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HOSPITAL RECORDS
188
RESPIRATORS AND DUST DISEASES
An Unfair Burden provide for superannuation, doctors
-
To in the National.Health Service are liable to a deduction of 6% from their net remuneration from State sources, to which the Government will add another 8%. For the well-established practitioner the sums in question will be substantial : for example, if a doctor is earning jE2400 from his N.H.S. practice, and a third of this is regarded as practice expenses, there will be a deduction of 96 from his income, the additional contribution from the State being fl28. Before July 5, when there was no official pension provision for doctors, most medical men found it necessary to take out heavy insurances to safeguard their families and provide for their own retirement. Under the new regime it was clearly going to be difficult for them to continue these insurance commitments when large sums were deducted from their incomes for superannuation purposes. Accordingly arrangements have been made whereby, between now and Oct. 4, practitioners may (subject to conditions set out in the official leaflet S.D.D.) exercise an option to remain outside the superannuation scheme, pay no portion of their income to superannuation, but receive instead the 8% State contribution towards the maintenance of approved insurance policies. Attention is drawn to this option in a letter which we publish this week from a medical insurance consultant. Clearly there may be definite advantages in it, especially perhaps for the doctor who is already well insured but will have few remaining years of service to count for superannuation. No doubt many doctors thus situated will welcome the chance of opting out of the superannuation benefits and receiving very present help towards their expensive insurance premiums. But there is another group whose need is even greater, and who can, nevertheless, receive no relief under the regulations as published. Many younger men have borrowed heavily in order to buy a practice, and for this purpose they have been required to insure their lives for considerable sums. The premiums they are paying sometimes represent a high proportion of their budget, and it may be almost impossible for them to go on paying these premiums if they also have to forego 6% of their income for superannuation. These are the very men who might find the 8% of State money paid towards insurance premiums most acceptable. Yet they do not qualify to receive this help, because their policies are technically assigned to the bank or to the insurance company that has lent them money to buy their practices. Many of these doctors belong to that group, enduring financial hardship, for whom the Government have promised early payment of compensation. If it had been possible for this compensation to be assessed and paid by Oct. 4 they would be in a position to have their policies released from assignment to their creditors, and could then exercise their option to keep these policies in being as an alternative to superannuation. As any such settlement is manifestly impossible in so short a time, this relief is withheld from them, and some whose budgets are already closely drawn will face certain insolvency if they must bear the double load. While it is obvious that if insurance is to take the place of superannuation and be the chief means of
for retirement, insurance policies must not be surrendered before maturity or be assigned to any other person, it seems that considerable latitude should be allowed in these particular cases. The assignment is directly attributable to a loan the date of whose payment (and the consequent redemption of the policies) depends on the date of payment of a sum of compensation promised (and guaranteed) by the Government themselves. It should not be hard to lay down conditions whereby the ultimate use of these policies for the benefit of the doctor and his dependants could be assured, even though the policies had temporarily to remain assigned to the bank or other reputable lender pending the payment of compensation. This is certainly a matter that needs attention urgently. A rapid and equitable solution might materially reduce the numbers of the young doctors to whom the early payment of compensation on grounds of hardship will otherwise be essential. Failure to find a solution will place an unfair burden on many harassed men, including many returned from war service, who, with growing families, are now striving to establish themselves in practice.
provision
,
Annotations HOSPITAL RECORDS NEARLY twenty years ago, when the old poor-law institutions were transferred from the boards of guardians, their records were in some instances mutilated or even destroyed in the process. Today a transfer on a much larger scale is taking place : hospitals of every kind -voluntary and municipal, big and little, new and old, general and special-are passing out of the care of their guardians into the smooth hands of the regional hospital boards. These hospitals possess records. In the long march of history the small hospital is just as important as the great, and what is new in 1948 may be treasure in the 21st century. Minutes of boards of management and of staff meetings, matrons’ reports, notes of operations, diet sheets, patients’ case-records, accounts, and other routine commentaries may seem drab enough just now, when there is little space for storage and much demand for salvage ; but they are the stuff out of which social history is made. Hospital records should be carefully preserved, at least until they have been reviewed by an expert. Many local authorities have record offices staffed by trained people who would take pleasure in sifting material of this kind. There is ample scope for voluntary work on the part of men and women who have an interest in local history. Let us not throw away this unique opportunity of service to history.
