary because it has come to our attention that supplementary health service practitioners are charging even higher fees than specialists in medicine for corresponding services. Provision is also being made now for the date of commencement of notices of contracting in or contracting out to be furnished on a quarterly instead of a monthly basis. This will to a large extent facilitate administration of schemes with regard to the payment of accounts. In paragraph 29(1)(c) it is being provided that, in the cases of a medical benefit scheme which has a closed panel of suppliers of services, a supplier outside such a panel who has contracted in may charge his own tariffs if an endorsement has been made on the membership card of the patient to the effect that such medical benefit scheme does not guarantee the payment of fees to such a supplier. This means that if a benefit scheme patient approaches a person who has contracted in and demands to be treated at the normal tariffs, this may be refused if his card does not contain the endorsement that his benefit scheme guarantees the fees. It is only fair that, if a scheme does not guarantee the payment of the fees of a supplier, it is not possible to claim tariffs which are determined for members of schemes.

In terms of the present provisions of section 30 of the Act, the Minister shall appoint a Remuneration Commission every three years. Such a commission shall investigate the tariff of fees in respect of medical practitioners and dentists. In clause 23 it is now being provided that the Minister—

1. (a) shall appoint a commission if an association representing suppliers of services and the representative Association of Medical Schemes jointly requested that a commission be appointed.

Then he shall—

1. (b) be able to appoint a commission if no agreement exists between the above-mentioned associations, and the affected association submits a request to the council which has to make a recommendation on the appointment of a commission to the Minister; and
2. (c) appoint a commission if a period of two years has elapsed after the last commission and an association were to request the appointment of a commission.

In terms of this provision the tariff of fees in respect of any profession or body rendering services for the care of patients may consequently be determined by a Remuneration Commission. A commission may also be appointed for a specific profession only.

As regards the constitution of the commission, it is being provided that the chairman may also be an advocate and that an additional member registered in terms of the Public Accountants’ and Auditors’ Act, 1951, be appointed. This is an additional member—a chartered accountant. Since more suppliers than only those from the medical and dental professions are now being involved, it will not be possible to find a judge to be chairman of each commission, and consequently provision must of necessity be made for some other person. The commission works with the income of practitioners and juristic persons, and consequently it is being considered desirable that someone having a knowledge of financial matters should also serve on the commission, and for that reason provision is being made for the appointment of an accountant or auditor as member. Apart from that, no change is being affected to the principles in accordance with which the commission is appointed.

In terms of subsection (3) the Minister is being empowered to specify by notice in the Gazette the supplier of services and the association which he regards as being representative of such suppliers. The new subsections (4) and (6) comprise only consequential amendments. The new subsection (7) requires the association representing the suppliers of services to submit a schedule of relative unit values to the commission in respect of the services rendered by such suppliers. In other words, the commission shall have no authority to weigh up the relative value of one service against another which is being rendered by the suppliers concerned. The commission will only attach a monetary value to a relative unit value, with the result that the calculation of the tariff of fees for all services by the supplier concerned is merely a simple arithmetical calculation.

On the recommendation of a previous Remuneration Commission provision is now being made in the new subsection (8) for the provisions of the Commissions Act, 1947, to be made applicable to the Remunerations Commissions as well.

The new subsection (9) contains only consequential amendments.

In the new subsection (10) provision is being made for the tariff of fees to be announced in the Gazette within three months after receipt of the report by the Minister. The change is necessary as a result of the fact that a commission is no longer appointed on a fixed date.

The new subsection (11) provides for members of the commission who are not in the service of the State, to be paid a remuneration for their services.

Until now the council has not had the power to determine fees for new items. The matter is now being regulated by the new subsection (12). What it will amount to in practice is that the supplier concerned has to take a decision on the relative unit value of such item and submit it to the committee established by clause 5. The committee shall then make a recommendation to the council as to whether the item should or should not be included in the tariff. If it is decided that the item should be included in the tariff, the monetary value determined by the Remuneration Commission is attached to the relative unit value of the item, and the council publishes the tariff in the Gazette in terms of the new subsection (13). In line 37 of the Afrikaans version, at the beginning of paragraph (a), a few words have accidentally been left out, viz. “die toepassing van”, and this mistake will be rectified when the legislation is reprinted.

In clause 24 it is being provided that the account of any person registered in terms of the Medical, Dental and Supplementary Health Service Professions Act, 1974, may be paid directly by a scheme. At present this applies only in respect of medical practitioners and dentists. In addition it is being provided that the second account instead of the third, may be sent directly to the scheme and that the scheme shall pay the account within 30 days. These amendments are being effected in the first place to bring them into line with the provisions of section 29 as amended by clause 22, and to expedite the payment of accounts with a view to giving greater satisfaction to the suppliers of services. The legislation also makes provision for the establishment of a statutory institution, viz. the Central Council for Medical Schemes. In no other health legislation is there a statutory institution, and apart from that a further statutory institution to whom appeal may be made if satisfaction cannot be obtained from the first. With the Appeal Board the status of the central council is being impaired, and the central council feels tremendously aggrieved at its decisions being subject to confirmation by another institution. Consequently the Appeal Board is being abolished by means of clause 25, and clause 26 contains consequential amendments only.

In clause 27 provision is being made for the promulgation of rules by the council after consideration of a recommendation of the Representative Association of Medical Schemes and with the approval of the Minister of acts or omissions in respect of which the council may take disciplinary steps. In this regard these provisions are similar to those contained in the Medical, Dental and Supplementary Health Service Professions Act, 1974. In terms of these provisions the creation of an ethical and administrative code for medical schemes is being envisaged. Such a code will assist in promoting the relationship between member and scheme and between member and supplier, and in eliminating problems and points of friction. From the nature of the case the envisaged rules will serve no purpose unless penalties are prescribed for contraventions of such rules, and consequently provision is being made for disciplinary powers.

In clause 28 the penal provisions are being revised. In the new section 40(2) it is being clearly stated that the provisions of the Act are not intended to control any person registered in terms of the Medical, Dental and Supplementary Health Service Professions Act, 1974 to practise a profession. The remainder of the provisions have been adopted from the Friendly Societies Act, 1956, and provide primarily for the automatic commencement of penalties for schemes if technical contraventions should occur. The object here is to limit legal process and to defray costs.

Section 41 makes provision for the making of regulations by the council with the approval of the Minister. Similar to legislation passed last year, this provision is being amended by clause 29 so that the Minister may make regulations on the recommendation of the council, and in cases of urgent public interest after consultation with the executive committee of the council. I am of the opinion that this is a power which should be conferred upon the Minister since the council in this case is the executive authority, and the Minister is not involved in that. Furthermore, additional provision is being made for the making of regulations pertaining to the application of the funds for medical schemes and the investment of funds by a medical scheme as envisaged in the Act and in the Bill.

Regulations in terms of section 41(1)(c) deal with the basis on which membership fees are determined. At the time the Act was passed the Post Office staff, for example, also fell under the Public Service Act, 1957. Since then, however, the position has changed, and consequently provision has also to be made now for consultation with the Minister of Posts and Telecommunications on the making of such regulations.

Since the dual registration of schemes is being abolished the amendment of the Friendly Societies Act, 1956, as indicated in clauses 31 and 32, is necessary.

With this Bill a serious attempt is being made to eliminate points of friction and problems. This is a result of talks held by the department last year, firstly with every interested group separately, and subsequently with all of them jointly. Arising out of the talks a draft Bill was compiled which was published for comment, and in view of the comments which were received, adjustments were made.

From the nature of the case it is a question of its being impossible to satisfy everyone. However, I believe that the changes which are being effected are of a positive nature and will lead to greater satisfaction.

In regard to this entire matter I want to point out that points of friction and problems can only be solved by communication and negotiation. To be able to achieve this, the idea has been expressed that the interested party, i.e. the physicians who are the suppliers, even the hospitals, and on the other hand the medical schemes representing the public, should voluntarily form a permanent forum on which matters may periodically be discussed and solved. From such a forum joint proposals to amend and in this way constantly improve and adjust, the Act could also result. I want to associate myself strongly with this idea and make an appeal to those involved in the application of this Act to make every effort to improve relations and to co-operate, if necessary, to effect changes. Through communication and negotiation far more will be achieved than by means of threats and obduracy. The person most closely involved in the application of this Act is the patient, and although all the interested parties put the interests of the patient first, or ought to do so, we should guard against influencing the primary object in a paradoxical way through our own actions.

Mr. Speaker, I have listened carefully to what the hon. the Minister has said. I, together with my colleagues on this side of the House, had the privilege and the benefit of having discussions with members of the hon. the Minister’s department. As a result of those discussions and after hearing the hon. the Minister, we shall support the Second Reading of the Bill.

When the original Act dealing with medical schemes was introduced into the House in 1967, we who took part in the debate then, expected that amendments would have to be brought in from time to time. We knew that requests would come from the various parties who are associated with the provisions of the Act. It is, therefore, no surprise that this voluminous amending Bill has come before us today.

It is quite obvious to us that a great deal of dissatisfaction has occurred during the past few years as a result of the implementation of the Act. It is quite obvious also that the doctors and the other people who have been providing services to the various schemes have been dissatisfied in one way or another. However, I feel that the hon. the Minister has made a sincere attempt to iron out some of those difficulties and after the discussions which he has had with the Medical Association, the Dental Association, the medical schemes and the Medical Council I feel that we should at least give the amended legislation a fair chance.

The tariff of fees has been one of the big bones of contention. We find that it has been necessary to bring in an ethical code, not only for the doctors but for the medical schemes as well. We find that administration costs of the various schemes have to be watched very carefully and that the finances of various schemes must also be watched closely. We find that there are anomalies in the tariffs which have been prescribed previously. The doctors have complained about the tariffs which have been laid down and the anomalies which they reveal. However, with the introduction of the relative unit value as a basis for the new tariffs, I feel that there is a fair chance of the doctors and the schemes coming together and working in harmony. If this fails and doctors are not satisfied with the new provisions in the tariff, it will not only be a serious blow to the medical aid schemes, but also be a very, very serious blow to those people who contribute towards the medical aid schemes. I shall refer to that again in a moment.

I want to say to the members of my profession, amongst whom there has been a lot of dissatisfaction, that there have been a good many of them who have been willing to go along and carry out their work as doctors under the provisions of medical aid schemes. Many of them, however, have been unwilling to do this work, but what perturbs me is that those who have been unwilling to do the work under the medical aid schemes have been influencing those who wish to do the work through a medical aid scheme and trying to persuade them to contract out of the medical schemes, and not to work under the provisions of the Act. I am pleased to state that doctors are having second thoughs about this because on them alone depends the success of providing an insurance against illness. If they do not co-operate, we shall be faced with a very serious position indeed. The contributor cannot go on continually adding to his present contributions. There has to be a limit because it is not only this cost that the contributor has to face; there is also the general rising cost structure which he has to face. He has to face up to the inflation period which we are going through at the moment and the additional cost of living which is facing every household throughout the country. If he cannot pay more, he has to be satisfied with either getting less for his money or with not paying at all. If he does not pay at all, he becomes a burden on the State and has to seek help either from the provincial administration or from the State itself. For those who cannot pay full fees, the provinces are providing the hospitalization, the hospital treatment and so on. Their charges are far lower than those of other hospitals. There is really no comparison between their charges and those of private hospitals. The contributor will begin to ask himself whether it is possible for him not to contribute any longer to a medical scheme but rather go to hospitals as an out-patient. He will ask himself whether it may not be more economical for him to lose a day’s pay and attend hospital as an out-patient, or if his sickness is so serious that he has to be hospitalized, he will have to ask himself whether it may not be better for him to stop paying to a medical aid and go into hospital and lose his pay. Not everybody who is working today gets sick pay, but whatever the sick pay is, it cannot possibly keep the family going and provide the extra money which is needed for illness.

