Home | Databases | WorldLII | Search | Feedback Papua New Guinea Consolidated Legislation

  Download original PDF

Public Hospitals (Charges) Regulation 1978

This reprint of this Statutory Instrument incorporates all amendments, if any, made before25 November 2006 and in force at  1 July 2001.

.........
Legislative Counsel
Dated 25 November 2006

INDEPENDENT STATE OF PAPUA NEW GUINEA.

Chapter 116.

Public Hospitals (Charges) Regulation 1978

ARRANGEMENT OF SECTIONS.

Public Hospitals (Charges) Regulation 1978

MADE under the Public Hospitals (Charges) Act 1972.

Dated                   200 .

1. INTERPRETATION.

In this Regulation, unless the contrary intention appears–

“after-care”, in relation to an operation, does not include–

(a) an operation necessarily performed in respect of complications arising after the primary operation; or

(b) such treatment of the original conditions as may be necessary, independent of and succeeding an operation and after-care of that operation;

“consultation” means an examination and questioning of the patient and the supply of pharmaceuticals and supplies needed for immediate treatment but not those to be supplied on prescription;

“intermediate”, in relation to–

(a) radiological services, means the services specified in Part 2 of Schedule 3; and

(b) operations, means the operations specified in Part 2 of Schedules 4 to 14;

“major”, in relation to–

(a) radiological services, means the services specified in Part 3 of Schedule 3; and

(b) operations, means the operations specified in Part 3 of Schedules 4 to 14;

“minor”, in relation to–

(a) radiological services, means the services specified in Part 1 of Schedule 3; and

(b) operations, means the operations specified in Part 1 of Schedules 4 to 14.

“private practitioner” means a registered medical practitioner operating on his own account and not affiliated to the State health system;

“Secretary” means the Departmental Head of the Department responsible for health matters;

“Schedule 1 service” means a service specified in Column 1 of Schedule 1 provided at a public section or public clinic;

“Schedule 2 service” means a service specified in Column 1 of Schedule 2 provided at an intermediate section.

12. ^[1]FEES FOR SERVICES.

Subject to this Regulation, a person who receives–

(a) a Schedule 1 service–shall pay the fee specified opposite that service in Column 2 of Schedule 1; or

(b) a Schedule 2 service–shall pay the fee specified opposite that service in Column 2 of Schedule 2.

3. FEES FOR MIXED SERVICES.

(1) A person who has received, or is receiving, a Schedule 2 service and with or as part of that service, at the direction of the Secretary, receives at a public section or public clinic a service specified in Column 1 of Schedule 2 shall pay for that service the fee specified opposite that service in Column 2 of Schedule 2.

(2) A person who has received, or is receiving, a Schedule 1 service who, at his request, receives with or as part of that service a Schedule 2 service shall pay the specified fee for that Schedule 2 service.

4. FEES FOR ALTERNATE SERVICES.

A person who, at his request, receives instead of the services specified in Part 1 of Schedule 2 special or additional services shall pay for those services the cost of those services as assessed by the Secretary.

5. FEES FOR OPERATIONS.

A person who receives a Schedule 2 service consisting of two or more operations shall pay for that service–

(a) the sum of–

(i) the fee for the operation performed which carries the highest fee; and

(ii) one half of the fee for the operation performed which carries the second highest fee; and

(iii) one quarter of the fee for each of any remaining operations performed; or

(b) K80.00,

whichever is the less.

6. FREE SERVICES.

No fee is payable if the service is–

(a) a prophylactic injection, vaccination or test being part of a disease prevention or control programme; or

(b) in respect of a venereal disease, tuberculosis or Hansen’s disease; or

(c) a blood test to ascertain whether filariae or malaria parasites are present in the blood; or

(d) provided to a person in a public section or public clinic where the Secretary is satisfied that the person is–

(i) destitute; or

(ii) under the age of 14 years; or

(iii) a child still attending high school; or

(iv) over the age of 59 years.

7. NOTICE OF FEES FOR SCHEDULE 2 SERVICES.

There shall be displayed in a conspicuous position in each intermediate section a notice stating that services provided in that section will be charged for in accordance with Schedule 2.

