MEDICAL SERVICE

Greymouth Evening Star, 6 December 1940, Page 8

MEDICAL SERVICE

VOLUNTARY CONTRACTS IF DOCTOR AGREEABLE [PER press association.] WELLINGTON, December 5. The completely-voluntary nature of the provisions for the contracts between patients and doctors under the Social Security Act was stressed in the House to-day by the Minister of Finance (Mr. Nash), in moving the second reading of the Finance Bill (No. 4), which contains an amendment to the Social Security Act. If a doctor who was approached by a patient refused to agree to a contract, Mr. Nash said, nothing could be done about it. The purpose of the amendment to the Bill was to allow any person to contract with any doctor to attend himself and his family, and the State would pay the doctor the fees incurred. It meant that the individual could go to his doctor and say he wanted to come under the provisions of the Social Security Act. Mr. J. A. Lee: If the doctor says no? Mr. Nash: Then nothing can be done about it. He has got to find a doctor who agrees. Mr. Nash continued that there was also a provision whereby contracts could be made between groups of in- | dividuals and a doctor. | After Mr. Nash had given a brief' outline of other provisions in the Bill, the debate was adjourned.

“SPLITTING THE 8.M.A.” MR. HOLLAND’S CRITICISM. WELLINGTON, December 6. In the House, this morning, urgency was accorded the passing of the Finance Bill (No. 4), on the motion of the Prime Minister. Mr. Holland said he did not think that there would be much opposition to the Bill. Referring to the social security provisions of the measure, he suggested that the Government should aim at giving all hospital treatment free, and pointed out that, if the doctors remaining behind were allowed to build panels, they would have a choice of patients, and when those on service returned, they might find that no practice was left to them. Under the circumstances, the Government should consider holding the scheme over until after the war. He contended that the clause was an attempt by the Government to split the B.M.A. The Government had decided not to make a contract with the Association, but with individual members. That was a thing they would not permit in the industrial world. Mr. Holland added that the Minister of Finance had admitted it was not possible to compel the doctors to give service, and at the same time for them to give their best service, but he also stressed the contention that some service should be provided, or some of the taxation remitted.

MR. ARMSTRONG’S REPLY. The Minister of Housing (Mr. Armstrong) said'that the Leader of the Opposition had alleged that the Government was trying to cause a split in the 8.M.A., but the Government had been -working to prevent that very thing. They'wanted the co-operation of the doctors, but the B.M.A. was the only powerful organisation that had given no sign whatever of co-operation. The Government was pledged to give a free medical service to the people, whose sons and husbands had gone to the war. It was all right for the

B.M.A. to say they had to keep faith with those of their number who had gone to the war, but the Government also had to keep faith with the people of New Zealand. There had been no war when the Act was passed in 1938, but the doctors were just as bitterly .opposed to the scheme then as they were now. They had never budged '■from their original conditions, but now they were saying that it was because

of the war. The Minister added that he was not antagonistic to the members of the 8.M.A., because there were some very fine gentlemen in it, but the Government had done everything that was humanly possible to bring about a spirit of co-operation, even to the extent of saying that it- yvould ,amend the law, to comply with something less than was in mind when the law was drafted. He added that the Bill did not say exactly what was proposed, but regulations had been drafted, and they would give the B.M.A. a fair go, as well as everyone else. “We cannot deal with the B.M.A. as an organisation,” he added, “but we are going to keep our pledge to the people, r and the people are going to get the service. The medical profession as a whole will be materially better off.” Mr. Armstrong said that the Government would issue to every citizen ' a certificate, which would be available lat Post Offices and Social Security [Offices, and probably other places, and the individual had to find a doc- . tor himself. If the doctor agreed to 'accept him, he signed the certificate, • which was then sent to the Social Se- [ curity Department. That gave the I citizen, his wife, and family the right to free medical attention. On the other hand, the doctor would be free to re- ■ fuse. He had the same right of choice las the patient. That would be done | under the regulations. The Government had in mind what was a reasonable fee, which it was proposed to pay for every person for whom the doctor was responsible. In the Friendly Societies, it was only the head of the family who paid, but in this case it was not only for the head of the family, but for his wife and every child under 16 years. The Minister said that out-patients’ services and pharmaceutical benefits would come into operation simultaneously with the medical benefits.

Mr. Lee expressed concern as to what would happen if the doctors refused co-operation. In the industrial field if the watersiders or tobacco factory employees refused co-opera-tion, their union was deregistered. Both the Prime Minister and the Minister of Health had frequently stated that the Government would not permit obstruction to prevent the carrying out of the full provision of medical services. If that firm intention were behind the present Bill, it deserved hearty approval. Nothing short of the original Bill in its entirety was good enough for the people. If there were not a genuine effort to apply the full benefits, members would have to revise their present approval.

OUT-PATIENTS’ TREATMENT The Minister of Marine (Dr. McMillan) contended that the present scheme would be just as successful l as the maternity benefits scheme. The i Leader of the Opposition had advocated free out-patients’ treatment, but he would also remind the House that the Government, too, had advocated similar treatment. He would also like to point out that a big scheme like the present one could not all be put into effect in a day. Very shortly, the Leader of the Opposition would not have any complaint to make about free out-patients’ treatment, because people would be receiving attention given under this category, by their own private doctors. He also contended that, far from delaying the introduction of the scheme, the war was a reason why it should be expedited. Dr. McMillan also contended that the majority of the doctors would be only too glad to be relieved of the financial side of their profession, which would be effected under the Government’s scheme, and he did not think it w’ould be long before 90 to 100 per cent, of the doctors would be attending patients under it. The debate was interrupted by the adjournment at 1 p.m.

FIRM RESISTANCE. NELSON, December 6. Dr. Jamieson, chairman of the National Health Insurance Committee of the British Medical Association, made the following comment: “Amendments to the general practitioner service will be resisted by the medical profession as firmly as the repealed clauses of the Act itself. The

amendments, in no respect diminish the danger of degradation of medical work against which the Association has fought consistently. It is evident that the amendments are designed to enlist the pressure of individual patients and organisations on individual doctors, in order to white ant the resistance of the Association against bureaucracy and socialisation. This will not succeed. A still worse feature is that the amendments, if they were effective, would result in seriously reducing the war effort of the profession.”