Report of the Department of Health / New Zealand.

  • New Zealand. Department of Health.
Date:
[1965]
Catalogue details

Licence: In copyright

Credit: Report of the Department of Health / New Zealand. Source: Wellcome Collection.

    50/112 (page 50)
    nature of medicines already being taken should be ascertainable easily and accurately. As rota systems and partnerships increase in number, and new drugs become more potent and more liable to produce side effects, this consideration carries more force year by year. Incidentally, it is reasonable to suppose that most patients will be less likely to transfer drugs from one container to the other if the label bears the proper name, than if it is merely marked “The Tablets” or “The Capsules”. Visiting Practitioner Dr Peter McKinlay took up his appointment in April 1964, in succes¬ sion to the late Dr Stuart MacKay. Dr McKinlay is stationed at Head Office, Wellington. A second appointment has been made, to be centred on Auckland, commencing about September 1965. During the year Dr McKinlay visited 630 doctors spread widely from Auckland to the Bluff. Here are some extracts from his annual report: In almost every instance I think the visits were welcomed though on occasions after a cautious or defensive opening on the part of the recipient. Rural practitioners, in particular, feel isolated from their fellows, and are glad of an opportunity to discuss their problems with another doctor. There is general widespread appreciation of the Prescribes’ Notes series. Criticisms are of a minor character. The overworked doctor welcomes them as reliable condensed post-graduate education, and the well-read doctor as useful summaries of his previous study. Details of drug costs and data on doctors’ individual costs to public funds are well received, and are studied with considerable interest. The biggest prescribing problem facing doctors seems to be whether or not to prescribe antibiotics, especially the broad-spectrum group. Patient-pressure is a big factor which many doctors find difficult to resist, and the doctor who considers himself over-worked tends to play safe and use the broadest spectrum available to cover any inadequacy in personal supervision. The increasing range of drugs for which specific effects are claimed, usually at increased cost, aggra¬ vates the temptation to treat patients symptomatically rather than after full diagnosis, and of course tends to result in poly-pharmacy. Many doctors are commendably cost-conscious about drugs, and we must continue the uphill struggle to give doctors the necessary information to weigh against the high-powered propaganda of the drug manufacturers and sales promoters. Many doctors try to explain their high prescribing costs by claiming that they are continuing expensive treatment started in hospitals or recommended by specialists. Hospitals, in turn, sometimes blame their costs on inadequate supervision of extravagant prescribing by junior resident staff. Lectures to medical students and junior hospital staff must therefore be continued. I lectured at Wellington and Christchurch Public Hospitals during the year. Medical Benefits The cost of general medical services was £4,091,565, an increase of only T3 per cent over the previous year. In the past five years expendi¬ ture on this item has increased by only 4T per cent, although the popu¬ lation has risen by 1T3 per cent. The number of services per head of population was 4*2 this year (4*3 last year). The only serious problem in connection with general medical services is maldistribution of doctors, particularly the growing tendency to a shortage in country areas. Rural doctors have great difficulty in disposing of their practices when they decide to move elsewhere, and death vacancies frequently remain unfilled. Yet the happiest doctors one meets are those in country practice. A survey of medical services in Maori areas by medical officers of