The White Paper - An Analysis
1944-03 1944 1940s 12 pages 3 (d) Voluntary hospitals will participate, if willing to do so, as autonomous and contracting agencies ; if so, they will observe the approved area plan, and certain national conditions applying to all hospitals in the new service alike ; they will perform the services f...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
| Published: |
March 1944
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/587EEEC7-94F5-4E6F-997E-DEEBF08CC509 http://hdl.handle.net/10796/AB7833AB-4626-426C-A840-4D5B434BACB9 |
| Summary: | 1944-03
1944
1940s
12 pages
3 (d) Voluntary hospitals will participate, if willing to do so, as autonomous and contracting agencies ; if so, they will observe the approved area plan, and certain national conditions applying to all hospitals in the new service alike ; they will perform the services for which they contract under the plan, and receive various service payments from both central and local funds. (e) Special provision will be made for inspection of the hospital service through centrally selected expert personnel. (f) Consultant services will be made available to all, at the hospitals, local centres, or clinics, or in the home, as required ; they will be based on the hospital service, and arranged by the joint authority, either directly or by contact with voluntary hospitals under the approved area plan. (g) Measures for improving the distribution of consultants, dealing with methods of appointment and remuneration, and relating the consultant service to other branches of the new service generally, will be considered after the report of the Goodenough Committee. 4. General Medical Practice. (a) Everyone will be free, under the new Health Service, to choose a doctor — the freedom of choice being limited, as now, only by the number of doctors available and the amount of work which each doctor can properly undertake. (b) Medical practice in the new service will be a combination of grouped and separate practice. Grouped practice means practice by a group of doctors working in co-operation. Separate practice means practice by a doctor working on his own account — broadly similar to practice under the present National Health Insurance scheme, but with important changes. (c) Grouped practice will be conducted normally, though not exclusively, in specially equipped and publicly provided Health Centres. In England and Wales, the Centres will be provided and maintained by county and county borough councils — in Scotland, by the Secretary of State with power to delegate to a local authority. (d) General practice in the National Health Service will be in the main organised centrally under the responsible Health Ministers. All the main terms and conditions of the doctor's participation will be centrally settled, and much of the day-to-day administration will be the function of Central Medical Boards — one for England and Wales and one for Scotland — largely professional in composition, and acting under the general direction of the Health Ministers. (e) The main duties of each Board will be :— (i) To act as the "employer" of the doctors engaged in the public service. Thus, the Board will be the body with whom every doctor will enter into contract. In the case of practice in Health Centres in England and Wales, however, there will be a three-party contract between the Board, the local authority and the doctor. (ii) To ensure a proper distribution of doctors throughout the country. For this purpose the Board will have power to prevent the taking over of an existing public practice or the setting up of a new public practice in an area which is already "over-doctored." (f) It is not proposed that there should be a universal salaried system for doctors in the new service. Doctors engaged in Health Centres will be remunerated by salary or the equivalent ; doctors in separate practice normally by capitation fee. In some cases — e.g. grouped practice not based on a Health Centre — remuneration by salary or the equivalent could be arranged if the doctors concerned so desired. Rates of remuneration will be discussed with the medical profession. (g) It is not proposed to prohibit doctors in public practice from engaging also in private practice for any patients who still want this. Where a doctor undertakes private in addition to public practice, the number of patients he is permitted to take under the National Service — and consequently his remuneration — will be adjusted. (h) Young doctors entering individual practice in the public service for the first time will normally be required to serve for a period as assistants to more experienced practitioners, and the Board will be able to require them to give full time to the service if necessary. (j) Compensation will be paid to any doctor who loses the value of his practice — e.g. by entering a Health Centre or because he is prohibited from transferring the practice to another doctor on the ground that there are too many doctors in the area. Superannuation schemes will be provided for doctors in Health Centres and the possibility of providing them in other forms of practice will be discussed with the profession, and the practicability of abolishing the sale and purchase of public practices will be similarly discussed. (k) Arrangements for the supply of drugs and medical appliances will be considered and discussed with the appropriate bodies. 5. Clinics and other services. (a) It will be the duty of the joint authority to include in its area plan provision for all necessary clinics and other local services (e.g., child welfare, home nursing, health visiting, midwifery and others), and to provide for the co-ordination of these services with the other services in the plan. (b) County and county borough councils will normally provide most of these local services. The exact allocation of responsibility between the joint authority and the individual county and county borough councils will be finally settled in each case in the approved area plan ; but the principle will be that services belonging to the hospital and consultant sphere will fall to the joint authority while other local and clinic services will fall to the individual councils.
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| Physical Description: | TEXT |