MEDICAL SERVICE.

Auckland Star, Volume LXIX, Issue 220, 17 September 1938, Page 15

MEDICAL SERVICE.

BRITISH COMPARISON.

" MANIFESTLY MISLEADING."

REPLY TO DR. McMII.T-AK. (By Telegraph.—Own Correspondent.) WELLINGTON-, this day. A reply to a recent statement Issued by Dr. D. (J. McMillan, M.l\, regarding the medical provisions in the Social Security Bill then before the House of Representatives was made to-day by I>r. J. I». S. Jamieson, president of the Xew Zealand branch of the British Medical Association. "Dr. McMillan," said Dr. Jamieson, "in his statement of September 9, traversing a previous statement of mine, still tries to bolster up his case by references to Sir Henry Brackenbury, stating tliem in an incomplete manner and thereby giving a misleading impression. He does not state the whole truth, of which he should be perfectly aware, on the following points:— "(1) In his remarks as to the part of the social reformer, Sir Henry was explicit that weight must be attached by such to the opinion of the medical profession, both as a profession and as a. body of citizens. And he further made it quite clear that it was not for the social reformer to socialise one section of the community. Standard of Medical Practice. "(2) On the question whether a universal scheme would lower the standard of medical practice, the utmost Sir Henry would concede was that he 'could conceive a universal hea.lth service in which the medical service could l>e quite high, if certain principles were maintained.' It is obvious that he saw no such possibility in the New Zealand (Sovernment's soiheme, for he advised that the strongest opposition should be given to it, and he recommended the association at Home to give the fullest possible support, financial and otherwise, to the New Zealand branch. "(3) As to health insurance having raised the standard of practice in Great Britain, Sir Henry took pains to makeit perfectly plain that he referred only to the character of the practice among insured persons under insurance conditions and the character of the practice under the old 'club' conditions; and that he 'meant no more than that the kind of service given to the poorer people was vastly superior to that given them under the old method of clubs.' "This is perfectly understandable when it is known that those medical clubs sometimes paid as little as 2/6 per member per year. Many paid a penny a week to cover medicine as well as attendance. This was the kind of practice, of which New Zealand has no counterpart, the standard of which was raised, and Sir Henry did not even claim that all the improvement was due to health insurance. "Asked whether he thought the standard of practice in New Zealand would be raised by health insurance, Sir Henry replied: 'In so far as there may be lodges in which practice is not very satisfactory. That is aa far as I would go-' When Best Standard is Fostered. "(4) In his reference to the standard of practice inside and outside the insurance scheme, Sir Henry's comparison related to health insurance practice and similar practice under private contract with societies of which a great deal is carried on in Britain; and there is evidently little difference. But Sir Henry, like all of us, held that the best standard of practice is fostered when patient and doctor make their own arrangements privately, free from the restrictions and regulations of any corporate contract. He regarded it as most important that as much as possible of that type of practice should be preserved in order that the general standard should be maintained and improved. "When Dr. McMillan says that the relationship between the State and the doctor in New Zealand will be the same a-s between the State and the insurance doctor in England, he is manifestly misleading the profession. In England doctors conduct insurance practice and private practice together, and are remunerated for their insurance work from an insurance fund constituted by contributions of employees and employers, to which the State contributes only administrative costs. Under the New Zealand universal system and so-called "free" hospital, the general practitioner will have no private practice, and will be wholly remunerated by the State from the proceeds of an income tax. Whatever name may be invented to cover his ignominy, he will be a civil i servant without the status, liberties, I amenities and protections of a civil servant."

Regarding I>r. McMillan's invitation to debate the issue with him on the publie platform, T)r. Jamieson said there was no occasion to put Dr. McMillan to this inconvenience a« the association preferred to present its considered statements to the public through the columns of the Press? where they could be properly studied and appreciated at their full value.