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Salient. An Organ of Student Opinion at Victoria College, Wellington, N.Z. Vol. 1, No. 10 June 8, 1938

Socialised Medicine — An Opposing Opinion

Socialised Medicine

An Opposing Opinion

In pursuance of its policy of maintaining contact with the outside world and not that of academic seclusion. "Salient" has obtained the services of a well-known Wellington medico. Dr. Alan Tennent to report the debate held last Friday on the subject: "That the medical services in New Zealand should be socialised." As a member of the medical profession. Dr. Tennent 's views and comments should prove to be of considerable interest.

Dr. Tennet

Before proceeding to examine the arguments put forward by either side I should like to say how much I enjoyed the debate and how much I appreciated being amongst students again and catching from them that infectious enthusiasm about things that is the prerogative of youth.

The speakers for the motion based their arguments in favour or socialisation on the following points. Let us examine each in detail.

Bird in the Hand.

The medical services were a murderous absurdity because doctors had a vested interest in ill-health. The interence to be drawn from this statement is that doctors do not practice preventive medicine because the less illness there is in a given community the less they can feather their nests. One must at once refute such a calumnious statement. Quite apart from the immoral nature or such practice is the fact that from the practical point of view the question as to whether a doctor is going to succeed, or not In practice is largely decided by the lay public on his ability to cure them quickly or their ills and prevent them getting those same ailments again. Further, one must here place on record the fact that New Zealand has the lowest Infant mortality in the world, the lowest tuber cular death rate, despite a highly susceptible native population, and the longest expectation of life of any country. These highly satisfactory vital statistics have been brought about by the loyal co-operation of the medical practitioners with the officers or the Health Department of New Zealand. Surely this is proof positive of the support given by doctors to preventive medicine.

Health And Wealth.

The poorer members of the community did not get a "fair spin" because "health is dependent on wealth." As applied to New Zealand conditions this statement is incorrect and showed an ignorance on the part of the speaker of provisions already in operation to cover the less fortunate in a very efficient manner. These provisions largely consist of voluntary lodges whose membership is open to all, general hospitals and free doctors and medicine outside the hospital for those unable to pay anything. For those who are destitute, or on sustenance and who cannot otherwise provide themselves with medical aid. application can be made through the nearest hospital for medicine and a doctor to be sent free or cost. In cases of emergency application can he made directly to a doctor. Surely nothing can better these services. Under the voluntary lodge scheme, too, these services can be administered much more efficiently, humanely, and cheaply than under any State scheme, because the administrators are usually voluntary workers.

On account or high entrance costs and outlay In medical training, the field or medical practice is narrowed down to the wealthier classes. Again, this is not true to fact, Actually, the majority of medical students come from parents or very moderate means and many from parents of very humble means, Few come from the [unclear: homes] of the wealthy, and one is confident in asserting that adversity breeds the best doctors.

Socialisation.

The wealth of a nation depends on its health and the health of its children especially, and It is only by socialising the medical services that the health of a community can be in there by improved. Although admitting the first part of this statement, actual figures do not substantiate the second claim. In no country where compulsory systems of health insurance have been Introduced can it be shown that these systems have improved the national health.

There is, under the present scheme, no adequate provision for research. This is true, but such a state of affairs could easily be grafted on to the present system providing finance were available.

Quackery.

No medical education of the population is provided for by the present scheme. In the past, facilities for mass education have been lacking. With modern radio this handicap no longer exists, and already much has been done by the Health authorities and Broadcasting Board. However, this is a very delicate question and it is important to know just how much knowledge on medical matters should be disseminated in this way without creating morbid fears amongst the laity. Speakers suggested that more knowledge and better medical services would do away with quackery. Knowing the frailties of human nature, one ventures to suggest that as "quacks" have nourished in all ages they will continue to nourish even more under a system of completely-socialised medical services.

The speakers against the motion mainly based their arguments on:—
1.The lowering of the standard of medical treatment under socialised schemes.
2.The interference or the intimate relationship between doctor and patient.
3.The increase of attendances at doctors' rooms by people who want to he sick and don't have to pay for it.

These are all important points, and from an intimate knowledge of persons engaged in panel practice in England. one cannot doubt the truth of the these assertions.

Happy Medium.

To sum up in as impartial a manner as possible, one must realise that there are two sides to every question and that the best course to follow is somewhere between the two extremes. And so one would suggest as the most ideal and practicable way of solving this knotty problem the following:—
1.To make some provision by why of cash benefits to all employed persons who through sickness or accident cannot attend work.
2.To provide medical, hospital and special list etc., benefits to all those below a certain income level who cannot reasonably be expected to make provision for them selves.
3.To provide home nursing facilities, to cut down admissions to institutions, and the length of stay of patients already in institutions.
4.To provide private wards and rooms in our general hospitals for persons able to pay for such. The profit accruing from this undertaking to offset of non-paying patients in class 2.
5.To provide for research and some further medical education of the public by the Health Authorities and it general increase of preventive measures.

One has purposely avoided quoting figures and statistics in this article because they always seem such dry bones on which to hang the meat and flesh of good argument, and one hopes that reading will be made easier thereby.

—Dr. Alan Tennent.

The motion: "That the Medical Services should be Socialised," was carried by an overwhelming majority.