- Email: [email protected]
NATIONAL HEALTH INSURANCE.
968
NATIONAL HEALTH INSURANCE. Notification of Measles Order. meeting of the London Panel
they had already day consulting hours ; four stated that if they were at home at any hour at which insured persons called they attended to them ; and nine declined to give further facilities for consultation. The question was put as
Committee the to whether it was possible to bring pressure on the doctors to out the wish of the Insurance Committee. The chairFinance and General of the adjourned report Purposes Sub- carry man replied that they had entered into contracts with the committee was considered, and a resolution was adopted the current year on the basis formerly arranged, ’’ that the Panel Committee are of opinion that it is very doctors for The had no power to break their contracts. and they desirable that the medical care and treatment of cases of Committee in arranging new contracts could deal with the measles and whooping-cough should remain in the hands of matter. general practitioners, and should not be transferred to full-time medical officers appointed by the local authorities for such purpose, and still less to nurses, who in THE THIRD REPORT OF THE YELLOW effect would be acting as unqualified medical practiFEVER COMMISSION. It was further recommended that the attentioners." tion of the General Medical Council, the British Medical Association, and the Medical Defence Union should be IN THE LANCET of Jan. 23rd, 1915, p. 196, we commented called to the matter. The question referred to has arisen upon the First and Second Reports of the Yellow Fever Com. out of the Order of the Local Government Board as to the mission, which brought the account of the incidence of the notification and nursing of cases of measles, and out of the disease in our West African colonies up to the end of May, scheme prepared in this connexion by the Central Council 1914. Since then cases of fever have been reported yellow for District Nursing in London. This scheme proposes that in as well as on the Gold Coast and in the Northern Nigeria it should be made possible for cases of measles and whoopingTerritories, making, up to September, 1915, a total of 82 cough to be attended by nurses without the direct supervision attacks, of which 45 occurred in Europeans (including 4 of a medical practitioner. It is suggested that the nurses Syrians) and 37 in natives ; 25 of the Europeans died, but should be directed to advise the calling in of medical assist4 natives. The outbreak of war interfered with the only ance if serious symptoms should be observed by them. This out of the investigations, as a number of the carrying would leave the nurses to detect dangerous symptoms, and members of the West African Medical Staff who were assign to medical men the responsibility of attending serious engaged in this work had to be recalled. Since the publicacases only, while denying to them the experience to be gained tion of the last report Dr. Andrew Balfour, C.M.G., has been by treating measles and whooping-cough in their simpler appointed by the Secretary of State for the Colonies to be a forms, as well as the emoluments to be earned by so doing. member of the Commission. Already two supplementary The report of the subcommittee referred to pointed out that volumes containing reports by the investigators under the no provision is proposed for the payment of the medical men Commission, and others, have been issued, and these were called in to attend the more serious cases except that the noticed in THE LANCET of Feb. 5th. A third volume is in local authorities should make arrangements with medical preparation. practitioners or should employ an assistant to the medical The Nature of the Seidelin Bodies and their Relation to officer of health. Yellow Fever. Panel Praotitio-ners’ Accounts for 1914. In accordance with the intention expressed in their second The London Panel Committee recently passed a resolution the Commission now proceed to deal with the question with a view to bringing about, if possible, a final settlement report, of the occurrence and significance of the protozoon-like of the accounts of the practitioners upon the London panel bodies, discovered in 1909 by Dr. Harald Seidelin, in the blood for the year 1914. When it is considered that the resolution and tissues of patients suffering from yellow fever, to which he referred to was carried on March 21st, 1916, its terms do not the name of Paraplasma flavigenum, claiming that this gave appear to be unduly forcible. It was agreed that the was the specific parasite of yellow fever. The Commission Panel Committee do strongly represent to the Commissioners now give a critical review of the evidence for and against the growing indignation of the practitioners on the panel Dr. Seidelin’s claim. The investigations undertaken by the at the delay which has occurred in effecting the final Commission’s experts as well as the researches carried out by settlement of the practitioners’ accounts for the medical other authorities have thrown fresh light upon the question year 1914." And the resolution concluded by stating that at issue and appear to justify the conclusions now arrived at the delay in the payment of the moneys so long overdue is the Commissioners and appended to their third report. by " most regrettable, and that the Insurance Commissioners Great care, it may be added, has been taken to state Dr. and the Insurance Committee be so informed." The case as far as possible in his own words so as to Seidelin’s - Panel Committee, however, had to occupy itself also avoid controversy arising later, if points had been imperfectly with the even more remote prospect of payment for the year stated or omitted, upon which he placed special importance. 