NATION’S HEALTH
B.M.A. AND CABINET A GRAVE RISK BEING RUN. MORE PRESSING NEEDS. (Special to the “Times-Age.”) WELLINGTON. This Day. The promotion of health is a greater object to be aimed at by the State than the treatment of sickness, though the latter is not to be under-estimated; and National Health Insurance, being merely a system of indemnification for sickness, does not materially advance the greater object. In emphasising this in an official statement issued today regarding the Government’s National Health and Superannuation Scheme, the New Zealand branch of the British Medical Association declares that the Government would have been better advised if it had just devoted itself to improving housing and working conditions, the provision of domestic help and better nutrition and prophylactic or preventive methods, and the development of research. House Improvements Neglected. Regarding housing the association points out that, while the Government is spending vast sums in the erection of elaborate houses, it has neglected altogether to make any provision for the improvement of existing houses which is absolutely necessary in so many cases. The Government, it admits, has taken some interest in this question by making investigations, but it has left it at that, although it has been demonstrated that a surprisingly large number of houses are inadequately provided with the necessary equipment for personal and domestic cleanliness. A large number of dwellings are insufficiently supplied with baths, sinks, tubs and proper sanitary and cooking arrangements, or are defective in light, ventilation and space. Remedy of these conditions, the Association urges, is more pressing than provision of free medicine for all. Need for Help in the Home. As ( to conditions at work the association states “that in shops, places of business and factories, employers and employees too frequently spend their working lives in quarters which are cramped, with by no means a sufficiency of light and air, and have sanitary arrangements which are primitive and unwholesome. In places of public resort, especially in the country, the latter point is frequently noted. We are not satisfied that the sanitation find cleanliness of schools, in which the children spend about a third of their waking lives, are always as efficient as they should be. “Also a good deal of indifferent health in women, and poor development in children, may be ascribed directly to insufficient home assistance. Women carry out duties too heavy for them, and, having too little out-of-doors recreation, become unable to care satisfactorily for their families. This is not remediable by medical means, but it often results in these being necessary, though the costs involved do not remove the cause.” Will Do More for the People. Dealing with the vastly important question of nutrition the association states that “every doctor notices in his daily 'Work a frequency of nutrition' defects, especially in children, which is out of keeping with the plentitude of wholesome nourishment this country affords. It is but necessary to choose a few of the well-nourished in any group, whether of a school class, territorial cadets or health camp, to see how far short of good standards too large a proportion falls. “There are admittedly problems of nutrition requiring investigation, but, without waiting for this, there are obvious common causes. As applied to towns, pressure of domestic duties encourages the housewife to use the most quickly and easily prepared foods, with least use of utensils. This leads to reliance on prepared and preserved articles of diet lacking in freshness, devitalised by sterilisation and of lowered nutritive quality from over-refinement, but lauded by advertisement. In country districts, children who have done farm work had a hasty breakfast, travelled to and from school with a pocket lunch, and have done more farm work after school, are not in a condition to make a healthful evening meal.
“Remedy of the conditions causing those things, and education in the value of the natural produce furnished in such variety and abundance by this country to suit every individual taste and requirement of omnivorous man, will do more for the people than all the dietary systems in vogue or the entire National Health Insurance formulary of medicaments.” Prophylactic or Preventive Methods. “It is naturally in the early stages of life,” proceeds the statement, “that prophylactic or preventile methods produce the best results. The growth of pre-maternnity supervision, Plunket Society work and school medical inspection are all a recognition of this. But all those are tending to develop into organisations divorced from the ordinary practice of medicine. In this connection we think that those types of prophylaxis would be made more effective by closer co-operation both amongst themselves and with the members of the profession who are working amongst the people and are necessarily most conversant with home conditions and family histories. Not a Single Better Tooth! “Certain conditions of disease, not unknown elsewhere, are met with so frequently in New Zealand as to constitute national blemishes. The treatment of these adds materially to the costs of medical care in this country. We hold strongly that a wiser policy is to stimulate research for the elimination of those Conditions. To provide more treatment which does not eliminate them merely adds to the cost. Examples of what we refer to are dental caries, goitre, the prevalence of adenoids and tonsillar disease, and the frequency of cardiac disease in young people and minor degree of malnuition. The first of these furnishes a good instance of what we mean. If dental benefit were included under National Health Insurance, the provision made would naturally be free extractions, standard fillings and standard dentures. But extractions, fillings and dentures provided ad infinitum and in perpetuity would not enable the whole population to produce a single better booth.
“Sil- Arthur Neysholme says: —“It is always true that prevention is more important than provision. In so far then as provision for sickness slackens personal or communal efforts for its prevention, or diverts funds which necessarily are limited, from prevention to provision, it is to be strongly deprecated.” “Such diversions of funds from prevention to provision is a characteristic of New Zealand’s policy in medical matters which should not be perpetuated, for this country, for a number of reasons, is now eminently suited for many branches of medical research. It has already been a source of satisfaction that the Government, realising the importance of these problems, has set up a Council of Medical Research which is undertaking consideration of these matters.” “Can Effect No Improvement.” “The associatidon urges that it would be far better for the Government to proceed along these lines than to rush through its health insurance proposals, which, even in their most successful application, provide no additional service and therefore can effect no improvement in the present health of the people. Indeed the Government runs the grave risk of achieving the reverse, due to conditions being introduced which may prove to be chaotic. The association, as the only expert body which can give advice on this issue, has already strongly advised the Government to progress along these lines, but not the slightest notice has been taken of its representations. Under these circumstances the association surely cannot be held to blame if it finds it impossible to co-operate with the Government in carrying out the Government’s scheme.
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Wairarapa Times-Age, 18 August 1938, Page 11
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1,209NATION’S HEALTH Wairarapa Times-Age, 18 August 1938, Page 11
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