British Medical Association and the National Health Service Bill
1946 1946 1940s 8 pages He should never be required, or be in a position to be required, to modify his standards of medical certification at the behest of the State, however concerned the State may be with the solvency of a Social Security Fund. This independence of professional judgment and respons...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
| Published: |
1946
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/20207625-EB8A-4373-9E26-1A7B75EB3C98 http://hdl.handle.net/10796/3B431EAA-9A6B-4CE2-87FC-977C8D690CB5 |
| Summary: | 1946
1946
1940s
8 pages
He should never be required, or be in a position to be required, to modify his standards of medical certification at the behest of the State, however concerned the State may be with the solvency of a Social Security Fund. This independence of professional judgment and responsibility of action, evolved over the centuries, is inconsistent with the conception of the doctor as a civil servant or local government officer, whose first loyalty would be to his employing body. Valuable though these forms of organization and control are in many fields of human activity, they would be fatal to the personal doctor-patient relationship which lies at the heart of good medicine. The doctor should be the patient's doctor and not the Government's doctor. The doctor's freedom is the public's freedom. A whole-time salaried medical service is inconsistent with free choice of doctor. It would mean the equal distribution of work between equally paid doctors regardless of the wishes and preferences of the public. It would tend to impose a uniformity in a form of work in which initiative and originality are essential. It would tend to bureaucratize what should be a human service. It would destroy what is a proper incentive with most kinds of people in most kinds of work, the relationship between remuneration and the amount and value of work done or responsibility accepted. It might tend to replace competition for patients by competition to avoid them. The proposals of the Government must be examined to see whether they lead "directly or indirectly to the profession as a whole becoming full-time salaried servants of the State or local authorities." It is not enough to postpone the danger. The public should satisfy itself that the proposals will not tend, sooner or later, to this form of service. Medicine is an art as well as a science. The family doctor is faced with human problems which for their solution demand not merely science but in addition wisdom, kindliness and knowledge of human nature. He is friend as well as adviser. He can give of his best only where complete confidence exists between patient and doctor. This confidence can exist only under conditions which leave the patient entirely free to choose or reject a particular doctor. Further, the patient in consultation with his family doctor should be free to choose the hospital, clinic or other institution at which he should obtain his medical care. He should not be required to choose a particular doctor or to attend a particular institution. There will be those in all sections of the community who will prefer to arrange their medical care for themselves outside the public service. The freedom of the citizen requires not only that he shall be free to obtain his medical care privately but that the arrangement should not be such as to penalize him or his doctor if he does. In practice this means that the citizen should be free to obtain private medical care from general practitioner, consultant or specialist, that practitioners in the public service shall not be precluded from providing it and that adequate facilities should be available in hospital for them to do so. Now that the war is over no compulsion, direct or indirect, should be brought to bear upon any citizen to work in any particular area. This principle should apply to doctors as to others. It would be inconsistent with this principle for doctors to be required by law to obtain permission from a governmental body before practising in any area whether in the public service, or privately, or both. The fact that the Government has decided to collect money from the public for medical services and to enter into arrangements on the public's behalf with doctors to provide them does not entitle a Government to apply direction to doctors merely because they desire to enter into contract with the Government to accept liability to treat the beneficiaries under the Social Security Scheme, in effect the whole population. A satisfactory medical service will be achieved only if it is staffed by doctors satisfied with their terms and conditions of service. A doctor under duress is no more likely to achieve this satisfaction than is any other worker in similar circumstances. The State recognizes and registers a medical practitioner only when it is satisfied that by education, training and experience the practitioner is fully qualified to offer his services to the public. Other governmental agencies, central or local, should not apply an additional test. No doctor should be in the position, having passed through the medical curriculum, satisfied the stringent requirements of the General Medical Council — the body established by statute for this purpose — of finding that he is not acceptable to this or that central or local body and so finds himself unable to practise his profession with his prolonged and expensive training and experience wasted. The General Medical Council amply protects the public without the imposition of other statutory conditions by other tribunals. Doctors have an important contribution to make in the planning, organization, management and development of health services. Indeed without it a service satisfactory to the public is impossible. They do not seek to control such services, but the public interest demands that at every level of administration there should be adequate representation of the medical profession. Their advice should be presented by them to administrative bodies by medical members of such bodies speaking with the authority which derives from such membership. This principle applies to central and local bodies alike, including regional bodies and the public health committees of local authorities. This is a matter of public and not only professional interest. 2
292/847/4/40 |
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| Physical Description: | TEXT |