MEDICAL CONGRESS.

Auckland Star, Volume XLV, Issue 34, 9 February 1914, Page 6

MEDICAL CONGRESS.

AUSTRALASIAN DOCTORS. GATHERING IN AUCKLAND. THE AST OF HEALING. MILESTONES IN PROGRESS. About three hundred doctors 'have gathered in Auckland for the triennial Australasian Medical Congress, and *he assemblage includes most <A the eminent men in Australia and New Zealand. These congresses aTe he-Id every three years. It is eighteen years since tihe last congress was held in the I>o>minTOn, end it will be eighteen years before the 'Dominion's turn comes round again. In 1911 the congress took place in Sydney, and it was one of the meet successful that have been held. These triennial gatherings of the foremost men in bhe profession do a great deal fo advance t2ie science which is essentially an experimental one. An exchange of ideas and views, and more especdally experiences is essential to t!he rapid advance of the art of healing, and these congreases enable this exchange to "be niade to the 'best ad-vantage. The useful receives the fullest recognition, and the useQess is discarded much sooner than it would be if those engaged in research were working witihout any means of comparing notes.

Auckland doctois, witTi Dr. A. C. Purchae (president) and Dr. B. J. Dudley (secretary) at the bead, hnv» made very complete arrangements for the conduct of the business and the fitting entertainment of the guests, most of whom take this opportunity of spending a brief -holiday before returning to their practices. The work of the congress has 'been divided into eleven sections as follows: Medicine, Dr. Sinclair Gillies, of Sydney; surgery, Dr. R. Hamilton Russell, cf Melbourne; obstetrics and gynaecology, Sir David Hardie, of Brisbane; .diseases of children and orthopaedics, Dr. W. F. Lifx-hfield, of Sydney; naval and military medicine, Lneut.-Col. T. Kaschi, D.5.0., of Sydney, opthalmology, Dr. F. Antill Pock'ley, of Sydney; dermatology, radiology and medical electricity, Dr. L. Herschel JJarris, of Sydney; rhinology, otology, anS laryngology, Mr R. H. Pullen, Adelaide; psychological medicine and neurology, Dr. Cliisiholm Ross, of Srdney; public health ami State medieiirc, Dr. C. S. Willis, of Sydney; and ba-c-teriology. Thosfc interested in these various sections will meet in the mornings, and most ai the afternoons will be devoted to social engagements. WORK OF TEE WEEK. The programme for the week is as follows: — (Monday.—9.ls a.m., registration of members; 10.15 a,m., Congress business nt V.M.C.A.; 12 noon, uddrese by l>r J. B. Macdonald, chairman of Central Council of BjM.A., London; 3.30 p.m., reception at tlhe Kiosk, Exhibition Grounds; 7.30 p.m., organ recital. Town Hall, 'by Mr. G. Maiighan Barnett. city organist; 5.30 p.m., opening of Congress, Town Hall, by His Excellency the Governor, and president's address.

Tuesday.—B.ls a.m., demonstrations at Hospital; '.) a.m.. address in meiiicane by Dr. Similttir Gilliee before full congress | in Training College Social Hall: 10 a.m., Motional work at Technical College and Training College; 2 p.m.. motor trip to Titirangi, given by his Worship the Mayor, Mr. ('. J. Parr, and City Council; 7 p.m.. dinner at Xort'hern Club, tendered by the Minister of Public Health to officers of congress; 8.30 p.m., «ol fresco entertainment at " Cintra," .Symonds Street, tendered by president and members N.Z. branch of B.M.A. Wednesday.—S.lii ajii, demonstrations at Auckland Hospital; 9 ara., sectional i work; 9.15 a.m., special general meeting; 2 pjn.. harbour excursion, tendered by Minister of Public Health on behalf of N.Z. Government (p.s. Wakftterc leaves No 3 jetty at 2.1-3 p.m.); 7.30, orgnn recital by cHy organist.: 8 p.m., public lecture, witOi lantern slides, by Dr. J. W. Barrett, of on "Garden Cities, Town Planning, and American Recreation Centre*," in the Town Hall. Thursday.—B.ls a.m., demonstrations at Auckland Hospital; 0 a.m.. lecture by Dr. F. Truby King, at V.M.C.A., 'before full congress, " Eugpnacs Jvnd Education," followed by discussion; 11 a.m., sectional work; 2 p.m., syphilis report and full dissuasion; 8 p.m., dinner, tendered by X.Z. members of congress to Australian members and other quests at " Cargen"; ladies' theatre party at His Majesty's Theatre (S p.m.), and supper at the "Broadway." Friday.—S.lo ajn., demonstrations at Auckland Hospital: 9 a.m., sectional work; 1.30 p.m., contract practice report;; 3.30 p.m., At Homo at " Mon De-β-ir," Lake Talcapuna. Steamer leaves Ferry Tee at 2.30 p.m.,; 9 p.m., President's ball, Town Ha.!l. Saturday.—o a.m.. final general meeting; excursion to Rotorua; At Home, Auckland Racing Club. THE CONGRESS OPENED. DELEGATES 'WELCOMED. The Congress was formally opened for ■business at eleven o"ck>ck th:e morning, ■Nearly 300 delegates were present, and the president (Dr. A. C. Purchas) wae in the chair. Only formal business was done. A number of reporte were received and referred to the eeotione of the Congress which they affected. The executive's report, which has already ■been putblislied, was received' and adopted. Dr. Purchas briefly welcomed the delegates to 'Auckland. He announced ■that <a num'her of Auckland institutions, including the Auckland Golf Club and t!:e 'Maungakiekie. had granted to the visitors the freedom of their institution. 'Hi trusted that ifch-eir stay in Auckland would be made as pleasant ac possible. RECEPTION OF VISITORS. Most of the Australian visitors arrived yesterday from Sydney in the Maiheno. Among the most notable of the gtiests is Dr. J. A. Macdonald, chairman of the Britisii Medical Association, wiio has ■come out from England to represent that body. The guests who arrived earlier in the week were received by the president anil Mrs. Purchas at their residence St. Arvons, Caxlton Gore Road, on Saturday afternoon. Yesterday at several of the churches reference was made to the opening of the congress, and appropriate sermons were preached. This morning the formal business was begun in the YjM.C.A. hail, and this afternoon there will be a reception in the Exhibition grounds, while this evening the congroet will toe tot wallj ojso*d by Hie £xqat-