I say to my colleagues and to those people in the paramedical services that they must be patient. Let us give this Bill a fair trial; let us not wreck it. Nobody wants to see the doctors work for nothing. Doctors are entitled to fair remuneration. Here the doctors have come together with the hon. the Minister and his department and they have decided that they will go forward in a new spirit—I hope—and on a new basis of remuneration. I am going to be very disappointed if after a year or so we find that doctors are still demanding more and more for their services. It has been laid down now in this Bill that after the Remuneration Commission has sat and the tariffs have been fixed, we should wait two years before the next review. Well, let us do so. Time goes quickly. None of us who provide medical services are actually starving. There is a great shortage of doctors and consequently they can make a good living easily. I say that for the good of the country, they must help. However, I do not want to stop there.

If the man in the street, John Citizen, is paying his way by contributions and the doctors are paying their way through reduced fees, I think it is up to the State to put its hand in its pocket and help out as well. We have been asking for this for a long time and it is becoming more and more important as the years go by. I am sure that today the Government, the State, itself is finding it necessary to help those working for them by supplementing the contributions the worker is making at present to medical aids so that the cost can be borne fairly and evenly by all those who participate in such schemes. But what of those who do not participate in the schemes because they are not allowed to participate for one reason or another? What are we going to do about those people? It is for that reason, primarily, that I have asked here over the years that we should introduce a voluntary contributory medical aid scheme which will operate from one end of the country to the other and which all of us can join. It can be voluntary. If the rich man does not want to join up, well and good. I am not concerned about him if he does not want to do it. However, the bulk of us will want to join. What is more, an ever-increasing number of Black people are earning more and more and they will want to join this type of scheme as well. We must allow for all of us to be given at least an opportunity of contributing to some scheme whereby we can get some alleviation from the consistently increasing costs of being ill.

How long can we go on in this way? The treatment of some illnesses is becoming more and more specialized. It is becoming impossible for the man in the street and virtually impossible even for some of the medical aids to provide the money for some of the special services given to people today to keep them alive. There is no medical aid scheme that can offered to pay the costs of a heart transplant. It is out of the question altogether. However, that is only one extreme example, but for that one there are thousands and thousands of ordinary cases that cannot afford today to go to a doctor with simple illnesses because they just do not have the money. It is strange but that is a fact. These people fall outside the very poor class and certainly outside the very rich class. They happen to be that group of people who cannot for one reason or another join a medical aid scheme. What are we going to do for them? I appeal on their behalf to the State to take a good look at this now to see whether or not it cannot take a share in the running of a nation-wide medical aid scheme. That is worthwhile and our best form of insurance. It is the best insurance the Prime Minister could offer if he were interested in the health of his people, and I am sure he is. The schemes themselves with the present growth of the population, are growing very rapidly indeed. I suppose that putting the members and the beneficiaries of the members together, there must be three million people at the moment who are enjoying the benefit of medical aid schemes. I know that already we pay R22 million a month in contributions and if I remember rightly, in 1973 more than R165 million was collected by medical aid schemes. And there is a vast organization that is controlling and administering these schemes. As a matter of fact, a new profession has evolved out of these schemes. Administrators of medical aid schemes have come into being. If one considers that plus minus 14% of the total contributions collected is charged by the administrators to see that the schemes are working properly, one can imagine what terrific amount of money is taken out of the coffers of these medical aid schemes, out of the pockets of the contributors.

That is another reason why I want the Government to look at this matter carefully. A Voluntary Medical Aid Scheme is something that will have to come into being in this country. We cannot avoid it. We have the additional problem here of not having enough doctors at the moment in South Africa to look after everybody’s wants and we have the additional problem of the doctors concentrating themselves in the cities and towns. The platteland is being denuded. I do not know what is going to happen in future. If we do have voluntary medical aid schemes, and the contributions made to the doctors for their services are such that one pays more to those who are doing the unpleasant and difficult work, then to some extent I think we do have a chance of halting the concentration in large towns and cities. We all know what is happening today. I do not have to tell hon. members that one cannot get a specialist to attend to one’s child in the country districts. In addition to the cost of seeing the specialist, there is still the cost of travel and the cost of staying in the town that one visits so that the child can see the specialist. There may be a delay of a few days and then the examination itself may also take some days. Imagine what all these costs amount to. People simply cannot stand the strain any longer. How they have been doing so up till now, I simply do not know. We all know how much a prescription costs, even with only one or two items on that prescription. The new drugs are expensive and they are going up in price. Money is losing its value. We want something done about this matter and we ask for it sincerely. Perhaps during the Health Vote we may have another opportunity of dealing with what I have just said. However, let me say one thing to the Minister and to the Prime Minister as well while he is in the House, and that is that if we want a really healthy country, if we want to see the health services properly carried out, if we want to see preventative medicine taking its proper place in the country, if we want to see curative services playing their part helping people who are ill, if we want proper health education, if we want family planning to be carried out as we wish it to be carried out, if we want research to take place, if we want rehabilitation centres to be erected, if we want physical training in the schools, if we want to keep a careful watch over the children in the schools, if we want all the programmes that we have envisaged over the years to be carried out properly, then there is only one way to do it and it is not the way we are doing it now. As I see it, it is necessary for a partnership to be brought into being between the man in the street, the employer and the State. If they will combine and contribute together, if they can find the money, we will then at least have a chance of carrying out what we want to do.

Mr. Speaker, this amendment Bill before us amends the Medical Schemes Act, which was the outcome of a commission of inquiry appointed by the Government to investigate the high cost of medicine. This commission was under the leadership of the present chairman of the Medical and Dental Council, Prof. Snyman. This Act was given rather a cool reception by the medical practitioners. I ask myself why this was so. Before this Act came into effect, medical practitioners of their own accord followed a policy known among themselves as the so-called Robin Hood policy—one charged a rich man more and treated a poor man free of charge. In general this worked well. However, it became clear from the investigation that there was a large section of the population that was suffering under the pressure of medical costs. The Government then decided—in my opinion wisely—to introduce the Medical Schemes Act. In the course of time certain problems cropped up in regard to the Act. There was dissatisfaction on the part of the medical practitioners, who form the majority of the suppliers. On the one hand one had the consumers, the patients, and on the other hand one had the suppliers, of whom the medical practitioners formed the majority. This Act regulated the mutual relationships, including the financial relationships, between the medical practitioner on the one hand and the patient on the other. Since prior to this, the medical practitioners had arranged these matters themselves, they regarded this as an invasion of their freedom. A feeling arose among the medical practitioners that the Act was controlling their practices, although this was entirely untrue. I think that the hon. the Minister has dealt with that aspect in detail. I think that my colleagues in general must realize that, however much of a pity we may consider it, we must accept that except, perhaps, on the platteland, which is inhabited by the least number of people, that intimate doctor/personal friend relationship is something of the past and, to my regret, is something that is gone forever in the cities. That is simply the way it is and we have to accept it. Therefore it is no longer possible for a doctor and a patient to come to a mutual agreement as to the fees to be paid. Under the old, intimate doctor/patient relationship, every doctor knew Oom Jan and Oom Piet and Tant Hessie and knew exactly what the financial position of each was, and charged accordingly. Those times are past, and now there is no alternative but for us to make the financial arrangements between patient and medical practitioner. It is for this reason that the original Medical Schemes Act established a council to organize medical schemes. I think that that council should be congratulated on the degree of success it has achieved, which has resulted in over 70% of the White population belonging to medical schemes today. This is an outstanding achievement and if one takes into account that in any event, a large number of patients receive free treatment in the hospitals and by district surgeons, a very high percentage of the White population is already being served by this Medical Schemes Act.

However, certain problems have cropped up, too. This Bill amending the Medical Schemes Act is now attempting to eliminate those shortcomings. Firstly, the doctors complained—although this was done at their own request in the first place—that the compensation committee was only appointed every three years. They said that the costs rose so high and so quickly owing to inflation that three years was too long. Unfortunately, a former compensation commission had seen fit to effect only very few and very minor changes to the tariffs. As a result the period that had to run before there could be another adjustment to the tariffs was really a little long. For this reason the hon. the Minister saw fit to insert clause 23, which amends section 30(1) of the Act inasmuch as it concerns the compensation commission, in the amendment Bill. Provision is now being made for shorter periods between the appointment of such commissions. Provision is made for a period of two years for those who request it, or immediately, if both the Representative Association of Medical Schemes as well as the Medical Association or any of the other suppliers of medical services should request it. If the council should ask for this and the Minister should agree, then this can also be done. That problem, therefore, has been eliminated, because now these fees can be attended to sooner. In this way a greater degree of satisfaction is guaranteed. Then, too, an unusual change has been made in the sense that the supplier—and again the biggest supplier is the medical profession —determine, through the Medical Association, a relative statement of unit value. This means that only a unit value—in other words, only a number—is allocated to the various activities of a medical practitioner—the private call, an appendix operation, a brain operation or whatever the case may be. The relationship between one item and another, viz. how they are to compare with each other will now, therefore, be determined by the supplier himself—those suppliers include dentists, suppliers of paramedical services and private hospitals, which are now also being brought into the picture by the Act. Each can lay down its own relative unit value. In my opinion, this arrangement should afford a great deal of satisfaction. Thus the only task that remains for the commission is to give that schedule of relative unit value, a money value. The moment the Compensation Commission has awarded that value, one has a whole table of fees which, in my opinion, should satisfy everyone. The professional people who provide the services will then have laid down their own tariffs and the compensation commission can then concern itself with keeping those tariffs within bounds.

As against the suppliers, there are the schemes, which, in the nature of their operation, have a bilateral function. In the first instance, they provide insurances whereby a patient, or future patient, ensures himself against possible future illness. Formerly that function was, to a large extent, covered by the Medical Schemes Act. They also have a second vital function, and that is the collection of savings funds. If one bears in mind that—as the hon. member for Rosettenville has already stated —these various medical schemes collect and handle a total of about R260 million annually, one realizes that here is an exceptionally large savings institution.

A second aspect of the changes incorporated in this amendment Bill is the fact that this legislation now registers the medical schemes as financial institutions as well, viz. not only as people supplying certain services, but also as financial institutions. This double registration, which was originally effected under the legislation concerning financial institutions and under the legislation concerning medical schemes, is now being brought under the legislation concerning medical schemes. In other words, the Department of Health is taking a formidable task upon itself. I am pleased to hear that the hon. the Minister has announced that he will continue to call in the assistance of the Registrar of Financial Institutions to exercise that control, because that control is extremely important. I think that it is important for patients to know that the funds they invest in the form of assurance for the future is not being eroded through excessive administration fees. If an administration levy is in the region of 15%, I think I have the right to say that that is excessive. When one begins to consider the extent of these funds capacity for savings—as I have already said, it is in the region of R260 million per annum—then I want to tell you that the administration fees can in fact mount up very high. I am therefore of the opinion that we should take a very, very careful look at those administration costs.

