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MEDICAL STAFF COMMITTEES IN MUNICIPAL HOSPITALS
351
Letters
to
the Editor
MEDICAL STAFF COMMITTEES IN MUNICIPAL
Nevertheless, 11 tne proression at nome were to cuscai’tt the principle of equity, such a split would be inevitable. My work brings me into contact with many Service doctors in all branches of medical work. I am reflecting their thoughts and their, views. It is most earnestly hoped that the civilian authorities will in their wisdom realise the urgency of the need to still the doubts and to allay the resentment and anxiety which their proposal at this stage of the war to fill a university chair has stirred
HOSPITALS of that unpopular class, the SIR,—As Medical Superintendent, and one who-extraordinary as it may appear to many-is proud of the work ,he does and feels that he is filling a very important function in up among’Service doctors overseas. his hospital, I have delayed entering into the controon in the medical has so J. D. W. PEARCE, which long gone press. versy CMF. Adviser in Psychiatry, AFHQ. But reluctantly I feel that the letter of March 3 by calls forth not defence but Assistant Medical Officer SIR,—The London chair of psychiatry is indeed counter-attack. for much of the future of psychiatry is important, are in 30’s their Most medical superintendents today in its fate. Psychiatry’s significance for involved or 40’s, and out of those I know only two are 60 or has been shown during this war by EMS and I know many senior physicians and surgeons of society over. Service psychiatrists to be greater than was ever sugvoluntary hospitals, who hold in fact far more dictatorial gested in peace-time, even by the chair concerned. powers, who are over this age ; and apparently it is Plans for teaching and research in the subject should be considered in order for them to have this power. I see made at the earliest moment possible ; and the decision, no object in medical staff committees in municipal after some years of delay, to appoint a professor to thisor voluntary hospitals unless they contain not only the the chair in England-can hardly be called precipisenior but also the junior staff. In many municipal tateonly or ill considered. further avoidable delay would hospitals the senior staff are part-time ; only the juniors be reprehensible, andAny the London County Council’s are full-time, and they are far more intimately concerned present eagerness to fill the appointment is one which with the welfare of the institution. It is one of the functions of a medical superintendent to retain close many will commend. The decision to allow psychiatrists, both in and out of contact with the whole of his staff, medical as well as the Services and the LCC, to apply for the chair is and he would be a bad superintendent who non-medical, proper, but unless sufficient time is-given for all who was unaware of the desires and views of members of his might be interested to apply, it may not be implemented. staff. You will have heard, Sir, that except in matters which In my’own hospital, and in those municipal hospitals concern operations and their planning, Service channels with which I am intimately acquainted, every member of communication are no quicker than jungle roads, of the staff has access at any time to the medical superinmountain highways, and the voyages of fighting ships tendent, and no difficulty is met with in formulating and at times are even slower than this, for the allow, for and alteration in the proposals improvement hospital serving doctor has no assured tenure of address. To get services. That does not mean that in every case the and read to and advertisements, arrange get proper medical superintendent agrees, or is able when he agrees references, to formulate a suitable application, and then to persuade the hospital committee to act upon the get it to London, may take some serving psychiatrists recommendations ; but strangely enough I have ex- more than six months. perienced an exactly similar state of affairs in voluntary London University might do well to follow the example where the committee has not invarihospitals, hospital set by my own university which last year invited applicaably agreed to the suggestions made by members of the tions for the vacant chair of surgery at Newcastle. medical staff, either collectively or individually. Most A preliminary date by which applications could be medical superintendents are delighted when their senior received was fixed some months ahead, but a, loophole was staff are sufficiently interested in the welfare of the hosleft for late applications, and in addition, the following or to make to him to an either pital suggestions request statement was circulated through Service channels to all opportunity of meeting the hospital committee ; and serving doctors :from my own experience the hospital committee has "... the University will make no appointment until been more than flattered at such a request, and has it is satisfied that persons serving overseas have had full always granted it. opportunity to apply, and the professor, if on national After a period during which they tended to lose their service, will not be required to take up his duties until his clinical interest and become administrators solely, more release from such service on the termination of hostilities and more medical superintendents are remaining or on such earlier date as may be possible." clinicians. Thev have realised that their work is better It is true, as your correspondents have stated, that understood, and can be made more useful to the community, when they retain their clinical interest and doctors serving abroad are sensitive about the deprivamaintain their clinical status among their senior staff. tions they suffer, and at times compare their lot with Men like Clark of Sheffield and McCormack who was at that of their colleagues in the homeland ; but even in the St. James’, Balham. are household names, and bear darkest days of the MEF they were upset only when somecomparison in their clinical work with any consultant, one in the United Kingdom so forgot his responsibilities no matter how eminent. to them as to further his future at the expense of theirs. H. I. DEITCH. The model statement of Durham University recognised Halifax General Hospital. that we gentlemen in England now abed " can reasonA CHAIR IN PSYCHIATRY ably ask serving doctors overseas for further sacrifices in SiR,-Brigadier James calls attention to the anxiety the present, only if we ourselves zealously guard their aroused in Service doctors by the activities of some of future. We can take satisfaction in the certainty that a
"
member
"
.
