British Medical Association and the National Health Service Bill
1946 1946 1940s 8 pages B. THE COUNCIL'S REPORT* STATEMENT ON THE NATIONAL HEALTH SERVICE BILL The Council, having considered the Government's proposals, recommends to the Representative Body:— That the following statement of policy on the Government's Bill for a...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
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1946
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/CC7BDD7B-9125-40C6-A3A0-FE692E65D22F http://hdl.handle.net/10796/2E2211C0-6CBA-445D-BBB4-98C3CCF11876 |
| Summary: | 1946
1946
1940s
8 pages
B. THE COUNCIL'S REPORT* STATEMENT ON THE NATIONAL HEALTH SERVICE BILL The Council, having considered the Government's proposals, recommends to the Representative Body:— That the following statement of policy on the Government's Bill for a National Health Service be approved:— 1. The profession, while anxious and willing to co-operate with the Government in evolving a complete health service, is opposed, on grounds of public interest, to certain important features of the Government's proposals. ORGANIZATION 2. In the Bill it is proposed that the Minister should assume general responsibility for the service and discharge this responsibility through three main channels. In the case of hospital and specialist services he will delegate the bulk of the administration to new regional and local bodies. He will place the responsibility for domiciliary clinic and health centre services directly on local health authorities (county and county borough councils). He will place the responsibility for general practitioner services on specially appointed local bodies acting within national regulations made by himself. 3. Will this proposed structure secure what the profession has long been seeking — the proper co-ordination and correlation of the country's medical services ? Will the individual citizen be well served by the proposed administration ? When he seeks attention from his family doctor he will be availing himself of a service administered by the local executive council. If that service is rendered in a health centre he will receive it in premises owned by another local body, the local health authority. If his doctor recommends him for hospital treatment he will pass to yet another administration, that of the regional body. 4. In the case of an expectant mother she may receive her medical care from her family doctor at home or in the consulting room, although the proposals on this point are not clear. She may attend an ante-natal clinic, part of the local health authority's service, receiving it there from a whole-time local authority medical officer. But if she proposes to be confined in hospital she may receive her ante-natal care at a parallel set of ante-natal clinics, this time administered by the regional body and staffed by hospital medical officers. If her confinement takes place at home she may be attended by a midwife appointed by the local authority, a doctor in the family doctor service, and, if specialist help is sought, by a specialist in contract with the regional body. 5. In the case of infectious disease the responsibility for preventing its spread will be that of a local authority, probably a lesser local authority. If a case of infectious disease needing hospital treatment occurs the patient will be conveyed to another service administered at the regional level. 6. There appears to be little immediate prospect of bringing to the general practitioner forms of work which should, in the interests of the patient, be undertaken by him. While the ultimate object may be to make unnecessary the provision of medical treatment by the school medical service, what is proposed at the outset and for an indefinite period is that such services shall be separately provided and organized by local education authorities, supervised by the Ministry of Education. No attempt is made to bring together the general practitioner service now rendered to mothers and children in clinics and the main general practitioner service, other than the suggestion that immunization, together with vaccination, should be carried out by general practitioners. To employ general practitioners in clinics is not enough. Much of the work now done in clinics should be undertaken by general practitioners as part of their normal work for those under their care. Child welfare responsibility is to follow educational responsibility, which in many cases will mean that a further authority is involved in health administration, a local authority which is not a county or county borough council. 7. The Association criticizes the proposed administrative arrangements as likely to divide the service into at least three compartments, to perpetuate or create barriers between general practitioner and hospital, between hospital and health centre, between the family doctor service and the local authority clinic services, between local authority medical officers and hospital staffs and general practitioners, as well as between the bodies employing them. 8. The Minister will provide and manage a public health pathological laboratory service for the control of infectious diseases, but local authorities are still to be free to provide their own laboratory services. No mention is made of the clinical pathological services unless these are to be regarded as part of the specialist service coming under regional administration. 9. At what level can co-ordination best be secured ? It is not enough to state, as the Minister stated in reply to questions from the Negotiating Committee, that co-ordination between general practitioner and hospital services can be secured by the policy of administration of the Minister, by the work of the Minister's officers, by the presence of some * The general principles of this report apply to Scotland as well as to England and Wales with the Secretary of State taking the place of the Minister, large burgh councils taking the place of county borough councils, subject to the modifications which the Bill contains on such points as the provision of health centres by the central instead of the local authority. 3
292/847/4/40 |
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| Physical Description: | TEXT |