Business suspended at 6.30 p.m. and resumed at 8.20 p.m.

Evening Sitting

Sir, when business was suspended, I was referring to the importance of the savings mechanism of the medical schemes in South Africa, which spend an amount of R260 million annually, and to the importance of exercising proper control over this aspect. In clause 27 of this amendment Bill, which amends section 39A of the principal Act, the possibility is created that the representative association of medical schemes may lay down their own ethical code. I think it is an exceptional achievement that this stage should now have been reached at which this representative association of medical schemes which will include all the medical schemes and to which everyone will be obliged to belong may now have its own ethical code. This ethical code will be submitted to the Minister and if the Minister accepts it it will be published in the Government Gazette and this will then confer statutory powers on the representative associations. Certain punishments may then be imposed if this ethical code is infringed. In the first instance a medical scheme which infringes this code may be warned or reprimanded or both warned and reprimanded. Its registration will be temporarily suspended or may even be withdrawn. Sir, this is all very well, but my problem is that if the registration of a medical scheme is suspended or withdrawn, the people who will suffer will be the members of the medical scheme. It seems to me as if the people who ought really to be called to account are the administrators of these schemes. I am not convinced that the hon. the Minister is taking sufficient powers in terms of this Bill to call the administrators of those schemes to account effectively. It seems to me that the aim should be to confer powers on the Association to acquire information concerning the profit levels of the administrators of certain medical schemes and to be able to combat excessive profits. The primary motive here is the protection of the members’ funds which, as far as this is reconcilable with good administration, must be available to meet claims. It should be noted, however, that before a maximum administration fee can be determined, the real cost of providing administration should be determined. In order to do this, there are a few preconditions that must be complied with. It seems to me that standard accounting procedures, to be made compulsory for all schemes, should be developed in order that comparisons between various schemes may be drawn. Secondly, it seems to me that the return which at present has to be submitted to the Registrar of Mutual Aid Societies, and which will in future have to be submitted to the Medical Schemes Council, should be revised to fit in with the standard accounting methods, and so as to determine a comparable figure for medical schemes. It is of the utmost importance that in determining these norms, the standard of the service provided to members of these schemes should be taken into account. As soon as these norms are laid down, the methods and the level of administration costs may be agreed upon in consultation with the Association of Medical Schemes and then laid down by regulation. It seems to me that as soon as these norms are determined, it will be necessary to confer this power on the Minister because it seems to me that the ethical code does not afford him sufficient powers. It would appear that as soon as the hon. the Minister has this power and these norms are determined, the medical schemes should subsequently be allowed to carry on business in the normal way within those norms and to see what profits they can make in that way. But I repeat that if it should be found that the administration costs of a medical scheme are about 15%, then that is too much. I think that a very careful check should be kept on that. If there is a check on that and the co-operation of the Association of Medical Schemes is obtained, then I think it would behave my colleagues, the medical practitioners, to offer their co-operation as well. I am grateful to be able to say this evening that the vast majority of the medical practitioners, as represented by the Federal Council of the Medical Association have displayed such a high degree of responsibility, in spite of the opposition of the chairman of the Federal Council of the Medical Association—who even went so far as to submit his resignation— that while this new amendment Bill was under discussion, these people, the federal council, decided not to continue encouraging the medical practitioners to contract out. Sir, while I am referring to “contracting out” and “contracting in”, I want to say that to me, these are two extremely ugly phrases. It seems to me that one contracts or one does not contract, but how one “contracts out” I have never been able to understand. I trust that at some stage we shall find two other phrases to replace “contracting out” and “contracting in”.

I want to appeal to my colleagues, as the hon. member for Rosettenville also did, to afford this amendment Bill the opportunity to show that it works, and I am convinced that it can work. The Minister and his department have already intimated that in spite of any shortcomings that may still exist, they will be prepared to go out of their way to make the legislation work and, if necessary, to effect still further amendments at a later occasion. But I remain convinced that this amendment Bill deals with the majority of the problems and objections raised by everyone who falls under the Bill at present, including the medical schemes. I trust that we are now creating a workable Act and I appeal to my colleagues to give it a chance and throw their full weight behind it.

Mr. Speaker, the hon. member for Fauresmith as an experienced medical man has shown the House that he has an intimate knowledge not only of medical aid schemes but of the Act and this Bill itself. He has referred to certain aspects concerning the Bill. However, I must say that I found his speech this evening very disappointing. I had hoped, nay, I would go further. I had expected that he would support my hon. colleague from Rosettenville when he urged that the time had now come, was in fact overdue, for the State to take more than a passing interest in giving financial assistance to the medical schemes. I am sorry that the hon. member for Fauresmith did not see his way clear to support this plea.

The hon. the Minister, in his very carefully prepared and expressed Second Reading speech, indicated most of the factors which apply in respect of the amending legislation. I just want to say that since the original Act was passed in 1967 this is the fourth amending piece of legislation which the House has had to consider. I want to draw attention to a passage in the 1972 report of the Department of Health, which stated inter alia: “As it was felt that the Medical Schemes Act had now been framed in its final form …” That was in 1972 and yet three years later, during this very session of the House, we find that we have to consider an amending Bill comprising 34 clauses. I believe it is appropriate for me, as previous speakers have done, to examine some of the possible reasons why it has been necessary to amend the Act at fairly regular intervals.

I think, to be specific, I must refer first of all to the suppliers of services who in the main consist of the medical practioners and the dental surgeons. According to the report of the Department of Health, a breakdown of the services rendered to 15 large medical aid schemes in 1971 indicated that medical practitioners’ fees were responsible for approximately 46% of the total expenditure and that dental surgeons received 15%. In fact, a total of 60% of the funds was paid to these two services. Then there is the question of the complaints. I believe that complaints deal mostly with the question of tariffs. In so far as this is concerned I believe that the department has done its best to amend the tariffs because there have been no less than four remuneration tariffs during the course of the implementation of the Act since 1967. The complaints revolve mainly around the rendering of services and the payment of accounts and although the records show that in 1971 there were approximately 2 500 complaints this, in effect, is a small consideration when one considers that the complaints represented 0,1% of the total funds dealt with at that time.

One of the major considerations has been the question of contracting out to which the hon. member for Fauresmith referred. Here it is interesting to consider the trend. It is a trend which I think has certain disturbing factors. By 1969 approximately 650 medical practitioners had contracted out, but this number had grown to 4 100 by the end of 1969. At the end of 1969 almost 90 dentists had also contracted out. However, four years later, at the end of 1973, because a fair number had again contracted in, the number of medical men who had contracted out stood at 1 100 and the number of dentists who had contracted out had grown to over 400. The reason why the dentists had contracted out to such a major extent was that they claimed that the increased price of gold had added to their overhead expenses in the rendering of services. What I believe is important to note is that significant numbers of the medical profession had contracted out of supplying services to contributors to medical aid schemes who numbered approximately 2 million together with their dependants at the time. So it means that a large proportion of the members of the medical aid schemes were required to pay more than the normal levy to supplement the accounts which were rendered by the professional men who had opted out because an appreciable number of these suppliers were not satisfied with the remuneration which they were getting for their efforts and their work.

Their blocks of flats were not growing fast enough.

Oh., is that what it was. The end result of it was that the members of the medical aid schemes themselves suffered. I go along with the hon. the Minister’s predecessor who is on record as having said as far back as 1972:

I believe that the members of medical aid schemes and their dependants find themselves in a difficult position when we see that it has been established from recent figures that 12% of the doctors and approximately 30% of the dentists have indicated that their charges will be in excess of the charges accepted by the medical aid schemes. I believe that the effect of this will be that the members of the schemes— especially the middle-income groups whose incomes are not keeping pace with the inflation of today—will be reluctant to make use of these services because they know that it will eventually be required of them to foot the additional account for services rendered by doctors and dentists who have contracted out. I believe that this will result in greater harm being done to health from both a medical and dental point of view and that ultimately it will be to the detriment of and lead to higher costs in respect of the medical schemes and the members of the schemes themselves. I believe too that the Medical Schemes Act can only function efficiently if suppliers are satisfied with their remuneration and if members of medical schemes receive adequate service at reasonable rates and in accordance with their needs. I believe that this Bill has been drafted with the intention of achieving this very purpose. I do not believe, however, that we have any guarantee that this position will be brought about by the legislation which, is before us although I accept that it is a sincere attempt to achieve that position. I also accept and appreciate the right of professional men, the suppliers of services, mainly the medical practitioners and the dentists, to expect and to receive adequate fees subject to prompt adjustment and subject to prompt payment. Here again I believe this amending Bill will overcome some of the administrative difficulties which have occurred in the past in so far as payment is concerned. I believe that the negotiations will have to be continued and that they will have to be conducted in a spirit of reasonableness.

I want to refer to the correspondence which appeared in the S.A. Medical Journal in March this year. The hon. the Minister has referred to it and the hon. member for Fauresmith has also indicated that he is aware of it. It deals with, the question of medical practitioners contracting out. On the one hand we have many doctors who resent the possible control of the medical profession by the medical schemes or interference by the medical schemes in the practice of medical men themselves. On the other hand we have the members who have a right to claim a satisfactory service at reasonable tariffs.

I want to associate myself with the remarks of my hon. colleague, the member for Rosettenville, in paying tribute to the efforts of the hon. the Minister and the Secretary and senior officials of his department who have been responsible for negotiations and the drafting of this legislation. I believe they have exercised their responsibility with patience and understanding and that they have been faced with many difficulties in maintaining an amiable equilibrium between the suppliers of services, the medical schemes themselves and the members of the medical schemes. The State is seeking to maintain stability, but unfortunately and regrettably remains uninvolved and detached when it comes to the question of finance.

