NATIONAL HEALTH SCHEME

Timaru Herald, Volume CXLV, Issue 21155, 30 September 1938, Page 8

NATIONAL HEALTH SCHEME

The “ Panel ” System

Doctor Relates English Experiences Medical Facilities Abused Trenchant criticism of the national health scheme and the introduction of the panel scheme of treatment by doctors was made to a representative of “The Timaru Herald" yesterday afternoon by a member of the medical profession, who has had considerable experience in panel work both in London and other cities in England, and who is now practising in Timaru. “My experience under the panel system at Home,” said the doctor, “showed that the standard of medical treatment which was entailed under this system was definitely bad, and could not be compared in any way with the treatment which all classes of the community receive in New Zealand to-day. “The principal reason for this,” he continued, ‘“was the tremendous mass of unessential and trivial work which had to be dealt with. In my panel experience I have seen as many as 120 patients in one day, a number which obviously could not be efficiently dealt with. It is safe to say that 90 per cent of these people did not require medical attention at all, but had become so accustomed to visiting the doctor that it had become part of their daily routine, and so accustomed to a bottle of medicine that it had became part of their daily diet. “As a result of this state of affairs the 10 per cent who genuinely required a doctor could not be dealt with. As an example, I may quote a case where a patient, who for years had been given a bottle of a simple mixture, came to the surgery of an overworked panel doctor complaining of the same symptoms. As the doctor had no time to examine him the same mixture was again given. Late that night he was operated on urgently for an acute condition which a simple examination would have revealed. “My experience in London hospital practice has also given me ample proof of the utter futility of this system, as in the out-patient departments of these hospitals the results of this system were daily in evidence—cases undiagnosed, misdiagnosed and obviously neither examined nor treated! Change in Attitude “I should also like to mention the unsatisfactory attitude of patient to doctor and doctor to patient,” he continued. “Instead of looking on his patients as his friends, a state of affairs which I know is the rule in this country, a panel doctor in England too often tended to look on them as his enemies and the unnecessary wasters of his time. The nervous strain of the mass of useless work tended to make the doctor Irritable; which, in turn, tended to produce resentment in the patient and a resultant generally unsatisfactory state of affairs. The patient, on the other hand, tended to look on the doctor as a paid servant to be at his beck and call for any triviality. I remember one instance which shows the attitude of many of the public towards the doctors. During one day I was three times called out to a woman in a tenement area. There was actually nothing wrong with her, and, when I remonstrated with her during my third visit, I told her that there was nothing the matter. She folded massive arms across her chest and retorted: ‘I pays to the Lloyd George scheme (as it is called at Home), and, when I sez come, you come’!” Economic Burden “The economic point of view has also struck me,” he continued. “Patients who had little the matter with them consumed vast quantities of medicine for which the country paid and they drew sick pay under the panel system for months on end. Any attempt to get many of these people back to work was met with resentment, and it was explained to me by a doctor of experience in the panel system that the doctor’s decision on such points was useless, and that if one sent panel patients back to work before they had decided that they wished to go, they simply transferred to the panel of some other doctor more easy-going or less scrupulous. “While I admit that in this country such a system, properly administered an! carefully regulated, might be of some beneflt to a small proportion of the population, the idea of making it applicable to everyone seems to me to be not only unnecessary, but the most retrograde step which medical practice in New Zealand could possibly take. I hope most sincerely, both for the sake of the medical profession and of the people of the Dominion that some modification of the scheme will be made.”