The National Health Service
1948 1948 1940s 38 pages The Goodwill of Patients The custom grew up in this country of regarding the clientele of a doctor as having a money, or 'goodwill' value. This was greatly stimulated by the old National Health Insurance Scheme under which all panel patients were transferr...
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| Institution: | MCR - The Modern Records Centre, University of Warwick |
| Language: | English English |
| Published: |
London : His Majesty's Stationery Office
1948
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/6BE172FF-E650-4A4E-80D2-7A5D42B2DF67 http://hdl.handle.net/10796/BFDF50C4-62D8-4FDF-88F1-48D5FC8BF3E2 |
| Summary: | 1948
1948
1940s
38 pages
The Goodwill of Patients The custom grew up in this country of regarding the clientele of a doctor as having a money, or 'goodwill' value. This was greatly stimulated by the old National Health Insurance Scheme under which all panel patients were transferred to the new doctor unless they took special steps to change. The position has been, then, that a doctor who removed or retired sold his practice to the doctor who took his place. The young doctor, therefore, has almost always had to buy his way into general practice. He might start as another doctor's salaried assistant, but he usually could not go far without buying a practice of his own or a share in the practice of a partnership. Usually he had to borrow the purchase money, often at a high rate of interest, guaranteeing repayment by means of a life insurance policy. Heavy commitments in the early years of his career, and the need to keep up and improve the value of his investment against the day for reselling it, made him work to attract as many patients as possible. Some think it often bred in him a proprietary attitude to his patients and a competitive rather than co-operative attitude to other doctors, and that the sale and purchase of practices is a bad thing in itself. But, whatever the merits of the custom, it would not fit the new circumstances. The fact that the new scheme enables the closing of an area to additional doctors or the non-filling of a vacant practice if an area needs no more doctors for the time being, itself would have destroyed the open market for sale and purchase. Moreover, the sale of public practices, as the Medical Planning Commission argued, must disappear wherever health centres are started. The sale of public practices, therefore, had to be abolished, and doctors are to be compensated at a figure of £66,000,000 for the whole of Britain, a figure agreed with the British Medical Association as a fair value. Doctors who are outside the Service remain free to sell their practices ; doctors in the Service, even if they also have fee-paying patients, can no longer do so, but if they joined by 5th July receive their respective shares of the compensation. Superannuation Scheme Although the doctor will not be able to sell his practice, a guarantee of security in his old age and for his widow is afforded by a scheme for superannuation and widow's benefit (this includes all health workers in the Service). Doctors may elect to be paid by capitation fees only or, with the consent of the Executive Council after consultation with the Local Medical Committee (or, on appeal to the Minister), to have a fixed annual payment of £300 plus capitation fees at a lower rate. This arrangement is specifically intended to help doctors starting up in practice. The fixed 27
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