The People's Health

New Zealand Listener, Volume 21, Issue 535, 23 September 1949, Page 18

The People's Health

A. D. G. Blanc; A. H. and A. W. Reed | MEDICINE AND THE MASSES, ; ‘6. x

(Reviewed by

J. D.

McDonald

: RE is a book to read carefully. It crystallizes questions that have been waiting, half-posed, in many minds. The theme is health-your health. It could be subdivided something | like this: Section One: "Look after it _ yourself," or "On patent medicines"; | Section Two: "Let George do it," or | "On Medical Men"; Section Three: "Let science do it," or "On Social medicine." ;

All three sections | bear heavily. on pre- | sent problems, even | though the book is a collection of revised lectures held together only by the native unity of the subject. The reader will carry away a great deal about this

or that aspect of health in New Zealand, but he will need to make a coherent pattern of it for himself. The mood of the writing varies, too. In section one, Blanc blazes with the anger and contempt that his subject warrants. In the following section we have a case stated logically, factually, backed by fair and ample statistics; but a one-sided case nevertheless. The book proper concludes | with a plea for social health. The last | chapters, on social security in New Zealand, supply information readily obtainable elsewhere and may be conveniently ignored. The section on patent medicines is strong meat. It opens by reference to the | "lying fraudulent propaganda" associ- | ated with certain alleged remedies. From | this promising beginning Blanc works up 'to a fine fury of indignation. And he | carries his reader with him. After reading this section it is impossible to doubt that proprietary nos- | trums are the refuge of poverty which | cannot afford medical care. Blanc believes they are being driven out of New @ealand. He correctly indicates the evils of self-medication and welcomes its decline. It is a pity that space forbids even a summary of his opinions on herbalists, osteopaths, chiropractors and naturopaths. However, his conclusions are nowhere in doubt. The analysis of the position of pharmacy is most interesting. Social Security raised it from a depressed trade to a most flourishing one. It is frequently said that in New Zealand medicine is a beverage. The total charge of under a pound a head for pharmacy benefits does not bear this out, but there is definite evidence of over-prescribing by a few medical men. © Vitamins and hormones are fashionable at the moment, but the sinister aspect concerns drug addiction. We are all prepared to believe that a reasonable increase in the consumption of drugs was bound to follow the pharmacy benefits because of the backlog of people needing these benefits. The United Nations has since asked why heroin consumption doubled in the past

few years in our country. Whatever the explanation, the mere inquiry is disquieting. T is on the "inside story" of medical benefits that our author is most interesting. We are shown how the successful operation of maternity benefits led to the present compromise method of payment for general medical services. Whatever the system, it.is a golden one. We read of one stout fellow who received £15,000 in a single year-say, one hundred and fifty patients a day, every day. But few general practitioners have failed to double their incomes. Few could avoid so doing. The long pent

up arrears of medical needs swamped them, Yet I think that Blanc is on safe ground when he says that the surprising thing is not that abuses occur, ‘ but that they are so few. As indeed they

are. On the patient’s’ side it appears that New Zealanders seek medical advice fewer than three times a year. About 6,000 of us are in hospital, but the more we use our hospitals the healthier we become. Medical men abusing the scheme are estimated at fewer than 10: per cent. After all, Social Security doesn’t make rogues, It merely reveals those who always were. Nevertheless, the system has not provided a satisfactory service. The patient knows this. So does the practitioner. It has not provided him with leisure for study, reasonable hours, group practice or freedom from overstrain. Clearly, what we have now is merely a step towards something better. Blanc comes right out for a salaried system. And it does seem that clergymen, teachers and scientists, under salaried schemes, attain a standard of devotion which loses nothing by comparison with that of medical men. New sets of comparable figures have become available since this book was written, but they leave all its major points as they were. Certain matters not touched upon include mental health (surely our most pressing problem), the reasons why girls fight shy of nursing, the positions of the medical staffs of hospitals and of chemistry in the -medical course at the University. And Blanc misses the point that the simple publication, on all proprietary labels, of the common names of the ingredients would be a_ self-exposure sufficient for the dullest. Perhaps there is to be a further analysis in more detail. If so, next time, an index, please! All through his book, Blanc is clearly and unashamedly proud of being a New Zealander. And, after reading it, so am I.