8. RECOVERY OF FEES.

An amount payable under this Regulation may be recovered by the State as a debt.

SCHEDULE 1 – ^[2]FEES FOR HOSPITAL SERVICES FOR PATIENTS IN PUBLIC SECTION OR PUBLIC CLINIC.

Reg. Sec. 2.

SCHEDULE 2 – ^[3]FEES FOR HOSPITAL SERVICES FOR PATIENTS IN INTERMEDIATE SECTION.

Reg. Sec. 2.

SCHEDULE 3 – Reg., Sec. 1.
RADIOLOGICAL SERVICES.

PART I – MINOR.

Radiographical examination of–

Extremities including toes to thigh and fingers to shoulder clavicle and scapula

Chest (with or without fluoroscopy)

Heart (including lateral chest with barium in the oesophagus)

Ribs, sternum, breast

Nose or eye

PART 2 – INTERMEDIATE.

Radiographical examination of–

Skull

Sinuses, mastoids, salivary glands

Mandible

Maxilla

Pelvis or hips

Spine–cervical, thoracic, lumbar, lumbo-sacral, sacral and coccygeal (one or more regions)

Abdomen (including pregnancy tests and pelvimetry)

Urinary tract (plain film)

PART 3 – MAJOR.

Special examination with or without contrast media

Barium swallow or meal or follow through or other opaque meal

Barium enema, or other opaque enema

Intravenous pyelogram

Retrograde pyelogram

Cystogram urethrogram

Oral chelecystrogram (Graham’s Test)

Cholangiogram (intravenous, T Tube or operative)

Myelogram, pneumonecephalogram, ventriculogram

Angiogram, venogram, lymphangiogram

Hysterosalphingogram

Sinugram

Bronchogram, sialogram, arthrogram

Tomogram

SCHEDULE 4 – Reg., Sec. 1.
GENERAL SURGERY.

PART I – MINOR.

Cystoscopy with or without retrograde pyelogram

Dressings or examination under anaesthesia

Excision of simple tumours–sebaceous cysts, dermoid cysts, papillomata, lipomata, fibromata, sebaceous adenomata, excision of moles (except melanoma), simple biopsy of any kind, incision and drainage of abscess (except where otherwise stated)

Exploration of extremities for foreign bodies

Castroscopy

Castrostomy

Injection of haemorrhoids, anal stretch for haemorrhoids or other conditions

Laparoscopy

Repair of umbilical, epigastric hernia

Sigmoidoscopy with or without biopsy

PART 2 – INTERMEDIATE.

Appendicectomy

Aspiration liver abscess

Cholecystostomy

Closure of colostomy

Closure perforated gastric or duodenal ulcer

Drainage of pelvis abscess

Excision bronchial cyst or sinus

Excision Meckel’s diverticulum

Excision of anal fistula or fissure

Excision of submandibular salivary gland or calculus

Excision thyroglossal cyst or sinus

Haemorrhoidectomy

Hernia–inguinal (unilateral or bilateral), femoral, incisional

Laparotomy–exploratory only or with simple biopsy

Open–polypectomy of stomach, small bowel or colon

Operation for elephantiasis

Phyloroplasty

Ramms tedt’s operation

Scalerne node biopsy

Simple mastectomy

PART 3 – MAJOR.

Abdominoperineal resection of rectum

Cholecystecomy

Cholecystenterostomy

Choledochostomy

Colectomy, partial or total

Colostomy

Diaphragmatic hernia

Division of adhesions for intestinal obstruction

Drainage of hepatic, sub-hepatic or subphrenis abscess

Drainage or excision pancreatic cysts

Gastrectomy, partial or total

Gastroenterostomy, with or without vagotomy

Hepatic resection

Ileostomy

Laparotomy for trauma of any kind

Mastectomy, radical or modified radical

Parathyroidectomy

Parotidectomy–superficial or total

Pharyngeal diverticulum–excision

Radical excision head of pancreas

Radical groin dissection

Radical neck dissection

Resection of small or large bowel

Splenectomy

Thyroidectomy

Vagotomy

SCHEDULE 5 – ORTHOPAEDIC.

Reg., Sec. 1.

