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Lower Hutt Community Centres: Final Statement (1950)

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Chapter 4
The Health Centre Scheme

The idea of health centres, as elaborated by Mr Douglas Robb and associates, is put to the people of Epuni, Naenae, and Taita, an overwhelming majority of whom thereupon petition the Government for a local health centre scheme; Hon. Mr Nordmeyer, as Minister of Health, in association with Hon. Mr Skinner welcomes the petition as providing the Government with an opportunity to establish health centres and promises prompt action; subsequent mystifying refusal of the Minister to take any action at all; Mr Nordmeyer retires behind "iron curtain"; Mr Nash makes and breaks promises; death of health centre scheme; conclusions.
I Have already described how I became a "health centre" advocate through reading "A National Health Service", by Mr Douglas Robb and associates of the Medical Study Group. With the consumers' Co-operative scheme under way, I now turned my attention to launching a campaign for the development of health centres in the State Housing areas of Epuni, Naenae, and Taita.
My first step was to discuss such a project with a few individuals in these areas, to whom I explained Mr Robb's views and gave copies of "A National Health Service". I found a ready and sympathetic response. Such was the inherent reasonableness of the health centre idea that it had only to be stated, it seemed, to secure support.
Next, I reported to Mr Skinner the favourable result of this initial and tentative enquiry. I pointed out also that, on top of the likelihood of popular local support for a proposal to establish health centres, there were three special circumstances which made the Epuni, Naenae, Taita settlements excellent fields for the development of this new type of medical service.
These three circumstances were:
1.
Each of these three settlements would before long have a population of the right size for a health centre,
2.
In the middle of each settlement was a vacant space ("neighbourhood centre"), State owned, of several acres extent which had been set aside by the town-planners as a site for public and community buildings; parts of these conveniently central spaces would be available for the health
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centres,
3.
And, most important, no doctors had so far established themselves in the areas, so that the field was clear for a health centre scheme.
Mr Skinner agreed that the opportunity was one which should be seized, so I wrote identical letters to him and to his colleague, Hon. A. H. Nordmeyer, Minister of Health, in which I proposed a certain procedure for ascertaining the degree of local support that might be secured for a health centre scheme.
The procedure that I suggested was as follows:
1.
Initial discussions between myself and the leading members of the local progressive associations and co-operative societies (as representatives of their communities) for the purpose of acquainting them with the nature of Mr Robb's health centre views,
2.
Assuming that sufficient interest was thereby aroused, a joint invitation from the executive committees of these bodies to Mr Robb to visit the area, to acquaint himself at first hand with its possibilities as a field for health centre development, and then to meet the executive committees for a general discussion of his views,
3.
Assuming acceptance by Mr Robb of such an invitation and assuming, also, that as a result of his visit the members of the executive committees became interested to the point of agreeing to support a health centre scheme, arrangements for a public meeting in the area to be addressed by Mr Robb,
4.
Preparation by Mr Robb of a written statement, setting forth the general case for health centres and giving an outline of a specific scheme for the Epuni, Naenae, Taita area; publication of this statement and its distribution to all local householders,
5.
The circulation of a petition to the Government amongst all the residents of the areas concerned, addressed to the Government and calling upon it for support and assistance in implementing a health centre scheme.
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I argued that an expression of opinion obtained in this way would be a valid one, as not only would it be based upon popular knowledge of the issues involved but would cover the whole population, allowing everyone to state his attitude on these issues. If, then, the response to the petition were favourable the Government would be democratically justified in taking action.
The final paragraph of my letter read; "To encourage the promotors of such a campaign (as outlined above) it is desirable that some indication be given by the Government of the attitude likely to be taken by the latter to a request for assistance from the people of Epuni, Naenae and Taita for health centre development in their communities?"

Interview with Mr Nordmeyer

Till the time of this letter I had not met Mr Nordmeyer. Mr Skinner therefore introduced me to him and vouched for my good faith. In the conversation that followed Mr Nordmeyer assured me that he held Mr Robb in high esteem, that he was familiar with his book "A National Health Service", and that he very largely concurred with the views on health centres as set forth therein. He and his Government would welcome an opportunity of giving those views a practical trial. The new State Housing settlements of Lower Hutt, he agreed, seemed to be the very place for such a trial. He had read my letter, and he thought the procedure I had outlined was the correct one for preparing the ground. If the outcome showed that the local people wanted health centres he would certainly use his influence to get them established.
Mr Nordmeyer gave me permission, finally, to let it be known locally that the Government was sympathetic to the idea of health centres and could be counted upon to consider favourably any popular request that might be made for their promotion in the Lower Hutt State Housing settlements.
Armed with this assurance I lost no time in conferring with members of the executive committees of the Naenae Progressive Association, the Epuni Residents' Association, and the Consumers' Co-operative Societies of Epuni and Naenae, supplying them all with
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copies of "A National Health Serviced Corresponding organisations in Taita had not as yet been formed, but I discussed the question of health centres with a number of individuals in that locality. Everyone I approached became interested in the health centre idea and willing to examine it more closely.

Visit by Mr Robb

On 23rd November 1945 a letter was forwarded from the four executive committees named above (signed by each of the Hon. Secretaries) to Mr Robb in Auckland, inviting him to visit Lower Hutt and to discuss with the committees the question of health centres in general and in particular their possibilities in the Epuni, Naenae, Taita area.
Mr Robb very kindly accepted this invitation and in February, 1946, made a special trip from Auckland to Lower Hutt. He was conducted over the whole of the State Housing area, and was able to see for himself the type of community that was springing up. Mr Robb then met the combined executive committees and had a thorough discussion with them about the health centre idea, as developed by himself and his professional colleagues in Auckland, and how it could best be applied to Epuni, Naenae, and Taita.
So impressed were the members of the executive committees by Mr Robb's presentation of his views that they there and then decided to sponsor a "health centre" publicity campaign in the locality. A Joint "Health Centre" Committee, with Mr H. G. Burrell (later a member of the Lower Hutt City Council) as Chairman, was set up. I was a member and, as readers may surmise, a guiding spirit.
Mr Robb, when invited to do so, agreed to make another trip from Auckland in March, to address a public meeting to be called by the Joint Committee. He also undertook to prepare a detailed statement upon the nature of health centres, the arguments in their favour, and how they could best be developed in the Epuni, Naenae, Taita area.
This statement, of about 4,500 words, was printed in a Special Health Centre Edition of the "Hutt Valley Co-operator" and distributed to all householders of the area several days before the date
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of the public meeting - 14th March. Everyone reading it must have secured a very complete and accurate conception of the new type of medical practice, both curative and preventive, that was being proposed for these communities. Of special significance for my present purposes was this paragraph:
"The Minister of Health (Mr Nordmeyer) has on several occasions stated that he would be prepared to give every possible assistance to the establishment of health centres in any part of the country, if a request for such assistance were made. It may therefore be hoped that a move from the residents in the Hutt Valley housing settlements to develop their own health centre scheme would meet with a very sympathetic official response."

