MEDICAL MATTERS.

Dominion, Volume 7, Issue 1994, 27 February 1914, Page 4

MEDICAL MATTERS.

IN ENGUNO, TALK Willi DR. J. A, MCDONALD. : An innovation, at the Australasian -Medical Congress heM recently at Auckland' was, tho presence of n ropresentativo oitho members of the medical ps-tt-'fessioji in Great Britain, iii the person of Dr. J. A. Mactloiiaid, Chairman of the Council of the. British Medial Association. Although tlw parent assoti* ■iitioii hqis irfiqu-enliy been invited., :la past years, to ueiuL a tlf?k»gato te the Australasian Congress, tho ...invitation was never auscpted iiiitil this year, Dp, Mac-donaki, who is at preselit spending a few days in Wellington, as a tjuest of Dr. Kennedy-Eiliott, told a reporter who interviewed" him, that lie, wis partly influenced, in deok'liijg. to EtHwc «at to Mew SHcalonsi ns the te.Jicsentalivo of his association by the rnet that lie wanted to make an. ■extended teilth trip. Ro added.that ho -.as ■very glad ire had come, and would certainly suggest that a British, representative, or representatives, should lieiieetorth attend tho Australasian Congress. It was highly desirable that doctors here and those in tho Old Country .should keep in touch with one another*, wid 1m hoped that Hot ordinary doctors only would visit Australasia,, 'but also some, of the leaders of the 'profession. i Dr. Macdonald declared that 'medical men iii this country, so far as he Was ■ii'hie to judge, were quite on a par, to ■put it on tho lowest terms, with the I members,-of the' profession at Momc, | and lie expressed tho opinion that British doctors could learn 3 great deal hy csiniiiß ml bore., just as New 'Zealand and Australian doctors «nd ■s'tudeii.ts could learn % great deal by sojoUriting' for a time in the Old CoiMitrw"

Oocters ana The British AoU . At- tho requßst of his Biterviowef Or. Miidonald stetehed interestingly the', inatiguratioii and ope.fawn of 'tho National liisnra-n.ee, AH in (Jr&lt firrt-ain. Ho empkiitit-alty roitrndiafad -a sngnts.ti«n that the Art tended in- any'wav to bring about na-tionalsation o : f the wcdmal iw&fcssian. It eaino pracfricivflv,m said, to "-dub" practice, ■so.-Bicfhifig «Ko i'Tiewlly Society practice iii this .Muntry. Under tho Act every worker. had a certain. s«m rledireted -from, his ivcetcly .wages, tho employer paid .afiirtlior co-iitr-ibutiott, an 4 still another was ] .made % tho Government. The benefits ■thus socurfid included niefei benefits, but only tor tlm worker who was it : contributor a&l not for his wife, and' faintly. The worker iwd a right U. choose any medteal nion he Kke.d while ■ the doe'ter was perfectly free to refuse the patient if he so desired. At ftrst conditions under tho iiisttfanco A"* gave rise to a good deal of friction with •n IS ■* o;f t ' 10 'toxical pt'ofessiai'i. UlO Bill was based te a great extent upon tho "iclub" or lodge practwo previously existing. In & s laiid each lodge had a doctor attached te it who a-t'tend-eo, nil of its members. Families, as i-ft-difiateu, ffeno t-K'a/ted as private paints except where some special arraiigcjnoiit was made. Oiioof tlio.objections'raiired by Uie -doctors to this system was thai they were under- the control jv 'f • cojnn » tt w> of lodge oiiicmi«. -fhey had fw reptesen-tatibii upon bQaies of this ki-hd, but were fiab'M' to in ea-ljed before fmrn. ivhcii Go'niplaints were made and found fau,tt with or dismissed. Tiro roniunetAfioii reeeiv•wl by the doctor "(in England), -was a.t- tho rate ef eno penny per tok far faeh iia-teeirfe-;.il*rssrate''rMji9}he(l : imdiaMfet(: teoin about 1844 until recently, altheifeh ' ■during that period the wages of ■worKiig .teicu iii.ei'.Gased something like threefold,- .and coiiicidontally • the' troiiiijig which a' daetor.has to niidergo became much more expensivo. l.h the 'forties v rough and ready practical training extending over about throe years was ■deemed suffleiewtr-ra ..very .different schooling to the nlnhorate'co-urso through 'which, a!'medical s-tudeiit is expected to pass .aswadays. Anottef jjoint made by the doctors was that in the aid days working men were "much less given to soektiig medical aid thanthev are at the' p-resent day. . The Insurance Bill drafted eontaiiir. ■cd pro.visiftn.s similar to tliflso hero'owtr Kneel, but the medical men raised objections, and in .a contest .-with the Government obtained A number of concessions. For example, they, seemed iyit in-drc-ase »i the rateftf paynicwt&oiii Gs. to ■Ss. 6<L per worker _ per .s-antuim*. This amount oarers nie'diein.es ant! applianeeai but is oen-sittored adqpjiato. ' As :fo.r lis the rate of payment goes, TJr, Jlae- ; doiiald stated, the doctors' are fairly ' satised, but the M, has 1 iiob yet been long enough in operation'te enable any definite eoiiefiision on tlio stibjeet- to be. 'arrived at. • •■ '

