CLIMAX OF SESSION

Evening Star, Issue 23038, 17 August 1938, Page 6

CLIMAX OF SESSION

PRELIMINARIES THE PROFESSION'S ATTITUDE ''ft'-’' ' ' ‘ RECONCILIATION OF VIEWS HOPED FOR [Fboic Our Parliamentary Reporter.] WELLINGTON, August 16. The Government’s relations with the friendly societies and the medical profession were mentioned by Mr Nash in appreciative terms during his introductory remarks on the Social Security Bill in the House. Its introduction, he said, had. been preceded by an immense amount of investigation, in respect to which much credit was due to Dr M'Millan and his committee in connection with the investigations into the health side of the measure. They had worked from 1936 until a short time ago so as to ascertain the facts and procedure which should be followed. There had been innumerable conferences with various interests for the purpose of finding out the facts regarding the various benefits which would bring about social security. “We have had a number of discussions with the doctors,” continued the Minister, “ and I would like to affirm how much we owe to them for the manner in which they met us from time to time with their criticisms of the proposals; and I say it is of great importance that we should come to an agreement. We are setting out on the .road we think we should travel to give people social security. The doctors have a different idea how this will be achieved. We respect them for their views, and we will continue to reason out and work away for the improved health of our people.” •The Minister went on to state that it would be unfair if he did not_ mention the contribution of the friendly societies in their approaches to the Government through the M’Millau Committee and through the Parliamentary Committee. The Government’s thanks were due them for the splendid help they had given and the statistical material which could only have been provided from the friendly societies. The Auckland section had sent down particularly valuable material in connection with the friendly societies’ dispensary and medical institute.

Security Bill Debated MR NASH’S SECOND READING SPEECH , 4 Opposition Produces Limited Plan The House of Representatives commenced its real task of the session last night, when the Minister of Finance moved the second reading of the Social Security Bill. The afternoon had been spent on the Estimates, which will alternate with social security as the business for the next few weeks, after which members will be hard to retain in Wellington when the campaigning is proceeding actively in their electorates. Though weeks have been occupied in discussing the Budget, members were loth to let their opportunities go, and talked general topics on the first item of the Estimates in accordance with time-honoured custom. However, the Prime Minister, after three hours of this tedious experience, brought it to a sudden end with the first closure motion of the session. His large majority made the task easy, and the first item passed. The Minister of Finance occupied an hour and. threequarters in explanation of the Government’s big Bill in the evening. A fair amount of his time was devoted to economic discussion in order to anticipate Opposition criticism that the measure was beyond the country’s financial resources. Mr Hamilton, Leader of the Opposition, sprapg a surprise on the Government, which had anticipated purely negative criticism, for he advocated an alternative health scheme which, he declared, could be financed without the wages tax. He called attention to the new classes of taxpayers—boys and girls between 16 and-20, domestic servants, and women formerly exempt from the wage tax. His criticisms had not concluded after one and a-quarter hours, when the adjournment came, and on the Prime Minister’s motion, the debate was set down for resumption to-day, although, , under the Standing Orders, private members’ business should take precedence. •,

Later in his speech Mr Nash returned to the medical aspect. “ We propose,” he said, “to negotiate with the B.M.A. and the friendly societies and all other people that are necessary for us to be able to carry out the health .side of the. Bill. Wo .are hoping to-have all the arrangements in hand prior to April 1 next, so that the Bill can automatically become' operative on that date.” He hoped that they could come to an arrangement with the doctors. He felt that if the medical practitioner had the complete outlook he should have, and his mind was completely devoted to finding the way of bringing his patient back to health, the fact that he received money from the State rather than from the patient should make no difference. He hoped that their viewpoints would be reconciled as soon as possible. There was every possible safeguard for those people who were associated with the health scheme to be fully represented. There bad never been a more democratic procedure than was provided in the Bill for representation of the people who were ,to benefit. “The attention that is necessary for.persons in ill-health should not be dependent on the amount of money they have, and a doctor’s services should not depend on the income of the person he is attending,” declared tlie Minister. “He should have the payment because he is rendering a service, and the person receiving "the service should get it because he needs it, not because he can pay for it.”

