MEDICAL SERVICE.

Auckland Star, Volume LXVIII, Issue 234, 2 October 1937, Page 17

MEDICAL SERVICE.

COUNTIES IN NORTH. REORGANISATION proposals. NOVEL FINANCING SYSTEM. (By Telegraph.— Special to "Star.") AUCKLAXD, this day. The collection of income at the source is ono of tho Important features of a plan for the organisation of a health service in Northland, comprising the conntics of Wliangaroa, Bay of Islands, Hokianga and Mangonui. The plan, in outline, has been placed before the Government committee, which for manv months has been hearing evidence and assembling data in preparation for the framing of the national health insurance legislation. The committee was informed that 1f the Government's proposals for tho whole of New Zealand do not go as far as the Northland plan, then Noi thla nd wishes to be allowed to "work out its own salvation."

The objects of the plan are five:—(l) To remove "tbe nightmare of doctors' and hospital bills"; (2) to abolish oneman hospitals; (3) to provide specialist treatment when required, at no extra cost to the patient; (4) to provide these services at no extra cost to the ratepayer; and (5) to provide for Maori as well as pakeha residents. Deductions from Cream Cheques. The novel features of the plan arc its proposals, (a) that the revenue now raised by the hospital rating system and subsidised by the Government, be supplemented by a fund derived from a head tax, collected at the source, and (b) that no fees be charged. It was pointed out to the committee that the main industry in the North is the dairy industry and it was obviously desirable "that the suppliers of dairy companies should insure themselves instead of waiting until they fall ill." This insurance could be effected by each supplier paying £2 or perhaps £3 a year— to be deducted in instalments from his cream cheque—and it would cover free medical and hospital service for the supplier, his wife and his children under 21 years. The hospital board would be well content, as the income would be certain, and would be collected and paid in lump sums by tho dairy companies. It was pointed out that many farmers now give orders on their crcam cheques to stock firms, stores, or Government Departments, and it is seldom that any hospital expenses are allowed for in their budgets, although their health is a very important factor in the production of their income. It is calculated that there are about 3000 dairy suppliers in the four northern counties. The remaining households number about 3700, and it m proposed that these also should pay £2 each, the sum to be collected at the source, possibly by some .form of wages tax.

The problem of Maori contributions to community services is particularly acute in the North. In Hokianga County there are more Maoris than Europeans, and in the four countics there are about 14,000 Maoris, or 46 per cent of the population, ITiese provide a very small part of county and hospital revenues, and one of the objects of the health insurance scheme is to lift a substantial part of the burden now unfairly cast on European ratepayers. Medical Organisation. On the medical side also the proposed organisation is also novel. It was contended before the committee that North Auckland could not afford both public and private medical services; that all medical practitioners should be full-time salaried officers; that the medical service must be complete—preventive and curative, institutional and domiciliary, and must include school medical inspection, health lectures, physical training, and ante-natal, post-natal and Plunket services.

It was urged that there should be appointed a director of curative medicine to control the four northern hospitals. He should be stationed at Kaikobe, where there should be a small, specially-equipped hospital, under the supervision of the surgical director. The latter, accompanied by a nurse and j anaesthetist, would visit any of the other hospitals as required. He would be j responsible for all the surgical work done in the northern district. In addition, an effort should be made to encourage the superintendents of the district hospital* to specialise in some subject. when other specialists were required they could be brought by aeroplane from Auckland. It' was suggested to the committee that if the Government's scheme included .only the wage-earner and his family, with a £250 limit for voluntary contributors, the Government should pay to the North Auckland organisation its share from the central fund and allow it to add to the scheme by including all. If the Government scheme was made optional for those over the £250 limit then practically everyone in the North would join, and the special method of contribution would not be required. North Auckland's needs would then be limited to the institution of a specialist service and the right to use the available in developing its own institutional system, with whole-time officers, rather than the domiciliary system adopted in more populous and less isolated districts.