"
their civilian colleagues at home. This anxiety is without doubt acute. widespread, and very real. The proposal to fill the chair in psychiatry at London University by Sept. 1 has caused frank consternation. Service doctors ask for no special privilege ; all they seek is equal opportunity. They regard this instance as the writing. on the wall, and they have a sharp feeling that their individual futures are being prejudiced and rendered
insecure.
-
Until comparatively recently Service doctors oyerseas have been able to apply themselves wholeheartedly to their Service duties. in the belief that their interests at home were being jealously safeguarded by their civilian colleagues. Incredulity is being rapidly succeeded by feelings of frustration, and, which is worse, distrust. Brigadier James speaks only too truly. It is essential that no split in our profession is allowed to develop.
do no personal canvassing for appointmust be careful to ensure that they have the same opportunities of applying in writing as their professional brothers in Britain. There is no need for generosity, but equity is their right. The profession need not search its conscience because the Goodenough Committee took evidence only from three civilian psychiatrists. land from none of the hundreds of psychiatrists in the Services ; it was a nonprofessional body. But if the only chair in England recommended by it for the responsibility of teaching post-graduate psychiatry were filled before psychiatrist-. overseas had ample time to apply for it, permanent cynicism would arise in many members of the profession -as any future professor of psychiatry will know. T. F. MAIN, Late Adviser in Psychiatry, 21st Army Group.
they, at least, ments, but
can
we
Letters
to
the Editor
MEDICAL STAFF COMMITTEES IN MUNICIPAL
Nevertheless, 11 tne proression at nome were to cuscai’tt the principle of equity, such a split would be inevitable. My work brings me into contact with many Service doctors in all branches of medical work. I am reflecting their thoughts and their, views. It is most earnestly hoped that the civilian authorities will in their wisdom realise the urgency of the need to still the doubts and to allay the resentment and anxiety which their proposal at this stage of the war to fill a university chair has stirred
HOSPITALS of that unpopular class, the SIR,—As Medical Superintendent, and one who-extraordinary as it may appear to many-is proud of the work ,he does and feels that he is filling a very important function in up among’Service doctors overseas. his hospital, I have delayed entering into the controon in the medical has so J. D. W. PEARCE, which long gone press. versy CMF. Adviser in Psychiatry, AFHQ. But reluctantly I feel that the letter of March 3 by calls forth not defence but Assistant Medical Officer SIR,—The London chair of psychiatry is indeed counter-attack. for much of the future of psychiatry is important, are in 30’s their Most medical superintendents today in its fate. Psychiatry’s significance for involved or 40’s, and out of those I know only two are 60 or has been shown during this war by EMS and I know many senior physicians and surgeons of society over. Service psychiatrists to be greater than was ever sugvoluntary hospitals, who hold in fact far more dictatorial gested in peace-time, even by the chair concerned. powers, who are over this age ; and apparently it is Plans for teaching and research in the subject should be considered in order for them to have this power. I see made at the earliest moment possible ; and the decision, no object in medical staff committees in municipal after some years of delay, to appoint a professor to thisor voluntary hospitals unless they contain not only the the chair in England-can hardly be called precipisenior but also the junior staff. In many municipal tateonly or ill considered. further avoidable delay would hospitals the senior staff are part-time ; only the juniors be reprehensible, andAny the London County Council’s are full-time, and they are far more intimately concerned present eagerness to fill the appointment is one which with the welfare of the institution. It is one of the functions of a medical superintendent to retain close many will commend. The decision to allow psychiatrists, both in and out of contact with the whole of his staff, medical as well as the Services and the LCC, to apply for the chair is and he would be a bad superintendent who non-medical, proper, but unless sufficient time is-given for all who was unaware of the desires and views of members of his might be interested to apply, it may not be implemented. staff. You will have heard, Sir, that except in matters which In my’own hospital, and in those municipal hospitals concern operations and their planning, Service channels with which I am intimately acquainted, every member of communication are no quicker than jungle roads, of the staff has access at any time to the medical superinmountain highways, and the voyages of fighting ships tendent, and no