Preventive Medicine

Press, Volume LXXV, Issue 22795, 22 August 1939, Page 8

Preventive Medicine

As the annual. report of the Department of Health was to be laid before Parliament at no long interval before the centennial celebrations, the occasion was taken to introduce it with a general survey of the activities and development of the department; and in the course of a few pages very interesting references are made to the progress of a century in dealing with epidemic and endemic disease, in setting up and enforcing proper standards of sanitation, in the regulation of medical services, in the control of food and drugs, in the official care .of school children’s health, in infant welfare, first aid, and home nursing, and in campaigns against such diseases as diabetes, dipktheria, hydatids, and cancer. It is an encouraging 'record of “advances in preventive and . “ curative medicine ” that have, since 1874-78, nearly halved the standardised death-rate; reduced . the infant-mortality rate still more sharply, and steadily increased the expectation of life. It is odd, however, to find the following sentence appended: “The Social Security Act, 1938, with its pro- “ visions for profound changes in the system “of medical care of the people, represents an- “ other important milestone in the progress of “ preventive medicine in : New Zealand.”

Nothing is said to support this strange tribute., to an act against which it is a major charge; that its emphasis is concentrated on curative - mfedicine; and nothing, moreover, appears - to/ support it in the summary of medical, hospital, and allied benefits under 1 the act,- later in? ■ the report. It would not be accurate to say that the act ignores the need and the scope for development of,; preventive -medicine. Thereis, for example,', spine provision for research, particularly in nutrition. But it is quite- accurate to‘say that the questipn is relatively neglected and-that no Minister has- given the slightest': sign of his recognising the error. It is,' perhaps, worth* adding that the report of the Medical Council,- included as Appendix; A; to .the: full report ■ affords no' evidence at all thak the act, is’regarded as the key 'to/wi&er^opportunities ; and: fuller facilities. But, as it could fail: to • do,- the report itself ;P9jhts .qiearly, in;directions ;,w i here the demand

for preventive service exists and where the State could organise or assist it. For example, the Director of the Division of School Hygiene remarks that “ it is hoped ” to extend the system of medical inspection from the primary to the secondary schools. Whenever secondary schools have been inspected, she says, the need has been found to be no less than in the primary schools. The report statistically sustains her. Of 65,782 European children inspected in the primary schools during the year, 58;98 per cent, showed “defects,” and 34.90 per cent. “ defects other than dental.” But 2487; secondary school pupils were examined, also; and the respective percentages, 62.04 and 35.10, were not better but, in: fact, slightly worse. Granted that the comparison is not wide enough to be wholly reliable; but it is suggestive, and the suggestion is that a system rightly; commended because it is protective and preventive and constructive is not sufficiently thorough and does nqt reach far enough., The fact is that New Zealand has developed a remarkably efficient' infant-welfare system, leaves , a gap until the infant has become a child of school age, then, applies a reasonably good system again, under unreasonable handicaps, .until the child is 11 or 12, and then abandons the system altogether during the years, of adolescence. The “ important milestone ” of the Social Security Act, in the march of “ preventive medicine,” does not carry the inscription . that it might, and should: “ Let the “school displace the hospital.”