FINANCE OF SCHEME BASED DN NATIONAL INCOME OF £174,000,000 FIRST YEAR COST £16,610,000 Can the benefits in this Bill be made available from the production pf the Dominion? was the question which Mr Nash early in his explanation of the Bill put rhetorically to his audience, and proceeded to answer emphatically, “ Yes.” The carrying out of the measure, he declared, would lead to increased production and more just distribution of it. Pointing out that there was much' more in life than adequate food and clothing, he referred to the necessity for healthier and happier conditions, better education, and other amenities, then asking the question whether these could be provided from the country’s production from the soil and its other resources. “The answer is ‘ yes,’ ” he affirmed. As a preliminary to discussion of the basis of the country’s economy, we had a lot of thinking to do in connection with overseas markets which had dictated this country’s economy, though it was the wrong psychology. The overseas business was tremendously helpful and valuable, but to the extent that we tried to build up our internal economy by dependence on external trade, we could not progress. Therefore, secondary industries had to be considered—an increased consumption of internallyproduced goods, leading in turn to greater consumption of the primary products. Another necessity was the reduction of our external debt. “ The crux of the whole criticism is: What will it cost? ” continued Mr Nash. “On the evidence of Mr Maddex, an able and competent man and a very fine character, wrong in his outlook at times in regard to some things—(laughter)—his estimate was

£17,850,000. In these estimates lie included war pensions and war veterans’ allowances. We can take this away from normal social security, for these payments are made as a national charge on the whole of the nation for services rendered, while the other charges are something we can legitimately ask everyone to pay because of the benefit which comes to themselves. The soldiers were fighting for national security, and 1 have deducted £1,790,000, which brings the total down to £16,060,000.

“ But since Mr Maddex made his estimate, the Government has decided to increase the benefit to the wives of pensioners where they are not of qualifying age to both receive the pension, A man aged 60 will receive 30s weekly, but his wife may be younger. In this case we have increased the benefit by at least 5s weekly for the wife and 5s for each child under 16, which will add £450,000. We have extended the benefits to widows by making them available in some cases, even though they have not had children, and the extra cost is £IOO,OOO. This brings the total cost for 1939-40 to £16,610,000. “ A very close analytical survey of the position leads to the conclusion that .some of the costs will not come to charge next year, and we have reduced the total to £15,000,000. Against that we estimate £500,000 from the levy, and from the Is in the £ on incomes £8,000,000. The revenue is based on the national income, which I have not the slightest doubt will be - £147,000,000.”

The estimate by Mr Maddex, explained the Minister, was on the basis of a national income of £150,000,000, but he had no doubt on the evidence of the progress of the last few years, and the evidence of income returns, that the income would be £174,000,000 to £175,000,000. Then there was the value of the benefits which were not chargeable to the social security contribution, which reduced it to £160,000,000. This at Is in the £ meant £8,000,000, and further £500.000 from the levy, leaving £6,500,000 to be found. There was already charged against existing revenue £5,135,000, the normal commitments on the Estimates for 1938-39. This left £1,365.000. In addition, something would have to be found for employment promotion, if necessary. If this difficulty existed they would look into it. but on the estimates he had submitted, he had no doubt that the country could build up the whole income necessary for the social security plan. Half the contributions necessary would come from the contributors, who would receive the benefits, and the other half from the ordinary Consolidated Revenue of the country.

