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THE GOVERNMENT AND THE PROFESSION
557 THE PROFESSION SBR,—The Annual Representative Meeting of the British Medical Association has agreed upon certain principles by which any Government proposals for reconstruction of the health services are to be judged. These principles would restrict progress to a postwar "two-way extension " of National Health Insurance. This is considered by the ARM to be a step towards the implementation of Assumption B of the Beveridge THE GOVERNMENT AND
Report. The public, however, is becoming increasingly
aware
of the deficiencies of the medical services, which do not allow of a full application of modern medical science to the prevention and cure of ill health. Further, many doctors are coming to realise that their working conditions hinder professional efficiency. The proposals of the Beveridge report have offered to our profession great opportunities to contribute to social progress, which it has not yet seized. The proposals of the annual representative meeting, indeed, are likely to impede rather than be a step towards the comprehensive health service promised by the Government. The decisions of the ARM have not been well received by the public, and the continuation of an unhelpful attitude on our part must inevitably injure the status of the
profession.
’
Norman Lawrie ; V. W. Lees ; S. Leff; J. G. L’Etang ; Harold Lewis ; J. Liddell; S. J. Lipetz ; F. J. G. Lishman ; R. C. Lowe ; F. M. Lucas ; G. R. W. M. Luntz ; R. A. Lyster. Alison MacBeth ; C. MacDonald ; B. C. Macirone ; A. E. McCandless ; Donald Macleod ; A. R. McGregor ; James McNabb; H. H. MacWilliam ; Joan Malleson; R. A. Manclark ; M. Marcus ; L. M. Masterman ; G. H. Miles ; E. H. M. Milligan ; E. Minalt ; D. A. Mitcheson ; L. J. Moir ; E. Montuschi; H. Munro ; D. Munro-Ashman ; J. J. Murnane ; A. L. M. Morrison. W. D. Newcomb ; Peter Nash ; M. Newfield ; Edmund I. Newman ; N. Newman ; R. Nuki. S. O’Boyle; Greta Olsson; G. M. Osborne; R. L.
Osmaston ; James O’Connor. Joseph Parness ; J. F. Payan; Mary E. Pearce; B. Perchman; A. Phillips; L. Phillips ; M. R. Pollock; H. W. Pooler ; R. Poots ; Janet Posner; J. Fowell-Evans ; J. D. Proctor ; D. M. Pryce ; Anthony W. Purdie ; R. F. Price. R. H. Rankin; Alexander Reid; M. P. Rhodes; J. Robinson ; H. D. Rosenberg ; J. Ross ; Kathleen Ruther-’ ford ; V. C. Robinson. R. Schultz ; F. E. T. Scott; J. A. Scott; C. I. Schiff; R. P. W. Shackleton ; W. J. Sheehan ; A. I. Silverman ; B. Singh ; F. E. Smith ; S. Smith ; D. H. Smyth ; E. Snell ; Arnold Sorsby; Max Sorsby ; M. Stein; Wm. Stott; J. Mitchell Stuart; Barnet Stross ; H. W. Swann ; F. A. H.
x
Simmonds.
In the absence of the white-paper the ARM discussions this year had an unreal quality. There is ample evidence that if and when positive and progressive proposals are actually put before the profession by the Government, there are sufficient medical men to ensure that these proposals receive careful and sympathetic consideration and to cooperate in working a progressive scheme. The signatories therefore urge the Government to produce without delay the promised white-paper, which they are confident cannot but provide a true implementation of Assumption B in all its aspects. They hope that those who hold similar views will be encouraged by this letter to join them in expressing their support of this view. 238 MEMBERS
OF THE BMA.
