SOCIAL SECURITY ... Health Dept Favours Benefit Increase

Press, Volume CIX, Issue 32166, 9 December 1969, Page 32

SOCIAL SECURITY ... Health Dept Favours Benefit Increase

(New Zealand Press Association) WELLINGTON, December 8. The general medical service benefit required upgrading in accordance with today’s values, stated a background paper by the Health Department presented to the Royal Commission on Social Security today’.

The department's paper was presented by the director of the Clinical Services Division (Dr A. W. S. Thompson) and stated that it was desirable that machinery should be introduced to keep the benefit under regular review.

Dr Thompson said that while the back-: ground paper was not the place to put forward i recommendations, he felt that the commission might wish to be given J certain points for consideration. The paper initially outlined the introduction, history and, the present position of medi-' cal benefits in New Zealand. ■ The inquiry, before Sir; Thaddeus McCarthy. met; today for its first full day.. It then adjourned till February 23. Dr Thompson said that thecommission might consider' the desirability of making the general medical servicesi benefit sufficient to cover the! full cost of some categories' of treatment. ’

He suggested that general medical services and specialist attention for social security beneficiaries and pensioners, and children under the age of 16 might be fully covered. Also that immunisations carried out in accordance with a programme approved by the Health Department could fall into the same category. Dr Thompson also sug-| gested that “a personal doc-; tor for every citizen” was an! ideal to be fostered. General Charge “While it is certain that! the capitation system would never be acceptable to the general practitioners of this country, there may be ways in which, within the fee per service system, patients could be encouraged to register with a doctor as their personal attendant,” he said. For example, said Dr Thompson, a patient who had registered with a doctor might be eligible for a higher rate of benefit, and general charge on prescrip-; tions in the case of prescriptions written by that doctor, “So long as whatever was done introduced no element of contract between the doctor and persons who were not actually needing medical attention at the time, the objections which apply to capitation might be avoided.” Doctors' Lists Apart from the advantages to health, savings in general medical service benefits should more than compensate for the cost and trouble of maintaining doctors’ lists, he said. Referring to pharmaceuti-

'cal benefits. Dr Thompson asked the commission to consider whether the limited list [for free medicines should be i abandoned along with the present system of part-j j charges. He said, however, that it must not he overlooked that the “limited list” was an; important safeguard to public, health. It was that system that saved New Zealand from! the thalidomide disaster in; ;1961. “It is difficult to see how, 'Part-charges could be abol-l ! ished without either severely; restricting the Tree list’ (the; 'drug tariff), or surrendering, completely to the drug firms; the responsibility for deter-; i mining drug prices.” “Very Flexible” New Zealand's social secuirity system was very flexible as, quite apart from the emergency benefits and supplementary assistance, a lot of discretion was vested in the Social Security Department, the chairman of the; Social Security Commission! (Mr G. 3. Brocklehurst), told; the Royal Commission today. The period for which benefits and supplementary assistance were continued depended not on the amount of contributions paid but rather on the continued need for benefit or assistance, said Mr Brocklehurst. He said there was a close, relationship between the ad-! ministration of income maintenance through benefits, pensions and supplementary assistance, and the associated social work and welfare service.

On finance, Mr Broeklehurst said the method of financing the system was simple and avoided the complexity and rigidity of systems with contributions which did not I automatically adjust to changing wage levels, as the New Zealand system did. “The elimination of the separate social security income ! tax from April, 1969, has resulted in a less obvious re- ; lationship between incomes and liability to contribute to ! social security,” he said. Exempt From Tax All benefits, except super- ; annuation, were exempt from i taxation. Little use was made of advisory committees in the administration of social security. “The department is represented on various committees which keep it closely in touch with the various Government and other organisations on aspects of social security and war pensions policy or admin-

istration,” said Mr Brocklehurst.. Social security had withstood major changes in New Zealand’s economic and social conditions and had become firmly implanted in the New Zealand way of life, said the Assistant Secretary of the Treasury (Mr W. A. E. Green) I today before the Royal Com- ! mission. Mr Green said that some ' benefits were paid to some 'groups who were more able 'to maintain themselves now ! than in 1938 by reason of the 'general improvement in living standards. This also applied in the [case of aged where changes had taken place and were i continuing to do so in their [access to alternative sources [of retiring benefits or other income. New Zealand’s economic goals for the 1970 s were defined'by the National Development Conference. 1938 Objective

The N.D.C. social committee considered there was scope for re-allocation of expenditure within that proportion. of Government money spent on social services. The 4.5 per cent average growth in real national product was supported by several hundred recommendations involving selective measures which enable the targets to be achieved.

The Treasury believed that this approach was appropriate to today’s full-employment economy.

In 1938 one objective was to create jobs and higher production through large-scale expansion of purchasing power directly associated with payment of benefits. “The problem today in a fully employed economy is to restrain, rather than boost, spending power, as overspending leads to excessive pressure on domestic resources and a demand for overseas goods and services in excess of our export earnings" said Mr Green. “If the country achieves its growth targets it should be able, in the coming decade as in previous decades, not only to produce enough goods and services to improve the incomes of the working population, but to have a sufficient flow of goods and services to keep on improving the lot of the dependent groups.”