DOCTORS AND WAR SERVICE

Dominion, Volume 10, Issue 3112, 16 June 1917, Page 8

DOCTORS AND WAR SERVICE

ADVISORY BOARD PROPOSED

MEDICAL ASSOCIATION'S

VIEW

AN OFFICIAL STATEMENT

The New Zealand branch of the British Medical Association, being desirous of providing a sufficient number of doctors with :i vioir to satisfying the requirements of tho military and civil authorities during the war, appointed a committee representative of tho profession throughout New Zealand, which committee. put forward tentative proposals to tho Hon. Minister of Defence and the Ron. Minister of Public Health. Tho Ministers could not see their way to adopt thoso suggestions in. their entirety, and whilo approving in. part of the .proposals of tho committee, suggested material alterations and additions, with special referenco to i tho civil requirements. ' Shortly after receipt of replies from the Ministers, i.0., on. .Tuno 12, a meeting of tho council of tho .New Zealand branch of tho B.M.A. was held in Wellington, at which delegates attended from tho various divisions of tho association throughout Now Zealand, and considered tho tentative proposals more fully, when they had tho advantage, of hearing tho views of tho Ron Minister of Public Health and Hospitals. This meeting took into consideration not only the requirements and conditions in Now Zealand, but also similar schemes, which have been proposed in Great Britain and Australia. Tho council of tho British Medical Association in New Zealand is entitled to speak with authority on these matters, being representative, of the doctors who aro personally and intimately concerned in the arrangements proposed, who are. in active practice, and cognisant of the conditions throughout New Zealand, and who have given this and kindred subjects the closest consideration. This representative meeting endorsed .unanimously the tentative proposals which had been put forward by the committee, and further submitted somo subsidiary proposals in reference to questions which had been raised by Ministers in reply to our previous communication. Tho National Efficiency Board has classified the medical profession as ono of the most essential industries, and no oilier class in the community has been called upon to mako sacrifices in any way comparable to those already made by the medical profession, as is evidenced by tho fact cited by tho Minister of Public Health that already out of 723 doctors on the medical register at tho beginning of the war 257, or raoro than one-third, are on military service at home or abroad. Wβ consider that the requirements of tho, defence and civil medical services are interdependent, and now- that difficulties are arising in the adequate supply of medical men for the civil community tho echeme proposed by tho Medical Association for military medical enlistment will prevent thoso 1 difficulties from being further accentuated. In this connection the council passed a resolution reaffirming that the wholedifficulty, military and civil, can lw met by tho establishment of an Advisory Board selected by the 8.M.A., to act in conjunction with the Director-General of Medical Services and the InspectorGeneral of Hospitals, as set forth in the committee's report. Similar Advisory Boards have been in existence in Great Britain and in Australia, and have been found invaluable. Recommendations.

The following are the recommendaions of the council: —

1. That it is essential that an Advisory Board be 'set up to which, the military and, civil authorities 'can, apply from time to timo for assistance and advice. 2. That tho board consist of six members of tho British Medical Association, to bo appointed by tho divisions of the New Zealan <lbranch each such member being empowered to appoint a deputy. That for the purpose of electing representatives on tho hoard tho divisions

be grouped as under:— (>,i) Auckland; (b) l'ovcvty Bay, Hawkos Bay Wanganui, and Palmerston North; (c) Wellington; (<1) Nelson and Westland; (c) Canterbury and South Canterbury; (f) Otago and Southland. Each group to appoint one member. ;j. That the council agrees to the enrolment .of the medical men practising in New Zealand with a view to their being called up coinpulsorily as required for military medical service, provided that in such case any man so called shall have the right to appeal to tho Advisory Board, as proposed by tho Special Committee. ■I. That the functions of the proposed Advisory Board shall bo to hear appeals, to consider the needs of the districts concerned, and tho exigencies of the war, and make recommendations to the Minister accordingly. 5. That the services of any applicant for registration under the Medical Practitioners Act shall be placed at tho disposal first of the Minister of Defence, and secondly the Minister of Public Health, and" that this shall be a condi- , tion of registration. G. That tho question of the use and distribution, of recently-qualified New Zealan'd graduates bo, referred to tho Advisory Board. 7. That an effort be made to prevent men in active practice from changing their place of practice during the period of the war without tho permission of tho Minister of Public Health.

