National medical service
1943-10-20 1943 1940s 15 pages -10- (a) Preventive - This work is mainly statutorily imposed on Local Authority. In many areas, especially large centres of population there is a full time Medical Officer of Health, the chief Public Health Adviser to the Local Authority. There are a smaller number...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
| Published: |
20 October 1943
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/4776A523-8F32-4EF9-9227-54B91A8605CE http://hdl.handle.net/10796/C1A6E655-FBED-4EAB-82FA-8F5F16A51563 |
| Summary: | 1943-10-20
1943
1940s
15 pages
-10- (a) Preventive - This work is mainly statutorily imposed on Local Authority. In many areas, especially large centres of population there is a full time Medical Officer of Health, the chief Public Health Adviser to the Local Authority. There are a smaller number of part time Medical Officers of Health but this is recognised as undesirable for many public reasons. The medical profession has never objected to such full time appointments, just as they have seldom objected to whole time institutional or clinic appointments. The duties of the M.O.H. are laid down and the Ministry of Health have certain powers. There is room for considerable improvement in public health as well as Maternity and Child Welfare work especially in rural areas. Many practising doctors raise one objection - that too commonly, members of L.A. are under the influence of the M.O.H. (b) Curative - The General Practitioner Medical Services. There are alleged to be about 44,000 medical men on the Medical Register. The G.P. members of the B.M.A. (the premier medical professional organisation) amount to 13,716, of which 9,870 are engaged in N.H.I. practice and 3,846, not so engaged. Of G.P's not members of the B.M.A. it is estimated that 5,963 are engaged in N.H.I. work and 3,689 not so engaged, a total of 9,602. Those engaged in N.H.I. work are under contract with the statutory Insurance Committees, engaging to give medical service of "average skill and ability" to insured persons or workers paying contributions under the N.H.I. Scheme. This medical service is quite limited in scope, to G.P. treatment, to only a section of the population, without consultant or institutional or laboratory services in many instances. Experience in the part [past] three decades has proved its insufficiency. The dependants of the insured persons are not included. The unemployed after a period of unemployment are debarred even from this limited assistance and have to fall back on the Public Assistance Medical Service. The standard of this varies with each individual contracting practitioner, and, though there are certain corrections, such as the Regional Medical Officer service, and the Prescription Examining and costings-comparing committees these often work inequitably and injudiciously. In other words the N.H.I. medical service is only elementary and partial, and is not nationally comprehensive, and the total expenditure in medical benefit of this inadequate type is £10 1/2 Millions per annum for the partial services of less than 24,000 doctors. The main objection to full time employment in a National State Medical Service emanates from these practitioners, who work singly or in partnership in competitive isolation, with surgeries not models of hygiene in many cases, without team work and often without adequate arrangements for substitution or for emergency calls. There is no organised local medical N.H.I. service in any district in a combined co-operative scheme. The doctors now maintain that they do not wish to have full time State service "under the heel of medical bureaucrats" and prefer to have only an extension of the limited N.H.I. scheme to dependants of insured persons. This is not sufficient and is no substitute for a comprehensive National Health Service. What form should the contemplated change in local medical practice take? (i) The doctors should either organise in teams for Group Medcine [Medicine], providing surgeries, proper arrangements for medical calls and responses, for domiciliary visits etc. or (ii) Work in properly organised and equipped Health Centres provided by the Local Authority. A National Scheme should be elastic enough having regard to community medical needs to provide for unusual or even exceptional
292/847/2/113 |
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| Physical Description: | TEXT |