A National Health Service : Report of the Council of the B.M.A. to the Representative Body
1944 1944 1940s 11 pages 7 Appendix REPLIES BY THE MINISTER OF HEALTH TO QUESTIONS PUT TO HIM BY THE REPRESENTATIVE COMMITTEE The Representative Committee submitted to the Minister of Health a series of questions on matters relating to the White Paper. The questions and the replies received are rep...
| 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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| Online Access: | http://hdl.handle.net/10796/ADF08244-A6EA-4603-9A55-4AA0BB73D34D http://hdl.handle.net/10796/75A1FB8B-7BDC-4748-B6F8-A92D9F766BB6 |
| Summary: | 1944
1944
1940s
11 pages
7 Appendix REPLIES BY THE MINISTER OF HEALTH TO QUESTIONS PUT TO HIM BY THE REPRESENTATIVE COMMITTEE The Representative Committee submitted to the Minister of Health a series of questions on matters relating to the White Paper. The questions and the replies received are reproduced below. Civil Rights of Doctors Question 1. — Can the profession be given an assurance that doctors who participate in the National Health Service will be allowed to retain as citizens their rights to serve as M.P.s and on local authorities and bodies concerned with the administration of the Service, and what steps will the Government take to protect these rights? Answer. — Yes. There will have to be exceptions, as there are now, like doctors employed in Government Departments and medical officers of health. But for the profession generally these rights must be fully retained. Any necessary provision to secure this will be included when legislation on the new service is put before Parliament. 100% Issue Question 2. — Will the Minister give an assurance that the inclusion of 100% of the comunity in a National Health Service is contingent upon the inclusion of 100% in the national security plan as a whole? Answer. — The proposals for the National Health Service were formulated on the assumption that there would also be proposals for a scheme of social insurance covering the whole community. If for any reason this assumption were not realized the National Health Service proposals would be reconsidered in this respect. Public and Private Practice Question 3. — By what machinery does the government propose to make it possible for a general practitioner or a consultant to distinguish between a public patient and a private patient? Apart from the necessity for a general practitioner or a consultant being able to establish those cases in which a fee may be charged, the question is of importance in many different connexions - e.g., (a) If a patient chooses private institutional accommodation does he thereby relinquish his right to both treatment and accommodation under the public scheme in respect of the current illness? Will the patient be able to avail himself of the public service at any level of an illness and for any purpose, it being understood that in doing so he would have to change his doctor for that purpose - e.g., short-wave therapy? (b) Can a patient be a private patient for general practitioner services and a public patient for consultant and/or hospital services, including radiological and pathological investigations and treatment, and vice versa? Can a general practitioner use public "investigation" services for a private patient? (c) If, in spite of the Government's contract to provide all necessary treatment without charge, the particular service a patient needs is not available in his area under the service but is available privately, what is the position as regards the payment of fees? Answer. — The Minister will particularly welcome the profession's help in working out the detailed problems of organization involved in this important group of questions. It seems to him that the general lines might be these: (i) The general practitioner would treat as public patients any persons who had become his public patients through some suitable machinery to be devised (e.g., of a medical card signed by both doctor and patient.) He would treat as private patients, outside the arrangements of the service, any patients not so associated with him, whether or not they were associated with any other practitioner within the public service. There would need, of course, to be proper cover for people away from their home areas and similar cases, as now. (ii) People would be entitled to take advantage of the public service at any time, and therefore to change at any time from being private patients to being public patients, either of the same doctor or of another — according to the ordinary process of choice and acceptance. If they thus became public patients of the same doctor, this would not affect any private liabilities incurred by them with him for any period while they were his private patients. (iii) People would have the right to take advantage of part of the public service instead of the whole — e.g., a person who chose to be a private patient of a general practitioner would not thereby deprive himself of the benefits of the public service in a hospital, or of whatever domiciliary consultant services were made publicly available through the hospital service. Similarly a person who chose to be a public patient of a general practitioner would be free, if he wished, to obtain through that practitioner any specialist consultation privately and otherwise than through the public hospital and consultant services ; and also, if he so wished to arrange privately for hospital accommodation and treatment outside the public service. Comprehensiveness Question 4. — Why should not the scheme be really comprehensive in the sense that a single central authority should be responsible for the administration of all the civilian health services and only for those services? Answer. — The scheme is intended to provide for all necessary personal medical services. There are other services, connected with the work of other Government Departments, in the operations of which medical advice is constantly required but in which it plays a minor part. If medical advice is to play its full part in such services it must be constantly available and cannot be detached from the administrative framework of those other Departments without losing in force and availability. There is already liaison centrally, and this has become increasingly close in recent years. The White Paper gives the reasons for regarding the industrial medical service rather as a part of the general welfare service in industry than as a part of the personal medical services, and on page 10 reference is made to the importance of increasing use in this work of general practitioners who have received appropriate postgraduate training. Sufficiency of Personnel Question 6. — How is it suggested that the number of doctors shall be increased so as to make the proposed service possible? Answer. — It is fully realized that it would be difficult, if not impossible, to operate the new service under present wartime conditions of medical man-power, and that its operation will depend upon a substantial return of doctors from the Forces. But, when judged by more normal standards, there is no reliable means of assessing at this stage what increase, if any, in the supply of doctors will be necessitated by the new service, particularly bearing in mind the many improvements proposed in
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