A National Health Service : Report of the Council of the B.M.A. to the Representative Body

1944 1944 1940s 11 pages BRITISH MEDICAL ASSOCIATION A NATIONAL HEALTH SERVICE REPORT OF THE COUNCIL OF THE B.M.A. TO THE REPRESENTATIVE BODY* The Council of the British Medical Association puts forward, for the consideration of the profession, the following draft statement of policy on the Governme...

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Institution:MCR - The Modern Records Centre, University of Warwick
Language:English
English
Published: 1944
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Online Access:http://hdl.handle.net/10796/7B0A208B-0348-4FB8-A17B-D70FC711331A
http://hdl.handle.net/10796/BDF516E2-7F3D-40F3-88A0-501B06D78E76
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Summary:1944 1944 1940s 11 pages BRITISH MEDICAL ASSOCIATION A NATIONAL HEALTH SERVICE REPORT OF THE COUNCIL OF THE B.M.A. TO THE REPRESENTATIVE BODY* The Council of the British Medical Association puts forward, for the consideration of the profession, the following draft statement of policy on the Government's White Paper on a National Health Service. It is intended that this statement should be the basis of discussion at meetings of the whole profession called by the Divisions throughout the country. At such meetings, which will be open to members and non-members of the Association alike, local professional opinion on this draft report should be expressed in the form of resolutions and instructions to Representatives at the Annual Representative Meeting to be opened on July 18, 1944. There is appended to this report the replies of the Minister of Health to a series of questions put to him by the Representative Committee in order that the profession might have some fuller details on certain points before formulating its statement of policy. The Representative Committee has taken and is taking no other steps, and no negotiations will start until after the Representative Meeting in July. The statement in the form finally approved by the Representative Body will constitute the framework within which the Association's representatives on the negotiating body will act. A report from the negotiators will be submitted to an Annual or Special Meeting of the Representative Body before the Association is committed to any course of action. The remainder of the Annual Report of Council on this and other subjects will be found in the Supplement this week. SOME GENERAL CONSIDERATIONS 1. The Government has put forward its first thoughts on a National Health Service in the form of a White Paper, asking that there shall be constructive criticism of them "in the hope that the legislative proposals which they will be submitting to Parliament may follow quickly and may be largely agreed." In response to this invitation the Association examines critically the spirit and form of the proposals put forward, and then proceeds to submit its own plan. It recognizes that criticism must be constructive, and relies on the Government's assurance that the proposals put forward are provisional only, and that they can be remoulded in the light of constructive criticism. 2. The medical profession is in complete agreement with the Government's aim to ensure that every man, woman, and child should be able to obtain all the advice and treatment and care which they may need in matters of health, and that the country's full resources are brought to bear upon reducing ill-health and promoting good health in all its citizens. The profession, particularly in the last quarter of a century, has again and again pressed upon the Government of the day developments and amplifications of health provision to this end. That pressure has been almost without avail. For example, the Interim Report of the Consultative Council on Medical and Allied Services (the Dawson Report) in 1920 outlined a scheme of primary and secondary health centres ; the British Medical Association in 1930 and again in 1938 published its "General Medical Service for the Nation" which recommended the integration and co-ordination of the medical services ; and in 1942 the Medical Planning Commission issued a Draft Interim Report which made further proposals for the reorganization of the medical services. All these documents were submitted to the Government for consideration. 3. The introduction to the Government White Paper on "A National Health Service" opens with the words: "The Government have announced that they intend to establish a comprehensive health service for everybody in this country." The emphasis in this opening sentence is on Health. One might expect this preamble to be followed by a description of the measures to be taken to promote and maintain the health of the individual. The emphasis, however, shifts to sickness. It is a medical rather than a health service with which the Government appears to be really concerned — a service which is "an essential part of any wider proposals for social insurance which may be put into operation." 4. It is natural that public interest in health should be heightened in time of war. But it is ironical that the Government should begin to display a lively interest in organizing medical services on particular lines at a time when the medical profession and its organizations are almost wholly preoccupied with the problems of war, including the recruitment of doctors to the Forces. The doctors in civilian practice are greatly diminished in numbers as a result of recruitment to the Forces, and heavily overworked in consequence. Many of the younger and more active members of the profession who are vitally concerned with these proposals are in the Services, and effective consultation with them is exceedingly difficult. 5. A controversial issue has been raised at a time when the energies of the profession, like those of the whole community, should be directed to one objective — the winning of the war. It is recognized that housing and employment are social issues of first importance which should be faced in advance of the return of peace. But it is idle to suggest that the recasting of the form of health services cannot wait until there is time and opportunity to give them the care and thought they merit, and until our colleagues in the Forces are back in our counsels and their practices. There is suspicion, not without basis, that these proposals found their first inspiration in a desire to control an independent profession in order to control medical certification and so the outgoings of a Social Security Fund. 6. To agree upon the objects of national reconstruction in the field of health is not necessarily to approve the methods or the time-table proposed. Similarly, controversy on the working out of the plan need not obscure the fact that the * [Footnote] Members should keep this number of the Journal and the Supplement, which contains the Annual Report of Council. 134/44 36/H24/42
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