Salient. Victoria University Student Newspaper. Volume 38, Number 13. 12th June 1975

History of NZ Health

History of NZ Health

The first seven chapters of the book, paragraphs 1 through to 208, give a general history of the development of NZ's health service. It's an interesting history, basically cuting on the chaotic and rather disjoined health system NZ has insisted on developing.

Our story starts with the early provision of health care facilities, especially 'lunatic asylums' and health legislation (eg. vaccination against smallpox) by the state. The Hospitals and Charitable Institutions Act of 1885 provided the first attempt to rationalise what was happening, and provide guidelines for government subsidies for public hospital fund raising. The stress in this period, one the Paper contends still exists in private health care, is a curative rather than a preventive medicine. At this stage, one starts to suspect where the accent of the Government's thinking is — on administration.

Moving through various insufficient attemps at reforming the Public Health and Hospitals set up we arrive at the fifth summary, chapter on Towards Social Security' which is probably the best of the book, giving a summary of the creep of 'creeping socialism' up to 1938. The 1938 Social Security Act is then looked at, and the retreat from principles of free State medicine is detailed: 'Eventually the Government compromised in order to get some scheme working' (p48) due to the intransigence of the medical profession. This group comes for quite a bit of criticism. 'Social security failed to produce an integrated health service because it left such a large amount of health care in the hands of private practitioners and private hospitals.' (p50.1). The development of private hospitals and practices since 1938, especially marked under the Holland and Holyoake administrations is considered. The great rationale for this was that each bed subsidised in private hospitals was one less for the public sector to provide. The White Paper often makes the point that in fact this is not fully true — the one more bed made available is essentially a bed for the wealthy (and those who are members of medical insurance groups, which often comes to the same thing). Lower class people miss out. There are other considerations — as the 1972 Royal Commission on Social Security noted, the existence of [ unclear: com] petition with the public sector [ unclear: means] 'there must be a consequent drain [ unclear: of] personnel (and resources) from the [ unclear: p] hospitals.' The growth of medical [ unclear: in] urance is seen in itself as a sign of [ unclear: di] satisfaction with the Public Health [ unclear: Se] vice. The historical section is closed with a long and boring chapter on hospital financing.

"...Just TAKE two Asprins And get A Sood Nights SLEEP..."

Ombudsman Regional Complaints Commissioners. People (i.e. US) Primary Care eg General Practioniers. Minister of Health NZ Health Authority Regional Health Authorities. (13 members, 6 Govt and 7 elected) District Management Groups (based largely on new local body areas) Hospitals large 'base' medium 'satellite', small 'community' Community Health, eg Education, welfare programmes.

Diagram 1. Proposed New Health Administration Set-Up.