The White Paper - An Analysis
1944-03 1944 1940s 12 pages 5 WHITE PAPER. Sufficiency of personnel. 2. The Government, beyond stating that the responsibility of meeting the needs of the whole population implies some degree of regulation of the distribution of medical resources, makes but little reference to the general question...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
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March 1944
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| Online Access: | http://hdl.handle.net/10796/CB5214C5-2669-4A1E-A3C3-E79535827CAA http://hdl.handle.net/10796/2DF0C11B-F60F-4B10-A6EB-12A3A730AAE8 |
| Summary: | 1944-03
1944
1940s
12 pages
5 WHITE PAPER. Sufficiency of personnel. 2. The Government, beyond stating that the responsibility of meeting the needs of the whole population implies some degree of regulation of the distribution of medical resources, makes but little reference to the general question of whether there are enough doctors. The need for more consultants and a better distribution of them is emphasised ; but before going into this in more detail the Government awaits the Report of the Goodenough Committee on Medical Schools. 3. The Government recognises the inevitability of some temporary limitation of the full service, e.g., in dentistry and ophthalmology, and states that "the design is to be comprehensive from the outset and to be fulfilled as fast as resources and man-power allow," but it does not appear to appreciate the numerical inadequacy of general practitioner personnel and the shortage of institutional accommodation — obstacles which will take years to remove. Medical Research. 4. The Government regards it as of first importance that medical research "should continue and develop under the encouragement and financial assistance of the Medical Research Council." No new proposals are advanced and it is pleaded that in this matter "the powers of hospital authorities seem to be already sufficient." Medical Education. 5. There are the following references to this subject in the White Paper. (1) In discussing the need for a new attitude in patient and doctor towards health, the Government states: "This means a changed outlook in much of present medical practice ... It will be helpful if a new trend can be given to undergraduate medical education and, fortunately, there are plenty of signs that medical schools are beginning to realise the importance of this ... To provide or to extend a service which considers only the treatment of the sick is neither in accordance with the modem conception of what a doctor should be trained to do, nor in keeping with the general desire that the family practitioner should begin to undertake many of the duties at present performed by his colleagues in the public health service." (2) The proposed functions of the Central Medical Board include the initiation of arrangements with medical schools and hospitals with a view to the provision of post-graduate and refresher courses for those in general practice. (3) In the section dealing with financial arrangements with voluntary hospitals, it is urged that particular regard will need to be given, in connection with the area plans, to the position of hospitals used for the clinical teaching of medical students. The question of financial assistance in respect of teaching work is to be reviewed when the report of the Goodenough Committee is available. (4) In discussing the better distribution of consultant services, the Government points out that this will have a beneficial effect upon general medical practice over larger areas and that the habitual presence and services of consultants will serve as a means of continuous post-graduate education. 6. There is no reference in the Paper to the recommendation that medical education should be brought within the financial resources of any suitable student. PRINCIPLE C. Subject to these general and overriding considerations, the functions of the State should be to co-ordinate existing provision, both official and non-official, to augment it where necessary, and to secure that it is available without economic barrier to all who need it. The State should coniine itself within these wide limits, invading the personal freedom of both citizen and doctor only to the extent which the satisfaction of these functions demands. PRINCIPLE D. It is not in the public interest that the State should convert the Medical Profession into a salaried branch of central or local government service. The State should not assume control of doctors rendering individual or personal health service. The profession rejects any proposal for the control of the future medical service by local authorities as at present constituted. WHITE PAPER. 7. The Principles expressed by the Government in paragraph 2 on page 47 conform generally with the Association's principles. The former include freedom for people to use or not to use the service ; freedom for doctors to work inside the service, outside the service, or both (this is inferred though not explicitly stated) ; freedom for the doctor to undertake his professional work without clinical interference ; the preservation of the doctor-patient relationship and the conception of the family doctor. 8. But the attachment of the Government to these "freedoms" and its attitude towards a wholetime salaried service can be judged only after a careful examination of the Paper as a whole. 9. Whereas the Association has expressed the view that the proposed comprehensive service should be available, without economic barrier, to all who need it, the Government lays it down that the service should be available to all who want it, "irrespective of means, age, sex, or occupation." In effect, the Association contemplated that the service would be available to less than the whole population ; the Government contemplates that the service will be open to the whole population to the extent to which they desire to use it. 10. The Government commits itself to a maximum use of good existing facilities and experience without unnecessary uprooting of established services ; it prefers the welding together of what is already there, adapting it and adding to it and incorporating it in the larger organisation.
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