PART I – MINOR.

Amputation fingers or toes

Closed reduction dislocated shoulder, elbow, finger, hip or toe

Excision of exostoses

Excision small bursae

Insertion of skull tongs and other skeletal traction

Manipulation of spine, knees or feet

Reduction of simple closed fractures

Wedge resection or total removal toenail or fingernail

PART 2 – INTERMEDIATE.

Amputation of limbs except fingers and toes (minor) and thigh, shoulder and hip (major)

Bunionectomy

Drilling for osteomyelitis

Excision head of radius

Manipulation for congenital dislocation of hip

Meniscectomy

Patellectomy

Synovectomy

PART 3 – MAJOR.

Amputation through mid-thigh, hip or shoulder

Arthrodesis any joint (except finger or toe)

Arthroplasty

Bone grafts

Excision of cervical rib

Open reduction of dislocation or fracture

Operative treatment of compound fractures

Putti-Platt or Bankhart operation

Radical excision of bone tumours

SCHEDULE 6 – PLASTIC AND TRAUMA.

Reg., Sec. 1.

PART I – MINOR.

Excision and closure BCC or SCC

Minor procedures relating to pedicle grafting

Primary repair small or uncomplicated lacerations

Reduction of nasal fractures

Reduction of simple zygomatic fractures

Skin grafting small areas

Tenotomy

PART 2 – INTERMEDIATE.

Blepharoplasty

Dupuytrens contracture

Excision rodent ulcer involving bone or eye

Peripheral nerve repair (primary or secondary)

Pronator teres transfer

Raising of tube pedicle, transfer of pedicle except for minor procedures

Resection of cutaneous malignancy with grafting or other reconstruction

Rhytidectomy

Skin grafting areas (less than major)

Sublimis transfer

Surgery for prominent ears

Syndactyly

Tibialis posterior transfer

Z plasty correction contractures

PART 3 – MAJOR.

Cleft lip and/or palate

Cross leg flap

Eyebrow grafting

Flexor tendon repair or graft

Hypospadias

Major skin grafting or rotating flaps

Mammaplasty (reduction or augmentation)

Primary repair major or complicated lacerations

Radical excision melanoma

Radical neck dissection

Radical operation for oral cancer

Rhinoplasty

Temporalis transfer

SCHEDULE 7 – NEUROSURGERY.

Reg., Sec. l.

PART I – MINOR.

Carpal tunnel decompression

PART 2 – INTERMEDIATE.

Burr hole and ventriculography

Burr holes only

Craniectomy for subdural or extradural haematoma

Elevation or other operation for fractured skull (except formal craniotomy)

Neurolysis

Ulnar nerve transposition

PART 3 – MAJOR.

Anterior cervical fusion

Carotid surgery

Cranioplasty

Craniotomy

Laminectomy

Shunt operations

Sympathectomy (any level)

SCHEDULE 8 – PAEDIATRIC SURGERY.

Reg., Sec. 1.

PART I – MINOR.

Exchange transfusion in newborn

PART 2 – INTERMEDIATE.

Relief of intussusception

PART 3 – MAJOR.

Relief of intestinal obstruction

Repair of atresia of oesophagus

Repair of omphalocele

Repair of tracheo-oesophageal fistula

Resection and pull through for Hirschsprungs disease

Resection of teratoma

Resection of Wilm’s tumour

SCHEDULE 9 – THORACIC.

Reg., Sec. 1.

PART I – MINOR.

Intercostal drainage

PART 2 – INTERMEDIATE.

Bronchoscopy or oesophagoscopy

Exploration of uncomplicated penetrating wounds

Rib resection for empyema

PART 3 – MAJOR.

Excision of mediastinal tumours

Lobectomy

Oesophagectomy

Other exploratory thoracotomies

Pericardiectomy

Pneumonectomy

Thymectomy

SCHEDULE 10 – VASCULAR.

Reg., Sec. 1.

PART I – MINOR.

Ligation minor varicosities

PART 2 – INTERMEDIATE.

Arterial angioma

A-v fistula

High ligation and/or stripping of varicose veins

Small vessel aneurysm

PART 3 – MAJOR.

