“M. And D”

Press, Volume CIV, Issue 30823, 7 August 1965, Page 14

“M. And D”

“ Medicine and Duties ” —usually abbreviated to “ M. and D. ” —are prescribed by army doctors for soldiers reporting sick when they are not ill enough to be sent to hospital. A nation at peace, no less than an army at war, has every reason to keep its hospital population as low as possible and to maintain its work force at its duties, even if some workers are on “M. and D. ” Viewed in relation to this objective, New Zealand’s annual bill of £9 million for drugs is comparatively modest. Pharmaceutical benefits cost £B.B million last year, an increase of £953,000 in 12 months. This represents 10s 6d for each of the 6.4 prescriptions a head of population.

Pharmaceutical benefits now comprise a third of the cost of all medical benefits paid from the Social Security Fund, the others being maternity, general medical services, hospital, and supplementary benefits. Judicious use of pharmaceutical supplies can reduce the need'for other medical services, part .cularly hospital services. There is some evidence that this aim has been achieved in New Zealand in the last 10 years. The expenditure on pharmaceutical benefits has increased since 1954-55 to nearly three times the 1954-55 1 figure of £3 million, whereas expenditure on all other medical benefits paid from the fund has increased to less than double the earlier figure. Total expenditure has doubled. Over the decade population has risen 24 per cent, and national income has doubled. The nation is spending just the same proportion of its wealth on health services, has a smaller proportion of its population in hospital, and has a higher proportion of its population on “ M. and

This is satisfactory, as far as it goes; but the Health Department, in its annual report, shows a proper concern for last year’s big increase in the cost of pharmaceutical benefits. Admitting it is not sure of the reasons for this increase, the department says there appears to have been “an undue prevalence of illness 1 .st winter, which led to a greater “ use of antibiotics and other drugs ”. New Zealand’s use of antibiotics, some years ago, was much lower, proportionately, than Australia’s, and very similar to Britain s. The department ,at the time noted this conservative prescribing of antibiotics with approval. These powerful drugs must be used with discretion if their maximum benefit is to be obtained. This aspect, rather than the increase in expenditure on pharmaceutical benefits, may be the most disturbing feature of the nation’s health bill last year.