The names appended to this letter are :Grace J. Adam; Robert Adam; Alice Akred; M. S. Aldridge, M. B. Alexander ; T. H. Almond ; D. Arning; 0. F. H. Atkey. E. T. Bailey ; J. Shackleton Bailey ; J. B. Bairds ; F. Balkwill; G. Barasi ; M. L. Barst; John Bee ; A. C. Bel. field ; R. H. Bembridge ; T. H. C. Benians ; Ruth BensusanButt ; J. Bentinck ; C. A. Birch ; George Black ; D. G. de Bouk ; Brian Boyd-Cooper ; D. S. Brian-Brown ; G. Brown ; E. Vipont Brown ; Harold Buckley ; Clifford F. Bullend ; O. Bulloch ; A. C. S. Burch ; H. H. Bradley. A. N. Cameron ; Esther Carling ; H. E. Carmalt ; W. Chadwick ; A. J. Clarke ; T. M. Cole ; S. Cochrane ; W. A. L. Collier ; V. L. Collins; W. F. Cooper ; B. Couts ; J. H. Crawford ; Georgette Crosby; C. K. Cullen; W. E. Chiesman. John Davenport ; Ann Davies ; James P. Davies ; J. O. F. Davies; A. W. Davison ; L. F. Delany ; W. Pointon Dick ; D. Lawson Dodd;-;- E. G. Dolton ; T. E. Dorran ; Frances Drew ; Margaret Duncan ; James Dunlop ; M. H. Dyson. N. B. Eastwood; 1. Eban; A. M. Edwards; Gilbert Elliott; I. J. Eppell. J. L. Farquharson; J. Faulkner; Nancie Faux; J. Fettes ; J. Fielding ; J. Fieldman ; L. Fieldman ; Samuel Fine; Mary Fisher; P. Fourman ; W. W. Fox; T. L. Frank ; L. M. Franklin ; C. Fraser ; Y. Friedl; 1. Frost ; L. S. Fry. H. Gainsborough ; Patricia Gairdner ; G. H. Gange ; B. Gans ; J. A. Gillison ; H. M. Glover ; W. N. Goldsmith ; M. Gordon ; T. Garland ; Martin A. Goodwin ; S. Gottlieb ; G. M. Gray ; L. M. Green; F. D. Griffiths. A. Hancock; B. M. Hearty; C. P. Hearty; Dora M. Hill; W. Hinds ; B. Hirsh ; S. Hodgson ; R. G. S. Howe ; S. R. Hulton ; J. H. Humphrey. P. Inwald. M. Jacob ; A. L. Jacobs ; A. S. Jarman ; T. Francis Jarman; M.B.Jay; E. Clifford Jones ; J.C.Jones; H.Joules. P. Kaplin ; S. Kaye ; I. J. Keidan; E. F.Kelly; E. Kerner ; P. Kidd ; E. W. Kirk; T. H. Kirk; Brian Kirman; B.
E. N. Taffs ; F. Taylor ; Evelyn Terry ; M. D. Thakore ; Felix F. Tietze ; O. F. Thomas ; R. H. Toothill ; D. M. Trice ; P. Tyrer ; S. M. R. Thomson. C. K. Vartan ; M. Le Vay ; Noel Vinter ; H. E. Vickers. M. Wayne ; David Waxman; E. Westerlow ; Joyce M. Wigram ; E. A. Worley ; R. R. Wilson ; John Winning ; A. H. Wortman. P. Yarrow ; S. L. Yates. ’
RETREAT TO 1938 our profound disappointment
Sin,—We wish to record
with the decisions taken at the Annual Representative Meeting of the British Medical Association. We had hoped that the ARM would reaffirm its support for a national medical service to cover 100% of the population and that it would develop its 1942 proposals for health centres. Instead of that, we have to witness a retreat from the progressive decisions of 1942 to the timid and out-of-date proposals of 1938. The BMA has taken one step forward and two steps back. The recommendation for a two-way extension of the panel system would seem to preserve the evils both of crowded panel practice and competitive private practice, while the recommendation that the development of health centre practice should wait until experimental centres have been tried out may result in indefinite
postponement.
We would urge the council of the BMA to reconsider their timid programme not in terms of prewar 1938, but in the light of present aspirations and postwar opportunities. The medical profession resisted the introduction of National Health Insurance in 1911. Today it appears that our biggest organisation, the BMA, may resist the introduction of a comprehensive medical service as required for the Beveridge plan of social security. Are we as a profession, to be blamed for trying to put the clock back twice in a generation ? T. H. ALMOND. JOHN PEMBERTON. A. SMITH. M. ATKIN. C. H. BÖSENBERG. H. J. WHITELEY. UNA M. CAMPBELL. ANDREW WILSON. F. R. ZADIK. BALBINA DROLLER. M. MIDDLETON.
