MEDICAL SERVICE

Otago Daily Times, Issue 25799, 21 March 1945, Page 4

MEDICAL SERVICE

CRITICISM OF NEW ZEALAND SCHEME

“ GREAT GIFT TO DOCTORS”

(Rec. 7 p.m.) SYDNEY, Mar. 20. The Sydney Daily Telegraph to-day publishes an article by Mr D. L. Thompson, the Telegraph’s chief of staff, who recently visited New Zealand, where, the paper says, he examined New Zealand's free medical service scheme. Mr Thompson says it is a great gift to the doctors. He concludes that the New Zealand experiment in free doctoring is a valuable lesson to Australia in how not to do it. The article says that one of every fiO boys in the school-leaving group in New Zealand takes the course of medicine. This is not because of any starryeyed resolve to save humanity from pain; it is because under social security and its free medical service the most ungifted doctor is assured of £2OOO to £4OOO a year, and the man with a shrewd head for systematising his practice can (and does) make £BOOO to £IO.OOO a year. The New Zealand experiment in free doctoring is a valuable lesson to Australia in how not to do it. The failure is due partly to the destructive attitude of the British Medical Association to all the Government’s plans, and partly to a Government which by false pretences sold the public a service which it did not possess to sell.

“ Practitioner’s Dream ”

After giving some details of the early history of the scheme, Mr Thompson continues: “ It is the most lucrative thing the general practitioner ever dreamed of. His bad debts (normally about 30 per cent.) have vanished. With about 25 per cent, of his colleagues on war service there is one doctor in New Zealand to every 2000 to 3000 patients. The peace-time figure was one to 1400. The money barrier between doctor and patient having vanished, the doctor no longer restricts visits out of consideration for the patient’s purse. He makes every attendance that is necessary and some that are not, and every time up pops 7s 6d out of the Government’s bottomless purse.” Mr Thompson added: “ Of course, the system is being abused. Patients make frivolous calls on a doctor, and some doctors unscrupulously extend their patients’ illnesses, continuing daily attendance right through convalesence and past it. Evils have resulted. It is hard to get a city doctor to visit at all, and almost impossible at night. The reason is that the fee for a call and a visit is the same. All the patients are herded through the consulting room on the lodge practice system, and they are encouraged to step lively. A doctor’s income depends on the speed at which they pass him. His secretary writes a chit like lightning, the patient signs, and the Government pays. Paying in a New Way "The shilling in the pound is not enough to meet all this, plus pensions, plus free medicine. It takes another £4.000,000 from the consolidated revenue. Yet for all this money the public is getting the old form of medical service, but paying for it m a new way. , , “A young doctor is attracted away from research and specialisation into general work The specialists say that the general practitioner tends to shirk any case presenting the least difficulty, and passes it on to an overcrowded hospital or specialists. And of the specialist's two-guinea fee the Government still pays only 7s 6d and the patient finds the rest. If you want a 50-guinea operation the Government pays only 7s 6d towards it, and perhaps a couple of other 7s 6d’s if there are post-operative calls. That is because if you will have a big operation you are expected to get it for nothing at the public hospitals, but at a public hospital it is left to a clerk to decide which doctor will do the job, and the public hospitals are more overcrowded and worse staffed than the big private hospitals. “ Some advantages can be seen from the new scheme. Patients now run to a doctor with a sore finger. Ihey want their shilling-in-the-pound worth. That is why boys leaving school want to become doctors —general practitioners. . , , . “New Zealand, with a population of 1 600,000, now allows about 270 students to begin first-year medicine at Auckland, Wellington, Christchurch, and Dunedin. Only 100 offered before social security. Who is to blame the lads if some of them sneer at professors of medicine who are paid a paltry £2OOO a year? They themselves will be getting £4OOO in six years’ time. The professors hit back savagely. They fail 45 per cent at the end of the first year. That is because the full medical course is available only at the Otago University, and the maximum intake is 120.