Evening Post. MONDAY, JANUARY 24, 1938.

Evening Post, Volume CXXV, Issue 19, 24 January 1938, Page 8

Evening Post. MONDAY, JANUARY 24, 1938.

THE NATIONAL. HEALTH

The establishment by the Government of* a Medical Research Council may appear at first,glance to be the creation of a new authority ■ whose functions might have, been , discharged by the existing Board, of , Health. The new council will, j . however, have q special duty and is 1 constituted so as to undertake that , duty with the greatest efficiency. 'It s will be c|osoly related.'la the Board ( of Health, as it includes all the j ! medical members of tho bpard, and { lit will have direct contact also with « resparch and medical organisations, , Its functions- as stated by. the g ■ Minister of HeaHh will be: , ( .1. Tq correlate as. far as may be < practicable medical research wprk in < , New Zealand, ■ ?. Tq recommend wjiat researches | arid investigations should be under- ' taken- ' 3. To appoint separate ad hoc com-. ( mjtteeg tq take charge of each in- ( vesfigation. ' \ t 4. To recommend what amount of 1 money sjipuld be allocated for medical •, research each year and to suggest an , apportionment of the amount tP the * separate investigations.- | It is evidently the intention of tho , Government, as expressed hy the ■ Minister of Health, to encourage i research by dirept grants and it is ] wise, therefore, to provide a means , . for the correlation of research ( activities so that whatever funds ( may he available may he applied to j the, most urgent and useful work, | We may assume also that the j Medical Research Council will ( assure that the results of research ( are directly related to medical practice and the general health < , services. I Research is important, but equally ; ' important is a scheme of'organisation i by which the, full benefit of health < knowledge and health services shall ] | be, received, by the public." A recent j : investigation by the organisation < ! known as P,E.P. (Political, and I 1 Economic .Planning) into the health i services of Great Britain •is ] illuminating on this point. The < authors of the survey calculated tha.t some £200,000,000 was spent : annually on the treatment and < prevention of ill health, and the j \ comment was added; ''There is a j conspicuous contrast between the >. ■ vast expense and loss caused by ill < health and the relatively insignifi- : cant sums spent on health research .1 and education." In the existing 1 system of services, the principal . defects, as discovered by P,E.P., 1 arose through incompleteness and ' absence of co-ordination. There i were gaps in the system, such as that s between the period when infant 1 welfare work finished and school " medical care began. Again, under •• [ the; National HeaHh Insurance ; , scheme there were benefits for the i insured persons, but not for their ' dependants, Between the ou.re of : disea.se and the removal of the causes ] of ill health there was also a ■ looseness of connection or even the ' absence of amy relationship. Thus, ' ~ while it might be apparent that '■ certain forms of sickness were closely associated , with environment, there was no certain means of associating the cure with prevention by attention - to nutrition, housing, and general health conditions. There were many ] authorities working for health, but < they were not all working together. ] .In Now Zealand conditions are i I different, but the comments of P.E.P, '- are not without lessons for us. We ( have not the same problem of i relating voluntary hospitals to thpse • supported by the rates. Our ' hospitals are. ' with very few I " exceptions, either maintained by ] rates, subsidised from taxes, and - fee,s, or are paid for entirely by the ' r fees of patients. There is a < c problem here in that many rate- ' j* payers and taxpayers must pay for : •- the public service, but make separate J provision privately for their own ■ s treatment; but this is not the same \ 7 problem as in Great Britain. In another ■ respect, however, we are. ' c behind Britain in that we have no national health insurance provision, ■ 8 Medical and institutional treatment c are provided by the, public hospitals, r but not upon a contributor basis. ' The only contributory health £ provision is that afforded by the c private friendly societies, A health " insurance scheme is proposed, but it d has not yet been disclosed how it I- will affect the public hospitals. Will "* the insured person be given medical n treatment in his home at the cost of • the fund, and institutional treatment £ in the public hospital at the cost of y tho rates? Will dependants be 6 covered, and will there be an ie income limitation for those who may a be insured? Will the scheme be under a separate and independent 'I authority-or will it be linked with tho authorities in charge of the hospitals a?id other health services? Space do.es not permit of move than the merest mention of the

problems that ayise in organisation. Tlio establishment of a Medical Uuscnrch Council touches only oho t)f ll\os« problems. The greatest Itisk is to knit closel)' together existing lteullh agencies, preventive us well as curative, private as well as public, educative and adniinistralivo. The eslablishmont a nolionnl health insurance scheme presents qii opportunity i'ov action on thesq linos. Tho scheme may be established as a separate part of th«j health machinery of-' the country, with another authority added to those now in existence. Or it may be linked from the. outset with a general plan for education and the prevention of disease, and treatment in all its phases, It may be introduced as a correction of the anomaly under which those called" upon to pay most for tho hospitals are largely barred from benefit; or it may add tq that anomaly. If the best results are to be secured it certainly appears that the inauguration of the /plan should be preceded by a thorough survey of the present methods and agencies, and the 'scheme should then bo designed to [close existing gaps and to promote the gradual evolution of a truly national health system..