HEALTH AND PENSIONS

Greymouth Evening Star, 27 April 1938, Page 7

HEALTH AND PENSIONS

CLOSING OF INQUIRY FARMERS’ UNION PROTEST [PEB PRESS ASSOCIATION.] WELLINGTON, April 26. A decision to hear no more evidence after' Wednesday. of next week was made to-day by the Select Committee on National Health and State Superannuation. An application was made by the New Zealand Farmers’ Union for an extension of the time in which it should present its case. This) was rejected. The Farmers"’ Union will have to give its evidence on or before Tuesday next. .The Dominion secretary of the New Zealand Farmers’ Union, Mr A. PO’Shea, said that his organisation had been given to believe that reasonable time would be allowed for the thorough discussion of the Government’s health and superannuation proposals. The Farmers’ Union would like, if possible to have had longer time for the discussion of the proposals. The Union would also like to know what was in the Government’s' mind regarding hospital finance. The chairman of the committee, Mr Nordmeyer, said that arrangements have been made to receive the representatives of the Farmers’ Jnion on Tuesday next. The question arose os to whether the committee would, be justified in postponing its proceedings merely for the sake of hearing evidence from the. Farmers’ Union. Mr O’Shea said that the Prime Minister had 'suggested that the discussion Should be ample. Mr Savage: I never suggested that we should go on for ever. Mr O’Shea: A fortnight is not a very long time for a. national organisation to consider such proposals. Mr Savage: We 1 are not going on after the middle of next week. We have to prepare the legislation. In reply to a question by Mr Richards, Mr O’Shea said that the evidence of the Farmers’ Union would be ready by next Tuesday. Mr Savage moved that the Farmers’ Union be heard on Tuesday next and that Wednesday be the last day for a taking of evidence. Mr Savage agreed to separate his motion. , The proposal to hear the Farmers Union on or before Tuesday was carried. , The Prime Minister then moved that no further evidence be heard after next Wednesday. Mr Kyle: How can we know that we can close down? There are othei organisations throughout the country that we might want to> hear. Mr Savage: We would have to sit longer hours. Mr Holland: I am prepared to work reasonably, but I am not prepared o come here and injure my health by sitting morning, noon and night. i don’t think it reasonable to suggest that we should have to work all the night. z . . Mr Savage’s motion was. carried, Messrs Cobbe. Kyle and Holland ie corded their protest. HOSPITAL BOARDS’ ASSN. AMENDMENTS TO SCHEME. WELLINGTON, April 26. The attitude of the Hospital Boards’ Association of New Zealand towards the Government’s health and superannuation proposals was set out m a report presented by Mr. J. W. Dove, pi esident, and Mr. E. Cannons, secretary, who attended the sitting of the committee this afternoon. The association summarised its views on the main points of divergence with the Government’s. proposals as follows: (1) A complete service embracing the full range of health service benefits to those most in need of them (those on a lower-income scale) is preferable to a limited range of benefits available to all. (2) A contributory basis of finance by the insured, £he employer, and the preferable to the proposed direct tax. “In submitting the views of hospital boards, we rely upon the consideration previously given by boards to health insurance,” said the report. “The Government’s proposals have not had the consideration of hospital boards as a whole, but the boards will meet later to discuss the complete scheme to ascertain the manner in which they can co-operate.” An outline was given of the proposals approved at a general conference of hospital boards in 1935, when it was resolved to urge the Government to introduce a compulsory scheme of national health insurance. The income limit then suggested was £3OO, with an allowance of £5O for each dependant, and contributions were to be subsidised by the State. Other recommendations were that the scheme should apply to persons receiving salaries and wages between the ages of 16 and 65. that it should include the dependants of the insured, and that the Health Department and hospital boards were suitable agencies to represent the central Government and local insurance committees. The willingness of the boards to co-operate fully with the Government could be taken for granted. “The general practitioner is the pivot of the whole scheme,” the report continued. “However, without additional benefits, particularly specialist, consultant, and home nursing, there is a limitation placed on the value of his services to those on a lower-scale income. This may result in an increase rather than a decrease in the admissions to hospital for diagnostic consultant services, as well as from, the lack of nursing facilities in the home.

“Concerning the provision of free hospital and sanatorium treatment by all hospital boards, the association assumed from previous evidence that any member of the community would be entitled to hospital care in an institution under the control of hospital boards with full relief from personal liability. The payment of about 6/- a day as a grant out of the Social Services Fund has been suggested by an actuary as the basis for hospital care. “It Is also assumed that a patient in a private hospital would be assisted to the extent of 6/- a day. Thus treatment in public hospitals would be made more attractive than in private hospitals. Because of the variation in charges, differentiation must be made in the payments out of the Social Services Fund. Furthermore, the new sources of revenue produced by the 6/- a day would be cancelled out by filling the present shortage of beds,