SURPRISE ATTACK OPPOSITION PRODUCES ALTERNATIVE SCHEME GOVERNMENT SEEKING TO SOCIALISE DOCTORS A strong attack was made on the universal health service scheme by the Leader of the Opposition, Mr Hamilton. Contending that there was no justification for a universal scheme, he submitted alternative proposals to meet what he contended was the real need, though the Government, in seeking a revolutionary change, was out to socialise the medical profession. “ What,” asked Mr Hamilton, “ are the problems the Bill purports to deal with? Take health, for a start. Although fairly full provision has been made, we consider that the problem needing attention to-day is that of a full, free medical and hospital service to those members of the community who, by reason of their financial position, cannot make their own provision. This, we consider, would be a warranted improvement to our present health service. and would meet the need of today. In actual practice it is almost provided for to-day. This additional cost would be justified, and could readily be met without undue burden to the taxpayers. The Government has to take into account our wonderful hospital system, and when it is trying to override the doctors, to recognise the wonderful service they give in an honorary capacity. “ What does the Government propose in the Bill? It makes this an occasion for a revolutionary change in our' health system, takes power to nationalise or socialise the medical profession. It has long been its programme. Instead of providing a full, free health service to the. poorer section of our people, it proposes a partial service to all our people.” An attempt had been made to show that the scheme was similar to that in operation in Britain. It was nothing of the sort. “ The health section is, in my judgment, just another step towards the Government’s objective of socialisation,” continued Mr Hamilton. “ This step is being taken under the guise of public health. There is nothing to show that there is any need for a universal service. The doctors say it will give many of them a bigger income, but that the standard of service will deteriorate. There is no public demand for a universal partial service. The public does not want, it; the profession does not want it; the health of the people does not demand it; it is a political stunt; it is merely socialisation of the doctors without any doubt whatever.

“ The Labour Party’s policy is to take from the people the freedom and liberty which we on this side of the House say is their traditional right and heritage. The Labour Party believes (quite earnestly I think) that a Government, especially if it is a Socialist Government, can order the everyday lives of the individual much more efficiently than can the individual himself. We disagree altogether with that philosophy. The Government does not want to see people making their own private arrangements for security in sickness or old age for the reason that under a system of State socialism, the individual must take his directions from the State. It insists on having a finger in everyone’s pie. I say that virile New Zealanders will not stand for this State domination. REDUCED STANDARD. “ Under a contract service the standard of medical service to the people must be reduced to the service capable of being performed by the least efficient, least qualified, and slowest medical practitioners who have qualified.” Hq went on to say that the alarm that many people felt at the possibility of the private hospitals standing the strain was well justified. This would probably suit tho Government,

which would gladly take them over. It was important to remember that onefifth of sickness was treated in private hospitals. Patients in private hospitals would still have to pav their private accounts. “ The State has the taxing power to override the financial arrangements of the private’ hospital. It will take it no time to crush them out of existence,” he concluded. HOSPITAL RATING. The public would be disappointed that nothing was being done to reduce hospital rating. The evidence was strong that the greatly increased demand for additional accommodation, resulting from the scheme, would add to the rates rather than reduce them. The Prime Minister: Will the payment of 6s a patient instead of 2s 8d not make for a reduction in rates? Mr Hamilton said the debits on the other side would probably outweigh the credits by 100 per cent. There would be a greatly increased demand for hospital accommodation. OPPOSITION PLAN. Mr Hamilton asked what was the approach as far as health was concerned. The Government said: “Socialise the medical profession.” The Opposition’s view was that the approach was by preserving and developing private enterprise with the co-operation of the State. The Government’s way to solution of the health problem was regimenting the doctors as bureaucratically controlled State employees;. That was the proposal under the Bill. The Opposition believed in encouraging the individual to develop his skill and to broaden his knowledge in the service of humanity. The science of medicine had grown to its present position by its individualism, not by State regimentation, which imperilled medical efficiency. Sickness was a matter of the most personal relationship, and could not be treated on a mass production basis. i “ The Government seeks to coerce the medical profession,” continued Mr Hamilton. The Minister could say it was optional. The medical profession to-day was doubting the wisdom of the j scheme, and was genuinely concerned about the proposals. Ninetyfive per cent, of the doctors were opposed to the plan. ‘' We seek to improve the health service by co-operating with the profession,” he added. “ Freedom and liberty are fundamental necessities to the medical practitioner. It was proposed to give partial service to all people, many of whom did not need or desire it. Fifty per cent, did not want the service. There were some who did want it, and full provision should be made for them. “ The Opposition proposed to give a complete service—everything a sick person could require——to those unable to provide for themselves. The Government intends to finance its scheme by the wages tax, with children of 16 years paying in, and those over that age,” continued Mr Hamilton. “ We will finance a scheme without the wages tax, and after providing that service,-we will inaugurate aggressive schemes to greatly improve the people’s health. Much sickness is preventable. We will improve public health and physical fitness. We will inaugurate a campaign for more healthy living, and make a thorough nutrition survey to inform people about the foods they eat.” Many complaints were avoidable, and dental decay was at the root of much sickness, and was also related to unwise feeding.