Statement Approved by Mr Nordmeyer

Before having it printed and with the concurrence of Mr Robb, I invited Mr Nordmeyer to peruse Mr Robb's statement. I was particularly anxious to make sure that in every important respect the health centre proposals as submitted to the Lower Hutt residents should have the support of the Minister and the Government, as otherwise arguments and cross-purposes could easily a rise. Mr Nordmeyer made one or two suggestions for amendments, which Mr Robb was happy to accept. With these amendments Mr Nordmeyer said that he fully approved the statement.

The Public Meeting

The public meeting was duly held, and was reported in a Special Health Edition No. 2 of the "Hutt Valley Co-operator" for distribution to all households. The report read:

Health Centres for the Hutt Valley

"To a keenly interested audience of citizens of Lower Hutt City, in the Waterloo School Assembly Hall on Thursday evening, March 14th, Mr Douglas Robb of Auckland gave an admirable survey of the modern "Health Centre" idea and of the possibilities of its application in the communities of Epuni, Naenae, Taita, and Northern Hutt.
Mr Robb's address followed, in much amplified form, the lines of the special article written by him for the first Health Edition of the "Hutt Valley Co-operator". Questions from the audience, and the enthusiastic nature of the vote of thanks for the doctor, revealed wholehearted approval of the "Health Centre" conception of co-operative medical practice, as did the following resolution moved by Councillor Horlor and unanimously approved:
That We, a public meeting of citizens of Lower Hutt city, having discussed the case for "Health Centres" with Mr Douglas Robb, of Auckland, declare ourselves in favour of the "Health Centre" type of medical service.
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That we believe the implementing of a "Health Centre" scheme for the new communities of Epuni, Naenae, and Taita would be in the best interests of those communities.
And that we invite the Government, the Lower Hutt City Council, the Wellington Hospital Board, and the New Zealand Branch of the British Medical Association to give to those communities whatever assistance is necessary to implement such a scheme.
His worship the Mayor of Lower Hutt, Mr J. W. Andrews, who presided, said that he would give his full support to "Health Centre" proposals for the district, and that he would be glad to do anything within his power to assist to realise them. He paid a tribute to Mr Robb as New Zealand's leading thinker in the field of medical practice reform.
Mr H. G. Burrell, chairman of the Joint "Health Centre" Committee, described the origin of the proposals for the Hutt Valley. Five organisations, he said - the Epuni Residents' Association, the Northern Hutt Progressive Association, the Naenae Progressive Association, the Naenae Consumers' Co-operative Society, and the Epuni Consumers' Co-operative Society - were sponsoring the proposal. The move, he was sure, would have mass support.
Councillor Horlor, who is a member of the Joint "Health Centre" Committee, pointed out that if the Hutt Valley was to develop for itself a "Health Centre" scheme a public meeting, no matter how enthusiastic, was not enough. Further action must be taken to show that the scheme had the backing of the people as a whole. This, he said, could best be done through a petition, and he explained that the Committee proposed to arrange such a petition for the suburbs of Epuni, Naenae, Taita, and Northern Hutt.
Mr Andrews welcomed this project, and said that he would be happy to include his own signature."

The Petition

After the report of the public meeting there was printed a statement that within a few days representatives of the Joint Committee would call upon all the householders of the communities concerned and invite their signatures upon a petition worded:
"We, citizens of the suburbs of Epuni, Naenae, and Taita (including adjacent areas bordering the Hutt River), having examined the case for "Health Centres", declare ourselves in favour of a "Health Centre" scheme for our community.
We invite the Government to give us whatever assistance is necessary to implement such a scheme, and we would welcome the co-operation of the Lower Hutt City Council, the Wellington Hospital Board, and the New Zealand Branch of the British Medical Association."
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Success of Petition

After the public meeting the Joint Committee immediately and with enthusiasm threw themselves into the task of organising the circulation of the petition. Helped by a number of volunteers, in a few weeks time they had made a practically complete coverage of the homes in the areas concerned. The result showed almost complete support - over 97 per cento - for the health centre proposals.

Further Professions of Ministerial Backing

In the meantime, the Joint Committee was receiving further encouragement from Government quarters. At the meeting between Epuni, Naenae, and Taita representatives and Mr Hash, Mr Nordmeyer, and Mr Parry (already referred to), when the community planning proposals were initially discussed, both Mr Nash and Mr Nordmeyer expressed their support for the health centre scheme and explicitly promised to give whatever assistance was necessary. The following are extracts from the official record of the meeting:
Mr Nordmeyer said that for a long time the Government had been anxious to establish some form of group medical practice as opposed to the individualist practice as conducted normally in this country. . . Nothing would please him better as Minister of Health than that the (Hutt Valley) health scheme should be established on a proper basis in their area when it did begin, and it seemed to him that the plan they proposed of having the health centre in the middle of their area was one that justified every possible support. They as a Government would help in every possible way. . . If the Government co-operated with them (the local health centre promotors) in the proposed venture, that would just be in line with the policy that they had in mind. He wished to say that he personally was entirely in favour of what they had in mind.
Mr Nash said. . . They had started along a road that was worthwhile because they had the full co-operation of Mr Nordmeyer with regard to their health centre; he had been dreaming about this for a long time and if they could get a central clinic or clinics operating in the Hutt Valley at the top
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end where they were, Mr Nordmeyer would be happy, and so would he. . . Mr Nordmeyer had the authority now that if they could find enough doctors to set up a health clinic, the Government would find means to put up the building and the facilities.
On 26th April 1946 the following letter was addressed to Hon. Mr Nordmeyer:
Hon. A. H. Nordmeyer,
Minister of Health,
Parliament Buildings,
Wellington.

