MEDICAL RESEARCH

Evening Post, Volume CXI, Issue 154, 30 June 1926, Page 10

MEDICAL RESEARCH

ASSURED FINANCE

SAVING OF LIVES AND MONEY

PROPOSALS OF BRITISH -MEDICAL

ASSOCIATION.

Tho Medical Eesearch Fund should not properly be reckoned hs a form of expenditure at all; fnin tho purely financial standpoint it is rightly to bo regarded in part as a direct saving of money, and in part as an insurance premium, i.'xporienco has shown that, quire apart from tho saving of lives and of suffering both now and for the future, and quite apart again from its contribution to tho general intellectual life, the research . work done by its aid ha 3 brought a lara;o and immediate saving in money to the country.—Report of Imperial Medical Eesearch Committee.

Dealing with the question of fin■nco, the Imperial Research Committee says it is a plain fact that many times the money expended through the Eesearch Fund from the beginning can be shown to have boon saved, while in other directions a saving, though just as real, is loss easily demonstrated or may not bear fruit till the future. By the unchecked action of even a single disease like influenza (in the epideihic of 1918), the insurance companies in England lost many millions, and the country lost far more in losing the economic value of the dead workers. In India during . a few months over six million livss wero icst from this cause. In South Africa the life and money lost were appalling. No sum measured in hundreds of thousands could bo too great for investment in research with a view to work directed toward defence from this plaguo itself. The argument, of course, is multiplied a hundredfold if wo th.'nk of all the other causes of disease ami death. The discoveries made so far have many brilliant aspects if we consider the infancy of modern medical science and the poverty of the support previously given to it. But these are nothing as compared with those that still hswe to bo made, and that aro certain to come in the widening light of new knowledge as it. advances. We know nothing of the cause of measles, or of scarlet fever, or of mumps, or of influenza, or of rheumatic fever—with its crippling effect through heart disease often upon the most promising of tho young people. Cancer is still taking its heavy toll, and it seems doubtful if this can be mastered until general knowledge of the laws of life has been very largely increased. We have little or no information about the causes of dead and premature births, because there has been no support availablo for proper comprehensive investigation in various parts of the country. Knowledge is urgently required of the laws of health for workers of all kinds* Those utilitarian considerations are advanced because they are those bearing moat directly upon the question of Better financial provision for research work, and they make the most obvious appeal to all. COMMONWEALTH PR.OPOSAL3. Tho report of the Australian Boyal Commission on Health is just to hand. The Commission recommends, inter alia: "That the Common- £ wealth, by Act of Parliament, should i- (1) establish a Eesearch Council; f (2) provide a special appropriation j •• or endowment of £30,000 per annum in aid of health research. A deputation of tho Executive Council of tho British Medical Association (New Zealand Branch) recently waited on tho Primo Minister and urged that New Zealand should do its part in medical research. In response to a request of tho Primo Minister (tho Eight Hon. J. G. Coates): 1. That .ye (the Medical Association) shall justify our demand for a Eesearch Institute; and 2, That we shall show approximately how the money will be expended, two statements wore drawn up. The first of these, outlining the essentially New Zealand problems demanding investigation, was published last week. The second, dealing with tho financial aspect, is aa follows:— FINANCE. A policy can neithor bo promulgated nor carried out unless / finance bo assured, for the policy to be adopted depends on the fnnds available. It is useless to attempt research unless a regular income is provided. After the spade work is accomplished, the director has to frame a policy spreading over years. Experience throughout the world has demonstrated that Government control of such an institute is undesirable. Eesearch in any direction cannot be undertaken at a moment's notice, and, to get tho best value for the money expended, a scheme has to be elaborated to prevent overlapping and duplication, and to allow ' the branches to spread out in an orderly manner in such directions as appear most urgent. Tho present position is impossible. Take tho work at present being dono in Dunedin. Tho £2000 grant for poliomyelitis is now, running out, as are the grants for goitre and rheumatoid arthritis. There is no promise or security that they will be extended or rcnowied. It is obvious that tho work cannot bo continued without money, and the research is of such a character that if it is abandoned or suspended at this juncture a great deal of the work already partly accomplished will have to be started again de novo, and thus valuable time and money already expended will have been wasted. A WHOLE-TIME JOB. It is impossible to continue encroaching on the accommodation and resources of tho University of Otago to carry out this work. The research work in the department of preventive medicine is seriously overcrowded, and occupies an undue proportion of the time of the teaching staff. Eesoarch is a whole-time job and demands reasonable facilities. Other things being equal, Dunedin is easily tho best centre for research ■work. Keseareh work on a small scale is already being carried out thcro, and anyone who is sufficiently interested to investigate will bo amazed at tho work accomplished with such limited facilities. Curative and preventive medicine aro intimately related, and it is necessary that the Institute for Eesoarch should he in close association with our Public Health service and with our Medical School, though in no way under tho control of the school nor associated •with its finance. It should be a separate institution, working in closest liaison possible with the curative side, and should form the intelligence department of our Public Health service. The value of the close association of the professors of curative medicine •with thoso engaged in research work ia inestimable; and, on the other hand, the existence of the Research Institute will have a groat influence on tho practitioners trained in the Medical School.- "Research should form part Of every medical student's study.