lency the Governor (Lord Liverpool) wiho has come up from Wellington specially for the occasion. The Prime (MinieteT, the Hon. W. H. Hemes, and t!he Hon. R. H. Rhodes are also in town for the event. EXHIBITION OF AFPUAITCES. A number of very interesting trade exhibits are being made at the Technical College hy representative firms from different parts of the world. Some of the exhibits are identical with those made at the Congress iheJd last year in London. Four rooms are devoted to the showing of the exhibits. There arc specimens of most of the latest preparations used in the treatment of disease, and the display of eurgicai appliances ia particularly comprehensive, lihe wonderful strides made during the last decade in this branch, is weH exemplified, and looking round at the applia-nces one would tlhink t&ey represented the last word. A feature of the displays ie tlhe finish of the xhibite. Competition fiae caused tlie keenest rivalry between the firms who deal in these things, and the result is •noticeable in tJie attractive manner in which the various articles are got up. BRITISH INStTRANCE ACT. DR. MACDONALD EXPLAINS. WHY DOCTORS OBJECTED. There was a full attendance in the concert chamber of the V.M.C.A. at noon to hear Dr. J. A. Macdonald, chairman of the British Medical Association, talk about the British Insurance Act. Dr. Parkcfi, chairman of the local branch, presided, and when introducing the speaker, said the profession was greatly indebted to him for coming so far to attend the congress.

Dr. Macdonald explained that Mr Lloyd George's act was compulsory and contributory, and affected all manual workers. There were also voluntary con tributors with incomes up to £160 a year. For every 4d contributed by the worker (the amount being deducted from his or her wages) the erilployer and the Government between them contributed 9d. The fact that the Act was contributory made those insured take a keener interest in its administration than they otherwise would. In some qnartfrs the fact that the Act was compulsory had caused dissatisfaction, more particularly among domestic servants and farm labourere. The servants before the Act came into force, in most cases were looked after by their employers during sickness, and medical attendance was provided. Now the servant had to consult the medicul man on the panel list, and she was supposed to keep herself out of the 7/0 a week which the Act allowed her. This alteration had caused much annoyance among servants. Farm labourers were notoriously healthy as a class; still they had to pay the same amount by way of contribution as those of le-s healthy trades, where the pay waa higher. Among the benefits conferred by the Act were medical benefite, sick 'benefits by which an insured man sot 10/ per week for 2lj weeks during sickness, and .">/ per week for the next 2ti weeks. A woman paid contribution, and she only got 7/0 per week. There was a maternity benefit, the wife of a worker getting 30/ for the time she lo=t during her confinement. There were some anomalies in regard to this maternity benefit, and a woman who whs herself a worker would draw £-1 10/ during confinement, while the worker's wife who did not herself <xo to work would only draw .10/. Tlir ttritish Act did not include the family of the workers in its benefits, and ia this irespecl, it varied from the arrangements with the friendly societies in the Dominion, which, he understood, included the whole family. The British Act, however, mnflo one exception, anil did include the family in what were milled "sanatorium benefits." Tlie doctors were not treated well under the friendly society arrangements in the ■ Old Country, and he did not think the I medical men in the colonies were under much better treatment. Dr. llacdonald went on to give a history of the introduction of the bill, which lie complained had been hurried, and said the medical men were not consulted as they should have been. Tho profession came to the conclusion that Hie bill was derogatory to the profession, and so they opposed it.