Dear Mr Nordmeyer,
The enclosed petition, addressed to the New Zealand Government, covers the streets marked in red on the accompanying map.
The number of homes contained in the area canvassed is 2018. Of these homes 1865, or 92.3%, were interviewed.
Representatives of 97.6% of the homes interviewed signed the petition.
The total number of signatures is 2294.
Yours sincerely,
(signed) H. G. Burrell,
Chairman,
Joint Health Centre Committee

Presentation of Petition and its Ministerial Reception

The above letter, together with the bound petition, were formally presented to the Minister of Health by the Joint Health Centre Committee on Friday afternoon, 26th April, in his rooms at Parliament Buildings. The deputation was introduced by Mr H. E. Combs, M. P. for Wellington Suburbs. Hon. Mr Skinner, as Patron of the Hutt Valley Community Planning Council, attended with the Minister of Health. Representatives of the press were present.
The report of the Joint Committee was received with enthusiasm both by Mr Nordmeyer and by Mr Skinner. Below are extracts from
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the account which appeared in the Wellington Evening Post the next day.
Both Mr Nordmeyer and the Minister of Rehabilitation (Mr Skinner) who also attended, expressed the view that the opportunity was presented of initiating in the Hutt Valley a type of service which, while it would be an experiment in New Zealand, had been tried out with success overseas. Mr Nordmeyer told the deputation that everything possible would be done to give effect to the wish of those who had signed the petition. He said he would place the proposal before the Government at an early date and that he hoped it would receive sympathetic consideration.
"This is a wonderful opportunity of implementing some of the things we have discussed for many years, that is, the establishment of health centres where some of the experiments that have proved successful overseas can be tried," said Mr Skinner, who spoke in support of the committee's project.
Replying (to the deputation) Mr Nordmeyer said that he was greatly impressed by the petition; the fact that the committee could get 97% of the people to support the scheme was a clear indication that it had the endorsement of those who would be served by it.
The Minister (Mr Nordmeyer) said he was wondering whether, in order to get the scheme operating, it would be possible to have some form of temporary premises by transferring pre-fabricated steel huts or buildings that were available in certain districts to the site decided upon and using them until such time as a permanent clinic could be provided. . . It was desirable that the spirit that was evidenced in the well-signed petition should be taken full advantage of and that the idea should not be allowed to cool off. He would be happy to bring the matter before the Government at an early date and would be
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pleased to examine the possibility of establishing a clinic in temporary premises.
As he had indicated on many occasions, added the Minister, it was his personal view and it was the Government's view that the medical service of New Zealand would not be complete unless and until a large number of the medical men were working in the form of group practice. That did not mean that all would; there would be some who would remain as individual practitioners. But there was room for the two classes to work side by side and the people represented by the deputation had indicated very clearly that they preferred the group practice centred round a clinic. Everything possible would be done to give effect to the people's wish in the matter, and he would undertake to place the proposal before the Government at an early date and to see that the deputation was given a decision before very long. If there were more details the deputation wished to place before him later he would be glad to have them.
"Quite obviously there was an opportunity of trying out in the Hutt a scheme which while it would be an experiment in New Zealand was well past the experimental stage in other parts of the world where it had been tried with success." (Mr Nordmeyer)
"I am quite satisfied you have presented us here with an opportunity," concluded Mr Nordmeyer, "and I personally will be happy to see that the Government gives early, and, I hope, sympathetic consideration to your request."
Needless to say, the members of the Joint Health Centre Committee were delighted with the nature of this Ministerial reception. They had, as yet, no reason to doubt the integrity of the Minister of Health.
With the presentation of the petition to the Government the Joint Committee was dissolved and the extension of its pioneering work
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taken up by the Health Centre Committee of the Hutt Valley Community Planning Council. The Chairman of this new committee was Mr H. G. Burr ell and its Hon. Secretary Mr P. J. Fenton, secretary of the Hospital Boards Association of New Zealand. Its membership included representatives of the Progressive or Residents' Associations of Epuni, Naenae, Taita, and Northern Hutt, together with co-opted representatives of the Department of Health (Dr H. B. Turbott), the Wellington Hospital Board, the N. Z. Registered Nurses Association, the Lower Hutt Plunket Society,, and the Wellington Division of the British Medical Association I of course was an "ex officio" member.

The Health Centre Committee Gets to Work

The now committee lost no time in getting down to work. At its second meeting Dr Turbott presented a paper on health centre planning in which (pursuing the suggestion made by Mr Nordmeyer at the presentation of the petition) he proposed that a start should be made with health centre development in the Lower Hutt State Housing areas by making temporary use of a number of hospital type prefabricated steel huts. As a result it was decided to make application to the Government through the Minister of Health for ten such huts for the purpose. It was also resolved to seek an interview with the Minister to discuss Dr Turbott's proposals and the work of the committee in general.
The Chairman, Hon. Secretary, and I met Mr Nordmeyer in the middle of June. (Dr Turbott had now gone overseas on a Departmental mission.) In the words of the committee's Minutes "the Minister was both sympathetic and helpful in the matter of both hut accommodation and provision of medical men to operate the suggested scheme."
As regards huts, Mr Nordmeyer felt that ten hospital type huts would probably be more than would be available, and he suggested that a smaller number should be agreed upon. (We were later given verbally to understand that five huts were set aside for health centre use. However, this was never formally confirmed.)
As regards medical personnel, the Minister thought that if, as
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seemed likely, the official British Medical Association would not be prepared to co-operate in developing a health centre scheme, he himself would be able to nominate suitable medical men who would be willing to accept appointment, on a salaried basis.
The meeting ended with the Minister assuring the committee that he would be happy to receive them for further conversations whenever necessary.

Discussions with B. M. A.