POINTS IN THE DEBATE SEDDON FACED SAME CRITICISM [Per United Press Association.] WELLINGTON, August 16. Moving the second reading, Mr Nash said this was an epoch making Bill, and he questioned-whether like legislation had ever been presented before to any representative Parliament in the world. Everyone he met who had criticised the Bill agreed with the different points which it covered, but asked if the country could afford to ipay for it. The same had been said when Seddon brought down the first Old Age Pensions ißill in 1897, and Mr Nash proceeded to draw a parallel, between criticisms of Seddon’s Bill and that levelled at the measure at present before the House. They were to-day able to offer the country the benefits set out in the Bill because of the work of some of the Government’s Labour and Liberal-minded predecessors. Could they implement the advantages contained in the Bill without any ill effect on other sections of the community? His opinion was that they could, and he was further of opinion that the measure would not only lead to an increase in production, but also to better distribution of that production. This country for the past decade had relied for its development on its export income. That was wrong psychology to observe to-day. No matter how valuable it had been in the past, and despite its very -great value even at the present time, we must tcy to build up our internal resources. Could we always continue to increase our external markets ? ■He did not think we could. The tendency was already for those markets to close, and countries which bought our produce were tending more and more to rely on their own produce. We had not yet touched to the full all the resources of the Dominion. What should be our objective was to extend and consume the production of the country inside the country itself. He had frequently been asked what the scheme would cost. The increase of certain benefits decided on brought the total to £16,610,000 for the cost of the scheme for 1940. The Government had come to the conclusion that 'such a sum could not be made a charge on the country in 1940, and bad reduced it to £15,000,000. The Government estimated that the Is in the £1 tax would bring in some £8,000,000. Taken all in all, the introduction of the scheme could bo effected without any increase in normal taxation at all, but something might have to be done for employment promotion if this were found necessary. Half of the contributions to the fund for the social security scheme would come from the contributors themselves, while the other half would come out of the ordinary Consolidated Fund of the country through the ordinary taxation levies. He went on to state that questions of increases in the war veterans’ allowances and war pensions would be contained in another Bill. EFFECT ON PUBLIC SERVICE. Dealing with the question of the effect that the superannuation scheme would have on the public service, Mr Nash stated that 52 per cent, of the railwaymen received less than £2OB in superannuation, and 29 per cent, less

than £l5O, and all these would enjoy the benefits which were being provided under the Bill. The benefits conferred by the Bill would fall on every section of the community, and would lift some on the lower rungs of the ladder to a better level—not that it was possible to give them all that they deserved at the present juncture, but it perhaps would be possible to even better their lot later on. FAMILY ENDOWMENTS. Speaking of the proposed family endowments, he said the Government considered that it was unfair that when a child was on the way the mother should be faced with the dread that she would have no money when it arrived, and that she would have to save harder than ever. In conclusion, the Minister stated that the Government would continue to negotiate with the 8.M.A., friendly societies, and all others to enable it to carry out the health side of the proposals. The principle of the Bill was that there would be no payment without benefit, and no benefit without payment. There was no means test for the health scheme, and none for the universal superannuation scheme. JUST A PLEASANT TITLE.