friendly Societies Displaced. One kipbrtaiit concession' lo the doc-' tors ■ was that the a.djni'iifetraJ.ion of inedieal benefite under the' Act was taken ■out of tho haivds <ii thi>'.Fri'ei'.dl.y Seqiflties and placed under the control of Insurance Committees, oir which eihpto-v-* crs, iusttted people, auol the doctors- all have representation. The doctorSi jiow■ever, consider thai the measure of representation granted'tirem en these bodies'k inadbljunto.. Where'fault.'ls feumd with a doc.kn'j the coaiiptoint, as inafiters •now stand.,' is investigated by -a- misei tribunal, coivsistihg half o:f doeters and. half «f fepreseutativos of inStire.d':|x i o.pic :j %vitk an -independent ■chairhwn. A-iiothef important aniendreent gives the -various I-tifihraiice Oommittees power to Indiyidnally fis -an "income' limit" if they so desire. Tho idea is that the Insurance Committee has power if it thinks proper to rule that persons in receipt q'f an incenw greater than tho {iniit fixed shall be exelijded from the hone-fits of tho Act. It was eon* side-tod. impractJcabta to fis a national inconie-limit on accotint of the esteni te which wages vary in. different parts of the country. As was the cfise under \he clnh or lodge, system, attend'-. aneo 011 the families and svives of ivorkers (unless the .Utter wt tlienissh'-fts 'CM-rtribiiters) is left to .private arrange-' iiifent or in some cases the 'woman and' children -ate fownetl into separate clubs apart from the Insurance Act. upon .the whole,. Dr.. J'JseclouaM considers that the Act; as it now stands, is likeb* to operate fairly satisfactorily..

■Physical Education. , There is'no State system <jf physical education in the. sehepis of Great Britain, but something has' bcßh daiie ]& this deparijiioiit in the way of privsle effort. Dr. Mn.cdenald considers tlvat such a system as has heeh ostablisilvcd. in New Zealand is likely to produce, valuahlo results I it is jttdieiOttsly administered.

A coffljjrohortsivfi system of medical . inspection .of school children exists in I Great Britain, but there is no ■ accqin* partying State treatment of .ailing :ii.n.3 defective children. Whero ctn'Mreft are found tts be <M«c|iv« »iv aiij way cards are seat to their parents with a simple statement of tho :fae-t. No clo* tabled diagnosis is supplied, Tlio local authorities in tho education areas have pmver. io draw upon tho local -rates to provide treatment far. childroftj a-.iid m souio cases do so. Sfcnjbbrs ol tho nieslieal profession., however,, favour an- '■ oilier systom~-4]iat of treatment by tho :' fa ml] J 1 doctor, They .consider ' thai',: ■children standing in need of treatment ■ should he. sent, to tb.c family doctor., ami that tho cost should bo pan} b,y: the local, authority. Advoeany of the family doctor orrangtoKmt is 'based, of : course., Mpan the .assiunptien that >|io . will b« familiar with tho cotistv'tiitioh '-. nf a child from its birth onwarfs, and,:';. 'knowing its weaknesses, will be 'hotter ' able to treat them ■nffectUi'illy tiltaij• a. | practitioner who -sees the ehild far the"f■ first timo. II