791

A NATIONAL HEALTH SERVICE" ESSENTIAL PRINCIPLES "

IN a statement issued this week the NegotiatingCommittee says that for a quarter of a century themedical profession has stressed the need for a completehealth service. The profession is willing and anxiousto cooperate with the Government in evolving thisservice, for it believes that the knowledge and experienceof the profession are indispensable contributions to itssuccess. It re-emphasises that good housing, social,economic, and environmental circumstances are theprincipal factors in the maintenance of health and theprevention of disease. It urges the expansion of medicalresearch. In the interests both of the public and ofmedicine, the profession regards the acceptance of thefollowing principles as essential :

1. The medical profession is, in the public interest,opposed to any form of service which leadsdirectly or indirectly to the profession as a wholebecoming full-time salaried servants of the Stateor local authorities.

2. The medical profession should remain free toexercise the art and science of medicine accordingto its traditions, standards, and knowledge, theindividual doctor retaining full responsibilityfor the care of the patient, freedom of judgment,action, speech, and publication, without interfer-ence in his professional work.

3. The citizen should be free to choose or changehis or her family doctor, to choose, in consultation

.. with his family doctor, the hospital at which heshould be treated, and free to decide whetherhe avails himself of the public service or obtainsthe medical service he needs independently.

4. Doctors should, like other workers, be free tochoose the form, place, and type of work theyprefer, without governmental or other direction.

5. Every registered medical practitioner should beentitled as a right to participate in the publicservice.

6. The hospital service should be planned over naturalhospital areas centred on universities in order thatthese centres of education and .research mayinfluence the whole service.

7. There should be adequate representation of themedical profession on all administrative bodiesassociated with the new service in order thatdoctors may make their contribution to theefficiency of the service.

COMPENSATION FOR PRACTICES

Commenting last week on the Minister of Health’sstatement to Parliament (see p. 794), Dr. CHARLES HILL,as secretary of the Negotiating Committee, said :The Government’s undertaking to pay compensation for

any loss of capital values incurred by doctors as a result of itsnew proposals-whatever they may turn out to be--is plainjustice. The capital represented by a doctor’s practice issomething which he has paid for or built up and somethingwhich he relies upon for his retirement years. Any Govern-ment which takes-steps to destroy or diminish a capital assetshould compensate for the loss it causes, and this Govern-ment’s desire to relieve anxiety on this point of principle isappreciated.When a practice changes hands, what is in fact transferred

is goodwill, the patients themselves being free to accept theincoming doctor or choose another doctor as they please.Many will not share the Government’s view that an efficientmedical service can be secured only by such a fundamentalchange in existing arrangements. This has yet to be argued.The Negotiating Committee representing the medical pro-fession has not yet had an opportunity of putting forward tothis Government its own proposals for a complete healthservice, including a wider distribution of doctors.The abolition of goodwill cannot be considered in isolation.

What matters most is what machinery the Government pro-poses to substitute for the present arrangements in order tofacilitate the entrance of doctors into medical practice andtheir freedom of movement thereafter. If, for example, it isproposed to substitute for existing arrangements a system ofposting or direction, the medical profession will be opposed toit. If the Government assumes that by destroying the good-will of existing practices it thereafter becomes entitled to

appoint doctors to practices, directing them where and howand with what colleagues they shall practise, the proposal isfraught with danger to public and professional freedom.Doctors should, like other workers, be free to choose the form,place, and type of work they prefer without governmental orother direction.For these reasons the attitude of the medical profession to

any proposal to abolish the sale and purchase of practices canbe determined only when it is known what is to be substitutedfor the existing arrangements. To promise compensation ifcapital values are affected by the new arrangement is onlyfair and just. But whether it is necessary to introduce suchnew arrangements and whether such arrangements involvethe loss of the essential freedoms of the public and the pro-fession can be judged only when all the cards are on the table.

On Active ServiceAWARDS

MC

Captain A. R. T. LUNDIE, MB, RAMC

MENTIONED IN DESPATCHES

COMMANDS AND STAFF

Colonel C. H. K. SMITH, OBE, MC, late RAMC

RAMC

Briqadiers.-W. M. CAMERON,OBE, J. KINNEAR, OBE,F. A. R. STAMMERS, CBE

Colonels.—W. A. D. DRUMMOND,T. D. INCH, CBE, MC, W. A. Y.KNIGHT, A. S. PERN, OBE,W. L. SPENCER COX, OBE, MC,J. T. ROBINSON

