State Medical Service

Press, Volume LVI, Issue 16848, 31 May 1920, Page 6

State Medical Service

Tho report of a. committee of tlio New • Zealand branch of tlio British Medical; Association, to which we referred on Saturday in our remarks on a hospital for paying patients, deals chiefly with tho question of a national medical ser- j vice. It is a matter which has been' much discussed of recent years, owing largely to the responsibility which, in numerous countries, tho State has as-; snmed in connexion with the proven-! tion of disease and tho improvement of the public health generally. The day may come, though not in this or in tho nest generation, when people will bo attended by the doctor allotted to the block of town or country in which they lire, whether they like him or not, just as under the block system they will have to take their milk from one par- J licular milkman. But tho doctors re-' sponsible for tho report under notice' do not look so far ahead. They content themselves with advocating a

modified form of national medical ser-

vice which has much to commend it, one which would be for tho benefit of remote nnd sparsely-populated districts and such special areas as mining fields, and also for poor patients in tho towns who hare to be treated in their homes. In both cases, such, a service should bo linked with a competent nursing service, somewhat on the lines of tho District. Nursing Association, but supported by the Government, and under control of the suggested Ministry of Health. Tho latter would take tho placo of the present Department of Public Health, and would be enlarged and strengthened to- permit of its carrying out properly its extended ftractions. The functions of the Department, as tho oommittee-point out, are now almost wholly administrative, ""and the district® health areas are far too large to enable the health officers to perform tho public service that might reasonably be expected of them. The committee's suggestions regarding the establishment of a Board of Health, consisting mainly of doctors, with some representation of the Department, seems, however, to provide for a division of authority which wo.uld invite trouble. The Board, it is proposed, should control —and presumably appoint—tho doctors engaged in the national medical service, and should fix the salaries to be paid them; it should also appoint and control the paid staffs of hospitals—tho whole staffs would bo paid, as tho committee desires the abolition of the system of honorary staffs. Local Hospital Boards should be retained, but shorn of a considerable proportion of their present somewhat restricted powers. If, however, the Department of Public Health is to be made of, mpre, importance and value, we do not see the necessity for this proposed executive Board of Health, which would take over some of the chief functions of the Department. That, however, is an opinion based on tho somewhat sketchy outline of the proposals of the doctors; a more detailed statement of their case might reveal reasons for their suggestion which would 'remove our present objection to- it. That fuller explanation will, no doubt, be forthcoming long, for the recommendations' of so influential n. body as the Dominion branch of the B.M.A. deserve at least full consideration and discussion.