The Health Centre Committee had felt from the first that the collaboration of the official British Medical Association would be most valuable (although not necessarily essential) in the task of formulating and putting into operation a practicable health centre scheme. Accordingly the committee now invited the Wellington Division of the Association to take part in an exchange of views. Two meetings - one in May and one in June - were held, at which Mr Burrell, Mr Fenton, and I represented the Health Centre Committee and Dr A. A. Tennent and Dr M. Kronfeld (Chairman and Hon. Secretary of the Wellington Division) with one or two of their official colleagues represented the B. M. A.
Those meetings were reported in another Health Centre Supplement of the "Hutt Valley Co-operator", dated September 1946. I extract the following:
From the outset (of the meetings) it was clear that the Association was definitely opposed to the Hutt Valley scheme. The doctors insisted that, although a health centre grouping of various preventive and educational agencies was quite desirable, nevertheless the traditional pattern of private practice in the curative field should be strictly adhered to. General practitioners, they said, should be distributed evenly throughout the community and should practice independently from their own residences or consulting rooms.
The Health Centre Committee were unimpressed with the arguments advanced in support of this contention. They pointed out that the objections voiced against co-operative practice seemed to be mere opinions, unsupported by evidence of a factual nature, and that contrary opinions were at least equally justified.
The Committee also pointed out that the objections to co-operative practice were by no means unanimously held within the profession itself, since it was known that certain members in good standing (such as Mr Douglas Robb and his co-authors of "A National Health Service") were definitely in favour of the inclusion of general practice within health centre organisation. Because of this lack of unanimity, therefore, there could be no surety that the official views of the B. M. A. were valid, and
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nothing but an actual test could prove who was right and who was wrong. Indeed (so the Health Centre Committee representatives argued) insofar as doctors were men and women imbued with the scientific spirit they should welcome a practical experiment in this field. If the experiment failed, no great harm would be done, the B. M. A. could say, I told you so, and the advocates of health centres would be placed on the defensive.
But if, on the other hand, the experiment were to succeed, its success would amount to proof that the application of the co-operative principle to general practice had, in fact, the virtues claimed for it by such pioneers as Mr Robb.
Objection to Salaries
One of the principal objections to health centres raised by the B. M. A. was against a salaried basis for doctors' remuneration. It seemed that the objection was not against salaries in themselves, but against certain alleged consequences. For if salaries were paid they would of necessity, either directly or indirectly, be paid by the State, and thus (it was claimed) the doctors would automatically become State servants and subject to all kinds of irksome restrictions upon their professional freedom, irritating bureaucratic annoyances, and so on. This, it was insisted, would destroy the doctors' incentive to render good service to their patients and would break down the 'doctor-patient relationship.'
The Committee replied that none of this need be so. There was nothing likely, much less inevitable, about the gloomy results forecast by the B.M.A. The relationship of the health centre doctor to his patients, to the community in which he laboured, and to the State was not something which would be determined simply and solely by his mode of remuneration. An essential consideration, the Committee maintained, would be the form of organisation, administration, and control decided upon for the health centres. And there was no valid reason whatsoever why the problem of organisation, administration, and control should not be solved in a manner which would permit the doctors to retain to the full every worthwhile freedom they now possessed. Indeed, it was easy to see that in one important respect their freedom might become far greater than before, since the conditions of health centre practice would give the doctors opportunities to take part in many activities - of a preventive and educational character - from which they were now effectually debarred by the cramping nature of "fee for service" private practice. . .
Doctors Free to Choose
During the second interview the Health Centre Committee enquired what would be the attitude of the B.M.A. if the Committee decided to attempt to interest individual doctors - for example, by an advertisement to the profession - in the Hutt Valley project. The chairman of the meeting, Dr A. A. Tennent, made it clear in reply that, although the (official) B.M.A. could not be expected to modify its opposition to the inclusion of general practice within the scheme, nevertheless they would put no obstacles of any kind in the way of any doctor who wished to participate in it. In support of this admission Dr Tennent quoted the following passage from the recently published final report of the medical planning committee of the B.M.A. (the underlining is ours):-
"While the refund system should be preferred as best calculated to preserve the ideal and standard of medical practice, it is the right of every qualified and registered modical practitioner, subject to ethical considerations and
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reasonable efficiency, to exercise his profession with complete freedom of choice of locality, character and method."
As soon as these two meetings with the B.M.A. were reported to the Health Centre Committee, the Committee set to work to put down onto paper an outline scheme of organisation, control, and finance which, they felt, would effectively dispose of the official B.M.A.'s contention that service with a health centre would deprive the doctor of his professional freedom, impair the 'doctor-patient relationship', and so on. They felt indeed that their scheme (which, of course, owed almost everything to suggestions thrown out by Mr Robb and his associates) should satisfy all reasonable requirements of the medical profession. Under it, the doctors themselves and other technical personnel would have the dominant say in the running of the health centres. At the same time the people of the communities served - the 'customers' of the medical service - would have an important part to play in the functioning of their centres. Room was retained, at a proper subordinate level, for Governmental and Hospital Board representation.

Recapitulation

Let me summarise the position that had now been reached:
1.
After a popular campaign of publicity and education which, in the words of a leading article in the "Southern Cross", was 'a model lesson in the way that democracy ought to work', the residents of the new State Housing settlements of Lower Hutt expressed themselves in favour of a health centre scheme for their communities, and petitioned the Government for assistance in implementing it.
2.
The Minister of Health (Mr Nordmeyer) and the Minister of Rehabilitation (Mr Skinner) welcomed the petition on behalf of the Government; promised to give it every support; stated unequivocally that the development of health centres was fully in line with Labour Government policy and wishes; and undertook to bring the Lower Hutt petition before the Government at the earliest date for favourable consideration.
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3.
The Health Department thought so highly, apparently, of the scheme that they were prepared to recommend an immediate start through the use of temporary accommodation.
4.
The official B.M.A. (i.e., certain of its executive officers) were found to oppose the scheme. Nevertheless, it was stated authoritatively on behalf of the B.M.A. that that organisation would in no way hinder or discourage any medical man who might wish to join the staff of a health centre, from doing so. Furthermore, the Health Centre Committee had good reason to believe that if the opportunity were created, doctors in sufficient numbers would be so attracted by the conditions of health centre service that the problem of staffing the centres would be readily solvable.
In short, the projects of a successful outcome to the work of the Hutt Valley health centre planners seemed bright.
When the Health Centre Committee had completed drafting its outline scheme of organisation, control, and finance it sought a second interview with Mr Nordmeyer. The Committee, which was without official powers or recognition, considered that it had now gone as far as it was able to go by itself, and that further progress was necessarily dependent upon active Governmental collaboration.
Specifically, what the Committee now wanted from the Government was:
In general -
1.
A formal decision by the Government (which the Health Centre Committee had been led to believe by Mr Nordmeyer and Mr Skinner would be forthcoming) to approve the Lower Hutt health centre project and to take steps to give it effect,
In particular -
2.
Consideration of the Committee's 'scheme of organisation, control, and finance'.
3.
Discussion, planning, and action on the proposal for the immediate use of temporary accommodation, as put forward both
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by the Minister of Health and by the Health Department (through its representative on the Committee, Dr Turbott).

