A National Health Service : Report of the Council of the B.M.A. to the Representative Body
1944 1944 1940s 11 pages 6 would reduce the number of potential buyers and so encourage the capital value of existing practices to evaporate. It would, for financial reasons, give an impetus, unrelated to the public interest, to the development of Health Centres out of all proportion to any case th...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
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1944
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/4F736519-4A81-465C-A587-9C16364C790F http://hdl.handle.net/10796/25C896AD-578F-48F4-B295-DCDB45375B77 |
| Summary: | 1944
1944
1940s
11 pages
6 would reduce the number of potential buyers and so encourage the capital value of existing practices to evaporate. It would, for financial reasons, give an impetus, unrelated to the public interest, to the development of Health Centres out of all proportion to any case there might be for the establishment of such centres. 55. If this view is accepted, the question of compensation must be approached on an "all or none" basis. It must be discussed as a general, not a partial, issue. In any case, the final decisions on the compensation question must await the results of the Health Centre experiments, though it does not follow that the form or forms of Health Centre finally approved will necessarily involve compensation. The approval of the "diagnostic and special investigation" type of Health Centre, for example, would not, of itself, raise any compensation issue. 56. But the uncertainty already caused by the White Paper proposals would be aggravated by the absence of definite decisions on compensation. What is recommended is that compensation formulae, standards, and amounts, relevant to both capital values and professional premises, should be calculated and agreed now, pending decisions as to whether compensation is involved by the forms of general medical practice ultimately approved. Rural Practice 57. Special consideration will need to be given to rural general practice, which has special difficulties and problems peculiar to it. Any plan of development should include extension of the system of cottage hospitals suitably equipped, an increase in the provision of maternity beds, and the provision of radiological and pathological facilities. The terms and conditions of service of rural practitioners should take into consideration the relative sparseness of population and the time and cost incurred in travel. Hospital and Consultant Services 58. The position of voluntary hospitals is dealt with under other sections of this report. This statement is being prepared for recommendation to the Representative Body before the publication of the report of the Interdepartmental Committee on Medical Schools. It is possible, however, to put forward certain principles affecting consultant and specialist services. It is highly desirable that, in general, consultant services should be associated with hospitals and that hospitals should be responsible for a complete consultant service, both institutional and domiciliary. The individual general practitioner should, so far as is practicable, retain the right to select the consultant he desires to consult. 59. The terms and conditions of service of consultants should, like those of general practitioners, be negotiated centrally between the Minister and representatives of the medical profession. There is much to be said for placing the individual consultant or specialist in contractual relationship with the hospital or hospitals which appoint him, it being understood that the content of the contract is negotiated centrally. It has, however, the real disadvantage that general practitioners will look in one direction for contractual purposes, and consultants and specialists in another. Further consideration will need to be given to this point. Private Practice 60. The future of private practice depends primarily on the proportion of the community to which this service is made available irrespective of means and as a right. The profession's present view on this issue has been stated earlier in this report. Before the profession can consider any modification on this attitude it needs fuller information on a number of points, including the general Social Security contributions, the administrative and professional arrangements, and the machinery for ensuring the continuance of private practice for those who desire to be treated privately. 61. In the case of general practice the points to be considered include the mode of distinguishing between Service patients and private patients, and the procedure to be adopted by citizens intending to utilize the Service for a particular item, or items, of medical service. In the case of consultant and specialist practice the profession needs fuller information as to the procedure proposed in the case of persons seeking consultative service in the consulting-rooms of consultants and specialists, and in private wards, wings, and blocks associated with general hospitals. 62. Whether or not the whole community is covered by this scheme, those who desire to obtain medical service privately should be absolutely free to do so from any doctor of their choice, and every practitioner should be free to render such service on a private basis with access to hospital facilities at every level, should such be necessary. This is an issue of the freedom of the public rather than of the interests of the profession.
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| Physical Description: | TEXT |