The leader of the Opposition, Mr Hamilton, said that to-night they began the debate on subjects which had been considered by the Government for years. It was now given the pleasant title of “ social security,” and was supposed to deal with the two important subjects of superannuation and national health insurance. These were two subjects in the Government’s election programme. The Government was nearing the end of its parliamentary term. It had been in office with a large majority, and excellent prices had been received for the exportable produce, but the Government would go to the election without either of these subjects being an accomplished fact. The Prime Minister had said that New Zealand was behind with its health service compared with the rest of the world. He did not tell the people that New Zealand had a hospital service not surpassed anywhere in the world, a Health Department supervising the public health service as up-to-date as any country; and a people enjoying a standard of health of which they could be justly proud, though that could be improved. There was also a first class medical service. That was all provided by previous Governments. The Government would have us believethat nothing had been done before-it appeared on the scene. In actual fact the Government had done absolutely nothing. All the health services in existence to-day were in existence when the present Government came into office. The subject of superannuation Was also not new in New Zealand. A very large proportion of New Zealand’s working population was to-day covered by superannuation schemes. The provision of pensions for aged people had always been a feature of New Zealand public life. Various Governments had from time to time widened the scope and increased the benefits under the pension system. The Opposition did not wish to quarrel with any proposal to increase pensions as such. They did say, however, that a grave responsibility rested on any Government to examine any new proposals with the greatest possible care and ensure that the country’s resources and its future productive capacity were sufficient to prevent the new proposals breaking down under any set of economic conditions that might arise. It was his considered. opinion that there was very grave danger of the new scheme breaking down under its own weight. The Government was going too far altogether, and too fast.

RETARDING TAXATION. The Government was imposing a burden of taxation on the country that had made the investment of capital in industry and trade so perilous, uncertain and unattractive, that development was being seriously retarded. In most experiments it was possible to drop an idea if it met with trouble, but he wanted to remind the House and the country that under the present proposals the existing scheme was absorbed by the new scheme, and if the new scheme became Jeopardised, or its soundness imperilled, then the whole structure was imperilled, and not merely the new provisions. Mr Hamilton said the Bill purported to deal with health insurance and superannuation. A study of the Bill, however, revealed that superannuation occupied only a very minor position. Pensions occupied the premier place, with health insurance fairly prominent, while superannuation was only squeezed in. It was fairly evident that the Government was not particularly interested in providing an up-to-date superannuation scheme. In this they had departed from their election points, which would indicate that they had lost interest in the prudent sound course of superannuation. Although fairly full provision had already been made for health," the Opposition considered that the problem needing attention today was that of full and free medical and hospital service to those members of the; community who, by reason of their financial position, could not make their • own provision. This additional cost could readily be met without an undue burden to the taxpayers. The Opposition proposed to give a complete service, which included everything a sick person could require, for those unable to provide for themselves, and they would finance their scheme without the wage tax. Mr Hamilton continued by paying tribute to the British actuary, Mr G. H. Mtddex, whose warnings should cause us seriously to ponder. He then proceeded to compare the cost of the Government scheme with that of the present health services. These figures showed, he said, that as the years passed costs would pile up. PENSIONERS WlLt INCREASE. As the rate of pensioners to total population increased, so the ratio of taxpayers to total population decreased. Dealing with the financial side of the Government scheme, Mr Hamilton stressed the increasing commitments which were facing the country under the present Administration, and asked what would happen if prices fell again. Mr Hamilton’s speech was interrupted by the adjournment at 10.30 p.m., when the House rose. The debate on the Social Security Bill will be continued at 2.30 p.m. tomorrow. ■