Relations With Mr Nordmeyer Begin to Deteriorate

Up till now the Committee had been quite happy in their relations with the Minister of Health. As already noted he had been (at least to all appearances) very encouraging, cordial and sympathetic both on the occasion of the presentation of the petition and of his first interview with the Committee's representatives.
From the moment, however, when they began to seek from the Minister decisions and action which would have permitted a practical start with their scheme, the Committee were forced to admit a steadily increasing sense of frustration. Now that the time had actually arrived for Mr Nordmeyer, and his Government, to give more than 'lip-service' to the health centre scheme and to replace encouraging words by specific constructive acts, it seemed as though they had become stricken with dumbness and paralysis. Reluctantly the Committee were driven to suspect - and the suspicion grew stronger and stronger with the passage of time - that the Minister had really no intention of furthering the Lower Hutt project, and that, to put it crudely, he was merely 'stalling'. For there seemed to be no evidence that he was prepared to take any definite action whatever to assist the Committee towards their goal. On the contrary, Mr Nordmeyer gave every appearance of wishing to avoid the Committee and to discourage them in their labours. The fair words he had used with the petition deputation were apparently forgotten.
To particularise. The Committee had the greatest difficulty, despite Mr Nordmeyer's previously expressed assurance that he would at all times be pleased to take part in further discussions with them, in arranging a second interview. Time passed, and although repeated representations were made through the Minister's private secretary, no information could be obtained as to when the interview might be expected. Indeed, it was allowed to leak out that Mr Nordmeyer actually thought the Committee unduly impatient, even 'unduly enthusiastic', and that he resented what he regarded as
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their importunity in wishing to press on with the practical development of their proposals.
The Committee were at a loss to account for this unexpected and disconcerting 'volte face' on the part of Mr Nordmeyer.
Finally, at the end of July, an interview was at last granted. Mr Burrell, Mr Fenton, Councillor Horlor, and I were present on behalf of the Health Centre Committee. But we could make no progress whatever. We could extract from the Minister no indication of his intentions regarding the 'temporary accommodation' proposal. He was not ever prepared to discuss the 'scheme of organisation, control, and finance' drafted by the Committee and long since placed in his hands. Concerning the scheme as a whole and what he proposed doing about it the most that could be elicited, in response to a direct question, was that "after all, your proposals are in line with the direction in which we want to go."
Two weeks later I had occasion to be in Auckland, and took the opportunity for a discussion with Mr Robb on the Lower Hutt scheme and the difficulties it was encountering. When I informed him of the extraordinary attitude of non-co-operation amounting to hostility that had without explanation been taken up by Mr Nordmeyer, Mr Robb was (to say the very least) surprised. He could not understand why the Minister, in view of his frequent public assurances that he and his Government believed in health centres and wanted to assist their development and of his promise of early and sympathetic consideration of the Hutt Valley project, should now show himself reluctant to get behind that project with promptitude and determination. Nevertheless, he (Mr Robb) would be willing to support the Health Centre Committee in further representations to the Minister, if a meeting could be arranged, and he would be available for this purpose in Wellington at the end of August.
On 28th August a meeting was held in the Minister of Health's rooms, with Mr Nordmeyer, Mr Skinner, Mr Robb, Mr Burrell, Mr Fenton, Mr Horlor, and myself present.
After some preliminary talk Mr Nordmeyer asked, "Well, what is
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the next step?" and it was left to Mr Robb to reply.

Mr Robb's Views

It was evident, said the doctor, that the existing Health Centre Committee had gone as far as it could hope to go, unaided. It lacked the necessary authority and official recognition to put the proposals that it had formulated into effect. The next step, therefore, should in his opinion be the setting up by the Minister of Health of a fully representative and authoritative 'ad hoc' committee equipped with adequate powers to plan in detail, to establish, and to control until such time as some permanent form of control could be instituted, a system of health centres for the Lower Hutt State Housing settlements. Finance should be made available to the committee both for the erecting and equipping of temporary premises for the centres and for running costs - including wages and salaries during the period of the committee's jurisdiction.
The first task of this committee, continued Mr Robb, should be the development of a fully detailed and explicit scheme of organisation, administration, control and finance. He considered the scheme prepared in outline by the Health Centre Committee to be fundamentally sound, and might well be used as a basis for the ultimate plan. Conditions of employment, scales of salaries and wages, terms of contracts, and so on would all have to be carefully worked out.
With the completion of the detailed scheme and its acceptance (either in its original or in a modified form) by the Government, the next step would be for the 'ad hoc' committee to submit it to the individual members of the medical profession, together with an invitation to them to join the scheme as staff members of the health centres. It was realised that the B.M.A. had expressed their official opposition to health centres. However, there was no reason to believe that the official B.M.A. (its leaders) represented in this respect the views of the rank and file of the profession, so it still remained to be seen what response the general body of doctors might make to an invitation from the 'ad
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hoc' committee.
Mr Robb agreed that it was, of course, always possible that the response might be insufficiently encouraging to warrant proceeding with the health centre scheme. In that case the conclusion would have to be drawn that the project was premature for New Zealand or that the scheme as drafted was unacceptable because of various defects. Mr Robb, however, was personally satisfied that the response would be a favourable one, not only because of the inherent advantages and attractiveness of medical service under health centre conditions to men and women of liberal outlook but also because (as noted above) the official B.M.A. had stated unequivocally that the Association would raise no objections to individual doctors volunteering for or taking part in such service.
If, in fact, sufficient doctors of the right type did so volunteer, the basic problem confronting the health centre organisers - the problem of the recruitment of professional personnel - would be solved.
The remaining task of the 'ad hoc' committee would be to co-operate with the successful professional applicants in the actual development and administration of the centres during the initial, experimental stages prior to the establishment of permanent arrangements.
Mr Robb considered that the existing Health Centre Committee, because of the valuable pioneering work they had done up to the present and because they in fact represented the communities concerned, should be drawn upon for 'laymen's' representation on the 'ad hoc' committee he was proposing. He concluded by agreeing (in reply to a query) that he himself, if asked, would be happy to act upon that committee and to continue to give the project every assistance within his power.
Mr Nordmeyer offered little comment, but promised to consider these proposals. He also said that he would give further consideration to the question of temporary accommodation.

Mr. Nordmeyer Retires Finally Behind Iron Curtain

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From that day to this, nothing whatever has been heard from Mr Nordmeyer regarding his intentions, or lack of intentions, on the Lower Hutt health centre scheme. After that interview he completely isolated himself from the Health Centre Committee, vouchsafing no explanation, excuse or apology for his refusal to treat with them.
On 30th September the Hon. Secretary of the Committee (Mr Fenton) wrote to the Minister asking "whether you are yet in a position to state when the matters discussed during the last interview are likely to be implemented. These are the nomination of a committee by yourself to establish health centres in the Hutt Valley for both curative and preventive medicine, together with the erection of temporary buildings for these purposes." A copy of this letter was sent to the Right Hon. W. Nash, M. P. for Hutt. No reply or acknowledgment was ever received from either Minister.

