MEDICAL SERVICE

Wairarapa Times-Age, 23 September 1941, Page 4

MEDICAL SERVICE

ON STATE SALARIED BASIS ADVOCATED BY MEMBER FOR MASTERTON. PUBLIC MEETING LAST EVENING A State salaried medical service was advocated by the member for Masterton, Mr J. Robertson, in an address last evening at a largely-attended public meeting held in the

Masterton Y.M.C.A. building/ The Mayor, Mr T. Jordan, who JnY sided, said that all were concerned with what was happening to the doctors, and he was glad the member for the district had called the meeting.

‘•The lack of co-operation lies with the doctors,” said Mr Robertson. “Clause 78 of the Social Security Act clearly shows the Government's intention to co-operate and work with the doctors in providing a workable scheme.” Since 1937, when the doctors produced their first scheme, the Government, he added, had endeavoured to get the doctors to adopt a universal health service, not on a basis of the financial capacity of patients, but in terms of patients’ requirements. After every measure had been adopted, the doctors had refused cooperation to the Government and the friendly societies alike. The present Bill had been introduced as representing the utmost concessions the Government could make to the prejudice of the doctors, while at the same time providing a universal medical service. A great deal of hysterical nonsense had been talked about the present measure, continued Mr Robertson. It was quite apparent that most critics had not even read the Bill. For instance, it was stated at a public meeting in Masterton that it would end the confidential relationship between doctor and patient and would prohibit private practice. It was quite obvious that the person making that statement knew nothing of the Bill. The Bill provided for two things, and two things only. (1) It fixed the fees. (2) It provided for payment from the Social Security Department. It in no way limited anyone’s freedom as to the choice of doctor, nor did it prevent any doctor entering into an arrangement with a patient to the mutual satisfaction ‘of both. Any keeping of records would be less onerous than the present book-keeping required by any doctor. It was interesting to note that the same objections as were made by the principal speaker at the recent protest meeting were raised by her and others when it was proposed to put the Maternity Medical Service into force. The service had been in operation for two years; yet no complaints were heard today from doctor or patient. All the dire things that were to happen when the Act came into force wep?.l. shown to have had no substance' of faA behind them.

It had been argued, said Mr Robertson, that because of the number of doctors at present overseas the scheme should be withheld until their return. Yet, out of the 250 doctors who joined up with the forces for active service, only 122 were in active practice when they joined up. and some of those were specialists and not affected by the present Bill. Further, in each of the years 1939 and 1940, 80 doctors graduated, and in 1941 there should be another 70. The Government has guaranteed that any doctor now overseas would receive for at least the first 12 months after his return the same salary as when he left.

The Director-General of Health in Queensland had stated recently that a group practitioner service, under State control, would be the inevitable result of a protracted war. In Africa the opinion had been expressed that doctors on service wanted to continue working for the State, and were now laying the grounds for a great State medical service. The question of shortage of doctors should not develop to any great extent. Further, if there was a shortage, the Bill provided that doctors in any given area could co-ordinate their own services and establish a clinic if they cared to do so in order to regulate their hours to give relief from overwork.

ON STATE SALARIED BASIS

“I do not regard this Bill in any way as perfect,” said Mr Robertson. “The object to be aimed at is a salaried medical service, and it is interesting to note that the trend of modern medical opinion is definite in that direction. If the younger men of the B.M.A. in New Zealand, who arc all aware of the faults in the present method of medical service, would assist themselves and make proposals to the Government for improving the service, then the Government would welcome it. The Government’s object has been to secure a universal service for everyone who requires it, irrespective of their financial standing.” Mr Robertson quoted from the “Lancet" and other publications, articles which expressed favourable views on a salaried medical service. “Dr Parr (Medical Superintendent of the Masterton Hospital) need not apologise for advocating a State salaried service,” Mr Robertson added, “because he finds himself in good company in doing so.” NEED OF CO-OPERATION. Mr Robertson quoted a report of a meeting of New Zealand friendly societies which showed that the societies | themselves regretted that the doctors had not co-operated with them in the manner suggested by the Government some months ago. “Doctors in New Zealand who accepted the capitation fee service find that night calls have declined,” Mr Robertson added. He explained that people who felt ill, when they had to pay for attention, delayed calling the doctor as long as possible. Temperatures rose at night and the doctor was called in. A STATEMENT DENIED. “Mrs Barrer is reported to have said at a recent meeting that, during the depression, when people could not afford doctors, there were fewer deaths,” Mr Robertson observed. “Surely it was unkind to say such a thing about the doctors.” Mrs Barrer: “I did not say that.” Mr Robertson: “I am assured by several people at the meeting that you did.” Mrs Barrer: “I did not say it that way at all. It was wrong.” Mr Robertson: “Well, I took the trouble to look up the figures and Mrs Barrer was right: there were fewer deaths.” Continuing, Mr Robertson said that Mrs Barrer had summarised the _ objections to the service under headings. One was: “The desire to raise the service rather than lower it for those better off.”

“That is an indictment of the doctors,” Mr Robertson said. "It shows that there are two standards of service. Well may the doctors say. ‘Save me from my friends.’ I would suggest that they get a new champion." Mrs S. Fletcher said she considered that the Government had been unfortunate in the way in which it had presented its case to the doctors. She suggested a compromise, adding that if there was a strike, a Minister of the r Crown went to the strikers and took his hat off.

Mr Robertson: “That is not correct.” Mrs Fletcher suggested that, the doctors should be paid by patients, who could obtain a refund from the Social Security Department.

In reply, Mr Robertson said it was simply reversing the present scheme. At this stage of the meeting Mr Jordan took strong exception to the remarks passed by a member of the audience. He said that he did not intend sitting like a “dummy” and pointed out that the offender should take direction from the chair or leave the meeting. !

PRIVATE PRACTICE. Dr J. C. Forsyth asked if the Act provided for the right of private,practice. He had been advised, in Wellington. that it did not. Mr Robertson, in reply, stated that it did.

A suggestion that the scheme should be left until after the war, as it diverted the attention of the public from the war effort, received a strenuous reply from Mr Robertson: “Why can’t the doctors come in?” he asked. “They will have to, in any case. There is only one Government in this country, elected by the people.”

In reply to another question Mr Robertson said that the doctors had not provided a medical service to the extent that it should be given. Cries of “Shame!” Mr Robertson: “The doctors say it themselves . . .”

Mrs Robertson stated that she had been misreported in connection with her remarks about Dr Parr and the Russian medical system. She said that at a recent meeting she had said that Dr Parr was not in favour of the Government’s scheme, but favoured a State salaried service.

(Our reporter’s statement that Mrs Robertson’s interjection was reported correctly is supported by independent testimony which can be cited if necessary.—Ed.) Dr N. H. Prior stated that, as Dr Parr was not present at the meeting, he would like all present to know that Dr Parr was not in favour of the Government’s scheme. Mr Robertson said that he considered Dr Parr was among those who had not read the Bill. Mr Jordan at the end of the meeting gave a brief address. He urged all present to lay aside their differences and to avoid looking at everything through “political specs." Mr Jordan considered that a good deal of the misapprehension which existed today would have been avoided had more publicity been given to the Bill.