I want to refer to the commission of enquiry which investigated the original Medical Schemes Bill. In the commission’s report, a unanimous report, it is indicated on page 33 that it was considered desirable that the minimum State assistance should be in respect of the administrative costs of the scheme based on the figure for the previous year. The commission went further and in clause 11(1) of the draft bill submitted to the Minister—on page 52 of the report—it is stated: “There is hereby established a fund to be known as the Medical Schemes Fund into which shall be paid … out of moneys appropriated by Parliament an amount each financial year of not less than the administrative expenses of the council for the previous financial year.” To me it is a cause of extreme regret that, when the Bill was placed before Parliament and debated in this Chamber, this particular clause was not embodied in it. I believe that this clause 11(1) of the draft Bill still provides a means whereby the State if it wished to, could assist the medical schemes and the members of the medical schemes by making some financial grant, concession or subsidy. As far as I can establish, the only amount which appears in the present Estimates in regard to expenditure on medical schemes is an amount of R4 000 which is allocated in the Estimates to the payment of the chairman of the Central Council for medical schemes. We accept that in other respects the State subsidizes medical aid for its own employees. It does so, by virtue of being the employer, in so far as the Civil Service Medical Aid Fund is concerned, but I am unaware of any contributions by the State even to cover the administrative costs of the medical schemes as they apply today. We have to bear in mind that according to the latest figures the administrative expenses of the medical schemes during the last year for which figures are available, amounted to no less than R11 500 000. This represented 11% of the total income of the medical schemes or 12½% of the actual membership fees paid by the members themselves. If one compares this with the State subsidy which for years has been given to the South African Railways and Harbours Sick Fund, which this year exceeded R10 800 000 and represented more than half of the total amount received and used for operating that sick fund, one realizes the difference in approach. In so far as the South African Railways and Harbours Sick Fund is concerned, this has been going on since the inauguration of the Act sixty years ago. I estimate that an amount of R70 million has been paid by the Railways Administration in subsidies to the South African Railways and Harbours Sick Fund. I ask the hon. the Minister very earnestly to reconsider the health needs of our citizens, particularly those in the middle income group to whom my hon. colleague the member for Rosettenville has referred. I want to emphasize that we are not suggesting a Welfare State or a free scheme. We are suggesting that there should be a State-aided medical scheme to assist the various members who need its benefits. I believe that a sympathetic and realistic approach to this matter by the State would make the task of the Department of Health so much easier because they could overcome many of the differences and difficulties which they have which arise between the suppliers of services, the medical schemes themselves and the members of the medical schemes. I believe that the members of these schemes are themselves confronted with a depressing alternative. They must be prepared either to pay higher subscriptions or face a diminution in the benefits of the schemes. If the State wishes to make a good investment in health, if the State wishes to place greater emphasis on preventive medicine, the State must give serious consideration to a State-aided medical aid scheme. I draw the hon. the Minister’s attention to section 11(2) of the existing Act where it is stated:

I believe it is this small clause which would enable the State, if it so wished, to assist the present difficult position in which the members of the schemes find themselves. I want to remind the hon. the Minister that his colleague, the Minister of Social Welfare and Pensions, has already indicated that he is carrying out an investigation into the practicability, desirability or advisability of instituting a national contributory pension scheme. This could also apply to medical aid schemes. The State is already subsidizing the poor, the indigent and the aged. In sickness and in health they have the facilities provided by the State. The State has already also accepted the question of subsidies for the foodstuffs which everybody in the country needs. There is a subsidy on bread, butter, cheese and maize, and subsidies on these foodstuffs alone amount to more than R100 million per annum. There are subsidies through the Department of Water Affairs in respect of drilling boreholes for farmers, and there are subsidies i.r.o. housing loans, industrial research institutes, the shipbuilding industry, sheltered employment services and border industries. For all these the State accepts the principle of a subsidy. Why then cannot the State help to finance the middle income group citizens of South Africa in sickness and in health?

I want to deal with clause 23 of the Bill itself. Reference has been made by previous speakers to the appointment of a Remuneration Commission, and I believe that in this clause there has been a fundamental change. I believe too that there has been a great improvement. The position now is that the Minister shall appoint a commission under certain prescribed conditions. Previously the commission was appointed every three years. Now, as I understand the proposed new section 30(3), when the tariff of fees is to be determined for the first time, the Minister may appoint nominees of an association representative of a particular profession to the commission, a profession which will become a contributor to or become associated with the scheme for the first time.

As I understand the position, other professions rendering services may be included now under the umbrella of medical schemes. I believe this could also apply to pharmacy because the term “pharmacist” is defined in the Act and the supply of medicines is referred to in the definition of a medical scheme. I am aware that when the Act was passed in 1967, difficulties were encountered. The reason given at that stage why it was not possible to include pharmacists in the list of suppliers was that while the pharmacist rendered a professional service, he also supplied various manufactured medicines over the price of which he had no control. I should like to suggest to the hon. the Minister that a not quite completely similar position exists as far as dentists are concerned. Dentists render a professional service but they also supply materials over the price of which they have no control. In this regard I want to cite the instance of gold fillings. I believe that if a formula can be worked out in respect of dentists it will be possible to find a via media by means of which the pharmacists also co-operate. I want to ask the hon. the Minister if he will indicate in his reply whether he regards it as desirable and practicable to include pharmacists. I do this because in the report of the Department of Health for 1971 there is a breakdown of the 15 largest schemes which rendered services. In this regard it was revealed that more than 18% was paid out in respect of medicines. Next to payments made to medical practitioners and dentists, therefore, the payment in respect of medicines would appear to be third highest in regard to the commitments met by medical schemes. I say as my personal opinion—I want to emphasize that it is my personal opinion— that I believe it is in the public interest for the pharmacists to be recognized. I believe too that it would be in the interests of the pharmacist to entrench him as a highly qualified professional man. I also believe that is desirable for pharmaceutical services to be recognized within the ambit of the Medical Schemes Act.

In referring to clause 23 of this Bill, I also want to refer to the provisions in the Bill whereby those organizations and services which have not been recognized in the past may now nominate appointees of the hon. the Minister although a period of only three weeks is allowed for them to do so. I realize that the period of three weeks was laid down in the original provision and that it applied then to the established contractors, viz. the medical practitioners and the dentists. However, I submit that if it is intended to bring in other services that are combined under the Medical, Dental and Supplementary Health Services Act then the period allowed them in the first instance to consult with their members and nominate a panel of five suitable individuals could be one with which they might find it a little difficult to comply. I want to ask the hon. the Minister whether he will not consider an extension of that particular period.

I also want to refer to the latest report of the department in which it is indicated that medical schemes for non-Whites in the Public Service are under review. I know that many of us here will welcome the extension of the schemes to non-Whites. I know that they exist at present. I also know that there are some 430 000 non-Whites participating in the medical schemes system. Although the amendments will make for smoother operation of the extended services, the report discloses in its memo to the Cabinet one aspect which I believe should be given very careful consideration. The recommendation in terms of the Report is that separate schemes should be introduced for Coloureds, Indians and Bantu employed in the public sector. The report states that it is not considered advisable to include a large number of non-Whites in a scheme for Whites because the non-Whites make less use of the services and there could be an imbalance under those circumstances. I have it from a very authentic source that, in so far as the schemes under the Industrial Conciliation Act—the medical benefit schemes—in which the non-Whites participate, are concerned, this trouble has not been experienced. In fact, in the schemes where all races are represented, less trouble comes from the non-White section of the schemes than from any other section. I believe that it is in the interests of the elimination of petty apartheid that this factor should be gone into very closely. In these days of sophisticated computerization, one should be able to think in terms of one scheme for all races.

In the amending Bill I see no specific provisions which will ensure that there will be a means of assistance in cases where benefits have of necessity been exceeded or where citizens are unable to belong to any of the existing medical aid schemes. They are not acceptable for certain reasons. Because of their financial position they may be entitled to make use of the hospital services, but I believe that very inadequate facilities exist for these citizens who may be taken ill in their own homes. In the large cities it is, I believe, impossible to claim that, under those circumstances, the district surgeons will be able to carry out their responsibilities in terms of the requirements of these particular people. It just does not happen. Where a person is confined to bed in his own home, it would mean that it might be necessary to use the ambulance service to convey the person to hospital to occupy a hospital bed which could have been occupied by somebody much more urgently in need of it. I would like to ask the hon. the Minister whether he is in a position to indicate that this particular aspect is receiving the attention of his department and that, in any future arrangements which are made under the Act, as amended, provision will be made to deal with this particular type of patient. I reiterate the opinion expressed by my colleague from Rosettenville, namely that we on this side of the House support the amending Bill.

Mr. Speaker, in an earlier debate you referred to the longest Second Reading debate ever conducted in this House. I think it was in 1914. I do not know whether we have a record here, but I should like to refer you to the long title of this amendment Bill which undoubtedly comes close to being a record. I tried to read it in one breath, but it was too difficult. One thing is very clear from this long title, viz. that we must thank the hon. the Minister and his department for their careful work, even though it has taken three years for them to come up with something that satisfies the public, the medical profession and the persons who are concerned with the financial aspect. This amendment Bill is based entirely on payment or the compensation for services rendered.

The hon. member for Rosettenville and the hon. member for Berea once again came along with the vehement and repeated call we have been hearing for years, viz. that the State should contribute towards a medical scheme for all. However, they have not yet mentioned where the State is to find the money. If we were to investigate the reasons and causes for the friction—everyone is talking about this friction—in regard to this legislation that already exists, we should find that this is one of the most important factors viz., that the medical profession is afraid that State health services will be introduced in South Africa. Everyone knows what Britain’s experience has been in this regard. Whenever there is any kind of reference to the State stepping in, the impression is created that medical practitioners are unable to run their own affairs and that as a result, the State has to interfere. Anything of the sort would lead to friction. Because the State appointed a compensation commission on which a judge and two laymen served, they regarded it with suspicion and did not want to accept it. They state that no one but themselves should interfere in their personal affairs. It is one of the premises of this legislation that the medical profession itself is to do its own evaluations. The hon. the Minister explained this very clearly in his introductory speech.

One thing we must remember—this is the most important factor—the medical schemes that are now also being disciplined, deal with public trust moneys. The second area of friction developed in regard to this very matter, viz. that the public was dissatisfied with the way in which the trust moneys were being administered. The medical profession was also dissatisfied with the way in which those moneys were being administered. Hon. members now want the State to step in in this regard as well and if that were to occur, then I should like to hear what the medical profession would have to say about that.

We have discussed virtually all the facets of this legislation but I want to associate myself with the hon. member for Rosettenville in regard to one thing, viz. the urgent appeal he made to our colleagues in the medical profession to give this legislation a chance. We are pleased that the hon. the Minister has also given the undertaking that he, on his part, will do his best to ensure that the medical profession and the medical schemes, as well as the public, through their various representatives, will confer regularly in order to eliminate areas of friction.

One does not want to speak too harshly about one’s medical colleagues, but they, too, have a great deal to do with the fact that this legislation has left a bad taste in the mouths of the public. As every one knows, a referendum was held. There was talk of “contracting out” and “contracting in”—I agree with the hon. member for Fauresmith that these are ugly words and that we should seek better ones—but basically, one thing must be remembered and that is that when one concludes a contract with someone, one has to honour that contract. When one is no longer covered by the contract—and this I want to tell the medical profession—then one must refrain from criticizing that contract, because if one is not in it, one is out of it. Unfortunately it is a fact that there have been various organizations in the medical profession which, although they had already contracted out, expressed opinions regretting the fact that there were still people who had not contracted out. The hon. member for Rosettenville quite rightly states that the people who were no longer covered by it, influenced those who were.

The compensation commission has been clearly explained by the hon. the Minister and other speakers, but while we are talking about medical ethic and control of their own values by the medical profession, the second facet is that medical schemes are now being disciplined too. This entire legislation has two legs, viz. the profession on the one hand, and the medical schemes on the other. The other important facet is that the medical schemes can now be pressurized to put their own house in order, because they are still handling public trust money.

There are a number of other minor aspects that may be discussed in the Committee Stage. The hon. member for Berea touched on a few other aspects such as hospitalization. It would be as well if the Minister, in his reply to the debate, were to give us an indication as to whether he envisages placing services rendered by private hospital institutions under the wing of this legislation as well. Sir, I want to let that suffice because there are other speakers who want to discuss certain other aspects of this Bill.

