The Hospital Problem : the Report of a Special Conference of Labour, Hospital, Medical and kindred Societies
1924 1924 1920s 12 pages 10 Mr. R. Lindsay (British Dental Association) held that the range of this discussion should include dental treatment. No doubt the British Dental Association would be able to suggest some means whereby that dental treatment might be carried out with the best effect, but the...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
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London : The Labour Party ; printed at the Office of the British Medical Association
1924
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| Online Access: | http://hdl.handle.net/10796/BA1E6A45-4EE2-4619-BEF7-40019F0BCBCE http://hdl.handle.net/10796/6B3CDA07-A3F6-4DE9-9EEE-4366EA490C7C |
| Summary: | 1924
1924
1920s
12 pages
10 Mr. R. Lindsay (British Dental Association) held that the range of this discussion should include dental treatment. No doubt the British Dental Association would be able to suggest some means whereby that dental treatment might be carried out with the best effect, but the voluntary principle, in so far as it applied to the provision of adequate dental treatment for the people of this country, was an absolute failure. It was a curious thing that dentists themselves had been the people who had supplied, not only the service and the time involved in that service, but also the money for the maintenance and support of dental hospitals. That was necessarily unsatisfactory. He thought the necessity for dental treatment was becoming so apparent to everyone that there would be general acceptance of the principle that the money should be found elsewhere. The whole point was that for the very large extension which was so pressingly required at the present time of dental treatment to all classes of the community the voluntary system was not sufficient. He thought it was not outside the scope of practical politics to discover some means whereby in the future, even when the State was taking a very large part in the matter, all those advantages of the voluntary system to which Mr. Harman had alluded might be maintained. He considered the real solution of the difficulty would be found in what Mr. Canter had said. Dr. Alfred Cox (Medical Secretary, British Medical Association) said that certain remarks had been passed with regard to his share as a member of the committee concerned in the production of the much criticized statement of policy with regard to the hospital crisis. The Labour party had set an example which other political parties might well follow of asking the Association of which he was Secretary to nominate a representative on that committee, not as a member of the Labour party, but as one through whom some of the views and feelings of the profession might be expressed. He hoped he had been of some use on the committee; certainly it had been of use to him. He must, however, say in self-defence that in the preparation of the report on hospital policy he was quite frequently in a minority on the committee; there were certain statements in the report with which he could not agree, though there were many others with which he did agree. He considered that the present conference had amply justified itself, and it was obvious that a large measure of agreement would be arrived at. The answer to the question before the conference, as to whether further State assistance should be given for the extension and maintenance of hospital accommodation, was in the affirmative. The only question remaining was as to the method whereby such assistance should be given. The difference between the parties represented at the conference turned on the question as to whether it was worth while to preserve that spirit of which Lord Knutsford had spoken in his moving address on the previous day. He believed that most of those present would admit that it was worth while. And such preservation could not be ensured by any statutory committee. What many of them were worried about was the obvious intention of some sections of the Labour party — it was not universal — to discourage the spirit of self-help. If the Labour party could convince some of those who stood outside that it was not out to suppress the feeling of independence, but to encourage it, and that it was not rigidly bound to any one system, he believed the Labour party would make many converts, certainly to its hospital policy. He felt that Mr. Bishop Harman's suggestions were the right ones, and his example of the financing of the universities was very much to the point. (Applause.) Dr. Gordon Ward considered that the London hospitals were a " back number " from the point of view of the real purpose for which they existed; 75 per cent. of the cases dealt with at the London hospitals could be better dealt with in the country so far as environment was concerned, and equally well so far as medical skill and care were concerned. This medical skill and care would be available through the service of country practitioners. He would like to have a distinct understanding from both the voluntary hospital side and the Labour party side as to whether either or both were in agreement on the contention of the Medical Practitioners' Union that hospital experience and practice should form a normal feature of general professional life wherever hospitals were available. Mr. Lingstrom (National Conference of Friendly Societies) hoped that the questions which had been discussed in the conference would be investigated by a Royal Commission. He held strongly that general practitioners ought