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CONTRACTING OUT
686 with ill-defined
margins ; while fig ill is obviously a postero-anterior radiogram taken as a teleradiogram. Such differences in technique would explain the differ-
these, and I
see no reason why a doctor should not on occasion visit his patient’s house for an interview which is perhaps not entirely necessary on medical grounds. And where the visit was made to the health centre, ences in the appearance of the hilar:shadows. there is no. reason why this should not be made at the I am aware that it is claimed that adenopathy can be diagnosed from lateral radiograms, but I have not mutual convenience of the patient and doctor, there being no reason why, if an appointment has been arranged, the been able to satisfy myself that it becomes easier to separate the glands from the vascular shadows by patient should waste valuable time waiting about. The whole thing in my view boils down to whether superimposing the hila of the two sides. we are going to provide a medical service for 100% Military Hospital, Wynberg, STEPHEN MONTGOMERY. of the population or only a proportion of it. At the Annual Representative Meeting of the BMA in 1942 OPINION OF SERVING DOCTORS the former was approved by a hairsbreadth majority, SIR,—Since the earlier part of the war discussions have but last September a motion was passed by a large been taking place as to the future of medicine. Up till majority which very nearly negatives this decision. ’It the present time only members of the profession at home is unfortunate that there should seem to be a divergence have had an opportunity of stating an opinion. There of opinion on such a fundamental point. I believe may be a vast difference in the outlook of a doctor that if we provide for only a proportion we shall lay engaged in an appointment or a practice which will- ourselves open to the possible criticism that we wish continue at the end of the war, and a service doctor who to make as much as we can out of that section of the will have to make a fresh start. In our opinion the population not covered by the national scheme. latter has been utterly and completely ignored up to I do hope that a good deal more thought will be given date. It is said that when the time comes machinery to the 100 % issue before we come to a final decision will be set in motion for communicating with Service in the matter, and that if the eventual decision is in men and women whose views cannot be obtained its favour, as much thought will be given to the through the normal channels. inadvisability of contracting out. It is perhaps not realised that replies may take several A. LUCAS YOUNG. Eastbourne. months. ’In our opinion a questionnaire should be sent out without any further delay to all members of the profession. It should be drawn up jointly by representatives of the profession and the Ministry of Health setting forth the points of difference. These LOUISA GARRETT ANDERSON should be voted on by ballot, and the results assessed. C B E, M D L O N D E. R. VAN LANGENBERG. T. S. STEWART. Dr. Louisa Garrett Anderson died at Brighton on By airgraph. Nov. 15 in her 71st year. She was the firstborn of CONTRACTING OUT Dr. Elizabeth Garrett, who married the shipowner SIR,—Your three correspondents, in their letters of James George Skelton Anderson in 1870 when she was 34. Oct. 30, appear to suppose that I am making a case From the chance meeting with Elizabeth Blackwell in for the discontinuance of private practice, if not for the 1859 that turned her thoughts towards medicine, to her actual inauguration of a state salaried service. This qualification as an Apothecary in 1865 and the Paris is not so. What I am at pains to point out is that ifdoctorate in June, 1870, her and this is by no means unlikely-a comprehensive mother’s life had been one long medical service available to the whole community comes hard-won campaign for women’s into being, then we must be_ prepared to forgo private rights, but as Louisa says in practice. If on the other hand the service is only her filial memoir: " No one can designed to cover people up to a certain income level, remain ’the stern pioneer,’ at the question of contracting out would hardly arise at any rate in her own home, if, all, because the great majority of those who would when she gives herself airs, she want to, and could afford to, contract out would find is laughed at-and loves it." themselves not covered by the scheme. Jamie did not understand I agree thoroughly with Dr. Nelson when he says jealousy; he delighted in her that we cannot run with the fox andhunt with the position, her success and her achievement: her cause in fact hounds, but I certainly do not conclude that all must be of the state. To try another metaphor, you cannot became their cause. It was into have your cake and eat it, and if, as seems plain, the such a home that Louisa was majority of the profession is against a full-time salaried born in 1873 and after the death service, we have the choice of some other type of service of a sister from tuberculous which should either be (a) universal, or (b) limited, with peritonitis at the age of fifteen From the experience other means of remuneration. months she shared it with her of a series of (so far) 17 public relations meetings with brother Alan, in whose life hosvarious lay audiences, I believe that what the public pitals came to compete with shipping in absorbing interest, wants, if there is to be. any change at all, is a universal while the perfect Banffshire " Aaa " reigned in the service. To compromise with any mere extension of nursery releasing their mother to her growing practice National Health Insurance to a higher income level and to serve the Hunter Street school as dean for two seems merely to perpetuate all the disadvantages of the decades.’ Later she was sent to school at St. Leonards, present panel system, and I am sure that the public Fife, returning to the Royal Free from which she qualified at least see in this proposal the danger that Dr. Leak MB Lond. in 1897. House appointments there and at the " is afraid of-that there will be a levelling down instead New " (Eliz. Garrett Anderson) Hospital followed and of a levelling up. after some foreign travel she took her MD and started Dr. Lindsey Batten gives several legitimate reasons consulting work, seeing outpatients at the New Hospital and the Harrow Road children’s hospital. She had many for a patient wishing to step outside an official scheme. friends and lived a very full life ; and then, true to type, I am bound to say I see no reason why a patient should not be able to obtain all these attentions in a compreshe gave herself selflessly to the militant suffrage movehensive service run by the state. The reason why the ment, serving a term of imprisonment. doctor can only give the young mother two minutes at The first world war closed this chapter and on Sept. 14, the clinic is usually because he has a good deal to get 1914, she went with the first unit of medical women for through in a fairly short time, and simply cannot afford service in France. This unit was attached to the French to give her any more. Surely one of the first objects Red Cross, and when they arrived in Paris they were sent of any organised service would be to ensure that the to Claridge’s Hotel, which had just been emptied so that the Women’s Hospital Corps might be housed. It had doctor who was running the clinic would be able to give each patient sufficient time to attend to his or her to be surgically cleaned from top to toe, but within,a few hours of the unit’s arrival French wounded were medical needs. And the point about health centres. It would obviously be impossible to be too rigid about being brought in straight from the battlefields, and Dr.
Cape Province, S. Africa.
’
Obituary
margins ; while fig ill is obviously a postero-anterior radiogram taken as a teleradiogram. Such differences in technique would explain the differ-
these, and I
see no reason why a doctor should not on occasion visit his patient’s house for an interview which is perhaps not entirely necessary on medical grounds. And where the visit was made to the health centre, ences in the appearance of the hilar:shadows. there is no. reason why this should not be made at the I am aware that it is claimed that adenopathy can be diagnosed from lateral radiograms, but I have not mutual convenience of the patient and doctor, there being no reason why, if an appointment has been arranged, the been able to satisfy myself that it becomes easier to separate the glands from the vascular shadows by patient should waste valuable time waiting about. The whole thing in my view boils down to whether superimposing the hila of the two sides. we are going to provide a medical service for 100% Military Hospital, Wynberg, STEPHEN MONTGOMERY. of the population or only a proportion of it. At the Annual Representative Meeting of the BMA in 1942 OPINION OF SERVING DOCTORS the former was approved by a hairsbreadth majority, SIR,—Since the earlier part of the war discussions have but last September a motion was passed by a large been taking place as to the future of medicine. Up till majority which very nearly negatives this decision. ’It the present time only members of the profession at home is unfortunate that there should seem to be a divergence have had an opportunity of stating an opinion. There of opinion on such a fundamental point. I believe may be a vast difference in the outlook of a doctor that if we provide for only a proportion we shall lay engaged in an appointment or a practice which will- ourselves open to the possible criticism that we wish continue at the end of the war, and a service doctor who to make as much as we can out of that section of the will have to make a fresh start. In our opinion the population not covered by the national scheme. latter has been utterly and completely ignored up to I do hope that a good deal more thought will be given date. It is said that when the time comes machinery to the 100 % issue before we come to a final decision will be set in motion for communicating with Service in the matter, and that if the eventual decision is in men and women whose views cannot be obtained its favour, as much thought will be given to the through the normal channels. inadvisability of contracting out. It is perhaps not realised that