Mr. Speaker, it is, of course, a great temptation for me to engage in a political argument with the hon. member for Brentwood about where the State could find the money with which to help to subsidize a medical aid scheme. I could suggest several areas where the State could save many millions of rands which could be applied to medical aid schemes. But, Sir, I am going to resist the temptation, because this is an important Bill. It is an apolitical Bill, it is a Bill which affects directly and indirectly probably something like 80% of the White population in South Africa that belong to medical aid schemes and which will affect more and more Black people each year, as growing numbers of Black people are becoming members of medical aid schemes. It is a Bill, Sir, which affects thousands of doctors, and it is a Bill which affects—the most important thing of all—the general health of the population of South Africa, so I shall avoid the temptation of getting involved in a political argument with the hon. member for Brentwood.

Sir, I have listened to the various speakers in this debate. Three out of the four previous speakers have been medical men, and I must say that some of them have had some harsh things to say about their medical colleagues. I just wonder whether the medical members of Parliament have not forgotten how difficult it is for their colleagues in real life to earn a living. It is not quite as easy as the hon. member for Rosettenville, for instance, tries to make out for a doctor to make a good living. He has to work very hard indeed, and I happen to have rather close personal experience of the difficulties and the hard work that medical men have to put in, in order to earn a decent living.

Sir, we are discussing a medical aid scheme amendment Bill, and I want to say at the outset that I intend on behalf of my colleagues on these benches to support the Second Reading of this Bill. I think it is a genuine effort to try to improve a situation which has been steadily deteriorating over the years, a situation where there has been great dissatisfaction both on the part of patients belonging to medical aid schemes on the one hand and on the part of the doctors on the other hand. This has been evidenced by the fact that so many thousands of doctors, as other hon. members have mentioned, have contracted out of medical aid schemes. They have done so for various reasons, not just because they are greedy and because they want to earn more money as has been insinuated. Indeed, very often they do not earn more money by contracting out, because they find that owing to regulation 82(A), whereby the medical aid societies have got to pay the preferential tariff part of the fee directly to the patient concerned, there are many cases where the patients do not pass these fees on to the doctors, with the result that they find themselves suffering very heavy bad debts. As a result of this there is a general increase in fees in order to offset the bad debts. I want to take up the hon. the Minister’s point that it is very difficult to accommodate doctors who contract out; that it makes it very difficult to allow doctors to deal with patients who belong to the same medical aid societies on different bases by charging some preferential fees and others a higher fee. I realize the difficulties involved, but I just want to tell the hon. the Minister that there are ways of attracting more doctors to the medical aid schemes. Some of them are embodied in this Bill. Some of them, however, will only be seen to be effective depending on the way in which this Bill is administered. I want to spend one or two moments talking about this.

First of all, I want to say that I think one of the difficulties encountered by the medical profession is in connection with the attitude of many medical aid societies, the arrogant attitude which they adopt when dealing with doctors. Many doctors resent the way in which they are treated by the administrators of medical aid schemes. They are treated as if they are simply out to grab more money from the schemes. They are asked to account for every one of their actions, be it blood tests done or various operations. They are under scrutiny by junior medical assessors, very often, and this, I can assure the hon. the Minister, is much resented by senior specialists. I have one or two examples of the sort of communication which specialists have received from assessors employed by medical aid schemes. In one of these letters the doctor, who is a leading ear, nose and throat specialist, was asked to furnish information as to the etiology, etc., and the first date of the onset of symptoms of a condition which was one requiring surgery for a fractured nose. It was then asked what the ultimate diagnosis was and why it was necessary to perform this operation. That is the sort of absurd inquiry which is being made by some of these bureaucrats. Then there is another one which requests a senior physician to give the reason for the necessity for blood investigations carried out on a patient. Now, I can understand that the medical aid schemes have to cover themselves to some extent, but they do not appear to use very much discretion in the type of investigation that they conduct in so far as doctors are concerned. I hope very much indeed that firmer discipline is now going to be exercised by the council which has been set up by this Bill and which will frame what you might call an ethical code of conduct for medical aid schemes. This might then influence many of the doctors who have contracted out of medical aid schemes into returning to those schemes.

Then I also want to agree with those members of this House who have spoken about the high administrative costs of medical aid schemes of the inordinately high percentage which is taken by these societies, ranging between 12% and 15%. This is an enormous amount when one realizes how subscriptions have gone up. The medical aid society calmly appropriates for administrative expenses 12% to 15% of the enormous amount which they are collecting from the general public in subscriptions. My information is that the estimated cost of rentals, staff and overhead expenses generally is about 5%, and yet, as I say, some of these schemes are appropriating anything between 12% and 15% for administrative and secretarial expenses. I hope that part of the ethical code which should be framed under this Bill—I think it is clause 27—ought also to lay down a maximum that can be appropriated by medical aid schemes for administrative and secretarial services. I would suggest that this be linked not with the overall amount that is collected by the medical aid scheme, but per patient. I suggest a per capita charge say, in the neighbourhood of R1,50 per member of the medical aid scheme rather than a percentage of the escalating subscriptions which are paid by the patients. This will be more reasonable.

I want to suggest too that in enforcing greater discipline on the medical aid schemes, they should also not be allowed to make their own exclusions from the benefits. This is something else which they are doing to a greater and greater extent. It may be necessary to have some limitation, in order to make the scheme viable, on the amount which can be paid out say for medicines or dental operations or cosmetic operations. Regulation No. 8 mentions this particular factor. However, the medical societies are laying down their own exclusions. I want to mention that dental limitations are R200 per family per year, which is far too low, I think, as most fathers and heads of families will agree. With the high costs of medicines, of antibiotics, cortisones, etc., it is also obvious that R200 per family per annum is also too low for medicines. As for cosmetic operations, believe it or not, some medical aid schemas actually include congenital deformities, like harelip, cleft palate and club feet in this category. I think all of these should be excluded entirely from the definition of “cosmetic operations”. A man who would otherwise have to go through, life with a cleft palate or a harelip or club feet needs an operation and I certainly would not put those in the category of cosmetic operations. There are lots of others I could mention but will not on account of modesty. [Interjections.]

I think that more and more frequently the medical aid schemes are now introducing a 20% disincentive. That is a bad thing as well. I can understand it for a first visit in order to stop the sort of hypochondriac type of patient just enjoying medical aid benefits without any real need. However, this becomes a real hardship for the average family, the middle-class family, if there is somebody who is suffering from a chronic disease or a long-term disease that requires hospitalization for any length of time. Diseases like coronary thrombosis, carcinoma and diabetes require long-term treatment. The fact that the medical schemes will only pay 80% of the costs is a very severe hardship indeed. Of course, the disincentive almost invariably excludes surgery. With this I do agree. Take nursing home charges as well. Very often a maximum is laid down which is quite unrealistic in view of the charges of nursing homes these days. There is a 40-day maximum and often many of these illnesses require more than 40 days’ hospitalization. There is also a R15 per day maximum for nursing homes by some of the medical aid societies, although if you are unfortunate enough to find yourself in an intensive care unit, you will find that can cost you up to R40 per day. So I think these determinations just do not cover the crippling costs of expensive hospitalization.

I know that the existing subscriptions being paid by the member together with what is paid by employers, are not going to be enough to cover all these expensive costs. Here I want to agree with those members in the House who have stated that the Slate should dip into its pocket to assist as well. It is absolutely essential in these days of very expensive medical care and hospitalization that the State should also play its part. If the hon. the Minister would like it at some stage or another, I shall be delighted to supply him with a list of reductions which could be made on other Votes so that money could be diverted to the Health Vote in order to enable the Government to assist in this regard.

Then I think special attention ought to be paid to those medical aid societies that do not in fact fall under this Bill and which I am therefore not competent to discuss at this stage. There are, however, some very important medical aid schemes which are excluded from the ambit of this particular Bill. They might get some indirect benefit because there is a representative of such societies on the council set up to draw up the code of conduct. I think of the medical aid fund of the Railways, of the building industry and the motor industry, all of which are excluded from the purview of this legislation. Something should be done because the maximum benefits there are even lower. In some cases the maximum benefits are even as low as R400 per family per annum. The limits are far too low and I think something should be done to help the members of those schemes. After all, the hon. the Minister must put his mind to this because they have great difficulty when they go to private nursing homes, which will not admit them and which demand that they pay the full cost of hospitalization before they even give them a bed. This can sometimes be an emergency and consequently a very difficult stituation arises. It is no good telling me that these people can go to provincial hospitals, because they cannot. Provincial hospitals do not admit members of medical aid schemes except under very special circumstances. Therefore that is no help to them either.

I want to mention the high cost of medicines which are charged by nursing homes to medical aid societies. Here there might be a saving which might easily be diverted to give greater benefits to the members of the schemes. I should like to suggest that there should be some sort of disputes committee, a pharmaceutical committee of some kind, which should vet any disputed account for medicines submitted by nursing homes to medical aid patients because these can and in fact do come to an enormous amount.

I should like to say that I am pleased to see that the medical aid schemes, by virtue of this Bill, will now be taken out of the hands of the Registrar of Friendly Societies and the Registrar of Financial Institutions and will be put into the hands of a much more professional body. I hope very much that they will be able to work out somehow a modus vivendi to make it possible for more doctors to join the scheme. I want to say that the change in the procedure for the appointment of the Remunerations Commission might go a long way towards this. Clause 23, which sets out the new procedure for the appointment of a Remuneration Commission, ought to help. It is no longer to be appointed, as the hon. the Minister pointed out, every three years; it can now be appointed on an ad hoc basis as requested by the people most concerned. I hope that in future the Remuneration Commissions will not be quite so secretive in publishing minority reports, because this certainly was a bone of contention with the doctors.

A very important thing which may encourage doctors to contract in is the setting up of the anomalies committee. That, I think, is very important because an enormous amount of discontent was caused among doctors by the absurd anomalies which were created by the Remuneration Commissions latest report. The specialist lost out almost in every respect. General practitioners did rather well out of this because they were given a 34% rise across the board, but it is an accepted medical axiom, one might almost say, that the specialist is meant to earn more than the general practitioner for the same medical attention. Yet, the anomalies that came out of the Remuneration’s Commission’s report revealed that in many cases general practitioners were getting more than the specialist for the same medical attention. This is the case especially as far as obstetricians and anaethetists are concerned. When general practitioners perform that work, they are paid at a higher rate than the specialists in these fields, which is obviously absurd. Some of the specialists whose running costs are indeed the highest in the profession, like the radiologists and the pathologists, received the lowest increase of all, something like 2% in the one case and 0% in the other case, despite the escalation of costs in these particular specialities. If the hon. the Minister is anxious to iron out the difficulties and to attract more doctors and more particularly specialists back into the medical schemes, he must do something about these anomalies. The appointment of the Anomalies Committee is therefore to be welcomed.

I know that more general practitioners are coming back into the medical aid schemes now that they have been given these appreciable rises but the recommendations of the Remunerations Commission have certainly not satisfied the specialists by a long chalk. My advice to the hon. the Minister is that as soon as this measure is through, he should get the council set up as fast as possible so that an ethical code can be laid down for the medical aid schemes, and so that that council can in turn appoint the Anomalies Committee as soon as possible so that it can get cracking to try to correct some of the absurd anomalies which have emerged from the Remunerations Commissions’s report.