Committee Prepares a Report

Because the Health Centre Committee had now apparently come to a dead-end in its negotiations with the Minister of Health and the Government, it decided to prepare a report upon those negotiations for release to the residents of Epuni, Naenae and Taita. It was felt that it was only fair that those who had supported the health centre scheme by signing the petition should be given some explanation of its lack of progress. I was deputed to prepare the report. After traversing the history of events as set down above I concluded with the paragraph:
To sum up. The Health Centre Committee, since they entered upon their task six months ago, have for all practical purposes received from the Government (as represented by the Minister of Health) no real assistance or encouragement of any kind whatsoever towards realising their objective - a system of health centre services for the Hutt Valley. The contrast between this lack of assistance and encouragement and the undertakings and promises given by the Minister on the ocassion of the presentation of the petition is, to say the least, remarkable. Instead of finding sympathetic and helpful collaboration the
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Committee have been dismayed by a Ministerial attitude increasingly negative, non-committal, and evasive. The Minister has become more and more inaccessible, more and more 'on the other side of the fence'. Stalemate, apparently, has been reached.
As the General Election was approaching, the Committee decided to hold up this report for the time being. We had no desire to "embarrass the Government" or, in particular, Mr Nash in his own, local campaign for re-election.

Mr Nash Makes a Statement

Both Mr Skinner and Mr Nash were well aware of the difficulties the Health Centre Committee was encountering in its attempts to deal with the Minister of Health. But Mr Skinner, whenever I sought assistance from him as Patron of the Hutt Valley Community Planning Council, professed himself powerless to make any impression on Mr Nordmeyer. One Minister, he said, could not interfere in another Minister's portfolio. Mr Nash, however, would probably have more influence, as he was not only the local Member of Parliament but also one of the most important members of the Government. I therefore decided to see what could be done to enlist his aid.
Towards the end of October Mr Nash addressed an election meeting in the Community Hall in Naenae. During question time I asked him on behalf of the Health Centre Committee what action his Government proposed taking with regard to the health centre scheme. To my considerable surprise, Mr Nash replied that Cabinet had just recently made a decision to go ahead with the scheme and in particular had authorised the erection of a building for the purpose at Naenae. Mr Nash's audience received this news with gratification and applause.
After the meeting was over I had a private word with the Minister and told him one or two things about our difficulties with Mr Nordmeyer. Mr Nash thereupon undertook to look into the whole question, and promised to convene a meeting of all interested parties immediately after the election - within three or four days, he said.
I was happy to leave it at that.
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Mr Nash Makes, and Breaks, Another Promise

The elections came and went, and two and a half weeks passed without a word from Mr Nash. Finally, on 14th December, as he was assisting with the formal opening of Taita's new Community Hall, I was able to have another word with the Minister. I found now that his post-election attitude was very different to his pre-election one.
When I asked him what he proposed doing about the health centre scheme, he replied that it was a matter for the Minister of Health, and that one Minister could not interfere with the prerogatives of another. (Compare this with a similar remark by Mr Skinner, already quoted.) I commented that the matter was surely one of high Governmental policy, that Mr Nordmeyer was apparently determined to do nothing, and under the circumstances was it not the duty of his colleagues to bring pressure to bear upon him? Was one Minister, just because he held a certain portfolio, to be allowed to frustrate Government policy? Mr Nash offered no answer to that one.
I then reminded him that he himself, before the election, had definitely undertaken to convene without delay a meeting of all concerned to discuss the health centre scheme and what was to be done about it; but here it was the middle of December and nothing arranged, no progress made. Mr Nash replied by saying that he had many more important things to do than discuss health centres. Did I, for example, want him to put to one side his organising of the British Petroleum Co. in order to attend to our health centre problems?
In view of the non-co-operative, not to say hostile, attitude shown by the Minister there was nothing for it but to inform him that, if he were not prepared to take action on this matter - an important matter of policy and one which concerned his own electorate - it would be necessary for the Health Centre Committee to release the report we had prepared (already referred to and a copy of which had been forwarded to Mr Nash for his information). At this Mr Nash became highly indignant, and threatened that if the report were released he would have nothing further to do with the health centre proposals - "You could say goodbye to them."
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(I commend this attitude to the student of politics. Here was a responsible Minister of the Crown saying in so many words that his support for a major social project - the Hutt Valley health centre project - would be withdrawn unless secrecy were maintained regarding the discreditable way in which his colleague, the Minister of Health, was frustrating that project.)
We finally compromised by my undertaking on behalf of the Health Centre Committee to withhold the report on the understanding that Mr Nash would, without fail, convene a meeting of all those involved in the health centre proposals - including Mr Nordmeyer, Mr Skinner, Mr Robb, as well as the Health Centre Committee - not later than the end of the following month, January, 1947.
That meeting was never convened, nor has any explanation of that fact ever been given, nor has Mr Nash ever since, by word or deed, shown the slightest interest in or awareness of the health centre scheme.
As regards his pre-election assertion (never confirmed in writing) that Cabinet had made a decision to have a centre established at Naenae, that may or may not be; beyond Mr Nash's bare statement there is no evidence that such a decision was in fact made. Certainly, four years later, there is as yet no sign of health centre activity in Naenae, or in Epuni or Taita.

