SOCIAL EXPERIMENT

New Zealand Listener, Volume 28, Issue 719, 24 April 1953, Page 12

SOCIAL EXPERIMENT

THE NATIONAL HEALTH SERVICE IN GREAT BRITAIN, by James Sterling Ross; Oxford University Press. English price, 30/-.

(Reviewed by

J.D.

McD.

HIS is an "historical and descriptive study" of a major portion of the greatest social experiment ever attempted. It covers in outline the long process of evolution culminating on July B 1948. From then on we have the detail one would expect from the chief "civil servant responsible for the operation of the scheme. He quotes Frankfurter: "Democracy demands that its citizens ufderstand its institutions." He attempts to help such an understanding. We can be grateful for that, even though he is not completely successful. One reads conscientiously through the book, but naturally returns to the aspects one considers important. The general reader will find Part 5, "The Service in Action," of absorbing interest. This is the nearest approach to a bird’s eye view that one can expect. Here are a few of the matters touched upon: The problems of medical care in an ageing population, mental health, specialised "medical ‘service, "The Drug Traffic" (pharmacy), nursing, the dental service, eye service. For good measure there is also a financial analysis, but Ross offers "no opinion as to whether the money could have been more wisely spent. Unfortunately for the scheme, its "merits are so much less spectacular than its occasional shortcomings. Wigs, dentures, glasses, and the indiscriminate gwilling of medicine make headlines. Yet when one considefs the pent-up demand, the immense pressure of accumulated human misery, which burst upon the scheme on the "appointed day," one wonders that the scheme survived July 5, 1948. Nearly half of the people of Britain needed eye treatment, and a still larger proportion, dental care. Yet the most merciful provision, to my mind, was the Medresco hearing aid. Not long ago I talked to many Britons about their scheme. I used it a little myself. And as I waited in the usual crowded surgery my aged neighbour tapped his hearing aid and said, "TI don’t know whether this gave the world back to me but it certainly gave me back to the world." d Of course, in a scheme which covers forty million people and spends four

hundred million pounds annually, there will be difficulties, some of them major ones. Ross is trenchant when dealing with the dental and pharmacy services. Yet his final verdict, on the whole,’ is reasonable. "The service has done well, It must do better." It must train’ more nurses and _ psychiatrists. It must grapple with mental disorder whether it be social failure, mental illness or mental defect. Ross also thinks that the New Zealand dental nurses would transplant readily. , It would be rash to point to 6missions. Yet one misses the clear statement of future aims which alone would give unity to the study. I think Ross realises that in a true "health scheme" the medical profession is not central. Housing, education and research should probably be ahead of medical care. But then a true health scheme would take a long view. This is not possible in the urgency of the situation. Ross admits that the scheme tried to go too far too fast. But would the temper of the times have permitted anything less? What has been missing all along is a sense of direction. The absence of amy warmth, even the heat ofi prejudice, may make for tedium with the general reader, and he may Well find the cool accuracy.a_ little damping. But .this book was worth writing. It is worth studying.