difficulty is met with in formulating and at times are even slower than this, for the allow, for and alteration in the proposals improvement hospital serving doctor has no assured tenure of address. To get services. That does not mean that in every case the and read to and advertisements, arrange get proper medical superintendent agrees, or is able when he agrees references, to formulate a suitable application, and then to persuade the hospital committee to act upon the get it to London, may take some serving psychiatrists recommendations ; but strangely enough I have ex- more than six months. perienced an exactly similar state of affairs in voluntary London University might do well to follow the example where the committee has not invarihospitals, hospital set by my own university which last year invited applicaably agreed to the suggestions made by members of the tions for the vacant chair of surgery at Newcastle. medical staff, either collectively or individually. Most A preliminary date by which applications could be medical superintendents are delighted when their senior received was fixed some months ahead, but a, loophole was staff are sufficiently interested in the welfare of the hosleft for late applications, and in addition, the following or to make to him to an either pital suggestions request statement was circulated through Service channels to all opportunity of meeting the hospital committee ; and serving doctors :from my own experience the hospital committee has "... the University will make no appointment until been more than flattered at such a request, and has it is satisfied that persons serving overseas have had full always granted it. opportunity to apply, and the professor, if on national After a period during which they tended to lose their service, will not be required to take up his duties until his clinical interest and become administrators solely, more release from such service on the termination of hostilities and more medical superintendents are remaining or on such earlier date as may be possible." clinicians. Thev have realised that their work is better It is true, as your correspondents have stated, that understood, and can be made more useful to the community, when they retain their clinical interest and doctors serving abroad are sensitive about the deprivamaintain their clinical status among their senior staff. tions they suffer, and at times compare their lot with Men like Clark of Sheffield and McCormack who was at that of their colleagues in the homeland ; but even in the St. James’, Balham. are household names, and bear darkest days of the MEF they were upset only when somecomparison in their clinical work with any consultant, one in the United Kingdom so forgot his responsibilities no matter how eminent. to them as to further his future at the expense of theirs. H. I. DEITCH. The model statement of Durham University recognised Halifax General Hospital. that we gentlemen in England now abed " can reasonA CHAIR IN PSYCHIATRY ably ask serving doctors overseas for further sacrifices in SiR,-Brigadier James calls attention to the anxiety the present, only if we ourselves zealously guard their aroused in Service doctors by the activities of some of future. We can take satisfaction in the certainty that a
"
member
"
.
"
their civilian colleagues at home. This anxiety is without doubt acute. widespread, and very real. The proposal to fill the chair in psychiatry at London University by Sept. 1 has caused frank consternation. Service doctors ask for no special privilege ; all they seek is equal opportunity. They regard this instance as the writing. on the wall, and they have a sharp feeling that their individual futures are being prejudiced and rendered
insecure.
-
Until comparatively recently Service doctors oyerseas have been able to apply themselves wholeheartedly to their Service duties. in the belief that their interests at home were being jealously safeguarded by their civilian colleagues. Incredulity is being rapidly succeeded by feelings of frustration, and, which is worse, distrust. Brigadier James speaks only too truly. It is essential that no split in our profession is allowed to develop.
do no personal canvassing for appointmust be careful to ensure that they have the same opportunities of applying in writing as their professional brothers in Britain. There is no need for generosity, but equity is their right. The profession need not search its conscience because the Goodenough Committee took evidence only from three civilian psychiatrists. land from none of the hundreds of psychiatrists in the Services ; it was a nonprofessional body. But if the only chair in England recommended by it for the responsibility of teaching post-graduate psychiatry were filled before psychiatrist-. overseas had ample time to apply for it, permanent cynicism would arise in many members of the profession -as any future professor of psychiatry will know. T. F. MAIN, Late Adviser in Psychiatry, 21st Army Group.
they, at least, ments, but
can
we