NATIONAL HEALTH SCHEME

Dominion, Volume 31, Issue 270, 11 August 1938, Page 13

NATIONAL HEALTH SCHEME

Limited Plan Urged

“SYSTEM STARTING ON • WRONG LINES”

B.M.A. Issues Statement

In a statement issued last night the New Zealand branch of the British Medical Association claims that the national health insurance, scheme, to be submitted to Parliament as part of the social security proposals, is starting wrongly. While urging a limited plan, the association expresses the opinion that far more can be done to improve the general health of New Zealanders than by assuming that the provision of universal free treatment will prove an effective measure for the reduction of sickness. The association states that, in view of the effect which the Bill, if carried into practice, must have upon the general health and well-being of the people of New Zealand —affecting indeed every individual person—it is of the first importance that the.present positioh should be thoroughly understood if a correct appreciation of the Government’s proposals is to be arrived at.

“The first point the B.M.A. wishes to stress,” proceeds the statement, “is that the whole desire for a universal health insurance system in New Zealand appears to arise from a politicosocial conception rather than from a consideration of the practical necessities, or, in other words, from a desire to copy the provisions made in other countries, while alm'ost totally overlooking the very much better conditions that already exist in this country and have existed for many years. Unchallengeable proof of this fact exists in the health statistics in which those of New Zealand compare more than favourably with those of any other country in the world. “Secondly, it appears that the Government, actuated by this politicosocial conception, is starting out on altogether wrong lines by ignoring the principle that prevention is better than cure, and that far more can be done for the improvement of the general health of the people of the Dominion by this means than by assuming that the provision of universal free treatment for the cure of disease after it has occurred will prove to be an effective measure for the reduction of sickness. “The 8.M.A., in what it considered to be the best interests of the people, has made representations to the Government along these lines from time to time during the past two years, but these representations, so far, appear to have been entirely rejected. Other representations have also been made providing for a limited health insurance scheme which the association, with the help of the Government, is prepared to carry out; but these proposals have shared the same fate. It has become necessary, therefore, to present the association’s case to the public, and it is proposed to do this by issuing a series of short statements dealing with one phase at a time. Experience Elsewhere, “Understanding that the motive of the Government, in embarking upon the proposed legislation is to raise the health standard of the community and to make treatment more available where required, the B.M.A. has pointed out that the experience of countries which have had systems in operation from twenty to fifty years is that national health insurance, as such and In itself, has not had appreciable or measurable effect in reducing the incidence and volume of sickness. This is because all systems so far in operation have been directed almost wholly to the treatment of disease after it has occurred. “The association desires that the Government of New Zealand should benefit by this general experience, and submits that prevention is the best insurance.' It is the recommendation of the profession that the greatest possible provision should be made for the elimination of known sources of disease and unfitness, the investigation of unknown causes of these, and cooperation between the branches of preventive and curative medicine. Curative medicine in this country is singularly well provided for, and it is urged that a strongly preventive trend should be given to the legislation contemplated. “While the association acknowledges the lively appreciation that the Government has shown of the value of investigation, and prevention, it regrets that an Irksome and costly system of universal treatment should be embarked upon. AH experience shows this will not raise the standard of the health of the people. It confers no great advantage on those requiring assistance, and will be a positive disadvantage to those who now provide for themselves. “The general conditions of life in New Zealand are so different from those in the countries of which national health insurance has come to be a considerable factor in medical service, such as Great Britain and Germany, that it is not safe to assume that It will prove to be of the same advantage here. In those countries there are large masses of dense, industrial population on low wages, for whose medical treatment insufficient provision was made, and who, even when employed, could not make effective provision for themselves. On these points conditions are markedly different in New Zealand. Limited Scheme Needed, "In the countries which have adopted the Insurance principle, public provision for curative medicine was at the time very limited and greatly below the requirements of their population. This was a reason urging its introduction. Tills is not so io New Zealand. In no other country in the world are the requirements of curative medicine so liberally and generally provided as here. With our hospitals and out-patient departments, mental hospitals, sanatoria, maternity hospitals, special treatment units of the Health Department, subsidised practitioners and district nurses, this country possesses, irrespective of contract practice and individual medical service, a public medical service of a scope already unrivalled anywhere.

“In the o] .nion of the association, the necessities and responsibilities of treatment are being fairly met, excepting at one point, and that is in respect of those unable to make adequate provision for medical treatment, especi-

ally the unemployed, disabled, and aged poor, where tr atmen and care not of a hospital character are required in their own homes. The association submits that it is only for this group that provision for treatment beyond hose already existing or being developed is required. “This requirement will be most effectively met by placing at the disposal of this group domiciliary medical attendance of their ovn choice, and nursing services where required, to the end that they may receive the same advantages as other members of the community. Such a proposal is castigated by members of the Government as ‘horrible,’ involving ‘discrimination,’ a poor-law system of ‘poor-man’s service,' 1 and ‘undemocratic,’ and yet identically the same principle of providing for the poor at the expense of the bet-ter-off is adopted by the same Government, with less justification, in its superannuation scheme.

“The standard of medical practice in New Zeala" 1 is unquestionably high, higher, indeed, than that under national health Insurance wherever practised, and New Zealand at the present moment has a quality of medical service better adapted to requirements than that provided under any national insurance system elsewhere. Is this to be wrecked?

"If the Bill is enacted in its present form, the British. Medical Association, which, after all, is the only responsible body whieh can speak with authority on the subject, has no hesitation in declaring that the present efficiency will be gravely endangered, and that any measure which does that must operate prejudicially to the general health of the people of New Zealand.”

IJeeause the Maori language was no* a compulsory subject trt schools attend ed by Maori children, the mutlliatlon of one of the most beautiful languages in the world was taking place, stated Mr. To Kata Thompson in an address at Ohluemutu. 'Che older members of the race were watching the decline of their native tongue with great sorrow.