Lieut.-Colonels. - H. J. B.ATKINS, T. F. BRIGGS, J. B.HERMAN, R. JOHNSTON,D. W. E. LLOYD, MC, C. M.MARSDEN, J. B. McEwEN,mc, J. S. MILLER, T. P.SEWELL, E. G. SIBLEY, W. R.SPRUNT, A. W. S. THOMPSON,OBE, C. S. THOMSON, A. P.TRIMBLE, A. S. WESSON,P. L. E. WOOD, DSO, MBE

Majors.—H. F. ANDERSON, R.L.BENISON, A.D.C.S. CAMERON,R. G. DAVIES, E. A. FIDDIAN,C. KENTON, W. MCLEOD,R. M. PATON, M. S. WILLIAM-SON, MC, G. H. WOOLER,A. BEARD WELL, D. BELL,A. B. BIRT, R. W. COPE,S. H. CROOT, D. H. CUMMACK,H. W. DAvis, A. C. DORN-HORST, T. DUNCAN, K. B.GIBSON, A. M. GILES, R. E.HASWELL, J. HOWELL, M. A.JpNES, A. R. KENNEDY,T. G. LOWDEN, L. G. MAC-FARLANE, W. B. McKENNA,R. J. MILBANK, R. I. MIT-CHELL, A. A. MURRAY, W. M.OWEN, J. H. PATTERSON,W. A. V. PAYNE, K. R. D.PORTER, MBE, H. E. SMITH,R. S. STEVENS, D. L. STEWART,A. M. TAJT, R. B. TERRY,

Majors—continuedA. J. THOMAS, J. H. VICKERS,M. A. G. WARD, J. H.WARREN, NIBF, G. N. WiLSON

Captain8.-.F,. S. AIELLO, J. W.CLARE, S. A. COHEN, H. J.S. COLDHAM, J. COMYN,A. FEARNLEY, D. FERGUSON,R. FLETCHER, N. E. FRANCE, ’C. B. HINCKLEY, B. L.HOFFMANN, M. S. HOWE, MC,P. H. JONES, W. A. D. JONES-ROBERTS, M. LATNER, R. S.LAWRIE, R. T. S. LOUTTIT,B. S. LUSH, J. MACDONALD,A. F. J.. MALONEY, J. F.MAWE, R. P. MAYBIN, R. I.MCALLEY, A. D. MCGILL,J. D. MCGREGOR, N. C. MOND,M. E. MOORE, N. P. ORCHARD,A. T. PAGAN, A. PATERSON,D. E. PATERSON, D. PURDIE,E. E. RAWLINGS, J. J. REEES,J. W. RICHMOND, J. F.ROBERTSON, F. H. ROBSON,L. C. ROBSON, H. D. ROSSITER,R. P. G. SANDON, J. SCOTT,H. A. SHAW, J. R. S. SHIELDS,E. C. S. TALBOT, J. E. TAN-

.. NIAN, A. L. TULK, E. VURE,A. S. WALKER, J. S. WALTERS,D. WEITZMAN, F. J. WHIT-

’. AKER, A. L. WYMAN, F. DEBURGH WHITE

Lieutenants.—W. H. CHANTER,i N. DANCER, J. R. GRICE,

W. HAWTHORNE, F. H.HOGARTH, R. J. HOLLIDAY,J. NOBLE, J. R. PURVIS,E. A. WILLIAMS, C. D.WOODHEAD

IAMC

Colonels.—M. KIRK BRYCE, D.DATT

Lieut.-Colonels.—C. W. GREENE,W. LAURIE, D. N. BASU

.

Majors.-R. H. NEEVE, P. K.CHATERJEE, S. L. RIKHYE,V. S. TRIVEDI

Captains.—BASHIR UDDIN, A.BHATTACHARYA, DULI- -

Captains—continuedCHAND, K. C. GANAPATHY,M. Y. GHAZNAVI, P. JACOBS,JAGIIT SINGH, 1. JAHAN,K. C. MAKBRJEE, J. D.PHIBBS, S. R. SARMA, S. B.DATTA; T. M. SEETAPATHY,T. STEPHENS, MC, S. V.GHURYE, A. B. RUSHTON

POSTGRADUATE COURSES FOR DEMOBILISED MOs.-Therefresher course on pulmonary tuberculosis is to be held at .Addenbrooke’s Hospital, Cambridge, and Papworth, beginningon Jan. 14 ; a general course at Ipswich and Colchesterbeginning on Feb. 11 ; and a course on social and industrialmedicine at Luton, beginning on May 6. All the courses willlast a fortnight, and they are intended for medical officersreleased from the Forces, but any vacancies which occurwill be available for general practitioners. Further par-tioulars from Dr. Douglas Firth, Trinity Hall, Cambridge.