1915, with regard to which it decided to take into consideraAmong the chief opponents of Dr. Seidelin’s claims are tion the period of time which must elapse before the mentioned Dr. Schilling-Torgau, of Hamburg, and Dr. would be of of accounts and calculation the amount possible, of Havana, both of whom maintained that it accordingly passed a resolutionthat the practitioners on Agramonte, similar bodies had been found in the blood of persons in the panel be invited to communicate to the committee their other conditions than yellow fever. It became clear to the views as to the desirability of pressing for emergency settleCommission that if it could be definitely shown that similar ment of their accounts for the medical year 1915." bodies are of frequent occurrence in the blood or tissues of man and animals apart from any suspicion of yellow fever, Morning Consultation Hour for National Health Insurance Doctors in Dundee. obviously the whole contention must fall to the ground, and At a meeting of the Dundee Insurance Committee held on there could be no necessity for any further discussion as to April 19th the vexed question of the morning consultation their specific nature. The work is quoted of Dr. David ’hour was again under discussion. Carrying out the finding Thomson, who examined in London the blood of 25 normal which was come to at a meeting of the Dundee National guinea-pigs for the presence of Seidelin’s bodies, and Insurance Committee held on Jan. 19th, where by 13 votes to who found in all of the animals bodies resembling them. 10 it was decided that doctors on the panel should be asked In Dr. Thomson’s opinion the majority of these bodies were to give one hour in the morning for consultation, the doctors artefacts and could not be considered as protozoal in nature. were asked at what hour in the morning they were willing Lieutenant-Colonel David Harvey, R.A.M.C., at to be in attendance for consultation, or what alternate the request of the Commission, undertook the examinaproposal they had to make, so that insured persons tion of normal and inoculated guinea-pigs, and found in might have opportunities for consultation in addition practically every slide one or two bodies which simulated The Medical the "paraplasmata." Further, Dr. C. M. Wenyon and Dr. to the evening hours already fixed. ’Benefit Committee reported that in view of the nature of G. C. Low, of the London School of Tropical Medicine, the replies, they regretted to say that they had been unable published in the Journal of Tropioal Medicine for December, to give effect to the desire of the Insurance Committee. Of 1914, a paper, quoted by the Commission, showing the the doctors who had replied, one undertook to see patients occurrence of Seidelin’s bodies in normal guinea-pigs born at his surgery between 9 and 10 A M. ; four (two of whom and bred in England, and these bodies it was almost were in Broughty Ferry and one in Monifieth) stated that impossible to separate from pure artefacts. AT
a
recent
NATIONAL HEALTH INSURANCE. Notification of Measles Order. meeting of the London Panel
they had already day consulting hours ; four stated that if they were at home at any hour at which insured persons called they attended to them ; and nine declined to give further facilities for consultation. The question was put as
Committee the to whether it was possible to bring pressure on the doctors to out the wish of the Insurance Committee. The chairFinance and General of the adjourned report Purposes Sub- carry man replied that they had entered into contracts with the committee was considered, and a resolution was adopted the current year on the basis formerly arranged, ’’ that the Panel Committee are of opinion that it is very doctors for The had no power to break their contracts. and they desirable that the medical care and treatment of cases of Committee in arranging new contracts could deal with the measles and whooping-cough should remain in the hands of matter. general practitioners, and should not be transferred to full-time medical officers appointed by the local authorities for such purpose, and still less to nurses, who in THE THIRD REPORT OF THE YELLOW effect would be acting as unqualified medical practiFEVER COMMISSION. It was further recommended that the attentioners." tion of the General Medical Council, the British Medical Association, and the Medical Defence Union should be IN THE LANCET of Jan. 23rd, 1915, p. 196, we commented called to the matter. The question referred to has arisen upon the First and Second Reports of the Yellow Fever Com. out of the Order of the Local Government Board as to the mission, which brought the account of the incidence of the notification and nursing of cases of measles, and out of the disease in our West African colonies up to the end of May, scheme prepared in this connexion by the Central Council 1914. Since then cases of fever have been reported yellow for District Nursing in London. This scheme proposes that in as well as on the Gold Coast and in the Northern Nigeria it should be made possible for cases of measles and whoopingTerritories, making, up to September, 1915, a total of 82 cough to be attended by nurses without the direct supervision attacks, of which 45 occurred in Europeans (including 4 of a medical practitioner. It is suggested that the nurses Syrians) and 37 in natives ; 25 of the Europeans died, but should be directed to advise the calling in of medical assist4 natives. The outbreak of war interfered with the only ance if serious symptoms should be observed by them. This out of the investigations, as a number of the carrying would leave the nurses to detect dangerous symptoms, and members of the West African Medical Staff who were assign to medical men the responsibility of attending serious engaged in this work had to be recalled. Since the publicacases only, while denying to them the experience