STATE MEDICAL SERVICES

Ashburton Guardian, Volume 70, Issue 104, 15 February 1950, Page 6

STATE MEDICAL SERVICES

MR. HOLLAND SPEAKS TO B.M.A. BEST RESULTS WANTED FOR EXPENDITURE (P.A.) WELLINGTON, Feb, 14. He pledged the Government always to consider sympathetically, and he hoped representations of the medica! profession, said, the Prime Minister (Mr S. G. Holland), addressing the annual conference of the New Zealand branch of the British Medical Association to-day. A prime minister wasj a doctor in the economic sense. “Economically my patient isn’t very well just now,” said Mr Holland. “I have just completed the diagnosis and found tlie cause of the complaint from which my patient is suffering. “The new Government is prescribing a remedy. The patient is no longer in danger, but'the doctor arrived just in time. I hope the patient doesn’t find the medicine entirely distasteful.”

The new Government wanted to cooperate Avitli doctors, not quarrel with them. He wanted doctors’ representatives and the Minister of Health to sit round a conference table for discussions.

“We mu3t look into cutting out a lot of extravagances, which I think you would he the first to concede exist, sometimes in considerable quantities,” said Mr Holland. “We want to see we get the best results from £47,000,000 a year spent on social security. Wasteful expenditure is wicked. We must face up to things as they are, not as we think they should be.”

“I believe we are not at the end of the State . organisation of medicine,” said Professor R. S. Aitken, ViceChancellor of the University of Otago, in an address to the conference. The only difference he saw being made by which ever , political party was in power was the speed, with which the process took place and the wisdom with which it was guided from step to step. The first concern of the medical profession should be to see that medical standards were maintained, he said.

GROWING COST OF SERVICES REVIEW BY MR WATTS (P.A.) WELLINGTON, February 14. The Minister of Health (Mr J. T. Watts) appealed to the medical profession for patience, understanding, and co-operation in dealing not only with its own problems but also with other problems of health in New Zealand when he addressed the New Zealand branch of the- British Medical Association this evening. Mr Watts said it had not taken him long to discover that there were many difficulties facing him in^the administration of, his portfolio. To- many of the problems there did not appear to be any easy or ready solution. “Not the least of these problems affect your profession,” he continued. “The introduction of health benefits under the Social Security Act has altered the whole attitude both of the public end of the profession to medical services. I know that when the scheme was first introduced, many members of the profession were gravely concerned and their concern has been justified. The criticism that has been levied against the profession should rather be levied against certaip. aspects of the system, for I believe 1c is the system which fundamentally has produced the present situation. .

Consultation with Profession

“I would, however, point out that in the field of public health there are other difficulties, apart from those affecting your profession. In fact your problems are only part, and not a large part, of the matters which I face as Minister of Health. I ask for your co-operation, in dealing with not only your own problems but the other problems of health which face New Zealand. I will consult with the profession on matters of mutual interest and I hope to receive the help and sympathy of the profession. “This may be a time of difficulty in the field of health, but it is also a time of great opportunity.”

Mr "Watts said figures for health expenditure gave cause for concern. The total expenditure on health benefits had increased from £1,776,685 an 1940-41, the first full year of operation, to £7,843,634 in 1948-49. In 1941-42 the cost of general medical . services was £831,397 and in 1948-49 it was £2,112,304. Payments to chemists for pharmaceutical benefits in 1942-43 were £530,695. They had increased to £1,727,556 in 1948-49. Expenditure on medical and pharmaceutical benefits for three-quarters of the current year exceeded expenditure for the same period of last year by nearly £258,000.

Abuses in Some Gases

“There are valid reasons for this rise in costs, but there is no doubt there have been abuses by some medical practitioners which have led to claims on the Social Security. Fund out of all proportion to the value of the services rendered,” Mr Watts said. “On the subject of pharmaceutical services, the department advises me there is evidence of much unnecessary and costly prescribing. The people of New Zealand have undoubtedly benefited as a result of Social Security medicine, but it must, be obvious to both the public and the profession that the services rendered must be paid for, whatever the method of payment.

“In New Zealand the cost of Social Security services is met by direct tax on wages or other income, and by a contribution from the Consolidated Fund. It is the duty of whatever Government is in office to ensure that, expenditure is kept within reasonable limits and that value is obtained. “I do not wish to comment at this stage on the two main methods of remuneration of medical practitioners under the fee for service system, as I understand that a negotiating committee has been appointed by the profession. As yet no proposals have been forwarded to me by my department and no decision has been made on this important matter. The first thing to do is to make a proper diagnosis be-

fore proceeding to treatment or to operation. Changes in Administration “The profession has been given the opportunity of legislation of assisting in the administration ,of the' act. My is in agreement with the proposed changes, because no system of administration will be satisfactory without the full co-operation and assistance of the medical profession. “It is obvious that alarming increases in expenditure associated both with the general medical services and with the supply of pharmaceuticals cannot continue indefinitely without a general breakdown, and that failure to eliminate abuses and reasonably to stabilise expenditure may make some alternative' system of payment of medical practitioners necessary. “My Government stands for a system of private enterprise and it wishes to see as much private and individual effort in the field of medicine as in any other branch of our national life. It wishes to see the great medical profession with its traditions of service and self-sacrifice standing at the pinnacle of public regard. Steps already taken will assist, and with a Government which is sympathetic to and understands the difficulties of the profession, I trust that the profession will make great strides.”