With these few words, I would just like to say in conclusion that I hope that the Medical Schemes Amendment Bill will in fact accomplish some of its objectives and that a better climate will exist in future between the Minister and the medical profession, and also between the medical aid schemes and the medical profession, more particularly those members of the medical profession who have in the past contracted out. I hope, too, that more will be done to see that the general public, i.e. 80% of the White population, together with the increasing number of Blacks who are coming into these schemes, are going to get a decent return on the money which they pay to these medical aid schemes.

Order! Before calling upon the hon. member for Cradock to speak, I just want to say that I have observed a tendency among hon. members to repeat the main arguments over and over again. I want to request hon. members rather to come up with new arguments.

Mr. Speaker, after having listened to the hon. member for Houghton proclaiming her support for this particular Bill, the Minister might well have exclaimed: “With such friends I need no enemies.” I find myself in the extraordinary position that I agree with most of what the hon. member for Houghton has said.

Practically everybody does from time to time.

However, I do not propose following her in her arguments because I think that a lot of what she has said actually has no bearing on the Bill before the House at the moment.

That is a reflection on the Speaker.

It was not intended as a reflection on you, Mr. Speaker.

*This evening we again heard both the hon. member for Berea and the hon. member for Rosettenville advocating a contribution by the State to the funds of medical schemes. This principle has been discussed on a number of occasions in this House and I think it ought to be clear that the Government does not see its way clear to introducing an element of socialism into our health set-up. Evidently the fact that the State is already making a very major contribution to the health services of this country is being lost sight of. An amount of about R120 million has been budgeted this year, part of which, by way of direct payment, is being spent on certain services such as hospitalization, for example, which is provided by the provincial administrations. Environmental services provided by local authorities are also subsidized by the State to a very large extent. Health services are maintained by the State and in my opinion, therefore, the State does in fact make is contribution in the field of health. One should never lose sight of the fact that the moment the State were to make a direct contribution towards the financing of medical schemes, the State would also necessarily have to have a say in the administration and policy of those schemes. We on this side of the House are totally opposed to that.

I should like to thank the Minister and the Department of Health for their happy idea of publishing this draft Bill and exposing it to general comment. Now I take it that not all the comment that was received was favourable and that not all the proposals were accepted, but this does show a preparedness to co-operate, to iron out problems experienced in implementing the old Act, account being taken, too, of the opinions of other people. In my opinion this is a procedure that could well be adopted.

I want to state one thing very clearly. Similarly to the 1967 Act, the aim of this legislation at present before the House is not to exercise control over the medical profession. The primary aim of this Bill is to control medical schemes. Medical practitioners and the associated professions are only involved for the sake of order and the organization that is involved. In order to put into perspective the polemic that has developed around this Act and this Bill, we must go back in history a little. We must note that medical schemes are not a new phenomenon which came into being when the Act was passed in 1967. I think that medical schemes have existed since the 1920’s. These medical schemes have been recognized by the Medical Association through the years. Each of these medical schemes acted independently in those years and each had its own policy. Each had its own conditions and, in fact, the entire setup lacked order. At that time the Medical Association as such also had the privilege of being able to determine the tariff after negotiation with the various medical schemes. It is true that in the period before 1967, many of these schemes were very poorly administered and that in many cases a very large percentage of their income was spent on administration costs. This gave rise to a great deal of suspicion among medical practitioners because they felt that money paid in respect of the treatment of patients was in fact going towards administration costs. I am concerned that this tendency towards escalating administration costs is raising its head again. I therefore want to make an urgent appeal that this aspect, in particular, should enjoy the urgent attention of the department, something that can in fact be done under the provisions of this new Bill.

Another disadvantage encountered under the old dispensation before 1967 was that although patients belonged to specific medical associations or schemes, medical practitioners sometimes had a tremendous struggle to recover their money from these medical schemes. There was no obligation on these people to pay punctually, and in many cases it was a struggle. Consequently it was essential to have control and to create order out of this chaos. That is why the 1967 Act was placed on the Statute Book. It was accompanied, as has already been mentioned here, by a great deal of dissatisfaction, particularly amongst medical practitioners, because as they interpreted sections 29 and 32 of the Act, they were being placed under a certain degree of control. They did not like that. Section 29 provides that a medical practitioner is obliged to demand the prescribed fees if he has not contracted out. The hon. member for Fauresmith must excuse my use of this term but for want of a better word I can only stick to the nomenclature we have known through the years. If a medical practitioner contracted out or gave notice of his intention to do so, he could not send an account to the medical schemes. However, section 32 provided that if a doctor agreed to treat patients at the prescribed tariff, viz. if he concluded a contract with the medical scheme, then he was obliged to make a specified account available to that patient. There were calls by the medical profession for this section to be scrapped. The hon. the Minister has already indicated that he is not prepared to take this step since if he were to do so, the whole aim of the Medical Schemes Act would be entirely defeated. Surely, in any contractual relationship, there must be a quid pro quo in respect of certain benefits enjoyed by the medical practitioner under the Medical Schemes Act, for example the guarantee of the fees, the punctual payment thereof and th fact that these schemes are subject to certain statutory provisions to which they, too, have to comply. There are very decided benefits for medical practitioners in this specific set-up. That is why it is only fair to expect that the medical practitioner should give something in return, to, apart from the services they render to the patient. He, too, must make certain sacrifices to the schemes to be able to maintain this specific relationship.

The determining of fees by an outside body is one of the major objections raised by the medical profession against the whole set-up of medical schemes. It is felt that it is not fair for medical practitioners to be subjected to a commission to determine their fees because most professions must have the right to determine their own fees themselves. From the point of view of the medical schemes it is of cardinal importance that fixed fees be laid down for the various procedures. Medical practitioners and others must be duly compensated for the services they render. This also affords the patient the opportunity to know in advance what it will cost him to engage the services of the medical practitioner. It also protects the patient against exploitation to the minor extent that this has taken place in the past. Particularly owing to this new system of awarding points and determining of relative unit value, it is being made possible for medical fees to be determined scientifically, to the benefit, not only of the medical schemes and their patients, but of the medical practitioners as well.

In my opinion, the chief value of this Bill is the fact that the medical profession is now, in fact, being put in a position to carry out its own evaluations; in other words, the medical profession, and no one else, awards points to a specific procedure. All that this so-called outside body, the Compensation Commission does now is to give that specific unit a money value. Comparable things within the medical profession can now be compared. Expertise and the time spent on specific procedures, technological problems, and so on, can now be taken into account in determining specific fees. In my opinion this is a far more scientific and satisfactory method of operation than the ad hoc basis on which fees were determined in the past.

In my opinion, most of the demands made by the Medical Association are, to a large extent, complied with in this Bill. I think that most of their objections have been eliminated by this Bill. We must not lose sight of the fact that in this process, control over medical schemes has been stepped up, a step which will undoubtedly be welcomed by the medical profession. I believe that with goodwill and mutual trust, the objectives of this Bill can be achieved. I believe that my medical colleagues will display the will to have this Bill succeed and to allow this unsavoury polemic, which is interpreted by the public as a pursuit of higher fees, to die a natural death, to the benefit of the patient and the prestige of and respect for the medical practitioner himself.

Mr. Speaker, there is no question about it that one of the most vital services which a country requires is that which is related to the health of its community. It is for that reason that one views this Bill, which introduces some 25 amendments in about 46 clauses, with a great deal of satisfaction and approval. I should like to say that the trigger which set off the introduction of these amendments was a threatened contracting out of almost the entire medical profession, if one is to believe some of the stories that circulated last year after the Remuneration Commission sat. And so, Sir, it is to meet a situation of this nature that we find ourselves presented with a Bill which has so many amendments. I should like, therefore, to add my share of praise for the efforts of the hon. the Minister, the Secretary of the department and his staff in having drafted amendments which I think will go a long way towards meeting the problems that have arisen as regards remuneration and the attitude of the medical profession itself.

I want to say immediately, talking as a lay person, that we must appeal to the medical profession to try to ensure that, with the provisions contained in these amendments, they will make the medical aid schemes the effective instrument they should be in the health affairs of the country. As has been pointed out, some 80% of the community are members of medical aid schemes. They are very seriously affected, because as far as they are concerned, their income levels prevent them from making use readily of hospitals and district surgeons, and compel them to make use of the normal medical services at the prevailing fees. To this 80% of the people, the middle-income group of the community, the medical aid schemes have been an absolute boon and a blessing. If one takes into account the suggestion that has been made, that the State is spending some R120 million per annum on health, which I think is a little exaggerated, one must also bear in mind that in the year 1974, according to the report of the Department of Health, the public itself contributed R165 million towards their medical services. This, I think, is a very fine example of the co-operation of the public when it comes to meeting this important problem. And that, Sir, is in addition to other forms of taxation which indirectly flow from the pockets of the public towards hospitals and other health services for the benefit of the lower-income groups in the country. I want to say that if the contracting out movement had continued on a large scale, it would have brought about a complete collapse in the medical services of the country, and I sincerely hope that the medical profession will, in these amendments, particularly those dealing with the Remuneration Commission and the frequency with which commissions can be brought into being in order to deal with anomalies, adjustments and new tariffs, find a solution to their problems.

The question of the assistance of the State in the field of medical health is, I think, very important. This side of the House has always stood for a national health scheme. There are other countries which to some extent, although not entirely, make some provision to meet this problem, and we in this country could meet it in the field of medicines. It has been pointed out, I think quite correctly, that in so far as medical and dental fees are concerned and probably also the cost of hospitalization, approximately 60% or 70% of these fees are paid by medical aid schemes on behalf of their members, but I think as far as the cost of drugs is concerned, the public should be able to look to the State for some degree of assistance. The Government need have no fear that if the State provided a certain amount of relief in this regard it would be regarded as a socialist scheme. Sir, once before when we discussed this particular matter here, the example of Australia was quoted, where there is a national health list with regard to the supply of drugs and where the patient pays a small sum of 50 cents to a rand for a prescription and the State expends at least R200 million a year on the provision of drugs for the public. In addition to the medical aid schemes which exist in that country, the State makes its own contribution to the cost of drugs supplied to the public. I think in that respect South Africa could take a page out of the book of a country like Australia. There is another factor that comes to mind in dealing with this whole problem, and that is our woeful failure to train sufficient doctors year by year. We have given our attention in recent years to the use of para-medical personnel such as medical aides to provide services which over the years had been confined to qualified medical practitioners. Sir, in considering this whole vast problem I think the State should give urgent attention to the provision of additional medical schools. I think we are turning out far too few qualified medical men in this country. We must look at the medical requirements of the whole of South Africa. It has been pointed out that most of our medical men are congregated in the urban areas and that the platteland is being stripped of medical services.

What has that got to do with this Bill?

It has a lot to do with it, because it is due to the fact that there is this tremendous pressure on the services of doctors in the cities that this problem of rising fees has arisen. I think in considering a Bill of this nature, we should at the same time consider the necessity of ensuring that there are sufficient medical practitioners available throughout the whole country. Sir, last year there was what was almost a threat by the medical profession to contract en masse out of the medical aid schemes unless some of their criticisms were met, and I think that the Minister should not only do everything in his power to ensure that medical practitioners do not contract out of the medical aid schemes, but that he should take the initiative to ensure that these problems do not arise in the future. With those few words, Sir, I associate myself with other hon. members on this side in supporting the Bill.

