The Pahiatua Herald. PUBLISHED EVERY EVENING WEDNESDAY, SEPT. 10, 1941. A CHANGE—WITHOUT AN IMPROVEMENT.

Pahiatua Herald, Volume XLX, Issue 14839, 10 September 1941, Page 4

The Pahiatua Herald. PUBLISHED EVERY EVENING WEDNESDAY, SEPT. 10, 1941. A CHANGE—WITHOUT AN IMPROVEMENT.

When a Government proposes to make a substantial alteration in a system of long standing, the responsibility falls upon it to demonstrate that the alteration will bring about an improvement. In other words, it must prove that its proposal involves not merely a change, but a progressive change. Will the change in the system of medical practice contemplated in the Social Security Amendment Bill be an improvement? Tt is quite obvious from the comments of the B.M.A. spokt smen that from the doctors’ point o? view the change will be not only unwelcome, but detrimental to the medical profession as at present organised. But for some people, including the members of the Government, and some of its supporters, the fact of the B.M.A.’s objection to the scheme is not conclusive, for they detect in the opposition large elements of political prejudice. Yet an impartial survey of the long controversy over the “general practitioner service” must lead to the conclusion that it is “politics” on the Government's side, which has been the principal factor in producing the present unhappy and potentially harmful situation. If the Government had not rashly given a political pledge to introduce a medical service which could not be introduced without the B.M.A.’s co-opera-tion—which it knew would not be forthcoming—and if it had not begun taxing the people to pay for the service, it would not now be under the political necessity of “delivering the goods” or attempting to deliver them, at the cost of creating a strong sense of grievance in the medical profession. But, leaving “politics” aside, how will the new scheme work ? First, it should be noticed that the amendment of the Social Security Act will not increase the number of general practitioners in New Zealand, a number already seriously reduced by the calls of war. It is well-known that the doctors remaining in practice are over-work-ed. This bill will not reduce tlic total volume of work, but increase it. Nor will it, by bringing about a reorganisation of the profession, tend to spread the burden more equitably. Such a reorganisation may become essential, as a war measure, but this bill docs nothing to promote it. This bill is concerned, ' first, to ensure that people pay nothing directly to the doctors, and, secondly, to fix the sums of money that the doctors may receive for their services. Only through sheer stupidity, or political partisanship gone blind, could the illusion be entertained that a piece of fee-fixing legislation is going to provide the people with a medical service better—for their health—than they receive at present. A doctor now T may visit a patient and spend an hour. For that he will in future receive the same fee (plus travelling expenses) as he will receive for attending, in five minutes to sonic tri-

fling ease in his surgery. Will not the fact that there is no differentiation for payment for different services lead to the using-up of the doctor’s limited time in attending the greater proportion of patients who have little wrong with them ? Much as the doctor will wish to distinguish between patients who really need his services and those who do not, how is he to succeed? Reflection upon the Government’s latest (scheme must, indeed, lead to the apprehension that not only does it promise no improvement in medical service, but also that, at least from the patient’s point of view, it is the worst scheme yet.