MEDICAL SERVICE

New Zealand Herald, Volume LXXIV, Issue 22694, 5 April 1937, Page 12

MEDICAL SERVICE

EIGHT OF THE PEOPLE INVESTIGATOR'S OPINION CENTRALISED SPECIALISATION [BY TELEGRAPH —OWN CORRESPONDENT] WELLINGTON, Saturday The people's right to the benefits of modern medical and surgical science are discussed by Mr. W. H. Freeman, S.M., in a report drawn up on a proposal to amalgamate two hospital districts in Southland. -Sir. Freeman was commissioned by the Minister of Health, the Hon. P. Eraser, to investigate the proposal, and in the course of his report he makes some observations of general interest. "The present trend appears to be toward making available to the public vital social service (and the medical profession is such a service)," says Mr. Freeman, "and I am of the opinion that the sick and needy of any district ■ should not be prevented from obtaining those services as of right, and no obstacle should be placed in the way. The medical evidence shows that at present there is that obstacle, and I consider I am entitled to rely largely on the medical evidence, because medical practitioners are the persons most interested, and their opinions should be treated with respect. "Medical and surgical science have advanced tremendously in the past few years. The whole tendency is toward centralisation and specialisation, and I have no doubt that as time goes on specialisation will increase. Specialisation will be found only in the larger towns, where there is the population to warrant it. For the same reason it is found in the larger hospitals with the larger number of patients. Small hospitals do not warrant specialisation." Reinforcing these points, Mr. Freeman referred to the difficulty of getting wide experience in small communities, adding: "This brings me to the point that there is apt to be a tendency on the part of a medical superintendent of a small hospital to undertake cases which would be better treated in the base hospital. This tendency may be due to pressure being brought to bear on the medical superintendent, either directly by his board instructing him to keep as many cases as possible within the district, or indirectly by the feeling that the sending of too many cases to base hospitals might carry with it the implication of incompetency."