Tlie terms vrcrr Uiat the doctors were to get C/ per head for the insured workers. Of that sum 1/G represented meddcal appliances, etc., so that the doctor jrot 4/6. The profession prepared its famous protest, known as the six cardinal points, and in this their minimum was 8/6 per head, exclusive of medical appliances etc Among other things the profession asked was that there should be freedom of contract Ibetween doctor and patient, instead of the patient being tied down to the panel doctor. The profession also objected strongly to the constitution of the committees administering the Act, on which the medical men were always in a minority. The doctor went on to explain the famous '"strike" of the profession, and its collapse, which, he said, wa3 brought about by misrepresentation of the numbers willing to work under the Act, the fact that some of the leading men in the profession weakening. He did not blame the doctors who gave way. They had their wives and families to consider. Moreover, the British Medical Association was not a tried body before the campaign, but ihe believed ft had come out of the struggle stronger and more united than before. He pointed out that the most difficult body of men in the world to deal wdth was a body of medical men, wlio from their youth were trained to independent thought and action. It was the old story of the bundle of sticks. The bitter pill the doctors had to take was the knowledge that the Government was really beaten. The Government had fourteen days to organise a medical service for 14,000,000 people. If the doctors liad only held out for a few days longer the task would 'have been impossible, and the Government must iiave capitulated. The profession had come to the conclusion after seeing the Act work that they were getting more pay than they were nnder the friendly society system, but they had not yet decided whether it was merely a case of transference from one section or the profession to another. The work was now different from what it was in the friendly epciety days. Then thpre were 4,000,000 or 5.000,000 persons working under the "contract system." whereas under the Act the number of persons was about 14.000,000.

Dr. Macdonalil said the profession was convinced that the contract system was not the highest Torm of service. The best form of service was obtained •where the doctor and patient were free to make an individual contract. Such a system was quite practicable even wrbh an Insurance Act. All that was needed was that the administration of ,the medicui beacfitte under the Act T iw<n]fl jig nn>i»r ■pn control d media*!

men, and not under committees, -which were so arranged that the medical men could not by any possible set of circumstances be in the majority. All that the doctors asked was that they should be tried by their peers as provided in the law of the land. The doctor gave stances where this system of individual contract was carried out in England in certain circumscribed areas. It would be possible to achieve the object if the Government insured the workers, not medical benefits, but the cost of medical benefits. Let fche worker have the money, but don't interfere with his liberty of contract with any medical mati he might choose, said the doctor. Another thing that still rankled with the profession was the way the Act had been foTced upon them. In conclusion Dr. Macdonald gave the meeting some hints as to the course to be adopted if the .profession were called upon to face an attempt to introduce such an Act here. First of all, they must be organised, and no body was so capable of dealing with such a question as the British Medical Association, to which every member of the profession should belong. They must, at the outset, consider their plans clearly afld carefully. In the Old Country the doctors had issued a report which was not carefully considered, and in the campaign thi3 was used strongly against them. An essential part of a campaign -was a defence fund, which must be ready before any action was taken. Dr. iMacdonald said that from hie observations an Insurance Act was needed even less in the colonies than it was in Great Britain. One of the delegates, in the course of a question to Dr. Macdonald, aeked whether, under the terms of the national insurance scheme, the medical men in England attending friendly society patients were not better off than the medical men in New Zealand. Here a doctor attended a man and his wife and family, if they belonged to a lodge, lor £1. In England the father, mother and one child would represent a return of 23/-. Dr. Macdonald replied that in some cases the direct return to the medical man would be as high as "/- for each person.

A delegate: And here we attencd a whole family for £1. Another delegate: It is absurd. A third delegate: Then, why do it? A further question put to the speaker was whether to some practitioners at Home the scheme had not meant an improved income. What, for instance, was the usual fee charged amongst poor people * Dr. Macdonald replied that there had been some improvement so far as the poorer classes were concerned, for the usual charge for a visit in such cases had been 2/6. Dr. Brennan (N.S.W.) asked what effect the administration of the Act had had upon the English friendly societies. Dr. Macdonald replied that the friendly societies had been led to believe th-at the administration of the Act would hf prictioally in their har.d«. When it ■was discovered that there would be 14 million people involved, instead cf four or five, the scope trad been extended, and other "approved" societies had been given governing power, the result was that a wonderfully organised body, known as the Credential Insurance Society, which went from door to door throughout the Old Country, doing business, had by far the bigoest "fonhection. Lonß-established friendly societies were either already bankrupt, or likely to become so very shortly unless the Act was amended. Another question was as to how the Act affected the people who went to hospital for free treatment.. Dr. Maedonald's reply was that there was e.n improvement in this direction, nnd people who previously always looked for free treatment now paid the doctors for advice. A hearty yot» of thanks was accorded Dr. Maedonald for his address.

B.M.A. AWOTJAI. MEETING. ELECTION* OF OFFICERS. The nnnual meeting of ttie B.M.A. of New Zealand was held this morning, the otrt<roin? president (Dr. Hafcherlev nf Wnnaanni) inducted the new president. Dr. W. H. Parkes. of Auckland, into the chair, and the orSinary business o\ the meeting, including the election rrf JifficeT*, wns proceeded with. Dγ William Trying, of Cliristehuroh. was elected wesideni-eiect for lt>ls, and it waX decided that the next annual meetin" shmild be held at Christ church.