Social Medicine Service Must Be Modified

Bay of Plenty Beacon, Volume 16, Issue 4, 6 October 1950, Page 6

Social Medicine Service Must Be Modified

Unless recently-introduced redorms provide satisfactory remedies, the present system of social security medicine in New Zealand will have to be considerably modified or replaced by a more readily controlable procedure. This assessment of medical services provided under the social security scheme is given by Dr Duncan Cook, director of the division of clinical services, in the annual report of the Health Department.

Increases in the cost of general medical services and pharmaceutical supplies have been of such magnitude as to lead to serious misgivings as to whether State medical insurance against sickness is practicable or whether the best method of payment has been adopted, he says.

The method of paying doctors should neither encourage quantity rather than quality of service nor encourage the people to make unnecessary demands on practitioners, private insurance companies in the past have experienced the same phenomena with accident and sickness policies. They have protected themselves against financial loss by limitation of policies both regarding the nature of the illness and its duration.

Dr Cook reveals that general medical services in 1949-50 accounted for £2,328,154. This represented 6,208,410 .individual services by doctors to less than two million people or an average of more than three attendances per head of population. Pharmaceutical services cost £2,043,843, an increase of £250,684 over the previous year’s expenditure. For this sum 7,240,000 prescriptions were dispensed at an average cost of 5s 7sd, which amounted to approximately 21s per head of the population. * Dr C. A. Taylor, director of the hospital division who discusses the increased cost of hospital services of the department, in the same report, points out that under the present system all additional expenditure is borne out of general', taxation and there is no restraining influence of local district or individual responsibility; for meeting the cost. So long as hospital and associated services are devoid of direct financial responsibility, the upward spiral of expenditure will be difficult to check, he says. While the principle of compulsory insurance against the financial hazards of illness is now popularly established, one cannot but feel that, as with other forms of insurance, an element of franchise should be retained as a safeguard and that the “insured” should be required to carry some of the risk, Dr Taylor states.

If the limitations of hospital administration are adequately recognised, there may, for instance, be a case for imposing a moderate maintenance change on patients for board and lodging in hospital.