Memorandum on first steps towards the improvement of the general medical services of the nation
1939 1939 1930s 6 pages 5 card, which should form a voucher for payment of the doctor, as does the present Medical Card, and should serve the other administrative purposes of this Card. (14) At the same time, the State might take authority to introduce salaried general practitioners, more especiall...
| Institution: | MCR - The Modern Records Centre, University of Warwick |
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| Language: | English English |
| Published: |
London : Council of the Medical Practioners' Union
1939
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| Subjects: | |
| Online Access: | http://hdl.handle.net/10796/02B71E3A-0607-4D15-B50C-B9C0E05A1E76 http://hdl.handle.net/10796/B3D73DAA-A629-4C04-A2C2-D779CE904A14 |
| Summary: | 1939
1939
1930s
6 pages
5 card, which should form a voucher for payment of the doctor, as does the present Medical Card, and should serve the other administrative purposes of this Card. (14) At the same time, the State might take authority to introduce salaried general practitioners, more especially in order to meet the needs of districts which are understaffed from the medical point of view. The State has already approximated to this position in the Highlands and Islands service. The value of these provisions as a basis for subsequent development in war or peace, without any sudden upheaval, is obvious. (15) The Union has always been opposed, and continues opposed, to any participation of municipal Medical Officers of Health in this general practitioner service. That these officers must, for a time, continue to be concerned with the provision of institutional and other services, such as they manage at present, is admitted, although they are thereby prevented from doing the essential work of preventive medicine. The Union contemplates that all treatment services, whether institutional or general practitioner, will eventually be brought under the control of the Ministry of Health operating through local committees analogous to the Insurance Committees, and Panel Committees of to-day. These are developments with which it is not, at the moment, concerned, but it wishes to make it clear at once that neither the education nor the opportunities of the municipal Medical Officer of Health, as we know him to-day, tend to fit him to supervise treatment services, while his unfortunate political position and often anomalous and undignified relationships to the members of his Council make even his existing work difficult to perform with the maximum of efficiency. 3. PUBLIC ASSISTANCE. (16) The Union calls attention to the immediate need for the removal from Poor Law taint and treatment of two classes of persons. First, those who are admitted to a Public Assistance Institution for treatment and, secondly, those who are now treated by Public Assistance district Medical Officers in their own homes. This would involve financial adjustments with the doctors concerned. The Union is not only concerned with continuity of treatment for these persons, together with liberty to change their doctors if desired, but wishes to see the Poor Law taint completely removed from all forms of medical treatment. It is true, of course, that the domiciliary treatment difficulty would be at once solved if the extension of services discussed above were to be introduced. 4. MATERNITY SERVICES. (17) In connection with Maternity Services there is also immediate need for remedies. The effect of the existing services is unsatisfactory in many directions. The supply of skilled obstetricians is being deliberately cut off by the State because general practitioners, with a few exceptions, are now deprived of participation in the conduct of cases. In a few years, the situation will be extremely serious, because general practitioners capable of dealing with obstetric emergencies will have almost vanished from practice, and there is nothing whatever to encourage others to become qualified for the work. The only possible remedy is to re-associate as many practitioners as can be persuaded to take up this work with the normal cases. The restriction of this service often to only a single doctor in each locality is a folly dangerous to the people and bound to prove still more dangerous as the years go by. (18) It is a further grave defect of the existing Maternity Service that mothers in the working classes are, in fact, although not in theory, precluded from having the benefit of efficient ansesthesia. This method of further frightening potential mothers is only to be remedied by providing that midwives must, whenever there is the slightest doubt, call in a doctor to decide if an anaesthetic be necessary or desirable, and, if so, to administer it. (19) A third defect of the recent Maternity legislation is that the nurse is advised that 14 days should be the proper limit of her attendance, and that she, in consequence, may often leave to her own devices a mother who ought to be either kept under observation, given appropriate treatment, or otherwise further aided to regain her health. There is no wish to attribute blame, but it may be that the Central Midwives Board has failed to realise that no midwife should leave her case unless she is either (a) satisfied that no further assistance is needed, or (b) has called in a practitioner to advise as to whether she should continue a little longer in attendance, or whether some alternative method of dealing with any particular situation must be adopted.
36/H24/38 |
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| Physical Description: | TEXT |