8. That necessary legislation shall duly safeguard the , interests of the profession, and shall remain in operation only during the period of the war and subsequent demobilisation. fl. That tho expense of bringing into operation and administering tho proposed scheme be borne by the Government. Civil Medical Requirements. Tho Minister of Public Health and Hospitals proposes that an Act of parliament should be passed to give power if necessary to mobilise tho medical practitioners of New Zealand, for the purpose of transferring doctors from districts, already adequately supplied, to other districts where there is a scarcity of medical practitioners. The council of the B.M.A. in New Zealand has taken this drastic proposal into its very serious consideration. Medical men recognise that such a proposal would moan the treatment of tho medical profession (an essential industry) in a way entirely different from all other classes of tho community. Compulsion for military servico is now recognised as essential, but compulsion for civil purposes is practically unknown in tho British Empire, and British subjects brought np in tho lovo of freedom are entirely averse to such drastic measures, unless it can bo shown that no other method is available. Tho Medical Association is bound to admit that there is already a shortage of doctors in some of tho country districts in Now Zealand, and on the staffs of hospitals, but there was a similar difficulty prior k> tho war. In point of fact, to moot this difficulty the Government have had already in force a system of subsidies to induco doctors to practise in sparsely-populated districts, and wo think that this system will require to be extended. We aro given to understand by tho medical military authorities that tho present shortage. is likely to remain stationary'throughout tho further period of tlfo war, and wo consider that the shortage is not so great as to warrant any further measures than wo have tho' honour to submit herewith. If, unforunately, in tho future tho shortage should" Lecoino of such a kind as lo warrant more drastic measures than wo pro|»se, tho medical profession would in that ca«o not shrink from making further' sacrifices, but at present in view of tho fact that tho shortage is by no means extreme, tho Medical Association is firmly of tho opinion that it is both unnecessary and undesirable that (ho medical profession should bo mobilised ■and that members of that profession should bo farced to practise on terma relatively disadvantageous to themselves for the benefit of communities in which all the other members aro free to carry on their business on their own terms, as formerly, ajnl ovon to inako war profit. Tho recurring graduation of medical

men from Iho University of Now Zealand, and the proposal thai, doctor; who como to New Zealand' for registration should 1)0 compolled to nfl'er their services, cither to tho Minister of Defence or to the. Minister of Public Health, mako it certain that t.ho shortage, it' (his proposal isndoplcd, can never become so nciito as t;o warrant [inch extreme measures as aro tit present proposed by tho Hon. tho Minister.

I An important point is this: That it would be loss expensive for tho Government to pay subsidies to mako practices attractive to medical men in. depleted districts, and to utilise the services of the proposed Advisory Board, than to embark on a costly and intrieafo scheme of legislation and mobilisation of tho ivholo profession to meet isolated case?. Tho council therefore make tho following recommendations:— I. That; for thoso districts which cannot at present bo supplied by medical men, the Government should adverse for doctors, offering, in addition to the emoluments to he derived from the practice, an honorarium of, say, .KHiO per milium (captain's pay), with travelling allowance.

2. That failing getting medical men by advertisement, the Advisory Board should endeavour to secure men voluntarily, and tluit stich moil should bo paid an adequate remuneration by tho Government.

'3. That in case- where tho-district is depleted by the calling up of a doctor for military service-, the difficulty could possibly bo met by recalling that practitioner to liis civil practice- and replacing him in the.-military service by a. doctor from a le.ss depleted district. With reference to the questions qnoted by the Minister from the "British Medical Journal" of March 3 for our consideration, they aro answered in the foregoing; but there remains the. question of what arrangement should l>e made i'oi , remuneration in a case whore a doctor has to leave his own practice to take up the practice of another in a depleted district. The remuneration should be made, as already proposed, by Government subsidy, together with the proceeds of private, practice. Further, if under Hie system of compulsion advocated by the profession every eligible, doctor is liable to take his turn for military service, and a system of one year's service as approved by the Director-General of Medical Services is instituted, the financial loss to medical men will be more, evenly distributed, and 'there will bo fewer casts in this respect of unduo hardship.