,
Klempamn.
Sheffield.
MEMORIAL TO PROF. WARRINGTON YORKE.-The council of the Liverpool School of Tropical Medicine is to use Sir Robert Rankin’s gift of t500 to commemorate the scientific work of the late Prof. Warrington Yorke. They will award a memorial medal twice yearly on the result of the examinations held for the diploma in tropical hygiene.
Captain Edward Raymond Stone, MD, Washington, was posted as killed last March (Lancet, 1943, i, 448). But we are glad to learn that his English namesake, Captain Ernest Richard Stone, MB CAMB, R1C, of Coulsdon, Surrey, is alive and well. RAMC,
Report. The public, however, is becoming increasingly
aware
of the deficiencies of the medical services, which do not allow of a full application of modern medical science to the prevention and cure of ill health. Further, many doctors are coming to realise that their working conditions hinder professional efficiency. The proposals of the Beveridge report have offered to our profession great opportunities to contribute to social progress, which it has not yet seized. The proposals of the annual representative meeting, indeed, are likely to impede rather than be a step towards the comprehensive health service promised by the Government. The decisions of the ARM have not been well received by the public, and the continuation of an unhelpful attitude on our part must inevitably injure the status of the
profession.
’
Norman Lawrie ; V. W. Lees ; S. Leff; J. G. L’Etang ; Harold Lewis ; J. Liddell; S. J. Lipetz ; F. J. G. Lishman ; R. C. Lowe ; F. M. Lucas ; G. R. W. M. Luntz ; R. A. Lyster. Alison MacBeth ; C. MacDonald ; B. C. Macirone ; A. E. McCandless ; Donald Macleod ; A. R. McGregor ; James McNabb; H. H. MacWilliam ; Joan Malleson; R. A. Manclark ; M. Marcus ; L. M. Masterman ; G. H. Miles ; E. H. M. Milligan ; E. Minalt ; D. A. Mitcheson ; L. J. Moir ; E. Montuschi; H. Munro ; D. Munro-Ashman ; J. J. Murnane ; A. L. M. Morrison. W. D. Newcomb ; Peter Nash ; M. Newfield ; Edmund I. Newman ; N. Newman ; R. Nuki. S. O’Boyle; Greta Olsson; G. M. Osborne; R. L.
Osmaston ; James O’Connor. Joseph Parness ; J. F. Payan; Mary E. Pearce; B. Perchman; A. Phillips; L. Phillips ; M. R. Pollock; H. W. Pooler ; R. Poots ; Janet Posner; J. Fowell-Evans ; J. D. Proctor ; D. M. Pryce ; Anthony W. Purdie ; R. F. Price. R. H. Rankin; Alexander Reid; M. P. Rhodes; J. Robinson ; H. D. Rosenberg ; J. Ross ; Kathleen Ruther-’ ford ; V. C. Robinson. R. Schultz ; F. E. T. Scott; J. A. Scott; C. I. Schiff; R. P. W. Shackleton ; W. J. Sheehan ; A. I. Silverman ; B. Singh ; F. E. Smith ; S. Smith ; D. H. Smyth ; E. Snell ; Arnold Sorsby; Max Sorsby ; M. Stein; Wm. Stott; J. Mitchell Stuart; Barnet Stross ; H. W. Swann ; F. A. H.
x
Simmonds.
In the absence of the white-paper the ARM discussions this year had an unreal quality. There is ample evidence that if and when positive and progressive proposals are actually put before the profession by the Government, there are sufficient medical men to ensure that these proposals receive careful and sympathetic consideration and to cooperate in working a progressive scheme. The signatories therefore urge the Government to produce without delay the promised white-paper, which they are confident cannot but provide a true implementation of Assumption B in all its aspects. They hope that those who hold similar views will be encouraged by this letter to join them in expressing their support of this view. 238 MEMBERS
OF THE BMA.