The two iiiytitutioiia (tliu Medical School and Kesenrch Institute) will mutually react on each other to tho benefit of both and tho community. Such association will also prevent duplication and consequent expense in

many directions, such as the library and the kitchen, electro-cardiographs, etc. OUTLINE OF CONSTRUCTION AND CONTROL. The "Institute of Preventive Medicine, as. an outpost of the 7 Public Health Department, shall bo created under the powers given in tho Health Act, 1920, trustcos to bo appointed by the Board of Health. Grant from tho Consolidated lund to be placed in tho hands of tho Public Trustee. Such trustees shall include tho Chancellor and ViceChancellor of Otago University, the dean of the medical school, and six other members to be nominated by Gov-ernor-in-Council, and to include" a representative each of the British Medical Association and the Hospital Board, and such other active business men whose Services are likely to benefit the institution. Appointment to be for five years and eligible for re-appoint-ment. The duty of such trustees shall be:— - (1) To appoint a director, and thereafter to consult with the director and provide accommodation for housing the institute, tho cost to be defrayed from the endowment fund or interest thereon. Note. —As the field work can be arranged with the co-operation of the Seacliffe authorities at a comparatively small cost, say £.2000, it is not necessary to" secure a large area of land, and tho cxamplo of tho Lister or Pasteur Institute can be followed, with central offices _and laboratories, though, of course, on a much smaller scale. The director shall, in consultation with the trustees, appoint his assistants. "The director and his assistants shall bii free from all regular lecturing and professorial duties. (Vide Sir E. Rutherfprd and Professor Schafer). After many consultations with those better 'qualified to make an estimate, the subjoined is a rough statement of the costs to be mot:— 1. Provision of housing (if dono quickly) and cost of conversion of same to laboratories, say £6000. 2. Equipment spread over first two years, say £3000. 3. Library and periodicals, say £1000. Making a total of £10,000. 4. Staff.—Three full-time laboratory and research workers: Director, say £1500; pathologist, say & 1000; bacteriologist*, say £1000; biochemist, say £1000. . Whole-time medical men, not available for Public , Health work. Statistician (£BOO-£1000), say £900; field Workers, one at £1000; me at £500, one at £500; clerk, £300, typiste, £150. Laboratory technicians: Senior:(at £475 to £500), say £475; junior (at £350 to £375), say £350; junior (at £350 to £375), say £350; porter, or handy man, say £200. 5. Arrangement with Seacliffe, say £2000; travelling expenses for staff, say £1000. 6. Provision for travelling scholarships, so that our institute may be au fait with work and methods in similar institutes in the world, say £1000. Note.—Laboratory kitchen: For some years this expense can be avoided by making use of the university and paying cost price of products. 7. Grants to assist invostigators working under tho direction ol the institution, £1000. Making a.total of £14,231. WELFARE OF THE PEOPLE. There is no doubt that the funds originally provided by tho State will bo greatly augmented by donations and bequests. Already some have been made and more promised to the Otago University, and such an institute established under non-political control, will, from the nature of its work, appeal to tho public. Experience in other lands has shown expectation to bo well founded. In conclusion, wo urge .that, as the matterfis one of such vital interest to tho welfare of tho Dominion, and incidentally involves considerable expenditure,; it is necessary that it should bo cstabliahod on sound lines and be cor-related-with similar institutions else-where.-V Let us benefit by their experience. . Our .educational system, and our railway . service, wero considered worthy of outside expert advice. Surely it is worth while to follow a similar procedure when establishing an Institute of Preventive Medicine. To that end we suggest that the British Government bo approached by cable, and asked to allow Sir George Newman, Principal Medical Officer, Ministry of Health — probably the foremost authority on medical organisation and administration in/the world—to visit and advise. His presence maybe difficult to secure, but it'is worth every effort. Failing Sir George Newman, let us go forward without further delay. We have men capable of establishing and directing such an institute.