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A CHRISTMAS APPEAL. a
1041
CORRESPONDENCE State medical service. I pointed out, also, that a inopportune time for preferring this request To the Editor of THE LANCET. could hardly have been chosen, in view of the chorus of SIR,—Next month we shall be preparing to give, dissatisfaction with the present conditions of national as is our usual custom, a Christmas gift of 30s. to health insurance, as recently voiced by bodies so each of our annuitants and to the most necessitous representative of the insured population as the Trades of the grantees. These gifts are looked forward to Union Congress and the National Conference of by many. Some of the regular recipients are blind, Friendly Societies. others are deaf, and many of them are old and infirm. I submit, Sir, that if the profession is going, as All are facing the hardships of poverty. Each year the B.M.A. Council wishes it to do, to ask for an the number on our books increases and we need extension of national health insurance, which it would no less a sum than :E550 this year if no one is to be cost at least ten million pounds a year to provide, left out. I bring this request before your readers it is not unimportant to ascertain whether those for in plenty of time before Christmas, because we whom it is to be provided, and who must find the urgently need money. Where a large donation cannot money, really desire that provision. Neither the be given I would ask them not to disregard my appeal, B.M.A. Council nor the panel conference is in a but to send any sum, however small, to the Treasurer, position to force these proposals upon the nation Royal Medical Benevolent Fund, 11, Chandos- if the nation is unwilling to accept them. The tone of the comments made at the panel conference on street, Cavendish-square, London, W. 1. I am. Sir. vours faithfullv. the reprehensible dislike that is shown by insured THOMAS BARLOW, persons for some of the conditions of the service now Nov. 5th, 1930. President, R.M.B.F. provided reminds me of a similar attitude adopted by the celebrated Prussian historian, Prof. Delbruck. In In a conversation with him at dinner in the year 1913, CRITICISM OF THE GENERAL PRACTITIONER discussing different conceptions of colonial governSERVICE. ment, I mentioned that I knew of many German To the Editor of THE LANCET. settlers who had migrated from German South-West SIR,—Dr. H. G. Dain, in your report of the recent Africa to British South Africa because they did not annual panel conference (THE LANCET, Nov. like the military rule exercised in the German colonies. " was very angry. I know that," he said, p. 972), is recorded as saying, during some remarks ! Delbruck " but it is for the good of the Fatherland that Germans upon the increase of sick benefit and the adverse criticism of such increase by the National Conference remain in German territory and " (here he thumped of Friendly Societies : " it was unfortunate that the table) " they shall like it." The chairman of the such people as Dr. Graham Little and Lord Riddell B.M.A. Council and the chairman of the Insurance should make statements without actual basis in fact. Acts Committee treated the recent conference like The service given to the panel patient was the best the mere puppet of the Association, which it has, type of general practitioner medical service in the in fact, become. As a prominent member of the world." I am entirely at a loss to understand conference quite correctly put it : the conference has Dr. Dain’s reference to me in such a connexion, and come to regard the Insurance Acts Committee of I must ask him to specify statements made by me the B.M.A. as the "executive " of the conference, "without basis in fact." In an article which I and the Insurance Acts Committee, in turn, is ruled contributed to the Edinburgh Rerisu in January, by the B.M.A. Council. Small wonder, therefore, 1929, discussing the National Health Insurance Act, in these circumstances that the conference says ditto ! to the council. The voice is the voice of Jacob, I wrote: " The majority of medical men in this country are engaged but the hands are the hands of Esau and, like Esau, in the medical service of the panel. The general practitioner is in fact the panel practitioner. The qualifications, com- the B.M.A. Council is selling the doctor’s birthright, petence and status of the general practitioner have improved his professional independence, for a mess of pottage. enormously in our own time, more especially during the But if the B.M.A. Council, when it approaches Parlia17 years which have elapsed since the Insurance Act came ment for an addition to the estimates of ten million into being. There is no better general practitioner in the world than the British general practitioner, and no criticism sterling a year, is going to maintain the Prussian could be directed against his capacity to deal properly with mood of meeting criticism displayed by the conference insured persons if that capacity were not in fact restrained under its tutelage, we who deprecate the imposition and hampered by bureaucratic regulations and by difficulties of universal panel practice can sleep in our beds. inherent in the circumstances of the Act... I am, Sir, yours faithfully, My criticism of the Act, then and subsequently, E. GRAHAM LITTLE. has been chiefly directed to its administrative, not House of Commons, Nov. 3rd, 1930. its medical defects. In two recent addresses to general practitioners (the Paddington Medical Society, on HÆMATOPOIETIC PROPERTIES OF DRIED Sept. 9th, and the Guildford Division of the British Medical Association, on Oct. 9th, reported in the MILK. Medical Press and Circular of Sept. 17th and Oct. 22nd To the Editor of THE LANCET. respectively) I deprecated the proposal of the Council SIR,-In his unstinted and exclusive praise to the of the British Medical Association to ask for an American investigators on this subject (THE LANCET, extension of the National Health Insurance Act to Nov. 1st, p. 957), Mr. A. L. Bacharach has done an on dependants, my objection being grounded (1) the menace to private practice which a universal injustice to the brilliant work of a British scientist. panel practice would imply, and (2) the encourage- An investigation occupying a period of over two years ment which such a request, made at the present on over 500 babies was carried out by Dr. Helen moment by the medical profession, would give to that Mackay1 on tþ.e same problem, and with far more political party which ardently desires to establish 1 Arch. Dis. Children, 1928, iii., 117. A CHRISTMAS
a
APPEAL.
