THE DOCTOR AND HIS PATIENT

Grey River Argus, 18 December 1940, Page 8

THE DOCTOR AND HIS PATIENT

By

a Socialist Doctor

The Socialisation of Medicine in New Zealand

THE FUNDAMENTAL PRINCIPLES on .which Soviet medicine is founded appear to be the right ones; they are the removal of the financial barrier between doctor and patient, and the emphasis on preventive medicine and team work of groups of doctors, nurses, etc. this is the system Capitalism adopts in war-time for the fighting forces, when it requires the greatest efficiency for destruction. Let us sec how medicine might be socialised in New Zealand.

The Social Security Act has already to a considerable extent prepared the way, and when the doctors have agreed to work the general practitioner service we shf.il have taken a. further step. We shall have got rid of the financial barrier between doctor and patient. The next thing to do is to arrange the doctors, dentists, nurses, pharmacists) and ether personnel into groups to suit the requirements bf each hospital area throughout the country. This will mean, cf course, a medical service with salaried members, a change which many of them may object to. Each hospital would look after its district sand would provide a complete service; visits, consultations, specialities, etc. Certain cases would, of course, have to be sent to one of the four larger centres as at present. Pvound these hospitals would be grouped smaller centres or dispensaries, staffed by one or more doctors and probably several nurses. These dispensaries would be placed in outlying parts of the towns, in large factories and mines, and in the country districts. They would be part of the central hospital system and would have all the resources - of the hospital behind them. They would take the place of the present rather isolated general practitioner. Importance of Preventive Medicine The preventive side of medicine is hardly touched on under Capitalism. Only Infectious diseases are controlled, the cynic says, because the rich are liable to catch them. Under Solialism the outlook is different and, in consequence, preventive medicine will hold just as important, if not a more important, place than curative medicine in the medical services. Under Capitalism we are apt not to realise the enormous hardly explored field of prevention. Doctors would have to be specially trained 'for the work, and there would be two types of ' doctors, the preventive and the curative. Their work would naturally overlap to some extent and they would both work from the same centre and be under the same administration.

The preventive work would consist in periodic examination of the workers in the factories and mines and oflices. In dangerous trades the examinations would be more frequent. School children and students would be examined in the schools and universities. In our school medical j service we have the nucleus *of this. And finally house to house visits would get* the rest of the community. The Plunket Society would be taken over and expanded. The object would be to detect disease in its earliest stages, when it is more easily and quickly cured, and to advise people on health matters generally. Propaganda would be necessary to awaken the public conscience to the advantages of living healthily. Another branch of the work would be the inspection of factories, mines etc,, public buildings and private houses to see that the community were living and working under healthy and safe conditions. Water supplies and drainage would be another responsibility of the medical services. And, of great importance, the rigid inspection of all food to see that it was of the best quality and produced under the highest possible hygienic conditions. As the reader will realise it is possible to go on for quite a long time suggesting important and’ useful work for the

preventive 'service. The point to remember is that this preventive work, although it is Io a great extent strange to us living as we do under Capitalism, will increase the standard of health of the whole Community. There will be less sickness.

A scheme on these lines would probably require 25 to 30 per cent, more doctors than we have in New Zealand at present, but as the preventive measures began to have effect there would be less disease to cure, and possibly the number could be gradually decreased.

It is often suggested that under Socialism the people would be regimented and made to conform to the Government’s ideas of what was good for them. After reading all about the suggested medical examinations, the leader may have gained the same impression. It must be remembered, however, that there would be no compulsion about these examinations and inspections, unless the health of other members of the community was endangered, as in the case of infectious diseases. And that each centre would be controlled by an elected commit-

tee. much the same as out. hospital hoards. Some way would have t 6 be found of letting the individual air his complaints and criticisms, and of ensuring that they would be investigated without bias. Democratic control, is part and parcel of Socialism. How the System Would Work The letter of an Englishman who was working on the new Underground railway in Moscow gives a good idea of how socialised medicine affects the individual. The letter is quoted by the Webbs in their book “Soviet Communism.” "I wish,” said the writer, “to describe what happened a few months ago when I had a bad cold and went to the Metrostroi Medical Station A few questions and I was given the num: ber of the doctor's room. A few minutes’ wait, during which I had time to observe the medical propaganda charts and models in the hall, and my name was called. ‘A cold.’ the doctor said, 'let me examine your throat; now your nostrils, and your ears.’ I discovered that I had a slight catarrh, and some foreign matter in my ears. After a syringeing 1 could hear ever so much better. Then I got two prescriptions, one for my nose, and the other for my throat. She also said she had better examine my lungs; I laughed, but realised how thorough the Soviet doctor was. After giving me an O.K. she sent me to the dentist. 1 have not had toothache for years, but nevertneless she insisted it would be better. Then 1 got one tooth stopped and two pulled out. The extractions were the most painless I have experienced.' When the gums were aet I was warned I would have to go back and get fitted for a set of false teeth. This would be given free, as also is the medicine. I left the clinic with my prescriptions and a great respect for the Soviet doctors and the system.” (Concluded).