Mr. Speaker, it was really a privilege for me to listen to professional colleagues in this House, and in my opinion the public of South Africa and medical practitioners of South Africa can rest assured that medical care in this country is in good hands. I just want to refer to one reference made by the hon. member for Rosettenville. I want to agree with him that we should like to call on medical practitioners to give this Act a chance, because I am sure that this Act, particularly as amended by the hon. the Minister, will be entirely successful in all its facets. But I still want to differ with him when he advocates a medical scheme to cover all sections of the population, in other words, a scheme that must surely amount to establishing some form of national health scheme or a socialization of the medical profession, because it has been proved over and over again that in countries where this process of socialization has taken root in the medical profession, not only have a greater number of areas of friction developed, but there has actually been a drop in the standard of medical care in that country, too. Sir, I should like to comply with your ruling that arguments may not be repeated, and consequently I shall only refer to a few matters which, I believe have not yet been raised in the House.

It is true, as the Minister said, that there has been a great deal of dissatisfaction in regard to this Bill. This is, in fact, true, but the dissatisfaction was not solely concerned with the tariff of fees per se. It is true that this was a reason, because the cost of living has gone up and the overall expenses of medical practitioners have risen, too, and they had to receive increased remuneration for that. But I just want to point out to you, Sir, that the medical schemes were originally brought into being to provide the lower income group of members with medical service. But circumstances have now changed to such an extent that this has been extended to virtually the majority of the population of this country. But when that lower income group had to be provided with medical services, the medical profession, too, made a contribution and stated that it would provide these people with medical services at a lower tariff. The objection which the medical practitioners raised at the time, was that that lower tariff, which could not be regarded as the normal tariff for medical treatment, was then taken as the standard by which medical fees were determined. But it was not only fees that were at issue; other aspects concerning principle were also involved. There was the intervention of a third party between the doctor and his patient, which resulted in harm being caused to the relationship of trust between the doctor and his patient. For example, the hon. member for Houghton mentioned here that there were certain operations, such as cosmetic operations, which were excluded, but I want to tell you that there have been other operations, too, such as operations in regard to pregnancy, which have been excluded by some medical schemes, and this has given rise to interminable correspondence between a clerk of the medical scheme and the doctor as to whether a certain gynecological operation could possibly have been connected with pregnancy or not, and that this most decidedly jeopardized the relationship of trust that existed between patient and doctor. Then, too, there was a protracted delay as regards the settlement of accounts. [Interjections.] I just want to point out a situation to you that has possibly not been mentioned as yet, namely the lack of confidence that is sometimes caused in patients. This is a situation which inevitably develop between the doctor and the patient owing to the intervention of a medical scheme. It does occur, as the hon. the Minister has also mentioned, that at a time of emergency, an emergency operation has to be carried out at short notice. In such a case there is usually no time to ask whether the patient belongs to a medical scheme or not. Sometimes the medical practitioner does not know that the patient belongs to a medical scheme. He therefore charges the normal standard tariff to which he is entitled. Subsequently it turns out that the patient does in fact belong to a medical scheme, and then the medical practitioner has to change his tariff. The patient who does not understand the position is consequently given the impression that the medical practitioner has a double standard. Then, too, I just want to point out—and I want to address these remarks to the medical schemes— that members of the scheme often misuse the services of medical practitioners. We know that medical practitioners practising outside the Medical Schemes Act, if I may suggest the term, have found that after they have started practising outside the Medical Schemes Act, their after-hours and weekend work drops by more than 15%. This means only one thing and that is that members of medical schemes are undoubtedly misusing their membership by calling in medical practitioners at all hours for every minor indisposition, because members of the schemes themselves make only a very small contribution towards settlement of the medical practitioner’s account.

However, the frustration has not been limited to the medical practitioners alone, but has also been felt by members of the medical schemes. There have been schemes that have not complied with the statutory requirements for registration, but, as we have now heard, fortunately these no longer exist. It has occurred that members of medical schemes have paid contributions to such schemes which have ceased to exist, with the result that the contributors have received nothing in return for the contributions they have paid. This has jolted their confidence in the medical schemes, and as a result these people no longer wish to belong to a medical scheme. I want to suggest that just as medical practitioners are given the right to practise within or outside the Act, membership of a medical scheme should be voluntary for each member of the public as well.

I want to conclude by saying that all the amendments in the Act which have now been proposed by the hon. the Minister by way of the Bill will give rise to a greater degree of satisfaction among the public and in the ranks of the medical profession, too, and that the cost of medical services, which is very high in this country, as in every other free country in the world, will be made less burdensome to the public. At the same time, the high standard of medical services that is maintained in this country will, as a result of this amendment, be kept up and even raised. The aim of the Bill is to bring sound medical care within the reach of every inhabitant of this country in a meaningful way without disturbing the traditional, sound doctor/patient relationship. It is my considered opinion that the amendments as proposed will contribute towards this in a large measure.

Mr. Speaker, we on this side of the House are of course supporting the Second Reading of the Bill for the very reason that we believe this to be an improvement on the principal Act of 1967. The various amendments which are proposed in the Bill should bring about improvements.

The hon. member for Pietersburg, in common with the other members on that side of the House, is of course speaking to a great extent as a member of the medical profession. I believe it is a pity that no hon. member on that side who is a layman has come forward to make suggestions and to put forward the point of view of the ordinary members of medical aid schemes. I believe that the medical aid schemes in South Africa play an important role in our health services.

Hon. members on the other side have tried to suggest that the hon. members for Rosettenville and Berea endeavoured to put forward a policy which would lead to socialism in South Africa as far as medical services are concerned. I should like to say quite clearly that no member on this side of the House has ever suggested that there should be a move towards socialism as far as our medical services are concerned.

I believe it is important for us to consider whether the existing position meets the needs of the people. I think even hon. members on the other side must agree that it is desirable to see that as many people as possible are covered by a medical scheme so that they can be given financial assistance in times of illness when they are faced with considerable expense. After all, membership of a medical scheme is an insurance against such a contingency. Therefore it is important for us in Parliament to ensure that legislation is placed on the Statute Book which will make for the smooth functioning of the principal Act and it is our duty to bring about amendments where they are necessary.

In the Government Gazette dated 11 April 1975 there appeared a list of registered medical schemes which showed that there are 251 such schemes. In annexure 1 of the latest report of the Department of Health an indication is given of the number of persons who belonged to medical schemes as at the end of the year—presumably 1974. It is also stated that the number of beneficiaries was some 2,5 million Whites and nearly 500 000 non-Whites, making a total of approximately three million beneficiaries. This is important because we should like to see a situation developing in South Africa where as many people as possible are covered by such medical schemes. We believe that where there is a gap in the system in the sense that there are people who are not covered by medical schemes, steps should be taken to ensure that they will also be covered. The suggestions which have been put forward by the hon. member for Rosettenville would, if accepted, go a long way towards attaining a situation where all persons in South Africa will be covered by medical schemes.

I think the position of the medical schemes and of the beneficiaries requires further consideration in order to assess whether the amendments which are proposed in the Bill are indeed going to assist the members of these schemes. It is on this basis that I should like to address some remarks to the hon. the Minister. We know that pension schemes and medical schemes are of prime importance in the fringe benefits that are offered by employers. We know that most of the schemes make provision for widows and pensioners to remain members of the scheme. That is why it is interesting to see in annexure 1 on page 38 of the latest report of the Department of Health that there are 13 782 widows and almost 31 000 pensioners who are still members of medical schemes. I refer in particular to this group because in terms of clause 27 provision is made for an ethical code which provides for certain penalties. This will alter the situation which exists at the present time. These penalties are extreme penalties as far as medical schemes are concerned because the council is empowered to cancel the registration of a medical scheme should it be found that such a scheme has violated certain sections of the Act or is guilty of any form of misconduct. If one looks at section 18 of the principal Act one sees that it is provided there that the registrar shall cancel the registration of a scheme on proof to his satisfaction that the scheme has ceased to operate or if he agrees that the scheme was registered by mistake in circumstances not amounting to fraud. This section also contains a certain proviso as regards the cancellation of such a scheme. In terms of clause 10 of this Bill, which amends section 18 of the principal Act considerably, the registrar can, if he is of the opinion after an investigation that it is necessary, after due notice apply to the council for the cancellation of the registration of such a scheme, if the scheme persists in violating the provisions of this legislation. As I have mentioned earlier, the promulgation of rules and disciplinary inquiries are detailed in clause 27. This establishes an ethical code, and subsection (4) on page 60 contains the following provision:

1. (a) a caution or a reprimand or a reprimand and a caution; or
2. (b) suspension for a specified period of its registration; or
3. (c) cancellation of its registration.

This is an extension of the existing position brought about by this amending legislation. My concern is for the person who belongs to a scheme in respect of which it has been found necessary to cancel the registration due to certain circumstances. In terms of the legislation, all schemes must be registered and, consequently, difficulties can arise where persons who are members of such a scheme which has been cancelled in terms of this legislation, can find themselves in a situation that they are unable to join any other scheme by virtue of the fact that, say, a widow might not be able to take employment with any other employer in order to enable her to join another scheme. It is improbable that many of the 30 000 pensioners would be able to take employment with an employer where they are covered by a scheme and whereby they could transfer the benefits from one scheme to another under certain circumstances in terms of another clause of this Bill. As I see it, should the registration of a scheme be cancelled, we could face a situation where people who are presently covered by a scheme may find themselves without the coverage of a medical scheme whilst many of these persons—particularly widows, pensioners and older members of the scheme—require such assistance to an increasing degree.

There are a few other aspects concerning the amendments of the principal Act which are before us. We know that the present Act makes provision for the timeous payment of claims. Several hon. members have referred to the position of doctors who are contracting out as a result of certain difficulties which I do not wish to repeat since they have already been mentioned by previous speakers. It does appear, however, that these people are often at a disadvantage when they have to pay an account. Indeed, I know of some cases where dentists and other members of the medical profession who have contracted out, have put an endorsement on the account saying that it must be paid first and then the receipt can be forwarded to the administrators of the medical scheme. It means that the benefits to which the contributors are entitled are only reimbursed after a considerable period of time. Clause 24 of this Bill, which amends section 32 of the principal Act, reduces the period which may elapse between the moment the medical aid scheme receives a copy up to the moment it is refunded to the person to whom the money is due, from two months to 30 days. Subsection (3) of this article of the principal Act is also amended by the deletion of the words “such medical practitioner or dentist”. This will perhaps facilitate the position of those persons who are able to pay such an account promptly and then sometimes have to wait for a month, two months or even longer to be reimbursed. In some cases I know of members of medical schemes are paying all their accounts as they are presented, irrespective of whether the doctor or dentist has contracted out, so as to avoid embarrassment because it is embarrassing for a member to receive accounts for services rendered with notes attached calling for immediate payment when the account has in fact been forwarded to the relevant medical scheme for settlement. Due to the long delay in the settlement of these accounts, these people are often embarrassed. The provisions contained in this Bill could lead to an improvement in the existing position, and we on this side of the House believe it is necessary to have the co-operation of all people concerned—the administrators of the medical schemes, the members of those medical schemes and or the medical profession— to assist in ensuring that the smooth functioning of the medical schemes, as envisaged when the original legislation was passed, and as it is now being amended, does come about in order to improve the present position.

