The Daily News. MONDAY, MAY 31, 1920. NATIONAL MEDICAL SERVICE.

Taranaki Daily News, 31 May 1920, Page 4

The Daily News. MONDAY, MAY 31, 1920. NATIONAL MEDICAL SERVICE.

The interim report of the New Zealand branch of the British Medical Association, on the subject of a national medical service (published in the Journal of Public. Health) is a document that should be of great interest to the people of the Dominion. This question has become prominent at the present -time chiefly by reason of the increased responsibility of the State to undertake the prevention of disease and the promotion of the health of the people. Moreover, the vexed question of hospital treatment for those who can well afford to pay for medical and surgical treatment as well as nursing, is one that calls for settlement in order that ratepayers may not be burdened with any part of the expense connected with these cases. Another phase of the matter is the provision of medical services for country districts—an urgent need. The Association is emphatically of opinion that the success of any modified scheme of national medical service is mainly dependent upon suitable control, which must largely be in the hands of the medical profession, and a strong point is made, with regard to the Board of Health, as already established, that appointments thereto should not be nominative, but that the members should be elected by the profession. The logic of this contention is irrefutable, while it is claimed the Minister should be a medical man. It would certainly seem that until the Health Department is thoroughly organised and the lay element made- subsidiary to the professional, the position will be adverse to the welfare of the people. That the Association, which voices the views of the profession in the Dominion, expresses opinion in favor of the establishment of a national medical service is not surprising, for the need of such a reform is apparent. The trend of the advocated changes is in the direction of extending and strengthening the Department, more clearly defining the functions of the administrative heads, making the health areas a size suitable for proper control, bringing the Department more into contact with the clinical side of medical work, bringing the medical services of the Education and other departments under the control of the Ministry of Health, provision of medical services for remote and sparsely populated and mining districts, payment of medical officers in this service by salary to be fixed by the Board on a scale in accord with the nature of the services and for speciai ability, and a modified form of national service for poor patients at their homes in the cities and larger towns, a service that it is considered could be performed by a part-time medical officer. Probably one of the most important recommendations is that which relates to hospitals. It is not proposed to abolish hospital boards, but to largely increase the State control of these institutions. The work now done by the honorary medical staffs should, it is considered, be adequately paid for on a part-time basis, thus abolishing all honorary staffs. Needless to say this reform would very largely in. crease the cost of hospital administration, though it is not surprising that the profession should put forward the proposal. The domil nant idea appears to be that, hos-

pitals should not only be equipped for ordinary eases, hit be provided with adequate operating rooms and appliances, X-ray, electrical and other specialist necessaries, as the new diagnostic methods urgently require these aids to successful work. 'With regard to private patients at hospitals, the adoption of the Toronto system is advocated. This involves the erection of separate buildings in hospital grounds, the patients being charged on a scale based on the nature oE the accommodation nursing and medical services required, the patients selecting their own doctor and paying him such fees as may be mutually arranged, but the fees for nursing would be on the private hospital scale, ar.d the profit would go to the genial funds of the hospital. There is no doubt a certain amount of abuse exists at present which cannot be obviated unless provision is made for this class of patient,. The scheme has been well tried in Canada, America, Britain, and on the Continent, as well as in maternity annexes in the Dominion. There is much food for serious reflection in the contents of this interim report, and the matter is of such great import that it should receive the earnest consideration of Parliament, the public, and the medical profession.