After years of often bitter negotiations, Swiss doctors have agreed to introduce a new uniform tariff system, clearing the way for the much-delayed overhaul of the health insurance system.

After years of often bitter negotiations, Swiss doctors have agreed to introduce a new uniform tariff system, clearing the way for the much-delayed overhaul of the health insurance system.

The Swiss Doctors' Federation reached the agreement on the TarMed fee structure at its assembly in Berne. 144 members of the federation's highest body backed the plan, while 30 voted against.

But the federation warned that, although TarMed was largely acceptable, many imponderables remained.

The decision now needs the approval of the federal government, which it is expected to get.

Switzerland currently has more than 20 different cantonal tariff structures. TarMed will introduce a single method of calculating medical and hospital costs.

The new tariff system was the product of lengthy negotiations between the Swiss Doctors' Federation, health insurers, hospital representatives and other interested parties. It was initially meant to come into force in 1998. More recently, January 1 was pencilled in as the starting date in a number of pilot cantons.

But its introduction had to be postponed after specialists protested that they stood to lose up to 40 per cent of their income.

The doctors' refusal to approve the plan until now had, for several years, held up the much-needed reform of the medical insurance system. Even now, experts say much work remains to be done before the reforms can come into force next year.

The new system lists over 4,000 different medical services, each given a certain number of points. However, the doctors are yet to agree on how much a point is worth. The government, in the shape of the interior minister, Ruth Dreifuss, has pledged to put pressure on them to make a speedy decision.

Health insurance costs have been spiralling in Switzerland in recent years, partly because of the high fees charged by doctors. Insurance companies say they're confident that the reforms will halt the trend.

They say uniform tariffs will provide a more transparent system and allow patients to have a clearer idea of the cost of their treatment.

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