Mr. Speaker, I shall not reply to all the specific matters raised by the various hon. members. If we talk so much when we agree, I wonder how long we would have talked if we disagreed from one another. In any case, I was glad to hear that hon. members are so particularly interested in this legislation, and I am glad that they have voiced their opinions about this matter so freely. I regret that I cannot reply in detail to every specific case that has been raised.

†I shall start off with the hon. member for Rosettenville, who mentioned initially that there was immense dissatisfaction over the past year or so amongst the medical fraternity. That is so, but dissatisfaction of that kind cannot always be dealt with immediately. It depends to some extent on circumstances and on the perspective of these people, i.e. how they see things and sometimes even how they understand the ordinary legislative process. They may believe one can change things overnight, but that is not always possible. There are many wheels which one must get to work together in order to find a way out of a particular problem.

A little more than a year after taking office, I admitted that there were certain defects in this legislation and certain grievances in connection with it amongst the medical profession and even among some medical schemes. I committed myself by saying at the beginning of 1974 that I would give my attention to this matter. In other words, this is not a Bill that has come about after the trouble experienced last year with the medical people. It has been foreseen. I did tell them beforehand that I myself was not satisfied with what had happened over the past five or six years. We learn by our mistakes. However, I must also say that the image of the medical profession is at stake here. It is very important that this image should not be tarnished. It must not be seen as a profession which looks only at its purse without being imbued with altruistic motives. I wish to remind people of that because such an attitude has been building up in the minds of some members of the public towards the medical profession. I would not like that attitude to continue. Nevertheless, my department cannot build Rome in a day. That is important and, I suppose, is understood. We are nevertheless always ready to listen, aid and consult whenever possible. We are responsible for the over-all health care of the population of this country and we must grant the profession its due and then not only as far as monetary matters are concerned. A lot of other things are also involved.

This Bill, however, is an earnest endeavour to see whether we cannot, at this stage, rectify many of the matters that have caused problems in the past. I think we shall have to give this a try, and that is why I am so very glad that many of the members who spoke made an appeal to our colleagues in particular, and not only the medical schemes, to give this new Bill a chance so that we can see whether we cannot, with reasonableness on both sides, find solutions in the future. I am sure we can. As it was so aptly put by the hon. member for Rosettenville, nobody is starving at the moment. [Interjections.] Yes, as far as the medical profession as such is concerned. One must take the average income into consideration. Although the hon. member for Houghton did mention the fact that medical practitioners were working hard, I can speak from experience about this. I have practised for more than 20 years so I have been directly involved for many years. I do not begrudge anyone a good income if he works hard. Nevertheless there are more things to be taken into account in this regard because at the moment we are living in an age where we have to regulate many aspects that have not been regulated before. We live in an age where give and take as a philosophy is part and parcel of the way our relations with each other are formed. It is not for the medical profession to cry for autonomy from morning till night. We have to see that matter in perspective.

*I feel, therefore, that we should be very careful not to adopt a one-sided approach to this matter. This is a matter where we, who are in the middle and who have to take great responsibility, have to take all these particular problems into consideration. The medical profession, which also is my profession, is a very important profession. The image of this very important profession, which has to render indispensable services, is at stake here. Nevertheless, the profession will have to conform. It cannot regard itself as being quite free to do as it should or would have liked to do 50 years ago. Not one of us can do that.

†I believe that the public, the medical profession and the medical schemes will have to act in liaison, partnership and co-operation. That is where I agree wholeheartedly with the hon. member for Rosettenville. He did mention the question of State subsidies for a voluntary national medical aid scheme. It has also been mentioned, though perhaps not in the same context, by other members. I must just tell the hon. member, however, that the present medical schemes have made it possible for 80% of the Whites to have some sort of medical aid structure. We are also in the process of establishing schemes for non-Whites. Although many non-Whites already belong to schemes, we are nevertheless in the process of establishing schemes for our non-White people. I do not now want to become involved in a political argument. Nevertheless the hon. member for Berea specifically stated that there was less trouble with the non-White members under the industrial schemes, a proposition which vindicates our statement that these people have a low claim percentage. Therefore to a certain extent they subsidize the White members.

*That is why we believe that, at this particular stage, it may be a good thing for these people to be enabled to obtain separate schemes by means of reduced contributions. That is why we are investigating the matter at this stage. We are working on the matter. I think this serves as an answer to certain of the questions that have been put here.

†At the same time, as far as the question of State assistance in respect of these medical schemes is concerned, this is not the only way in which the State can or does assist. The State also assists through the medium of clinics, district surgeons and hospitals, to mention only a few. The State assists in many ways in order to assist our people to obtain the medical care they need.

*The hon. member for Fauresmith gave a brief explanation of the Robin Hood approach of our medical practitioners in the early days when they fixed their own fees. The days of the family doctor who never really charged anyone anything and still became rich, are gone forever. As I have said a moment ago, we are living in an age which all these things have changed. These things have to be regulated now. There are many people who have to receive medical attention, and we can no longer leave these things to the discretion and habits of people. Sad as it may be, rules and regulations have come and we therefore have to sacrifice a certain degree of autonomy on both sides. The good old days just do not exist any longer.

I would like to mention one particular aspect. I want to refer to the question of administrative costs which has also been mentioned here. I want to deal with the various points simultaneously, for we do not have much time. As far as administrative costs are concerned, it remains a fact that these have increased to a level which disturbs everyone of us. This is a matter which we shall have to watch very carefully. We must remember that these people will have an ethical code. They are even compelled in terms of the Act to have an ethical code. If they want to apply an ethical code, they can apply an administrative ethical code as well. Then I shall be able to keep an eye on the position in future because they can only be registered with the central council and no longer with the Registrar of Friendly Societies. We can keep an eye on this matter. If these people fail to act in a reasonable way or make profit-seeking their main object, it would be my duty to take steps. I shall, however, give them a reasonable time and a reasonable chance and then we shall take steps.

†I must say that I agree with the hon. member for Houghton. She said that the practice of using a percentage of turnover as a basis for administration costs must be prevented or done away with and that there should rather be a levy per member. I must say that I think that that is a very fair suggestion that one can investigate. I shall definitely look into it. If these people fail to apply their own code of ethics we will then have recourse to the application of suggestions like that made by the hon. member for Houghton.

*In my argument a moment ago I perhaps forgot to deal with one point. I just want to say that our medical profession, in its attempts to obtain complete autonomy, must remember that it has already surrendered its autonomy to the extent that the South African Medical and Dental Council has always been in the position to determine arbitrarily whether a doctor has overcharged a patient. This is being done by a different body now and in future this will be done by a body in which the profession is in the majority. To me this is a particularly important aspect.

The hon. member for Fauresmith made the point that members would suffer if steps were taken against medical schemes because they did not honour their ethical codes. I just want to point out that the schemes are controlled by bodies of control and when these have their annual meetings and a scheme has not done its duty, it is the duty of that control body to take steps against that scheme and see to it that it does not violate its ethical code again. We therefore have a method of rectifying this matter in some way or other.

†I have discussed the question of State aid and I do not want to go back over it. The hon. member for Berea mentioned the question of pharmacists and their position in regard to the principal Act. Pharmacists are free to come in. If they want to be included as a professional body amongst the professions in terms of this legislation, they are free to apply for inclusion. If they want to be general dealers, of course, that is another story. As far as the costs of medicines are concerned, they are under the Act already. They are not, however, covered by the Act as professional people. Nevertheless I personally consider these people to be professional people and I would very much like them to take the initiative themselves in this regard.

The hon. member also mentioned the fact that an increasing number of practitioners had contracted out because of the decisions of the remuneration commission last year. I must point out that this is not necessarily true. Propaganda was made and various influences were brought to bear on these people and sometimes they contracted out because of personal or administrative reasons, but many of them have come back.

The hon. member for Berea also said that the period of three weeks was too short for any of these interested groups to nominate members.

New ones.

Yes, new ones. Many of these groups know beforehand that nominations are in the offing. They should therefore make the necessary arrangements beforehand. If they start their negotiations timeously they should be able to nominate their representatives even before the start of the period of three weeks.

I have already dealt with the position of non-White members. As far as members are concerned who are no longer able to enjoy benefits because they have exceeded those benefits, provision is being made in this connection in the Bill. The hon. member will find these provisions in clause 15. In terms of these provisions a scheme may grant loans to any of its members. There are no other provisions in this connection at the moment, but at least this provision now exists.

The hon. member for Brentwood made a fine contribution. I refer in particular to the earnest request he made that his colleagues give this legislation a chance, and to his reference to the ethical code.

Various other aspects were mentioned by other hon. members.

†I do not want to become involved in squabbles between the medical aid schemes and certain doctors and specialists. I do not even want to go into the question of private hospitals charging too much for medicines, because that forms part of another investigation which was undertaken last year. I am at the moment considering the recommendations of the commission which undertook those investigations. We are, therefore, looking into matters of the sort mentioned by the hon. member for Houghton. I do not think hon. members would expect me to go into the question of the high cost of medicines and the personal relationships between people in the various categories. As regard the anomalies, the hon. member knows that we will now have an Anomaly Committee which will rectify these matters.

To my mind the hon. member for Cradock dealt very ably with the matter of contracting in and contracting out. He just confirmed what I said previously.

†The hon. member for Jeppe offered me his support, which I accept. He offered it graciously, as always. [Interjections.] He has supported me all along on medical matters. It is unfortunate that in other matters which are sometimes more important, he has not supported me. Nevertheless, medical matters are very important and I appreciate his support. He can raise the subject of the lack of doctors under my Vote and I will give attention to that later on.

*The hon. member for Pietersburg made an earnest request to practitioners. It was, like all the others, a fine request. He also raised certain practical problems. I just want to tell him that although I listened carefully to what he had to say, it is not within my power to reply to all those practical problems. Nevertheless, I have listened and we shall discuss it again.

†The hon. member for Umbilo mentioned certain things but he also specifically referred to many matters that I think we should rather discuss in the Committee Stage or elsewhere. Nevertheless, at the moment it is impossible for me to go into them and I think that he will agree and appreciate it.

*I have tried to reply as well as I could in a short space of time to the matters raised by hon. members. The Bill is an attempt to try, after a year of negotiations, to rectify to the best of our ability what has gone wrong over a period of six years. We have tried to rectify the matter by means of patchwork over a period of time, but we did not quite succeed in doing so. I am certain that with the goodwill we have in this House—we have to govern and give guidance to people—we should influence our colleagues, the public and the medical schemes and tell these people that by discussing this matter we shall appreciate that all of us are in the same boat of inflation and high costs and that we are faced with major problems and that we sometimes set too much store by our services. We should rather try to make this legislation work and to see whether we cannot make of it something that is more satisfactory than we have had over the past six years. I am certain that we have taken a great step forward with this legislation and that we have eliminated many of the deficiencies.

Motion agreed to.

Bill read a Second Time.

Mr. Speaker, I move—

Agreed to.