Aneurysm of major vessel

Endarterectomy

Hypertension

Porto-caval anastomosis or other definitive operation for portal circulation

Vascular grafting

SCHEDULE 11 – GENITO-URINARY.

Reg., Sec. 1.

PART I – MINOR.

Circumcision

Cystoscopy

Hydrocele, any method

Urethral dilatation

Urethral meatotomy

Vasectomy

PART 2 – INTERMEDIATE.

Cystolithotomy

Cystostomy

Epididectomy

Orchidectomy (simple)

Orchiopexy

Partial amputation of penis

Varicocele

PART 3 – MAJOR.

Adrenalectomy

Amputation of penis (total)

Cystectomy, partial or total

Kidney–any operation

Prostatectomy (any method)

Ureter–any operation

Urethral reconstruction

SCHEDULE 12 – Reg., Sec. 1.
GYNAECOLOGY AND OBSTETRICS.

PART I – MINOR.

Assisted breech delivery

Biopsy of cervix

Breech extraction

Cauterisation cervix

D & C

Examination under anaesthetic

Excision of simple tumours of vulvo-vaginal area

Insertion of radium for ca. cervix

Laparoscopy

Manual removal of placenta

Posterior colpotomy

Removal cervical polyps

Shirodkar operation

Uterine aspiration

Vacuum extraction or forceps delivery

PART 2 – INTERMEDIATE.

Excision cyst of borad ligament

Ovarian cystectomy

Repair of cervical laceration

Repair of cystocele and/or rectocele

Repair of 3rd degree tear

Salpingo-oopherectomy

Simple vulvectomy

Symphysiotomy

Tubal ligation

PART 3 – MAJOR.

Caesarean section

Construction of vagina

Destructive operation

Hysterectomy of any kind

Hysterotomy

Manchester repair (cystocele, rectocele and cervix)

Myomectomy

Radical vulvectomy

Repair of ruptured uterus

Salpingectomy for hydrosalpinx, pyosalpinx or ectopic gestation

Uterine suspension

SCHEDULE 13 – EARS, NOSE AND THROAT.

Reg., Sec. 1.

PART I – MINOR.

Laryngoscopy

Reduction nasal fractures

Incision of peri-tonsillar abscess

Myringotomy

Nasal Polypectomy

Tonsillectomy and/or adenoidectomy

PART 2 – INTERMEDIATE.

Bronchoscopy and oesophagoscopy, with or without biopsy

Intra-nasal antrostomy or other sinus operation

Rhinoplasty

Simple mastoidectomy

Submuscous resection

Tracheostomy

PART 3 – MAJOR.

Fenestration

Laryngectomy, partial or total

Labyrinthectomy

Radical mastoidectomy

Stapedectomy

Tympanoplasty

SCHEDULE 14 – OPHTHALMIC.

Reg., Sec. 1.

PART I – MINOR.

Cauterisation of corneal ulcer

Excision biopsy lesions of eyelid

Excision pterygium

Probing of tear duct

Removal of chalazion

Removal of foreign body embedded in cornea

PART 2 – INTERMEDIATE.

Enucleation or evisceration

Excision of lacrimal sac, all methods

Iridectomy

Needling for cataract

Paracentesis

Plastic repair of ectroprion, entroprion, ptosis, strabismus

Repair corneal lacerations

PART 3 – MAJOR.

Cataract–lens extraction

Corneal grafting

Exteneration of orbit

Removal of intro-ocular foreign body

Removal of intra-orbital tumour

Office of Legislative Counsel, PNG

1. ^[1]Section 1 (definition of “private practitioner”) inserted by Public Hospitals (Charges) (Amendment) Regulation 1994 (No. 16 of 1994), s1; Section 1 (definition of “Secretary”) inserted by Public Hospitals (Charges) (Amendment) Regulation 1994 (No. 16 of 1994), s1.
2. ^[2]Schedule 1 replaced by Public Hospitals (Charges) (Amendment) Regulation 1994 (No. 16 of 1994), s2.
3. ^[3]Schedule 2 replaced by Public Hospitals (Charges) (Amendment) Regulation 1994 (No. 16 of 1994), s3.