Caygill says institutional care ‘inappropriate’

Press, 24 March 1988, Page 8

Caygill says institutional care ‘inappropriate’

PA Wellington New} Zealand || was locked!into large-scale in-, stitutional health care, which looked increasingly inappropriate, said the : Minister of, Health, Mr Caygill, said yesterday, p "We are clearly now at a point when a fundamental; re-evaluation of our approach to health care is necessary,” he told the Pharmaceutical Manufacturers’. Association. I j !■ Equity was I not being achieved in health, care partly ; because too (many people! were postponing visits to their doctor because jof the cost, partly because victims -bf|j accidents i got better [deals than victims ofl illness,

and also because sdme treatments were.( subsidised while others were not. ( i ■ (| "Tinkering with the system will not overcome the prob|ems. We have (to reaffirm the philosophy bn which it is based,” Mr Caygill said. 1 ; • While Mr Caygill was concerned about the (escalating cost of the! drug bill, I he was even I m(ore worried about the continuing rapid increase* | in the || Pharmaceuticals Benefit Scheme. The (recent I system encouraged overprescribing and waste — not only was too much paid, too much was being bought. | j . Everyone had to‘ reassess ; | the way j they

• i * ' i responded to illness and take !a more] “holistic” approach to health, rather than I just treating the symptoms. .HI i. r- ’ “I am keen to see the primary health care service become less [passive, more active,”; said Mr Caygill. . . J J . i( “Of course, if we are to to reach more people, two things mustl happen: a greater proportion of the health system’s resources will have to be (channelled towards primary care, and the definition of who may provide primary care ■ will have to be broad- ! ened.” ;( I h !| "While I see the general practitidner as the centre point' of primary

health I care services in the; community, I predict that he or she will increasingly be joined in partnership by a range of other health professionals, including counsellors, professionals and pharmacists. ]l' | .j- ! "Working with this core of specialist I advisers |I ■ would see the outreach ( specialists — the community health nurses, thje I Plunket nurses, the community psychiatric nurses,” he said. Some delegation of treating and I prescribing responsibilities | might make sense and it might be necessary to fund the I expanded group practices on a bulk allocation basis.