THE OTAGO DAILY TIMES Thursday, February 14, 1946. THE DOCTORS’ DILEMMA

Otago Daily Times, Issue 26077, 14 February 1946, Page 4

THE OTAGO DAILY TIMES Thursday, February 14, 1946. THE DOCTORS’ DILEMMA

The addition to medical knowledge that was acquired through the violent agency of war provided an interesting text for the presidential address of Dr Eisdell Moore this week to the New Zealand branch of the British Medical Association. It is on record that the need for a new antiseptic to meet the demands of war led Sir Howard Florey and his team of researchers at Oxford to study the practical extraction of penicillin, eleven years after Fleming recorded the properties of his remarkable mould. It is well known that in the early stages of the war in wound cases the use of blood plasma and the sulfa group of drugs, later greatly aided by penicillin, reduced the rate of loss below any figure previously believed possible. And while estimates would be so hazardous as to be without value, it can belaid with safety that the use upon civilians of techniques and drugs either evolved or developed in war-time has preserved hundreds of thousands of lives which a few years ago would have been beyond saving. A good instance was provided by Dr Moore in the revolutionary effect of penicillin upon the treatment of the dread osteomyelitis, of which a number of children in the past became pathetic victims. The contribution made by medical science during the. war may, indeed, rapidly outbalance in cold terms of life and death the toll of the conflict. And the contribution of the medical profession to humanity’s need in this period of crisis should not be overlooked. On the battlefields and in the base hospitals, and, it is fair to add, on the home front also, doctors have served with full-time zeal in these difficult years. Many of them are now, in New Zealand as elsewhere, coming back to take up their practices or to enter civilian practice for the first time—to claim, as do other servicemen, a place in the world they have been fighting to preserve. But their expectations in New Zealand are in great danger of nonfulfilment. The Government, while Mr Nordmeyer as its spokesman remains non-committal but suavely threatening, is tightening its grip on the profession. The young doctor who, training expensively, believed that he would be able to enter a free, competitive'field in the practice of his profession cannot be so sure to-day. Mr Nordmeyer’s appeal to doctors to accept the direct fee for service scheme—of payment by the State to the doctor of 7s 6d per consultation—has been accompanied by a calculated threat of a State medical service. In other words, while the Government is not bold enough, or not foolish enough, to attempt to force doctors to accept its dictatorial terms, it is considering the practicability of breaking their independence by introducing a salaried scheme, virtually in opposition to the general practitioner service. This is the hand of StalinSocialism, scarcely concealed in the glove of co-operation which the Minister extends to the doctors. It may be that, the economic aspects of their work being reasonably assured by the fee for service, the members of the medical profession may decide to accept this basis as being from the viewpoint of their duty to the public preferable to a' straightout State service. In making a decision they should, however, consider well the insidious methods by which the Government has extended its control into other, lessexalted, private enterprises. They should realise that the fee for service fixed can always be reduced at the Government’s pleasure, and that they will be, in effect, placing their welfare unreservedly in the keeping of an Administration that has shown itself to be ill-disposed towards their profession and capricious in its social planning.