more
,
1st,
i
I i
"
CORRESPONDENCE State medical service. I pointed out, also, that a inopportune time for preferring this request To the Editor of THE LANCET. could hardly have been chosen, in view of the chorus of SIR,—Next month we shall be preparing to give, dissatisfaction with the present conditions of national as is our usual custom, a Christmas gift of 30s. to health insurance, as recently voiced by bodies so each of our annuitants and to the most necessitous representative of the insured population as the Trades of the grantees. These gifts are looked forward to Union Congress and the National Conference of by many. Some of the regular recipients are blind, Friendly Societies. others are deaf, and many of them are old and infirm. I submit, Sir, that if the profession is going, as All are facing the hardships of poverty. Each year the B.M.A. Council wishes it to do, to ask for an the number on our books increases and we need extension of national health insurance, which it would no less a sum than :E550 this year if no one is to be cost at least ten million pounds a year to provide, left out. I bring this request before your readers it is not unimportant to ascertain whether those for in plenty of time before Christmas, because we whom it is to be provided, and who must find the urgently need money. Where a large donation cannot money, really desire that provision. Neither the be given I would ask them not to disregard my appeal, B.M.A. Council nor the panel conference is in a but to send any sum, however small, to the Treasurer, position to force these proposals upon the nation Royal Medical Benevolent Fund, 11, Chandos- if the nation is unwilling to accept them. The tone of the comments made at the panel conference on street, Cavendish-square, London, W. 1. I am. Sir. vours faithfullv. the reprehensible dislike that is shown by insured THOMAS BARLOW, persons for some of the conditions of the service now Nov. 5th, 1930. President, R.M.B.F. provided reminds me of a similar attitude adopted by the celebrated Prussian historian, Prof. Delbruck. In In a conversation with him at dinner in the year 1913, CRITICISM OF THE GENERAL PRACTITIONER discussing different conceptions of colonial governSERVICE. ment, I mentioned that I knew of many German To the Editor of THE LANCET. settlers who had migrated from German South-West SIR,—Dr. H. G. Dain, in your report of the recent Africa to British South Africa because they did not annual panel conference (THE LANCET, Nov. like the military rule exercised in the German colonies. " was very angry. I know that," he said, p. 972), is recorded as saying, during some remarks ! Delbruck " but it is for the good of the Fatherland that Germans upon the increase of sick benefit and the adverse criticism of such increase by the National Conference remain in German territory and " (here he thumped of Friendly Societies : " it was unfortunate that the table) " they shall like it." The chairman of the such people as Dr. Graham Little and Lord Riddell B.M.A. Council and the chairman of the Insurance should make statements without actual basis in fact. Acts Committee treated the recent conference like The service given to the panel patient was the best the mere puppet of the Association, which it has, type of general practitioner medical service in the in fact, become. As a prominent member of the world." I am entirely at a loss to understand conference quite correctly put it : the conference has Dr. Dain’s reference to me in such a connexion, and come to regard the Insurance Acts Committee of I must ask him to specify statements made by me the B.M.A. as the "executive " of the conference, "without basis in fact." In an article which I and the Insurance Acts Committee, in turn, is ruled contributed to the Edinburgh Rerisu in January, by the B.M.A. Council. Small wonder, therefore, 1929, discussing the National Health Insurance Act, in these circumstances that the conference says ditto ! to the council. The voice is the voice of Jacob, I wrote: " The majority of medical men in this country are engaged but the hands are the hands of Esau and, like Esau, in the medical service of the panel. The general practitioner is in fact the panel practitioner. The qualifications, com- the B.M.A. Council is selling the doctor’s birthright, petence and status of the general practitioner have improved his professional independence, for a mess of pottage. enormously in our own time, more especially during the But if the B.M.A. Council, when it approaches Parlia17 years which have elapsed since the Insurance Act came ment for an addition to the estimates of ten million into being. There is no better general practitioner in the world than the British general practitioner, and no criticism sterling a year, is going to maintain the Prussian could be directed against his capacity to deal properly with mood of meeting criticism displayed by the conference insured persons if that capacity were not in fact restrained under its tutelage, we who deprecate the imposition and hampered by bureaucratic regulations and by difficulties of universal panel practice can sleep in our beds. inherent in the circumstances of the Act... I am, Sir, yours faithfully, My criticism of the Act, then and subsequently, E. GRAHAM LITTLE. has been chiefly directed to its administrative, not House of Commons, Nov. 3rd, 1930. its medical defects. In two recent addresses to general practitioners (the Paddington Medical Society, on HÆMATOPOIETIC PROPERTIES OF DRIED Sept. 9th, and the Guildford Division of the British Medical Association, on Oct. 9th, reported in the MILK. Medical Press and Circular of Sept. 17th and Oct. 22nd To the Editor of THE LANCET. respectively) I deprecated the proposal of the Council SIR,-In his unstinted and exclusive praise to the of the British Medical Association to ask for an American investigators on this subject (THE LANCET, extension of the National Health Insurance Act to Nov. 1st, p. 957), Mr. A. L. Bacharach has done an on dependants, my objection being grounded (1) the menace to private practice which a universal injustice to the brilliant work of a British scientist. panel practice would imply, and (2) the encourage- An investigation occupying a period of over two years ment which such a request, made at the present on over 500 babies was carried out by Dr. Helen moment by the medical profession, would give to that Mackay1 on tþ.e same problem, and with far more political party which ardently desires to establish 1 Arch. Dis. Children, 1928, iii., 117. A CHRISTMAS
a
APPEAL.
more
,
1st,
i
I i
"