NEW BILL IS CONDEMNED

Southland Times, Issue 24534, 8 September 1941, Page 4

NEW BILL IS CONDEMNED

STATE MEDICAL SCHEME STRONG PROTEST BY DOCTORS “COERCIVE MEASURE” A demand that the council of the British Medical Association withdraw its committee forthwith from collaboration with the Government on the Social Security Amendment Bill, which was before the House of Representatives on Friday, has been made by the Southland executive of the association. At a meeting held on Saturday the executive took strong exception to the principles embodied in the Bill. Members objected particularly to the compulsory clauses, which, they claimed, interfered with the liberty of patients and doctors alike.

The following grounds for the demand were given:—

(1) That the Government is forcing a fundamental change on the profession when one-third of the members are overseas.

(2) That the Government Bill is a coercive measure destructive of both public and professional liberty. (3) That the Government introduced the Bill without consultation with the rank and file of the profession. (4) That the only acceptable principle in the Bill is that of payment for service. (5) That the essential feature of part payment by the patient is omitted. INDIGNATION EXPRESSED After the meeting the president of the Southland executive (Dr S. E. V. Brown) said that a feeling of indignation at the compulsory clauses had prevailed. The rank and file of doctors had had not information except what had been published in the newspapers. Representatives of the British Medical Association had met the Government a week ago and had been told something of the provisions of the Bill. This information, however, was not very much and the representatives had been pledged to secrecy. All that the doctors know about it is that the essential feature of part payment by the patient had been omitted. “The opinion in Southland is that the payment for service scheme could have been protected from abuse only by patients paying a portion of the fee,” said Dr Brown. “Under the suggested conditions the patient is free to call a doctor as often as the whim takes him, while an unscrupulous doctor would be free to pay unnecessary visits to collect the Government fee.” If on the other hand the patient was called upon to pay a small proportion of the fee, he would not be so likely to send unnecessarily for a doctor. Likewise no doctor would pay unnecessary visits. CHIEF OBJECTION Although the doctors considered that the standard fee of 5/- was too low, their chief objection to the Bill was not connected with its financial provisions. They were chiefly concerned with the principles involved. I One third of the members of the medical profession in New Zealand 'were now overseas, continued Dr Brown, and the passing of the measure in their absence would be tantamount to their being disfranchised when a fundamental change was being effected. They would find when they came home that they had been “left out in the cold” if the Bill was made law.

The doctors were quite in favour of the payment for service provision provided there was part payment by the patient so that abuses would be pre-, vented, he added.

“MUST TOE THE LINE OR STARVE”

CRITICISM BY DUNEDIN DOCTOR

(Special) DUNEDIN, Sept. 7. “This new amendment to provide a general practitioner service contains a strong coercive element,” declared Dr J. B. Dawson, president of the Otago Division of the British Medical Association, when asked to comment upon the Social Security Amendment Bill. “Again,” said Dr Dawson, “the Government seeks to introduce a general practitioner service: (1) Without seeking the-advice of the recognized leaders of the medical profession; (2) without negotiations with the profession prior to the drafting of the main provisions of the bill; (3) while 250, or 30 per cent., of the active practitioners of the country are professionally disenfranchised by absence on active service.” He added that the new amendment provided that no doctor should demand or be entitled to sue for a fee for services, payment for which was provided for in the Bill, except in the extremely unlikely event of a patient refusing to certify that the services had been given. Even if a patient for any reason wished to pay his doctor’s bill himself, the fees charged must be those prescribed in the Bill. “In short,” said Dr Dawson, “the provisions of the Bill mean that the doctors must toe the line or starve. The Minister of Health, howevef, expressed regret that the word ‘coercion’ was used. These provisions have been introduced without submission or any arrangement for submission, to any court of arbitration,” he added. “This appears to be a denial of the commonest. principles of democracy or even of trades unionism.” Dr Dawson said that from a financial point of view the provisions of the Bill did not appear to be unfavourable to the doctors. In fact, they were quite as good as those proposed in the general practitioner scheme introduced earlier in the year. “The problem before the medical profession is, therefore, once more, hot a question of money, but whether it is to remain free or bound,” said Dr Dawson. “The answer to this question must await the decision of the individual members of the British Medical Association when it. is submitted to them by the association.”