to be gained tion of the last report Dr. Andrew Balfour, C.M.G., has been by treating measles and whooping-cough in their simpler appointed by the Secretary of State for the Colonies to be a forms, as well as the emoluments to be earned by so doing. member of the Commission. Already two supplementary The report of the subcommittee referred to pointed out that volumes containing reports by the investigators under the no provision is proposed for the payment of the medical men Commission, and others, have been issued, and these were called in to attend the more serious cases except that the noticed in THE LANCET of Feb. 5th. A third volume is in local authorities should make arrangements with medical preparation. practitioners or should employ an assistant to the medical The Nature of the Seidelin Bodies and their Relation to officer of health. Yellow Fever. Panel Praotitio-ners’ Accounts for 1914. In accordance with the intention expressed in their second The London Panel Committee recently passed a resolution the Commission now proceed to deal with the question with a view to bringing about, if possible, a final settlement report, of the occurrence and significance of the protozoon-like of the accounts of the practitioners upon the London panel bodies, discovered in 1909 by Dr. Harald Seidelin, in the blood for the year 1914. When it is considered that the resolution and tissues of patients suffering from yellow fever, to which he referred to was carried on March 21st, 1916, its terms do not the name of Paraplasma flavigenum, claiming that this gave appear to be unduly forcible. It was agreed that the was the specific parasite of yellow fever. The Commission Panel Committee do strongly represent to the Commissioners now give a critical review of the evidence for and against the growing indignation of the practitioners on the panel Dr. Seidelin’s claim. The investigations undertaken by the at the delay which has occurred in effecting the final Commission’s experts as well as the researches carried out by settlement of the practitioners’ accounts for the medical other authorities have thrown fresh light upon the question year 1914." And the resolution concluded by stating that at issue and appear to justify the conclusions now arrived at the delay in the payment of the moneys so long overdue is the Commissioners and appended to their third report. by " most regrettable, and that the Insurance Commissioners Great care, it may be added, has been taken to state Dr. and the Insurance Committee be so informed." The case as far as possible in his own words so as to Seidelin’s - Panel Committee, however, had to occupy itself also avoid controversy arising later, if points had been imperfectly with the even more remote prospect of payment for the year stated or omitted, upon which he placed special importance. 1915, with regard to which it decided to take into consideraAmong the chief opponents of Dr. Seidelin’s claims are tion the period of time which must elapse before the mentioned Dr. Schilling-Torgau, of Hamburg, and Dr. would be of of accounts and calculation the amount possible, of Havana, both of whom maintained that it accordingly passed a resolutionthat the practitioners on Agramonte, similar bodies had been found in the blood of persons in the panel be invited to communicate to the committee their other conditions than yellow fever. It became clear to the views as to the desirability of pressing for emergency settleCommission that if it could be definitely shown that similar ment of their accounts for the medical year 1915." bodies are of frequent occurrence in the blood or tissues of man and animals apart from any suspicion of yellow fever, Morning Consultation Hour for National Health Insurance Doctors in Dundee. obviously the whole contention must fall to the ground, and At a meeting of the Dundee Insurance Committee held on there could be no necessity for any further discussion as to April 19th the vexed question of the morning consultation their specific nature. The work is quoted of Dr. David ’hour was again under discussion. Carrying out the finding Thomson, who examined in London the blood of 25 normal which was come to at a meeting of the Dundee National guinea-pigs for the presence of Seidelin’s bodies, and Insurance Committee held on Jan. 19th, where by 13 votes to who found in all of the animals bodies resembling them. 10 it was decided that doctors on the panel should be asked In Dr. Thomson’s opinion the majority of these bodies were to give one hour in the morning for consultation, the doctors artefacts and could not be considered as protozoal in nature. were asked at what hour in the morning they were willing Lieutenant-Colonel David Harvey, R.A.M.C., at to be in attendance for consultation, or what alternate the request of the Commission, undertook the examinaproposal they had to make, so that insured persons tion of normal and inoculated guinea-pigs, and found in might have opportunities for consultation in addition practically every slide one or two bodies which simulated The Medical the "paraplasmata." Further, Dr. C. M. Wenyon and Dr. to the evening hours already fixed. ’Benefit Committee reported that in view of the nature of G. C. Low, of the London School of Tropical Medicine, the replies, they regretted to say that they had been unable published in the Journal of Tropioal Medicine for December, to give effect to the desire of the Insurance Committee. Of 1914, a paper, quoted by the Commission, showing the the doctors who had replied, one undertook to see patients occurrence of Seidelin’s bodies in normal guinea-pigs born at his surgery between 9 and 10 A M. ; four (two of whom and bred in England, and these bodies it was almost were in Broughty Ferry and one in Monifieth) stated that impossible to separate from pure artefacts. AT
a
recent