MEDICAL SERVICE

Evening Post, Volume CXXXIX, Issue 68, 21 March 1945, Page 4

MEDICAL SERVICE

N.Z. SCHEME CRITICISED

"GREAT GIFT TO DOCTORS"

SYDNEY, March 20. The "Daily Telegraph" publishes today an article by its chief of staff, Mr. D. L. Thompson, who recently visited New Zealand, where, the paper says, he examined New Zealand's free medical .service scheme. Mr. Thompson says it is a "great gift to the doctors,'* and he concludes that the New Zealand experiment in free doctoring is a lesson to Australia in how not to do it.

The article says: "One out of every 60 boys in the school-leaving group in New Zealand takes medicine. This is not because of any starry-eyed resolve to save humanity from pain; it is because under social security and its free medical service the most ungifted doctor is assured of £2000 to £4000 a year. A man with a shrewd head for systematising his practice can (and does) make £8000 to £10.000 a year. "The New Zealand experiment in free doctoring is a valuable lesson to Australia in how not to do it. The failure is due partly to the destructive attitude of the British Medical Association to all the Government's plans and partly to a Government which, by false pretences, sold to the public a service which it did not possess to sell." . ABUSES OF THE SYSTEM. After giving some details of the early history of the scheme, Mr. Thompson continues: "It is the most lucrative thing the general practitioner ever dreamed of. His bad debts (normally about 30 per cent.) have vanished. With about 25 per cent, of his colleagues on war service, there is one doctor in New Zealand to every 2000 to 3000 patients. The peacetime figure was one to 1400. The money barrier between the doctor and the patient having vanished, the doctor no longer restricts visits out of consideration for the patient's purse; he makes every attendance that is- necessary and some that are not, and every time up pops 7s 6d out of the Government's bottomless purse.

'Of course, tlie system is being abused. Patients make frivolous calls on doctors. Some doctors unscrupulously extend their patients' illnesses continuing a daily attendance right through convalescence and past it. Evils have resulted. It is hard to get a city doctor to visit at all, and almost impossible at night. The reason is that the fee for a call and a visit is the same. All patients are herded through the consulting room on the lodge practice system. They are encouraged to step lively. The doctor's income depends on the speed at which they pass him. His secretary writes a chit like lightning; the patient signs, and the Government pays. "The shilling in the pound is not enough to meet all this, plus pensions, plus free medicine. It takes another £4,000,000 from the consolidated .revenue. Yet of all this money not a penny has been earmarked for research and preventive medicine. The public is getting the old form of medical service, but is paying for it in a new way. ATTRACTION FOR GENERAL WORK. "The young doctor is attracted away from research and specialisation into general work. Specialists say that the general practitioner tends to shirk any case which presents the least difficulty and passes it on to the overcrowded hospital or to specialists. And of the specialists' two-guinea fee the Government still pays only 7s 6d; the patient finds the rest. If you want a 50-guinea operation the Government pays only 7s 6d towards it; perhaps a couple of other 7s 6d's if there are post-operative calls. That is because if you will have a big operation you are expected to get it for nothing at the public hospitals, but at the public hospital it is left to a clerk to decide which doctor will do the job, and the public hospitals are more overcrowded and worse staffed than the big private hospitals. "Some advantages can be seen from j the new scheme. Patients now run to the doctor with a sore finger. They J want their shilling in the pound worth. "That is why boys leaving school want to become doctors —general practitioners. New Zealand, with a population of 1,600,000, now allows about 270 students to begin first-year medicine at Auckland, Wellington, Christchurch, and Dunedin. Only 100 offered before social security. " Who is to blame the lads if some of them sneer at professors of medicine who are paid a paltry £2000 a year? They themselves will be getting £4000 in six years' time. The professors hit back savagely. They fail 45 per cent, at the end of the first year. That is because the full medical course is available only at Otago University, and the maximum intake is 120."