estimated at 1000, extensions to outpatients’ departments, and the payment of the present honorary staff, since honorary service could not be reconciled with free hospital treatment for all.” Wholehearted support of the Government’s proposal was expressed by Mr. Alexander Scott and Mr. W. O. Beere, giving evidence on behalf of the Edward Bellamy Society of New Zealand. It was contended that the cost of the scheme was tod low, and that the country could afford a much higher standard of living. Superannuation should, not be regarded as a compassionate allowance, but as something to which every citizen over 60 with residential qualifications, was entitled. ACTUARY’S EXPLANATION. WELLINGTON, April 27. In a statement submitted to the Parliamentary Committee on superannuation and national health, Mr. Maddex said that the figures he submitted in his report on April 12, relating to the ratio of the number of pensioners to the number of workers, had been misinterpreted, to mean that in ten years’ time every 100 workers would have to support 46 old-age pensioners. “If the calculation is carried a little further, and on the one hand only the numbers drawing superannuation allowances over the age of 60 are taken into account, and on the other hand, men and women following a gainful occupation from 16 years upwards are counted as workers (including such persons over 60 years) a rather different picture is presented. I estimate that in 1939, for every 100 men and women who follow a gainful occupation, there will be 12 men and women drawing superannuation allowances, and that in 1949, for every 100 workers on this definition, there will be IS persons drawing superannuation. Thus in ten years’ time, the ratio of pensioners to men and women workers will be approximately 50 per cent, greater than at present (that is, IS per 100, compared with 12 per 100). It should be noted that the number of pensioners taken into account does not include persons drawing various existing State benefits and pensions, which would, of course, substantially increase the proportion of State beneficiaries to workers.” Mr. Maddex also submitted statistical information relating to the occupational grading of men under and over 60 years respectively, and relating to the estimated number of beneficiaries in the Government’s superannuation proposals. The last-mention-ed return estmated that the number of recipients of superannuation benefits would rise from 59,100 at February this year to 88,000 in 1939-40. and 128,000 in 1949-50. B.M.A. ATTITUDE. PREVENTION MORE THAN CURE 1 1 WELLINGTON, April 27. A statement was presented to the Committee by J. P. S. Jamieson, Pre- 1 sident of the New Zealand Branch of 1 the British Medical Association, and i chairman of the National Health In- ) surance Committee of the same body. 1 Mr. Jamieson stated the Association desired that .so far as practicable, obs- : taeles to obtaining the necessary ser- 1 vice should be removed wherever they existed, in older that everyone < should have access to complete neces- ' sary medical attention. It was con- 1 sidered, however, that to maintain i that end it was neither necessary nor I desirable to restrict the freedom of the people to seek their medical attention as and where they preferred, nor was it desirable that individual responsibility in this matter should be lessened or abolished. i

“In any steps we take,” the statement continued, “we should keep our feet on the firm ground of experience, direct attention first to the needs which are greater, and employ methods which are related to practical requirements.” All were agreed that the promotion of health was a greater object than the treatment of sickness, in that prevention was better than cure. They did not. under-estimate the importance of curative medicine, but national health insurance, which was really a system of indemnification for sickness, did not, especially in the proposals put forward by the Government, materially advance the object of the promotion of health. There were certain conditions in relation to environment, to the conditions at work, to domestic help, to nutrition of the young, to preventive medicine, and to research, which the medical profession knew to be unsatisfactory. Continuous and studied attention to those conditions would do far more for the people than the introduction of any costly scheme of health insurance, and the provision of a universal general practitioner service would do nothing towards remedying these deficiencies.

Further, there was pressing need for reform, by proper co-ordination, of all health services in the community. This was specially apparent in hospital administration, the reform of which was long overdue, and would remedy with very little extra cost to ratepayers, many of the defects in the present system. PROFESSION’S OPINIONS. After a comparison of conditions in Germany, where a health insurance system has been instituted, with those in New Zealand, the statement added that the Prime Minister’s proposals provided little for people which was not available to them at present, and Omitted real impediments to efficient treatment. They suggested that the Government was more concerned with changing the present system, than with improving the medical service of the people. Dealing with the origins of the proposals announced by the Prime Minister, the statement says:- "It was first brought to the direct notice of the profession through the representations] made to the Association by Dr. McMillan, M.P., after his appointment as l Chairman of the Investigation Com-' mittee. This Committee was not, in, the opinion of the profession, a body! qualified for the task allotted to it.”| The statement proceeds: “With unflagging energy and enthusiasm, Dr. | McMillan canvassed the majortiy of medical practitioners, pressing the advantages of the contemplated system. His representations left no doubt in the minds of the profession, that the ultimate object was State control of the entire medical services, rather than provision for the actual medical needs of the There can be no doubt that the great majority of the profession were opposed to the proposals, and during the months that we have been studying the problem, this opposition has strengthened. Our opposition is based on the conviction that such a service would not only fail to satisfy real health needs, but would lead to the deterior-

ation of the standard of medical practice.” Summing up, the statement says: “We see in the projected universal general practitioner scheme a mistaken method of approach to the problem of raising the standard of the health of the community, no appreciable advantage in the treatment of disease over what we possess at present, unnecessary interference with and discouragement of individual initiative and enterprise. State dominion over the people’s freedom and professional liberty, and deterioration of the standard of medical work. OTAGO FARMERS’ CRITICISM DUNEDIN, April 26. Criticism of the Government s plans for a national health and superannuation scheme was expressed at the monthly meeting of the Otago Provincial Council of the New Zealand Farmers’ Union to-day, and the fol--1 lowing resolution was carried unamImously: — I “This council is in favour of a national health and superannuation '• scheme, provided such scheme com- ! plies with the principles laid down by the Dominion conference of the Farm,'ers’ Union. The main principles laid j down were that any scheme propound- ■ ed should be contributory, and that . every person should be eligible to pai- ! ticipate. Naturally, any scheme adoptJed should also be fundamentally sound. | “In the opinion of this council, the ; social security proposals now brought J forward by the Government have ser- [ ious weaknesses which, make it imj -possible for this council to support - the proposals in their present form. ) We believe that the Governmental soc--5 ial security scheme is unjust in prin- - ciple, in that the majority of those - who will be called upon to pay into j the scheme will never be able to par--1 ticipate. We further believe that it i definitely discourages individual thrift ■- and self-reliance.”