The Last Meeting

In the light of all this evidence one might be pardoned for concluding that the Government - while reluctant for certain carefully hidden reasons to turn down unequivocally the Hutt Valley health centre proposals - had nevertheless secrectly decided to withdraw its support from them. On any other hypothesis it is difficult to fathom the behaviour of the Right Hon. W. Nash and the Hon. A. E. Nordmeyer.
Mr Skinner, however, still seemed to think that his Government was favourable to the Hutt Valley scheme. He showed this at what proved to be the last meeting ever held for the discussion of the Hutt Valley health centres.
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Towards the end of January I was informed by Mr Robb that he would be in Wellington early in February, and that if there were still any chance of making progress with the scheme he would be available for consultation. Accordingly (as Mr Nash had now joined Mr Nordmeyer in refusing to promote or take part in discussions) I arranged a meeting in Mr Skinner's office which was attended by the following: Mr Skinner (in the chair), Mr Robb, Dr Turbott, Dr F. S. McLean, Dr D. Cook (these three from the Health Department), and Mr Burrell, Mr Horlor, and myself. The Minister's opening remarks, which I quote below from the stenographic record of the meeting, seemed to indicate that despite appearances the Hutt Valley scheme had the backing of the Government.
"The Hon. Minister said he had been in touch with Mr Nordmeyer and they had thought they could take advantage of Mr Robb's being in Wellington to get the health centre idea clarified and some scheme under way. The Government had given its blessing to the principle of the work of health centres. A committee (the Health Centre Committee) had been set up, of which Dr Turbott was a member, which had given a good deal of thought to the matter. He thought they had reached the stage where something of a concrete nature could be done. Six of the 48' × 20' hospital type of hut from the Pacific had been earmarked for the centre, with the chance of one or two more. The type of organisation that would be necessary to get the scheme under way could be decided, also details regarding sites, etc., could be discussed and some decision made as to the way they should proceed. First of all, it would be necessary to decide just what type of control would be necessary to start these centres, and then try to find sufficient medical men to make the scheme operate. . ."
Mr Robb reiterated his view that an 'ad hoc' committee (such as he had previously advocated the August before during the meeting with Mr Nordmeyer - see page 58) should be set up. This view was accepted by the meeting, as is shown by this sentence from the
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official notes; "It was finally agreed that a committee should be set up as widely representative as possible to help in the planning and in the control of the health centres, the committee to have Government recognition, with full powers to go ahead in collaboration with the Health Department and do the job."
The reader will by now be as mystified as was the Health Centre Committee. For here, on the one hand, was Mr Skinner asserting that both Mr Nordmeyer and the Government were giving their backing to the health centre scheme and wishing to push on with it, and on the other hand, the behaviour of Mr Nash and Mr Nordmeyer which seemed to indicate as clearly as could be that those two Ministers at least were having no part of that scheme.
Whatever the explanation, the fact remains that the committee agreed upon at Mr Skinner's meeting was never set up nor was more heard of it; indeed, nothing whatever came of the meeting. As I have said, it proved to be the last.
The Health Centre Committee now came to the conclusion that they were being treated with a form of contempt by the Government, and that additional efforts on their part would be simply waste of time® They accordingly went into recess.
For a while I attempted to act on my own to keep the scheme alive; or rather, to revive it. In August 1947 I contributed a series of six articles to the "Southern Cross" on the Hutt Valley health centre proposals, in which I set out to answer all the objections to them that had from time to time been made by spokesmen of the B.M.A. The Editor invited Mr E. M. Luke, chairman of the Wellington branch of the B.M.A., to discuss my points and attempt to refute them, but he refused the invitation.
After the appearance of these articles I had an opportunity of discussing the scheme with Dr Hubert Smith, the then Medical Officer of Health for the Wellington district. I found in Dr Smith a very keen supporter of the health centre idea. In fact,
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the doctor said that if the Hutt Valley scheme were proceeded with, he himself would be willing to relinquish his present office to join the medical staff. (I understand he made this willingness known to his Departmental superiors.) Dr Smith thought, too, that if the correct approach were made to the doctors of New Zealand, sufficient of the right type would volunteer for health centre service to make the Hutt Valley scheme practicable and successful.
When Mr Nodrmeyer relinquished the portfolio of health to Miss Howard in May 1946, Mr Skinner introduced me to the new Minister. Mr Skinner and I described to her the health centre scheme for the Hutt Valley, showed her the plan of the locality with the proposed sites of the centres, and invited her support in pushing forward with the scheme. Miss Howard said that she would look into the matter and have further discussions with us later. But I never saw or heard from her again.

Ministerial Responsibility for the Wrecking of the Scheme

Three Ministers (if we except Miss Howard) have been involved in the Hutt Valley health centre story - Mr Skinner, Mr Nash, and Mr Nordmeyer. In varying measures they must be held responsible for the wrecking of the Hutt Valley health centre scheme.

Mr Skinner

As with the consumers' co-operative scheme, Mr Skinner bears the smallest blame. I believe that at all times he was sincere in his support for the health centres. It would seem, too, that at least until after Miss Howard became Minister of Health he really thought that his Government had some intention of going forward with the Hutt Valley proposals. It may be that he was kept deliberately in the dark by certain of his colleagues regarding their true purposes. However that may be, his influence was evidently negligible compared with whatever hidden counter-influences were brought to bear to kill the scheme.
Nevertheless, Mr Skinner has something to answer for. As Patron of the Hutt Valley Community Planning Council it was his duty to
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represent the mind of his Government faithfully to the health centre planners. When difficulties arose and became insurmountable in the Health Centre Committee's dealings with Mr Nordmeyer, Mr Skinner should have had a plain talk with that Minister and should have insisted that he deal straightforwardly and honestly with the Committee. If Mr Nordmeyer had refused or had remained evasive, Mr Skinner should have made a. Cabinet issue of the matter. (He should either have done these things or have resigned as Patron of the Planning Council, explaining that he was not able to fulfill the functions of that office.) And when at last he could no longer escape the realisation that there would be no support from his Government for the Hutt Valley health centre scheme, he should have put the health centre planners out of their uncertainty by informing them frankly of that fact.
But it appears that Mr Skinner was too weak a Minister to take any of these steps. As a result he failed lamentably in his duties as Patron of the Planning Council.

Mr Nordmeyer

On the surface at least, Mr Nordmeyer is the one whose conscience should be most guilty. We have seen with what fair words he welcomed the Hutt Valley health centre scheme, and how he promised to do all he could to secure its advancement. We have had the evidence of both Mr Skinner and Mr Nash that the Labour Government desired the promotion of health centres and that the Minister of Health had all the necessary authority to put such a scheme as the Hutt Valley scheme into actual operation. To those who presented the petition Mr Nordmeyer said that "quite obviously there was an opportunity of trying out in the Hutt a scheme which while it would be an experiment in New Zealand was well past the experimental stage in other parts of the world where it had been tried with success"; he said that "it was his personal view and it was the Government's view that the medical service of New Zealand would not be complete until a large number of the medical men were working in the form of group practice"; he said that "everything possible would be done to give effect to the wish of those who had
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signed the petition"; he said that "it was desirable that the spirit that was evidenced in the well-signed petition should be taken full advantage of and that the idea should not be allowed to cool off."
And yet, what has Mr Nordmeyer done to square actions with words and to develop health centres in the State Housing settlements of Lower Hutt? As we have seen, precisely nothing. And not only has he done nothing, but at no time has he had the common courtesy to explain to those sponsoring the health centre proposals why he was doing nothing nor, indeed, to make the unsatisfying but definite minimum statement that nothing would be done. On the contrary, with the fair words quoted above scarcely out of his mouth he proceeded to lock his doors against the Health Centre Committee and to refuse to treat with them, leaving them outside in utter and continuing ignorance of the reasons for the dismaying frustration of their plans and hopes.
Mr Nordmeyer indeed has much to answer for.

