A National Health Service : Report of the Council of the B.M.A. to the Representative Body
1944 1944 1940s 11 pages 9 local) contract and consultants under local contract? Will this not split the profession? Answer.— It is believed that consultant services will best be based on the hospitals, and that the engagements of the consultants should therefore be with the hospitals con...
| 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/10796/78ECC222-C970-4F53-838E-8E672B0C5121 http://hdl.handle.net/10796/ACCBCAE2-2598-4D26-96D4-76A6386B05B8 |
| Summary: | 1944
1944
1940s
11 pages
9 local) contract and consultants under local contract? Will this not split the profession? Answer.— It is believed that consultant services will best be based on the hospitals, and that the engagements of the consultants should therefore be with the hospitals concerned, voluntary or municipal. This is thought to be an arrangement which the consultants and the hospitals would on the whole prefer; but the whole consultant service arrangements have still to be discussed with the profession's representatives, and this point will not doubt be included in the discussion. Question 15.— What type of person are the part-time members of the Central Medical Board expected to be? Would they be medical practitioners spending the other part of their time in practice, or would they be civil servants? Answer.— The part-time medical members of the Board would be medical practitioners spending the other part of their time in practice. Question 16.— What influence is it expected the part-time members could have? Answer.— The part-time members would be the majority of the Board. A part-time basis is contemplated because it will secure that the Board is mainly composed of members who are themselves actively engaged in medical practice. Local Administration Question 17.— How can there be comprehensiveness of local administration when the various services are distributed among several different authorities? Answer.— It is assumed that the question refers not to the "comprehensiveness" of the services given but to the "unification" of the means of giving them. It will be seen from the White Paper that the main key to that unification is in the arrangements for a single area plan, prepared locally by the joint authority with full professional guidance and approved centrally by the Minister, and covering the whole scope of the service for its area. Question 18.— What is to be the relationship of the environmental services to the curative services provided by the local authorities? Answer.—The importance of the environmental services is emphasized in pages 10 and 11 of the White Paper, where it is also made clear that responsibility for all these services is not included in the National Health Service organization, which is directed only to the medical and allied care of personal health. Responsibility for the wide variety of environmental services will continue to rest with whatever authorities are most appropriate to carry it in each case. Question 19.— How is it proposed to associate the general practitioner with work in the hospitals? Answer.— This is eminently a subject on which the profession's own views will be welcomed, both in planning the service and in subsequently operating it. It is impossible to deal with so important a question in a short answer. The arrangements in each area will rest on the area plan, worked out in consultation with the profession and requiring central approval. This will be able to provide, as and where appropriate, for suitable "general practitioner" hospitals ; but, quite apart from that particular kind of hospital provision, it must be recognized generally that it is in the best interests both of the public and of the medical profession that the general practitioner should have as many and as close contacts with hospitals as possible. Question 20.— What is to be the relation between general practitioners and medical officers of health? Answer.— The general practitioner, whether is separate practice or in a health centre, will not be under the direction or supervision of the medical officers of a local authority in the clinical pursuit of his professional work, it is important that he should have every opportunity of keeping in touch with the preventive work of the medical officers of health, and it is the intention that the services of the general practitioner should be used increasingly as time goes on in the performance of functions which have hitherto been mainly the concern of separate whole-time clinics. Question 21.Into how many joint board areas is it proposed to divide the country? Answer.— No proposals as to the actual areas are yet under consideration. These can only be settled after consultation with the organizations and interests concerned. Question 22.— What is the objection to vocational, including medical, representation on joint health authorities? Question 23.— Is it contemplated that joint health authorities should be required to establish committees to which definite functions are referred? If so, is vocational representation on these bodies contemplated? Question 24.— Will the Minister give an assurance that voluntary hospitals shall be represented on the join board authorities? Answer.— In the White Paper it was recognized that there are arguments for and against including on the local administrative authorities, or on their various committees, a proportion of non-elected members to represent professional organizations and the expert point of view. On balance, it was felt that the risk of impairing the principle of public responsibility lying with the elected representatives of the people outweighed any advantages which were likely to accrue. The Minister will be glad, however, to consider carefully any proposals which the profession has to offer that will not conflict with this principle of democratic responsibility. Question 25.— What type of experience will be expected of the medical advisers, if any, of the new joint authorities? Answer.—It is anticipated that the new joint authorities will need—for their varied and important functions—not only full-time ofHcers of high calibre but also part-time advisers in specialist and general practice. In addition they will have the regular advice and guidance of the Local Health Services Councils. It is probably the senior full-time ofHcers that the question has most in view. Recruitment to such posts should clearly not be restricted to any particular group or class of doctor, but should be open to the most suitable person in each case, whatever the source from which he or she is recruited. Experience in medical administration, hospital organization, or public health will obviously be relevant qualiHcations, and there is scope for further development in training and postgraduate education in these Helds. Question 26.— Will the Minister describe the structure and functions of the local bodies referred to on page 29, paragraph (2)? Answer.— The profession's own views are wanted before the exact constitution of these bodies can be settled. The intention of the White Paper was that they should perform on the spot the kind of duties at present performed by the Insurance Committees, and thus avoid overburdening the central organization of the Central Medical Board with functions in relation to the general practitioners which experience has shown can be locally discharged. Hospital Services Question 27.— What is the objection to voluntary hospitals being paid in full for the services they render under the scheme? Answer.— If the whole of the cost of the whole of the public service rendered by voluntary hospitals — i.e., all their ser-
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