MEDICAL SERVICE FREE

Dominion, Volume 11, Issue 147, 11 March 1918, Page 8

MEDICAL SERVICE FREE

NEW ERA IN BRITISH NATIONAL HYGIENE

FAR-REACHING SCHEME FORE-SHADOWED Dr. Addison, Minister of Reconstruction, has been offered and has accepted tlio post of Minister of Public Health, says the "Daily Express." The. salary will be that of a Secretary of State, £5000 a year. He hopes to carry a Bill through Parliament before Christmas for the formation of the new Ministry. The scheme 13 of a far-reach-ing and revolutionary character, and nifl throw the whole medical system of the country into the melting-pot. The new_ Minister of Public Health will dominate and overshadow the Local Government Board, whose powers hereafter will be greatly diminished, and will ami at notbmg less than- the nationalisation of the medical profession, involving free medical attendance for all without any element of charity. An immediate consequence foreshadowed by doctors is that little of the present system can survive, except, perhaps, that a few independent consulting physicians in extensive and lucrative practice may continue their independence for a time. Many problems will have to be faced and overcome, but the Government is undismayed bv either political or professional opposition. , The Prime Minister believes that the time is ripe for the change, when noshould be prevented or deterred on the score of cost or charity from obtaining the best medical attendance h is believed that tne Government mil obtain a large measure of support for tie scheme among Mr. Asquith's followers,-who will view the new Ministry on humanitarian, as opposed to party,, lines. The medical profession will be strongly divided. On one hand; it will be contended that a Stato niedical system -kills individual effort in the profession, and tends to arrest development and medical and surgical science. On the other hand, the fact that it guarantees a competence and a pension to all medical men may commend the scheme to thousands. His frionds say Lord Rhondda will feel some disappointment at his scheme passing into other hands. Great Reforms Impending. Judge Parry makes an important contribution to the question of public health reform through the columns of the "Daily Chronicle." He writes:— "Many of the old methods of dealing with disease will have to be scrapped. The first step to be taken is well understood. There must be a Minister of Health. The various powers relating to public health in the hands of health insurance, poor law, sanitary, education, and oilier authorities must be grouped together in one new Department—the Ministry of Health. "Fifty years ago our governors and rulers were perfectly happy in their minds about the duty of the State towards the sick poor". Doubtless they did not dispute that it was a Christian idea 'to heal all manner of sickness and all manner of disease," but they waited patiently for the business to be brought about by miracles, and wero sufficiently pious not to make uny sustained effort to interfere with the matter themselves. "To this end any relief of ihe sick 1 poor was rendered as grudgingly as I could be; The Stato ideal was the I negative of the Christian ideal. Medii caf relief was only to be provided for ] such persons 'as could properly bo i deemed paupers,' and the Poor Law J Commission of 1840 laid down the prin--1 ciple that the rules and practice relating to the treatment of the sick poor should bo drafted with a view to 'withdraw ■ from the labouring classes, tlio administrators of relief, and the medical officers all motives for applying for or. administering medical relief unless where the circumstances render it absolutely necessary.' Fighting Disease,"Already wo have school clinics, health visitors, tuberculosis officers, and are beginning to recognise that it is unwise to wait until wo are attacked by disease beforo we make any efforts to prevent its spreading, hut in the New Utopia we must greatly enlarge our responsibilities, and have a national medical service with powers to seek out disease aud combat it in its earliest stages. "A real national health service will not ho effective without a system of national hospitals equipped and staffed at least as well as the best modern voluntary hospital In saying this one ought, perhaps, to add that the country owes a great debt to the older hospitals, and that no interference' should be permitted with their endowments or management. In order to establish universities in Manchester, Leeds, and Birmingham it was not necessary to disestablish Oxford and Cambridge. In tbo same way St. Bartholomew's and the Manchester Iloyal Infirmary, and many other hospitals may well be left untouched, as examples to emulate. "Over and above the institution of a national medical and hospital service wo shall have to give the Minister of Health power to enforce some of his decrees,' if certain diseases are to bo stamped out of our midst. A nation that has welcomed compulsory education, and put itself under compulsory military service, cannot raise any serious objection to compulsory health. At present 11 per cent, of the deaths, or 1 in f), aro due to tuberculosis, ami our national annual death roll from this plague runs up to 75,000. As far as a layman can understand the matter, it seems clear that our present methods of cure, though they may pp-vent much suffering, will not abolish the disease. '■'The Ministry of Health in this— and, perhaps, in .other diseases—ought to have the power to enforce a reason- 1 able measure of separation against dan-1 gerous and infective persons. One is not allowed to-day to travel abroad with small-pox or scarlet fever, and looking at the terrible suffering and economic waste cau-scd by tuberculosis, once it is agreed that the segregation of consumptive infectives would be in ' thp interests of public .health, mere. 1 sentiment and sympathy should not hinder us from making the experiment."