FOR THE POOR.

Dominion, Volume 5, Issue 1292, 22 November 1911, Page 5

FOR THE POOR.

OUTDOOR MEDICAL RELIEF. AX EXPERIMENT, AXD RESULTS. Some interesting statistics, supplemented by instructive comment, wero tabled at the monthly meeting of the "Wellington ilo.-pital and Charilablo Aid Hoard yesterday in connection with (ho board's three months' trial of a system of outdoor medical relief for poor people. The I ot id number of cases dealt with was 2X I If tlu-e, It! originated with the doctor, while the oilier seven were attended by doctors at the request of the officer on the application of patients or for charitable aid purposes. .Vine doctors reported original cases, whilo three attended patients at the request, of the officer. The total medical fees amounted to .£2O, and chemists' amounts for prescriptions to Jfl lis. Sd. Six of tho twenty-three patients were ordered into the Hospital, two were reported for outdoor treatment, at tho Hospital, eleven wero treated at home, one merely required a consultation, and three attended for charitable aid purposes only. Field Should be Extended, "Theoutstanding fart disclosed by tho abovo figures," commented l.he Siiperinlendenl. of Charilablo Aid (Mr. A. 11. Truebridge), in his report, "is tho small number of cases reported—sixteen only— during Ihe three months, from which' it would appear at first sight that the necessities of the poor are well met by tho Hospital and that, assuming that all suitable cases have been reported bv all the medical men, the volume of ' free medical treatment falling upon the shoulders of the medical profession was overestimated at the conference from which tho present, arrangement originated. It has been pointed out to me, however, (hat the limits proscribed under (ho present service are very strictly defined, and that they exclude a class of eases which is more numerous than that of the, strictly indigent. Particular instances of such cases have been described to me where {•lie details given would, if confirmed, havo justified their acceptance, but. they were not reported because tho suggestion pi charitable aid was repugnant and met by promises to pay, which though most probably impossible of fulfilment were apparently sincere. The representations made in this direction would indicate that there is an intermediate territory between tho strictly indigent as interpreted by us and these whom the Friendly Societies reach, which is the most urottuc in providing non-paving eases "for the medical profession and vet inaccessible to any free system. "If this is so," continued Mr. True"the question arises whether the Provident Dispensary.' outlined and recommended by tho English Poor Law Commission, would be desirable or practicable. The scheme indicated is tho association of given numbers of subscribers of very small weekly sums, subsidised by the local authorities, into societies to each of which are attached a given number of stipendiary physicians and also dispensing facilities. As this amounts to no more than tho establishment of pub->-ciT s " 1)?ltl 'sod sick benefit societies, the difficulties and disadvantages in such a community as that of New Zealand become immediately obvious. A line of demarcation between such societies and tho ordinary Friendly Societies might possibly bo created by a wages limit but it appears to mo that this presents tremendous difficulties, sb far as I'can see, therefore, and in this view I am supported by these doctors with whom I have discussed the question, there is no practicable way of dealing with this class of case except by (he personal philanthropy of tho medical profession as at present. Gain to Charitable Aid Economy. /'Another class of case, 1 am told, provided a good many free patients, namely, that of minor accidents. Men turn lip at a doctor's surgery with perhaps broken heads, or wounds about tho limbs, ihe injuries have to bo attended to, but I in many instances the patient is unable to give any very definite account of

himself, perhaps through drink. In nine cases out of (en ho has no money, and forgets (o return to pay the doctor. Should cases of this kind come under the. service;' If is next to impossible to prove indij,'enee or the contrary, so that much would have to bo left to the surgeon's discretion.

"J have endeavoured (o ascertain whether, if the service is continued, it would be desirable to appoint n givon number of doctors under it instead of making it apply (o all. I am led to think that (ho present plan is must acceptable to the profession and certainly il is best for the patients. One of the objections to limitini; the number of doctors i.-. that; if is fioriuenlly impossible to rliLssify a case until a visit; lias been paid. As far as the eases treated are concerned the service gives grounds for satisfaction. Generally speaking, (herefore, it. may be concluded that while the number of eases is small, (hey are all such a.-, justify (he outdoor medical service. Another important and valuable feature of the service is that il, is capable of affording material assistance in Jhe Charitable Aid Department, proper. The cases listed as for charitable aid purposes only belonged to country districts where it. would have been costly to send the visitor, and whore, moreover, medical reports were alone, of value. Tim results were that, in one instance a cosllv r ,"S ws * t«'rmiiiatc«l; in another a nws't 'lifhcull; and delicate case was effectively dealt with; in another wo wero enabled to adopt an effective course otherwise impossible: while in (ho last, wn are able to continue assislanco with confidence. .My experience has always been that; modiral advice is often the only mea.us for deciding doubtful charitable, aid eases I should like to fake this opportunity ot acknowledging the carefulness ami fulness of the medical reports sent, mo in response to orders under this service for one visit, for examination and report'." lii moving (he adoption of the report, pi •'•,, \-\ ty™" 'chairman of fho Charitable, Aid Committee), said that in View of Mr. 'lruebridgo's report he would nsk (be board to consider the question of continuing the service for an addilional three months.

This was agreed to and Mr. M'Kwen'ssuggestiou adopted without discussion. '