DEBATE IN HOUSE RESUMED

Evening Star, Issue 24005, 2 October 1941, Page 5

DEBATE IN HOUSE RESUMED

ALTERNATIVE HEALTH SCHEME (Special.) WELLINGTON, Oct. 1. Attention to the salaries received by the medical staffs in New Zealand hospitals was drawn by Mrs Dreaver (Government, Waitemata) in the House when she was supporting the Social Security Amendment Bill. , “ I have heard a great deal about what is happening to the medical profession. and how medical men are suffering,” said Mrs Dreaver. “ T even heard one member say that the doctors were giving their services to the hospitals. 'At one time they did give honorary service, but since the Social Security Act came into operation they have ceased to do it.” Mrs Dreaver said that the salaries of medical men in public hospitals for the vear ended March 31, 1940, amounted to £114.540; for the following year the amount had increased to £190.545, and this extra expense was largely due to abandonment of the honorary system. Mr Frost (Government, New Plymouth) : Payment to the doctors. Mrs D reaver said that the medical men had waited on the hospital hoards and made the claim that they should benefit under social security. In the north'the doctors had worked for over 30 years on an honorary lhasis. They had given wonderful service, and some of the finest surgeons and physicians in the world were on the honorary staffs. The hospitals were practically‘run on the socialistic system. When the Social Security Act came into force the doctors asked for payment of £OOO a year, hut the payment was £SOO. In the Auckland Hospital, in addition to the stipendiary staff, there were 50 visiting doctors. Of these. 20 were leading members of the B.M.A. associated in the campaign against the Bill. Of the 50 members of the visiting staff, 20

received £SOO a year, 20 were paid £3OO a year, and the remainder £2OO a year. In face of that it wa.s strange to hear that they considered that they were not getting a fair deal. These senior men were called specialists, but it had to be remembered that they came into the hospital- as plain doctors, and through being able to call themselves specialists they received £lO a week for nine hours’ service. Many gave more hours, but they were paid for nine hours’ service. The specialists were made in New Zealand. They did not all have academic qualifications. They were gained in the hospitals, where they treated the patients. Mrs Drearer received a round of applause when she concluded. A BETTER SCHEME. What the Opposition stand for as an alternative to the medical practitioner clauses of the .Social Security Bill was explained by Mr Bfoadfoot (Waitomo), who incidentally expressed satisfaction at a statement by the Minister of Health that there had been no boggling about fees by the doctors. The Opposition, he said, strongly condemned the principle of coercion in the present measure, and reiterated that they would stand for a complete, not a partial, medical aid scheme to those who required it. He pointed out that the Government’s scheme excluded specialist treatment, and suggested that a large number of common complaints which would be taken out of general practitioner treatment would have to be paid for under a system which excluded specialists. The friendly society leaders, continued Mr Broadfoot, considered the Bill a devastating blow which would bring their medical services to an end. In two years they had lost 9,000 members, and the societies were on the road to destruction.

It was not too late to suggest an alternative scheme whereby the friendly societies would be protected. There could be a health insurance scheme which would be universal, and a rebate made of social security charges to the members of the friendly societies, with a subsidy in any case where the average earnings of each individual in a family were under 25$ a head weekly.

