THE OTAGO DAILY TIMES FRIDAY, AUGUST 12, 1949. THE HEALTH SERVICES

Otago Daily Times, Issue 27157, 12 August 1949, Page 6

THE OTAGO DAILY TIMES FRIDAY, AUGUST 12, 1949. THE HEALTH SERVICES

It is nothing new for the medical section of New Zealand’s social security schemes to be the subject of drastic criticism by laymen and experts at home and abroad, and there is perhaps nothing that is new in the comments of Dr E. W. Maples which were published in our cable news yesterday. They are of interest, however, as the opinions of an overseas observer who studied the system in operation, and also it is timely that public attention to the matter should again be stimulated in view of the possibility that legislation may be placed before the House during this session. This legislation, it may be expected, will embody at least some of the recommendations which were made in the report of the Medical Services Committee—a body representative both of the doctors and the Department of Health —which was issued last September. • That document contains one of the most comprehensive reviews of the whole problem and it deals with most of the points raised by Dr Maples. It also includes a number of recommendations, and to that extent it represents a positive approach to the subject. The continued toleration of a number of anomalies in the system and of some cases of flagrant abuse reflected unfavourably upon the profession as a whole and also upon the Government. Allegations of self-interest and of political motives which have been made from time to time have not been convincingly repudiated, and the public of New Zealand has had to pay the price. The medical benefits system has been in.operation long enough now for ample data to be available for thorough study with a view to removing the imperfections from a major piece of experimental legislation. Moreover, the attention given in recent years to similar planning in Great Britain, the United States and other countries has resulted in the production of a large amount of material which might be of considerable assistance in an overhaul of our own system. Among the matters upon which Dr Maples commented was the system of payment to doctors. He found the New Zealand system an undesirable one, but admitted the difficulty of finding a , remedy. The report of the Medical Services Committee contains references to this subject and a recommendation is included in it for a “ fee for service ” arrangement which it is hoped would effect an improvement on the present system and would also preserve the doctor-patient relationship which has a real value in medical practice. Other recommendations in the same report are aimed at giving the profession a greater and more direct responsibility for the administration of the scheme and power to deal with complaints of unethical behaviour. , One other point made by Dr Maples deserves to be considered. In effect he expresses doubt if the financial basis of the scheme is sound. Expenditure under the heading of social security is already largely responsible for the high rate of taxation in this country, but there are no reserve funds against the heavier commitments of the future. In less prosperous times the whole costly and often extravagantly wasteful system might prove to be an insupportable burden.