“CONSCRIPTION OF RIGHTS” B.M.A. President’s Comment (P.A.) . AUCKLAND, September 7. The imposition of a socialized general practitioner scheme upon the medical profession on the Government’s own terms was condemned on the grounds of principle by the president of the New Zealand branch of the British Medical Association, Dr H. M. Wilson, of Hastings, in a statement of his personal views before his departure for the south today. “The fundamental objections to the Bill are two in number,” said Dr Wilson. “In the first place it forces a revolutionary and socialistic change upon our profession behind the backs of those of our members who are serving in the forces overseas; and secondly, it substitutes conscription of private rights as a permanent feature of medical practice. The scheme now proposed is far too complex in its implications to be rushed through in a hurry. In plain English the present proposals amount to permanent and peace-time conscription of the medical profession and they present a set of terms and conditions which the present Government would neither wish nor dare to impose even upon the weakest and least significant trades union in this Dominion. “NOT FAIR PLAY” “The present Bill abolishes entirely all suggestion of agreement or contract in relationship of patient and doctor, and it shuts and bolts the door against any appeal by the doctors to the principles and benefits of collective bargaining. In the absence of so many of our colleagues it is grossly unfair that we should be asked to assent to a change which is so revolutionary and which will so vitally affect them on their return. It is far from ordinary British justice; it is not even decent fair play. If the Labour Party were in opposition would its members agree silently to a proposal for the permanent conscription of workers when a third of their number were fighting overseas? Would they agree to peacetime conscription of workers in any circumstances? Yet that is exactly what they intend to impose on the members of the medical profession at a time when so many of them are away and cannot be heard in their own defence. We maintain that a medical man, like anyone else, has an imperative right - under the law to be allowed to earn a living in his own way. This has always been one of the fundamental features of British law. As a citizen in a free country a doctor should be at liberty to employ his skill, knowledge and ability in whatever way he thinks best, but with a proper regard for the interests of the community. BILL DESCRIBED AS VICIOUS “The members of the medical profession have never failed in their duty in this latter respect. What have they done that they should now be placed upon the auction block of party politics Why should their liberty of action, their right as free citizens, be bartered for votes? This Bill is vicious in principle and is certain to be injurious in practice. It rests upon coercion—an ugly word in the ears of British people—and it takes away the natural rights of some hundreds of doctors who are not- here to protest and protect themselves. “The Bill will do nothing to improve the medical service in general or to secure a worth-while improvement in the health of the people as a whole. To the ordinary citizen I would say, Have you evei- heard of such a thing as the golden rule? Would you be prepared to have your own job conscripted? If not, how can you stand silently by while mine is treated in that manner? If you allow my job to be conscripted, what will you say when your turn comes to be dealt with in a similar way?”

PRIVATE PRACTICE TAKEN AWAY DR JAMIESON’S VIEWS (P.A.) WELLINGTON, September 6. In a telephone interview from Nelson, Dr J. P. S. Jamieson, chairman of the National Health Insurance Committee of the British Medical Association, said he had not seen the exact terms of the Social Security Amendment Bill as it appeared in the House of Representatives but he imagined it was quite similar to the draft Bill which was discussed between the Minister of Health and the association during the week. “I have no other comment to make than to say that the Bill extends far beyond the question of medical services alone, because the principle on which the Bill is framed in my opinion strikes at the liberty of the subject,” he said. “The Bill, as I understand it, takes away the right of private general medical practice. That seems to be the very fundamental matter. Last Wednesday, the following direct question was put to the Minister: Is it the intention that the right and freedom, to make individual, personal and private arrangements should no longer be permitted? The Minister replied: ‘That is the intention. It is not the intention that those personal, private arrangements should continue.’ In view of this frank expression of intention it appears to me,” said Dr Jamieson, “that it is high time everyone, irrespective of whatever creed or party, rose in protest against this infringement of rights.” COMMENT ON OMISSIONS “The Bill will require radical alteration before it will meet with the approval of the profession,” said Dr L. G. Drury, president of the Auckland branch of the British Medical Association. Some of the most noticeable omissions, he said, were the absence of any provision for a doctor or a patient to continue their own private arrangement, as at present, if either or both desired to do so. Na mention had been made about specialist or consultant services and no notice had been taken of the British Medical Association’s request for the payment of a small fee by the patient, when able to do so, to the Social Security Fund for each consultation. No heed had been given the doctors’ request that men on active service should be consulted about the measure or alternatively that the medical service should not be introduced until after the war. The omissions concerned matters which were fundamental in the minds of the profession and made the Bill impossible of approval, even to those disposed to think some change in medical practice in the future was desirable and inevitable. Dr Drury added that a meeting of the branch would be held next Wednesday to discuss the Bill.