This method would include the same list of medical benefits as provided by the friendly societies. This would be a basis on which to build, and he was confident that an amicable solution could be arrived at with the doctors. Such a scheme would mean a tremendous saving in administrative costs, which always under State schemes had a tendency to grow. That saving could be turned into convalescent benefits for mothers and families, and could include housekeeping help and nursing in the case of sickness. This method would preserve the liberty of the individual, with the right of selection of a doctor on a complete voluntary basis. He strongly urged the Government to consider this method to preserve the friendly societies, which had 112.000 members and had been established in New Zealand 100 years. Their sound administration hatT resulted in the building up of reserves worth £si millions. MR LEE SARDONIC. “ This House takes its hat off to the doctors,” declared Mr Lee (Grey Lynn) from the cross benches. “ Heaven help the miners if they demand a 50 per cant, increase in the hewing rate, or the watersiders.” Mr Goosmau: Did the doctors ask for more ? Mr Lee suggested that the Government’s first proposals were the most practicable, and the medical fraternity should have assisted by building up a clinic system, making for improved health. He believed that the war on disease should be a State war. There was much to be said for the capitation system, where the practitioners got a fixed fee, and had an interest in keeping down the number of visits to the home. He admitted that this was still possible under the Bill, but, unfortunately, the selfishness of the pro- 1 fession had made so many gaps in the fence that he almost despaired. Better,’ in his opinion, to pay the doctor the best fee he was getting now, and give him a vested interest in health, rattier than pay him 7s fid for each visit, thus giving him a- vested interest in disease. “ The doctors,” he said, “ have insisted on turning this Bill into a 1 get the people ill ’ Bill.” He was sorry for the Opposition, because the doctors had let them down, though the Opposition leader was saying the latest amendments embodied what he wanted; but they only included the special demands of the medical profession for an increased amount of State income, and in no way altered the principle of the measure. Tlie feature which allowed a doctor to refuse a patient was a weakness. though he ennld understand his refusing the malingerer nr the tvpe of wealthy patient who ‘ plays ill health ns another man plays golf.’ They visited the doctor six days a week as if they were enjoying themselves. From

what he was told by a doctor of the number of visits paid daily, and the number of surgery consultations, it was evident that the latest increase in fee conceded by the Government added £7 a day to a doctor’s receipts. “ The.doctors’ attitude to the country,” concluded Mr Lee, “ is not ‘ {)ut yaur tongue out, but put out your purse.’ ” PLEA FOR CO-OPERATION. The Minister of Public Works, Mr Armstrong, said he sincerely hoped that the doctors would be in favour of the Bill, because he was anxious to get their co-operation in the interests of suffering humanity. In fairness to the doctors he would say that they _ had never at any age pressed for higher fees, and the higher fee offered under the amendment mentioned by the Minister of Health the previous night was given because, after due consideration, the Government had arrived at the conclusion that the fees originally offered were rather too low. He would sooner be blamed for paying too much than too little, because, after all, the profession was rendering a very useful service to society, and its members were entitled to be reasonably remunerated for that service. The Government was trying to get co-operation, and still hoped to get it. In any case, the Government was determined that people who could ill afford to pay for medical attention should get it free. Mr Broadfoot said Mr Armstrong had said trade unionists wore entitled to as good treatment as the doctors. His reply to that was that the doctors wore entitled to just as good treatment as trade unionists. What about the 40-hour week, double rates of pay on holidays, and treble time? be asked. Were those things being offered to the doctors? PLEA FOR BROAD VIEW. Mr Coates made a .plea for a broad view regarding the amendments to the Act. The Bill they were considering, he said, was a very far-reaehing one, and he believed that every member of the House would he glad to support a measure which would protect those who could not afford medical services without disrupting their economic position. Some thought that those who could pay should pay, but that would mean a “ means ” test. He thought a means test was wrong, but he was sure that those who could afford to pay would be glad to help those who could not. Mr Coates expressed concern regarding the position of the doctors overseas, but said that, without going into the rights or wrongs of that, they should consider the objection of the medical profession to what they claimed was coercion in the Bill. He was not going to argue whether the Bill was coercive or not. hut he did say that without the willing co-operation of the doctors they could not have success with the scheme. The Minister of Railways. Mr Semple, said the Government for several years had been discussing with the doctors the best method of giving a general prae titioner service. The scheme was not being rushed through, and at the previous General Election he would remind the Opposition they had said that if they became the Government the Social Security scheme would never he operated . Mr Holland : We would put something belter in its place. The debate was interrupted by the adjournment at 10.20 p.m.