WARTIME MEDICAL AID

Evening Post, Volume CXXXVII, Issue 8, 11 January 1944, Page 4

WARTIME MEDICAL AID

Figures quoted in our columns last night, together with comment by an official of the British Medical Association, draw attention to the serious position which has arisen, especially in the main cities, as a result of a shortage of doctors. Cases have been reported lately of difficulty in securing medical attention promptly, and an Auckland coroner last week suggested that it was high time that steps were taken to deal with the situation. As the official of the B.M.A. pointed out, the present shortage is largely due to war conditions. Not only are some 350 doctors —over one-third of the total number of registered medical practitioners^ —serving in the Armed Forces, but newly-qualified men are being directed to hospitals where, owing to increased hospitalisation, their ser-

vices are urgently required. Such experience is essential for young practitioners, but even when the period of hospital service is completed the doctors are not available for general practitioner work. They are either retained by the hospitals or drafted to the Armed Forces. The increased training facilities provided at the Medical School at Dunedin are more of an insurance against future needs than a source of immediate relief. It seems clear, then, that while the war lasts no increase in the number of general practitioners can be expected. Therefore, if the public are to receive the best "service under existing conditions it will be necessary to, plan in such a. way that the most efficient use is made of available personnel. The basis of any medical service, especially on the curative side, is the general practitioner—the man who is'readily available ■in case of emergency and who is in jl position to give treatment in the patient's own home, where the nature of the illness makes that possible. A direct result of the shortage of general practitioners is an. increased burden on the hospitals, for a doctor endeavouring to care for the wants of up to 40,000 people obviously cannot spare the time to supervise personally every case to which he is called. In the majority of cases he has no alternative but to send the patient to hospital. If an increased number of general practitioners were available there would be a corresponding relief for the hospitals.

The representative of the B.M t A. stated that Everything possible was being done to organise the depleted forces of doctors to the best advantage of the public. He mentioned particularly a weekend roster which ensured medical attention being available in cases of emergency. The doctors them-i selves are anxious to -do everything possible to meet the needs of a difficult situation, but it is open to question whether the people are sufficiently informed of the plan to co-operate in its application. There are many healthy people who have no occasion to consult a medical. man until an emergency occurs, and, as recent cases suggest, they discover too late that if they had communicated with either the hospital or the Free Ambulance they might have obtained prompt assistance in securing attention. What is needed is not only a free service but a service that is freely available in cases of emergency. This could possibly be achieved, even under present conditions, by a co-ordinated plan taking in the doctors, the hospitals, and the ambulance services—an organisation task in which the medical services branch of the Social Security Department might give useful aid. In such a plan for the emergency period, the co-operation could be sought of specialists and other doctors who normally do no outside work. The aim should be, not only to increase the number of practitioners available, but to assure, as far as possible, that there is the least waste effort in using their services. If the people were fully informed of what steps to take in an emergency, complaints of delay in securing medical advice and. attention should be greatly reduced.

In his comment yesterday, the official of the B.M.A. mentioned "aggravating factors which are not always taken into account by those who would seek to blame the medical profession for the present state of affairs and who are naturally annoyed when repeated attempts to secure the services of a medical man fail." He mentioned a shortage of petrol which often prevents a doctor from making a trip to outlying districts. This is a matter1 that could be speedily rectified without giving rise to any abuse. The health of the public is a first essential, and a restricted supply of petrol should not be allowed to stand in the way of prompt. medical attention. There is another matter (not mentioned by the' B.M.A. official, but calling for attention) and that is the way the excess profits tax operates to penalise unfairly doctors and other professional men who are working long hours in order to meet an emergency. This places a severe limitation on their rewards which does not apply in the case of persons on salaries or wages. The doctors are working for the people's health and have not protested against this unfair exaction, and the countryshould see that those who serve in this public-spirited way are not deprived of a just reward.