to be more closely in touch with the hospitals and more regular in their attendance there. Every doctor ought to spend a certain amount of time in a hospital every year. Dr. Astley Clarke said that the hospital with which he was connected at Leicester had no paid beds and no almoner. But a community hospital conscience had been aroused, and in eighteen months as much as £75,000 had been raised as the result of a special appeal. One feature of the present hospital position which he regretted was that medical students at the big teaching hospitals were not able to get the clinical experience which they ought to receive. He thought there should be some system of drafting of students from the large central hospitals to the smaller provincial ones, where, under proper supervision, they could acquire the experience which at present they were unable to acquire in the few large institutions. Mr. L. Hill (Association of Approved Societies' Secretaries) denied that the Labour party's hospital policy was of a revolutionary character; it need not involve any violent change. Surely, if an increased State grant were forthcoming, some measure of State control must accompany it. He thought Mr. Harman's calculation of the number of available beds was foolish, seeing that, to arrive at his result of 10 beds per 1,000 of the population, he had included the beds in fever and small-pox hospitals. What would be said, in the event of an outbreak of fever, if the authorities had not reserved a sufficient number of beds ? He also criticized the conditions in out-patient departments. Dr. Gordon Dill said that no allusion had been made, in the different policies brought before the conference, to the great necessity of developing National Health Insurance, yet that was a very important consideration in its bearing on the hospital problem. He proceeded to speak of the Sussex contributory scheme, which now numbered some 17,000 beneficiaries; this scheme had been in existence for three years and had proved extremely successful. He agreed that a voluntary system had certain anomalies, and what was done under such a system was almost necessarily more expensive than under a compulsory system. Mr. H. S. Souttar said that so far as his hospital was concerned he and his colleagues would be only too glad to welcome lay representation and co-operation in every sense from those whom the hospital tried to serve. He thought that a great debt of gratitude was due to the Labour party because it had not been slow to recognize the services of hospital staffs. The document which had been laid before the conference outlining the Labour policy he personally regarded as statesmanlike. There were things in it with which he disagreed, but he hoped much from the clear statement that the Labour party would insist on the treatment in any State hospital being equal in efficiency to that provided in the best voluntary hospitals. He had had considerable experience of Continental hospitals, especially in France and Switzerland. The drawback of these hospitals was that they were not backed up. as were the hospitals in this country, by such an excellent nursing service, and this service was essential to the future of hospitals. But he did admire the State or municipal provision of equipment in Continental hospitals, and he instanced some provisions made at Basle, which were quite extraordinary in view of the comparative smallness of the town, and of which it was difficult to think of any counterpart in this country. One or two other members spoke briefly from the Labour party side to the effect that voluntary help, while gratifying, could not meet the situation, and that rate aid was necessary. Mr. Bishop Harman confined himself to only one point in reply. The Chairman and others had used the magic phrase "guild socialism." The withdrawal of the hospital service from the control of statutory committees and the humdrum routine of statutory authority would be one of the greatest experiments in guild socialism, which every Fabian should welcome with open arms. The public authority was quite in its right place in dealing with drains and sewers, but in an institution of the intricacy and delicacy of a voluntary hospital its influence did not make for efficiency, but the reverse. Let there be guild socialism for hospitals throughout England and he and his friends would be perfectly satisfied. STATE- AND RATE-AIDED HOSPITALS. The final session of the conference was devoted to the question of State-aided and rate-aided hospitals. The opener was Dr. John Buchan, Medical Officer of Health for Bradford. The chair was taken by Mr. G. W. Canter. Dr. Buchan began by observing that the hospital problem in this country owed its origin to four factors : (1) an increasing urbanization of the population with a deterioration of living conditions; (2) the awakening of the health conscience of the people, giving rise to a demand for further hospital provision; (3) a greater measure of thoughtfulness and care in the means for the relief of poverty; (4) an ever-increasing improvement and complexity in medical and surgical science, bringing within the scope of the hospital large numbers of cases which previously could be treated at home. Through the operation of these causes the voluntary hospitals became faced with a load which they could not be expected to carry, and a way out was found in the establishment of rate-aided hospitals. These rate-aided hospitals first appeared to deal with special conditions or special classes in the community, and during the last
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