The Health Services

1944-05 1944 1940s 23 pages 19 VII. — CRITICISMS OF THE WHITE PAPER. The Government's plan is a threefold compromise with the vested interests of the present health services, with private practitioners, with the voluntary hospitals, and with the local authorities. (1) A doctor...

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Bibliographic Details
Institution:MCR - The Modern Records Centre, University of Warwick
Language:English
English
Published: London : C. W. Publishing Ltd. May 1944
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Online Access:http://hdl.handle.net/10796/80C50BC2-9AE2-4911-90B9-6AFE76B21178
http://hdl.handle.net/10796/0812D773-14B8-4D5B-BCDA-BB492FE30164
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Summary:1944-05 1944 1940s 23 pages 19 VII. — CRITICISMS OF THE WHITE PAPER. The Government's plan is a threefold compromise with the vested interests of the present health services, with private practitioners, with the voluntary hospitals, and with the local authorities. (1) A doctor in public practice may take private patients. This is a privilege which is of no value, unless it is abused. If a doctor gives his best service under the public scheme, it is pointless to pay him fees for the very thing for which everyone is already paying, through rates, taxes and social insurance. If a doctor is offering a better service to fee-paying patients, the worst evils of the present panel system will remain. (2) While there is a case for allowing established doctors to keep their private practices, the fact that young doctors entering the public service may take up private practice means that their efforts to build up the latter are bound to distract their attention from the public service. (3) Although the Government's intention is "to place the group idea in the forefront of their plans," the provisions about Health Centres are tentative, and give no indication of the speed and scale of development in this direction. A progressive local authority may be thwarted by local doctors' refusal to co-operate ; or the doctors' desire to develop group practice may be frustrated by the apathy and poverty of the local authority. Ultimately it all depends on whether the Minister of Health is progressive in dealing with the plans submitted to him. (4) The White Paper neglects the subject of preventive medicine. The most serious omission is industrial health supervision, which will not come into the scope of the national service, but remains the responsibility of the Ministry of Labour. Little is said about mental health and convalescence, and nothing about social medical work. Nothing definite is said about a positive cultivation of health with regular medical overhauls. (5) Voluntary hospitals will retain their autonomy although most of their income will be derived from public funds. They represent the strongest vested interest in the medical field, and it is doubtful whether the proposals for co-ordination in the White Paper will ultimately lead to a unified hospital service. Moreover, it is undesirable that appeals to public charity should continue under a public service. On the other hand, there is no attempt to profit by the lessons which the voluntary hospitals can teach local authorities in administrative and other matters. (6) Local administration will be on two levels — joint authorities and major local authorities. The formation of joint authorities may be the only method, without general local government reform, of creating sufficiently large administrative areas, but it is a defect that the administration should not be unified. Another cause for doubt is the additional burden of £8 millions which is to be borne by local finances. 15X/2/98/10
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