RESPIRATORS AND DUST DISEASES this week asks why writers on pneumoconiosis do not mention the use of a simple mask, such as nurses wear during operations, as a protection against the inhalation of dust. It is virtually impossible to design a completely efficient dust respirator which does not impose some discomfort or disability on the wearer ; and tests on miners and other workers have shown that they will not tolerate one which is uncomfortable. Simple gauze respirators similar to a surgeon’s mask are acceptable to some miners, but unfortunately they are almost useless in stopping the passage of pathogenic dust particles, which are less than 5 in diameter. The official Mark IV dust respirator is much more efficient ; but very few miners are willing to wear a respirator of this type, which incorporates a halfA
CORRESPONDENT
RESPIRATORS AND DUST DISEASES
An Unfair Burden provide for superannuation, doctors
-
To in the National.Health Service are liable to a deduction of 6% from their net remuneration from State sources, to which the Government will add another 8%. For the well-established practitioner the sums in question will be substantial : for example, if a doctor is earning jE2400 from his N.H.S. practice, and a third of this is regarded as practice expenses, there will be a deduction of 96 from his income, the additional contribution from the State being fl28. Before July 5, when there was no official pension provision for doctors, most medical men found it necessary to take out heavy insurances to safeguard their families and provide for their own retirement. Under the new regime it was clearly going to be difficult for them to continue these insurance commitments when large sums were deducted from their incomes for superannuation purposes. Accordingly arrangements have been made whereby, between now and Oct. 4, practitioners may (subject to conditions set out in the official leaflet S.D.D.) exercise an option to remain outside the superannuation scheme, pay no portion of their income to superannuation, but receive instead the 8% State contribution towards the maintenance of approved insurance policies. Attention is drawn to this option in a letter which we publish this week from a medical insurance consultant. Clearly there may be definite advantages in it, especially perhaps for the doctor who is already well insured but will have few remaining years of service to count for superannuation. No doubt many doctors thus situated will welcome the chance of opting out of the superannuation benefits and receiving very present help towards their expensive insurance premiums. But there is another group whose need is even greater, and who can, nevertheless, receive no relief under the regulations as published. Many younger men have borrowed heavily in order to buy a practice, and for this purpose they have been required to insure their lives for considerable sums. The premiums they are paying sometimes represent a high proportion of their budget, and it may be almost impossible for them to go on paying these premiums if they also have to forego 6% of their income for superannuation. These are the very men who might find the 8% of State money paid towards insurance premiums most acceptable. Yet they do not qualify to receive this help, because their policies are technically assigned to the bank or to the insurance company that has lent them money to buy their practices. Many of these doctors belong to that group, enduring financial hardship, for whom the Government have promised early payment of compensation. If it had been possible for this compensation to be assessed and paid by Oct. 4 they would be in a position to have their policies released from assignment to their creditors, and could then exercise their option to keep these policies in being as an alternative to superannuation. As any such settlement is manifestly impossible in so short a time, this relief is withheld from them, and some whose budgets are already closely drawn will face certain insolvency if they must bear the double load. While it is obvious that if insurance is to take the place of superannuation and be the chief means of
for retirement, insurance policies must not be surrendered before maturity or be assigned to any other person, it seems that considerable latitude should be allowed in these particular cases. The assignment is directly attributable to a loan the date of whose payment (and the consequent redemption of the policies) depends on the date of payment of a sum of compensation promised (and guaranteed) by the Government themselves. It should not be hard to lay down conditions whereby the ultimate use of these policies for the benefit of the doctor and his dependants could be assured, even though the policies had temporarily to remain assigned to the bank or other reputable lender pending the payment of compensation. This is certainly a matter that needs attention urgently. A rapid and equitable solution might materially reduce the numbers of the young doctors to whom the early payment of compensation on grounds of hardship will otherwise be essential. Failure to find a solution will place an unfair burden on many harassed men, including many returned from war service, who, with growing families, are now striving to establish themselves in practice.
provision
,
Annotations HOSPITAL RECORDS NEARLY twenty years ago, when the old poor-law institutions were transferred from the boards of guardians, their records were in some instances mutilated or even destroyed in the process. Today a transfer on a much larger scale is taking place : hospitals of every kind -voluntary and municipal, big and little, new and old, general and special-are passing out of the care of their guardians into the smooth hands of the regional hospital boards. These hospitals possess records. In the long march of history the small hospital is just as important as the great, and what is new in 1948 may be treasure in the 21st century. Minutes of boards of management and of staff meetings, matrons’ reports, notes of operations, diet sheets, patients’ case-records, accounts, and other routine commentaries may seem drab enough just now, when there is little space for storage and much demand for salvage ; but they are the stuff out of which social history is made. Hospital records should be carefully preserved, at least until they have been reviewed by an expert. Many local authorities have record offices staffed by trained people who would take pleasure in sifting material of this kind. There is ample scope for voluntary work on the part of men and women who have an interest in local history. Let us not throw away this unique opportunity of service to history.
RESPIRATORS AND DUST DISEASES this week asks why writers on pneumoconiosis do not mention the use of a simple mask, such as nurses wear during operations, as a protection against the inhalation of dust. It is virtually impossible to design a completely efficient dust respirator which does not impose some discomfort or disability on the wearer ; and tests on miners and other workers have shown that they will not tolerate one which is uncomfortable. Simple gauze respirators similar to a surgeon’s mask are acceptable to some miners, but unfortunately they are almost useless in stopping the passage of pathogenic dust particles, which are less than 5 in diameter. The official Mark IV dust respirator is much more efficient ; but very few miners are willing to wear a respirator of this type, which incorporates a halfA
CORRESPONDENT