Mr Nash

And now for Mr Nash, Member of Parliament for Hutt. Mr Nash had said to the Hutt Valley community planners on 26th March, 1946, that "they had started along a road that was worthwhile because they had the full co-operation of Mr Nordmeyer with regard to their health centre; he had been dreaming about this for a long time and if they could get a central clinic or clinics operating in the Hutt Valley at the top end where they were, Mr Nordmeyer would be happy, and so would he. . ." (see page 47). Mr Nash, not only as a politician professing support for the health centre idea and a powerful member of a Government professing similar support, but also and in particular as the Member of Parliament for Hutt, has a very special and heavy responsibility in this matter of the wrecking of the Hutt Valley health centre scheme.
Why has he done nothing to give the scheme effect? Why did he allow his colleague the Minister of Health to maintain his extraordinary and disgraceful attitude to the Health Centre Committee, the members of which were Mr Nash's own constituents? Why did he
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merely look on while a social scheme of great promise - the Hutt Valley health centre scheme - which could have put his own electorate on the world health map, was strangled at birth? Why did he make promises, on two separate occasions, to convene meetings of all persons concerned to discuss ways and means of developing the proposed health centres and then rot only fail to convene those meetings but give no explanation of his failure? Why has he been, in effect, a party to the betrayal of the Hutt Valley health centre scheme?
These are Questions which perhaps only he can answer.
I shall conclude this chapter with a few remarks on the question - Could Doctors Have Been Secured for the Health Centres?
Unless Mr Nordmeyer had been guilty of the most shocking hypocrisy when he replied to the health centre petition deputation, we must conclude that for some reason or other he thereafter decided to change his mind and to withdraw his support from the Hutt Valley health centre scheme. (Nevertheless the mere fact that he might have so decided can in no way be held to excuse his evasiveness and lack of candour with the Health Centre Committee.) But what could have caused him to change his mind?
We have already seen that (according to Mr Nash) the Minister of Health had full authority to provide the necessary buildings and equipment for the scheme. The only factor, therefore, over which Mr Nordmeyer did not have full control was the supply of doctors - the professional staffing of the centres. Thus it is conceivable that the Minister reversed his attitude to the Hutt Valley proposals because he had managed to convince himself that, after all, it would not be possible to secure sufficient of the right type of doctors for staffing purposes. And he might have arrived at this conviction either because he felt that the B.M.A. would bring pressure upon its members to refuse appointment or because he felt that (even assuming no such pressure) there would be insufficient response from the doctors to a call for volunteers.
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Attitude of the B.M.A.

Let us first look at the Question of pressure from the B.M.A. It is true that the (official) B.M.A. had expressed their opposition to the Hutt Valley scheme. But it is also true that Dr A. A. Tennent, chairman of the Wellington Division of the British Medical Association, authoritatively informed the Health Centre Committee that the B.M.A. would put no obstacles of any kind in the way of any doctor who wished to participate in the work of health centres. In support of this declaration Dr Tennent quoted on behalf of the B.M.A. the following official statement:". . . It is the right of every qualified and registered medical practitioner, subject to ethical considerations and reasonable efficiency, to exercise his profession with complete freedom of choice of locality, character and method." (see page 55).
It is clear from the above that Mr Nordmeyer had nothing to fear from the B.M.A.; the B.M.A. (on the word of the chairman of the Wellington Division) would not attempt to influence its members against joining a health centre scheme, and recognised their right to do so without hindrance.
Furthermore, Mr Nordmeyer knew all this, as he had been kept fully informed by the Health Centre Committee on every aspect of their discussions with the B.M.A.

Attitude of Individual Doctors

The second point that might conceivably have troubled Mr Nordmeyer was the possibility that in any case (even with no obstructionism from the B.M.A.) the doctors of New Zealand might find the prospect of health centre service insufficiently attractive to prompt them to volunteer for such service.
Did this possibility justify Mr Nordmeyer in killing the Hutt Valley scheme? Clearly, no.
The fact of the matter is that nobody - not Mr Nordmeyer or his advisers, nor Mr Robb, nor anyone else - knows what response New Zealand doctors might make if invited to join the staff of a health centre, and the reason for this ignorance is simply that no such invitation has ever been offered - that the question has never been
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put to an actual test, It is true that certain officials of the B.M.A. (getting on in years and solidly conservative) are known to dislike the idea of including general practice within a health centre framework. It is also known that many doctors are loath to give up their "vested interest in sickness" which is an unfortunate and lucrative feature of present-day "fee for service" private practice. But it toy no means necessarily follows that all the younger, more progressive and liberal doctors are of the same mind. It may well be that a considerable number of them would welcome an opportunity of giving their profession truly efficient and disinterested service - an opportunity which membership of a health centre would afford.
Indeed, that the medical profession is not unanimous in dislike of health centres is proven by the fact that Mr Robb and his professional colleagues of the Medical Study Group actively proclaim their support for the health centre idea, and that Dr Hubert Smith - a doctor with wide experience both in private practice and as a public health officer - has asserted that he would have been glad to accept appointment to the proposed Hutt Valley health centres. How many other doctors are of a similar mind is simply not known, and must remain unknown until a clearcut query is put fairly and squarely to the doctors themselves.

Means of Putting the Query

That such a query should be put to the doctors of Hew Zealand was the contention of Mr Robb and the Hutt Valley Health Centre Committee. Furthermore, we contended that Mr Robb's proposed 'ad hoc' committee provided the best agency for properly framing such a query and for properly putting it to the profession.
It will be recalled that Mr Robb's suggestion was this:
First, that an 'ad hoc' committee, so widely representative and so authoritative as to command respect from all parties concerned, should be set up by the Government to assume (at least temporary) responsibility for the development of the Hutt Valley health centres,
Second, that the 'ad hoc' committee should prepare a detailed
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plan - including proposals for organisation, administration, control, finance, salaries, conditions of service, buildings, equipment, etc. - for the Hutt Valley centres,
Third, that the 'ad hoc' committee should submit this plan to the individual members of the medical profession, and should invite applications for staff membership of the centres.
How if, as a result of this mode of approach, sufficient doctors of the right type volunteered for health centre service, the Hutt Valley scheme could be put into operation with little delay.
But if, on the contrary, there was insufficient response, then the scheme at least for the time being would be held up.
Whatever the outcome, this mode of approach to the problem of health centre staffing would give a usefully satisfactory answer to the question,, Can medical personnel be found for the Hutt Valley health centre scheme?
Why did Mr Nordmeyer and his Labour Government refuse to adopt this straightforward, honest, and eminently sensible procedure? (Or for that matter any other conceivable procedure for securing the same end?) Was it because they feared that the doctors' response might be so favourable that there would no longer be any vestige of excuse for failing to proceed with the Hutt Valley health centre scheme?

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