replies may take several A. LUCAS YOUNG. Eastbourne. months. ’In our opinion a questionnaire should be sent out without any further delay to all members of the profession. It should be drawn up jointly by representatives of the profession and the Ministry of Health setting forth the points of difference. These LOUISA GARRETT ANDERSON should be voted on by ballot, and the results assessed. C B E, M D L O N D E. R. VAN LANGENBERG. T. S. STEWART. Dr. Louisa Garrett Anderson died at Brighton on By airgraph. Nov. 15 in her 71st year. She was the firstborn of CONTRACTING OUT Dr. Elizabeth Garrett, who married the shipowner SIR,—Your three correspondents, in their letters of James George Skelton Anderson in 1870 when she was 34. Oct. 30, appear to suppose that I am making a case From the chance meeting with Elizabeth Blackwell in for the discontinuance of private practice, if not for the 1859 that turned her thoughts towards medicine, to her actual inauguration of a state salaried service. This qualification as an Apothecary in 1865 and the Paris is not so. What I am at pains to point out is that ifdoctorate in June, 1870, her and this is by no means unlikely-a comprehensive mother’s life had been one long medical service available to the whole community comes hard-won campaign for women’s into being, then we must be_ prepared to forgo private rights, but as Louisa says in practice. If on the other hand the service is only her filial memoir: " No one can designed to cover people up to a certain income level, remain ’the stern pioneer,’ at the question of contracting out would hardly arise at any rate in her own home, if, all, because the great majority of those who would when she gives herself airs, she want to, and could afford to, contract out would find is laughed at-and loves it." themselves not covered by the scheme. Jamie did not understand I agree thoroughly with Dr. Nelson when he says jealousy; he delighted in her that we cannot run with the fox andhunt with the position, her success and her achievement: her cause in fact hounds, but I certainly do not conclude that all must be of the state. To try another metaphor, you cannot became their cause. It was into have your cake and eat it, and if, as seems plain, the such a home that Louisa was majority of the profession is against a full-time salaried born in 1873 and after the death service, we have the choice of some other type of service of a sister from tuberculous which should either be (a) universal, or (b) limited, with peritonitis at the age of fifteen From the experience other means of remuneration. months she shared it with her of a series of (so far) 17 public relations meetings with brother Alan, in whose life hosvarious lay audiences, I believe that what the public pitals came to compete with shipping in absorbing interest, wants, if there is to be. any change at all, is a universal while the perfect Banffshire " Aaa " reigned in the service. To compromise with any mere extension of nursery releasing their mother to her growing practice National Health Insurance to a higher income level and to serve the Hunter Street school as dean for two seems merely to perpetuate all the disadvantages of the decades.’ Later she was sent to school at St. Leonards, present panel system, and I am sure that the public Fife, returning to the Royal Free from which she qualified at least see in this proposal the danger that Dr. Leak MB Lond. in 1897. House appointments there and at the " is afraid of-that there will be a levelling down instead New " (Eliz. Garrett Anderson) Hospital followed and of a levelling up. after some foreign travel she took her MD and started Dr. Lindsey Batten gives several legitimate reasons consulting work, seeing outpatients at the New Hospital and the Harrow Road children’s hospital. She had many for a patient wishing to step outside an official scheme. friends and lived a very full life ; and then, true to type, I am bound to say I see no reason why a patient should not be able to obtain all these attentions in a compreshe gave herself selflessly to the militant suffrage movehensive service run by the state. The reason why the ment, serving a term of imprisonment. doctor can only give the young mother two minutes at The first world war closed this chapter and on Sept. 14, the clinic is usually because he has a good deal to get 1914, she went with the first unit of medical women for through in a fairly short time, and simply cannot afford service in France. This unit was attached to the French to give her any more. Surely one of the first objects Red Cross, and when they arrived in Paris they were sent of any organised service would be to ensure that the to Claridge’s Hotel, which had just been emptied so that the Women’s Hospital Corps might be housed. It had doctor who was running the clinic would be able to give each patient sufficient time to attend to his or her to be surgically cleaned from top to toe, but within,a few hours of the unit’s arrival French wounded were medical needs. And the point about health centres. It would obviously be impossible to be too rigid about being brought in straight from the battlefields, and Dr.
Cape Province, S. Africa.
’
Obituary