HEALTH CARE GAPS

Auckland Star, Volume LXXVI, Issue 119, 22 May 1945, Page 3

HEALTH CARE GAPS

ORGANISATION URGED

A SURGEON'S CRITICISM

Pointing to "gaps" in New Zealand's health system, which, he declared, needed to be filled if proper medical attention were to be given this country with the resources available, Mr. Douglas Robb, wellknown Auckland surgeon, told Auckland members of the New Zealand Society for the Protection of Women and Children last night that a new conception of health services was required. That, he said, would be the most difficult hurdle to overcome. So much progress had been made in so many different fields that the whole subject of health services was now a most complex one, said Mr. Robb. There were so many techniques that no one worker had anything like complete equipment. In consequence, there was necessity for organisation and planning to meet the new condition. Everyone disliked parting with freedom, but when human welfare was at stake they had to give way. Deficiencies of Present System Pointing to the deficiencies in New Zealand's health system, Mr. Robb said thai there was a gap in child care between where the Plunket Society left off and the school health service began; there was a further gap, except in some special cases, in secondary school period, in the period when youth was just starting out on a work or university career, and a further gap in regard to industrial health care. That the gaps were there was shown by the number of outside societies that had been formed to try to fill the need. They were better than nothing, though "sometimes they get the answers in the wrong place." However, they could not at present be criticised because they were trying to fill gaps which should not exist. There were other gaps, also. As an illustration he asked members to consider the contrast between trying to get good surgical treatment and trying to achieve good psychiatric service for returned men, intimating that in the first case there were plenty of opportunities available, but that in the second there were serious deficiences resulting from a lack of specialists in the subject. A greater degree of concentration on training was required, not only for specialist doctors, but also for nurses and technicians. The present lack was immediately noticeable when one thought of the things that were wanted in the home—specialist advice on such things as nutrition, child psychology, other human factors, and social and family affairs in general. An expansion of modern psychiatric knowledge was needed even if it meant sending personnel overseas to learn the subject. It was time, too, that New Zealand took a share in the investigation of disease. Doctors Grouped at Clinics Mr .Robb advocated the organisation of medicine to the extent that doctors would work in groups in health centres scattered strategically throughout the suburbs of a city such as Auckland, instead of engaging in private practice on ttheir own. He suggested that a group of four doctors at such a centre, with a proper complement of nurses and technicians, could serve 10.000 people. The doctors could pool their knowledge and abilities, and the centres could be better equipped and staffed than was possible in the surgery of a private practitioner. In addition. the doctors, by relieving one another, could provide a complete 24 hour service all the year round; and they would be ready, at a moment's notice, to meet an emergency. Specialists were best based on hospitals, he said, and they should spend more time in outpatients' departments. That work had never really been undertaken in the hospitals, and certainly better facilities were needed. Specialist teams working in country centres could give a much better, and more economical service than could now be provided by num'oers of small hospitals, each trying and failing to give a complete service. Hospital service, throughout the Dominion had grown up haphazardly, and there was great need for thorough organisation of available resources. He advocated the division of New Zealand into six regions, with a corresponding number of boards, instead of the 42 now existing. On these boards some of the members should be appointed and some elected, and there should be a sufficient representation of technical people, including doctors and nurses. Marriage Advice Clinics Among the things that were required was some degree of coordination between health and education authorities on the question of career guidance. Some health service to take care of youth during secondary school and university periods was another requirement, the whole aim being to maintain good health rather than to concentrate on curing ills that had already developed. "There should be. too. something in the nature of a marriage guidance clinic, where all classes of people could get advice on all aspects of marital relations," said Mr. Robb Whether this should be at a central clinic at the hospital, or a part of the suburban clinics, was a matter to be decided. He was confident, however, that by giving comprehensive marriage guidance to young couples it would be possible to "stave off some of the disasters that come more from ignorance than through viciousness."