THE New Zealand Herald AND DAILY SOUTHERN CROSS WEDNESDAY, OCTOBER 1, 1941 SUGARING THE PILL

New Zealand Herald, Volume 78, Issue 24084, 1 October 1941, Page 6

THE New Zealand Herald AND DAILY SOUTHERN CROSS WEDNESDAY, OCTOBER 1, 1941 SUGARING THE PILL

An attempt to sugar the pill for the doctors regardless of the added cost to the taxpayers is made in the latest amendments to the Social Security Amendment Bill brought in by tlie Minister of Health. In fact the Government has been induced by the popular outcry against its original proposals to modify the scheme substantially. Nevertheless it is still open to the gravest objections. It represents a dictated and not a negotiated settlement; the element of coercion remains in fact if not in theory ; in its working a damaging deterioration in medical practice seems certain to occur ; and the scheme does nothing to promote public health, merely providing for treatment after people fall sick. However the doctors may regard the new proposals, the people can feel no enthusiasm, being required to pay more heavily for medical services that promise no improvement and that may in practice decline in quality. Under the new scale of fees, the Government has raised its bid to the doctors by 50 per cent and more. Their fees, estimated on the scale previously offered at £1,800,000, may now aggregate £3,000,000 a year. This steep rise is absolutely unnecessary because at no time did the doctors object to the previous scale. Apparently, however, the Government takes the cynical view that money talks, and thinks to buy the doctors' compliance by a deeper plunge into the people's purse.

Sir Carrick Robertson has clearly explained his profession's standpoint. He insists the doctors' objections are not financial, because most general practitioners would make more under the scheme than they do to-day. They contend that under the scheme the personal relationship of mutual trust and complete confidence between doctor and patient would be destroyed by the new conditions of practice. The doctors would be overwhelmed with work, they could not be sure of the genuineness of the patient, their increased work would necessarily become more mechanical, quantity would tend to prevail over quality. The Government has never shaken or seriously attempted to answer Sir Cartick's conclusion that "under the scheme it would be impossible to keep up the high standard of medical service that the people of New Zealand have had in the past." Can it be that the Government is not really concerned with the quality of the medical service it proposes to deliver, that it merely wishes to make a show of doing something, and so gain a political point 1 Its action in pressing on with the scheme at the present time is the more suspect because the Government knows that three out of every ten doctors are on active service. Apart from its tactics of stealing a march in their absence, the Government knows that the remaining seven out of ten doctors are already over-worked and could not cope adequately with the new flood of work that will be loosed by the scheme. In order to make a gesture to the unthinking, the Government is inviting mass consultation and mechanical work. Later the people will be called to pay heavily in higher wages tax for this doubtful boon. May they not have also to pay in health.

One most objectionable feature has been removed from the bill. The doctors are no longer forbidden to demand or accept any fees other than those paid from the Social Security Fund. In theory, therefore, they retain the right of private practice. In fact, however, private practice may dwindle almost out of sight and it would carry the risk that under the bill the doctor would not be entitled to recover fees—he would not be able to sue. A strong element of coercion therefore remains. Few doctors will be able to insist on cash in advance and, unless they continue to stand together, economic pressure will force them into the Government's scheme. The rule of the bludgeon remains—not so heavy a bludgeon as originally intended, but heavy enough for its coercive purpose. All other workers have won and cherish the right of collective bargaining with their employers. A Labour Government now proposes to tear up this charter of freedom in the case of medical workers and dictate their wages and conditions. This arrogant action is not being taken in the interests of public health, which will not be served, but merely to gain a political point.