" That Difficult Section "

438 decisions to be reached, particularly on a new system of remuneration for general practitioners, before April 1. Mr. RICHARD WOOD: Can the Minister say whether the Review Body’s decision will be final ?-Mr. ROBINSON: I do not think that the Government can commit themselves to the report until they have seen it. Fluoridation of

Water-supplies

Mr. W. S. SHEPHERD asked the Minister if he was aware that in certain areas decisions against the fluoridation of watersupplies were being taken; and if he would give an undertaking that he would take steps to ensure that children in these areas would not be allowed to suffer unnecessary damage to their dental health through any fluoride deficiency in their watersupplies being allowed to continue.-Mr. ROBINSON: I am hopeful that those local health authorities which have not yet resolved in favour of fluoridation will soon recognise it as an effective and completely safe means of preventing dental decay; but the responsibility for action to promote the dental health of children in their areas is theirs. Mr. SHEPHERD: Does the Minister realise that this has brought forth all the cranks in Christendom, and that he has a responsibility beyond that which is stated, which is to see that the dental health of the nation does not suffer because of the ridiculous utterances of this bunch of cranks ?-Mr. ROBINSON: I would not altogether dissent from the general sentiments expressed. I welcome the support which many Members are giving in persuading the public to accept fluoridation, but I think that, at this stage at any rate, persuasion and voluntary local action are the right way to

proceed.

Mr. ERIC LUBBOCK: What steps is the Minister taking to re-educate reactionary councillors in the local authorities who have rejected fluoridation ?-Mr. JOHN RANKIN: Reactionary Members.-Mr. ROBINSON: All steps of a persuasive nature. Mr. RANKIN: Is not the word " fluoride " a disguise for the medical term " sodium fluoride ", which is a well-known poison and cannot be good for anybody ?-A4r. ROBINSON : This supplementary question is not untypical of the propaganda with which local authorities are being deluged.

Authority

Industrial Injury Claims During the latest period of 12 months for which there are figures for prescribed diseases, about 28,000 awards of injury benefit, some 2000 initial awards of disablement pension, including about 1500 for pneumoconiosis, and about 3000 initial awards for disablement gratuity were made.

for Blood-transfusions

Mr. SHEPHERD asked the Minister whether, in view of the inconvenience caused to hospitals in having to seek recourse to the courts for permission to use blood where objections are raised, he would give authority to hospitals to make use of plasma without such procedures.-Mr. ROBINSON: Hospital authorities have in fact been advised not to resort to the courts in such cases but to rely on the clinical judgment of the consultants concerned after full discussion with the parents. Mr. SHEPHERD: Do not some hospitals feel that there is not sufficient ground for so doing ? Will he draw to the attention of hospitals the fact that they are entitled to use blood when their clinical judgment determines ?-Mr. ROBINSON: I will see if any further guidance is needed, but I am advised that if he obtained the written supporting opinion of a colleague that a patient’s life was in danger, and an acknowledgment from the parents that they refused consent, despite their having been given an explanation of the danger, a doctor would run little risk in a court of law if he acted with due professional competence and in accordance with his own professional conscience. Number of General Practitioners The total number of principals providing full general medical services in England and Wales at Oct. 1, 1965, was 20,027. The numbers of admissions and withdrawals during the preceding 12 months were 980 and 1199 respectively, but it is estimated that these figures may include 170-180 principals leaving and returning to general practice during the year. Provisional figures for the last quarter of 1965 indicate a further net loss of 44 principals during that period.

Medicine and the Law " That Difficult Section " IN a publication circulated free to doctors, a plastic surgeon under his own name wrote an article which was entitled " Be Plastic’ Surgeons"" Wary of Those Smooth-Tongued " referring, inter alia, to quasi-qualified plastic surgeons" and to patients who " unless guided to a properly qualified surgeon will find some charlatan and rue the day ". A surgeon who had appealed to the Judicial Committee of the Privy Council against the General Medical Council’s decision to erase his name for infamous conduct in advertising, claimed that, although his name did not appear, the article referred to and libelled him. After the dismissal of his appeal he wrote to the author asking for an apology, coupled with the statement that he recognised that the plaintiff " is one of the leading cosmetic plastic surgeons in England as well as being a fully qualified surgeon and a consultant ear, nose, and throat surgeon ". The author’s solicitors replied refusing, saying that they were unable to advise their client to give the plaintiff a free advertisement, particularly as he was no longer on the Medical Register, but that they would publish a disclaimer and expression of " regret, making no reference to fully qualified ". The six-day trial of the libel action brought against the author resulted in failure of the jury to agreed During the five-day retrial the author’s counsel, in mitigation of damages (if any) claimed that he was justified in refusing to apologise in the terms " required as he would be aiding and abetting, or committing, some sort of criminal offence against section 31 of the Medical Act, 1956, because once a man’s name was erased a registered practitioner could not send him patients, give anaesthetics for him, and in general could not cooperate with him in any way ". Mr. Justice HAVERS, during the course of his direction to the jury, said that section 31 of the Medical Act, 1956, imposed a penalty if anybody wilfully and falsely pretended to be, or took, or used, certain names and titles implying that he was a registered practitioner. There had been a number of cases on that difficult section, and the law was not as clear as one would like it to be. He was not prepared to say that the defendant author would have been committing any criminal offence if he had signed a document such as the plaintiff required, but it might be enough for counsel’s argument if there was some risk of the defendant’s committing a criminal offence. His Lordship did not think that he could go so far as to say that there would not possibly be some risk of the defendant’s committing some criminal offence by doing that. The point that the plaintiff had been making-namely, " You have described me in your article as one of these quasi-qualified surgeons, whereas you know I am a fully qualified surgeon, and no apology would be adequate and sufficient to vindicate me in the eyes of the public unless you say that I am fully qualified, so I shall not settle but shall go before a jury "-was a view he was perfectly entitled to take, but it was for the jury to decide whether he was reasonable or unreasonable to do so, and take that into consideration if and when they came to assess

damages.

In the event, the second jury failed to agree, and leave was given to the plaintiff to set the action down for retrial. Gardiner v. Moore. Queen’s Bench Division. Havers J. and a jury. Feb. 11, 1966. Counsel and solicitors: Colin Duncan, Q.c., Douglas Lowe, Q.c., and Greville Janner (Ambrose Appelbe). Desmond Ackner, Q.c., and Michael Kempster (Bird & Bird). L. NORMAN WILLIAMS Barrister-at-Law. 1. See

Lancet, 1965, ii,

125.