The names appended to this letter are :Grace J. Adam; Robert Adam; Alice Akred; M. S. Aldridge, M. B. Alexander ; T. H. Almond ; D. Arning; 0. F. H. Atkey. E. T. Bailey ; J. Shackleton Bailey ; J. B. Bairds ; F. Balkwill; G. Barasi ; M. L. Barst; John Bee ; A. C. Bel. field ; R. H. Bembridge ; T. H. C. Benians ; Ruth BensusanButt ; J. Bentinck ; C. A. Birch ; George Black ; D. G. de Bouk ; Brian Boyd-Cooper ; D. S. Brian-Brown ; G. Brown ; E. Vipont Brown ; Harold Buckley ; Clifford F. Bullend ; O. Bulloch ; A. C. S. Burch ; H. H. Bradley. A. N. Cameron ; Esther Carling ; H. E. Carmalt ; W. Chadwick ; A. J. Clarke ; T. M. Cole ; S. Cochrane ; W. A. L. Collier ; V. L. Collins; W. F. Cooper ; B. Couts ; J. H. Crawford ; Georgette Crosby; C. K. Cullen; W. E. Chiesman. John Davenport ; Ann Davies ; James P. Davies ; J. O. F. Davies; A. W. Davison ; L. F. Delany ; W. Pointon Dick ; D. Lawson Dodd;-;- E. G. Dolton ; T. E. Dorran ; Frances Drew ; Margaret Duncan ; James Dunlop ; M. H. Dyson. N. B. Eastwood; 1. Eban; A. M. Edwards; Gilbert Elliott; I. J. Eppell. J. L. Farquharson; J. Faulkner; Nancie Faux; J. Fettes ; J. Fielding ; J. Fieldman ; L. Fieldman ; Samuel Fine; Mary Fisher; P. Fourman ; W. W. Fox; T. L. Frank ; L. M. Franklin ; C. Fraser ; Y. Friedl; 1. Frost ; L. S. Fry. H. Gainsborough ; Patricia Gairdner ; G. H. Gange ; B. Gans ; J. A. Gillison ; H. M. Glover ; W. N. Goldsmith ; M. Gordon ; T. Garland ; Martin A. Goodwin ; S. Gottlieb ; G. M. Gray ; L. M. Green; F. D. Griffiths. A. Hancock; B. M. Hearty; C. P. Hearty; Dora M. Hill; W. Hinds ; B. Hirsh ; S. Hodgson ; R. G. S. Howe ; S. R. Hulton ; J. H. Humphrey. P. Inwald. M. Jacob ; A. L. Jacobs ; A. S. Jarman ; T. Francis Jarman; M.B.Jay; E. Clifford Jones ; J.C.Jones; H.Joules. P. Kaplin ; S. Kaye ; I. J. Keidan; E. F.Kelly; E. Kerner ; P. Kidd ; E. W. Kirk; T. H. Kirk; Brian Kirman; B.
E. N. Taffs ; F. Taylor ; Evelyn Terry ; M. D. Thakore ; Felix F. Tietze ; O. F. Thomas ; R. H. Toothill ; D. M. Trice ; P. Tyrer ; S. M. R. Thomson. C. K. Vartan ; M. Le Vay ; Noel Vinter ; H. E. Vickers. M. Wayne ; David Waxman; E. Westerlow ; Joyce M. Wigram ; E. A. Worley ; R. R. Wilson ; John Winning ; A. H. Wortman. P. Yarrow ; S. L. Yates. ’
RETREAT TO 1938 our profound disappointment
Sin,—We wish to record
with the decisions taken at the Annual Representative Meeting of the British Medical Association. We had hoped that the ARM would reaffirm its support for a national medical service to cover 100% of the population and that it would develop its 1942 proposals for health centres. Instead of that, we have to witness a retreat from the progressive decisions of 1942 to the timid and out-of-date proposals of 1938. The BMA has taken one step forward and two steps back. The recommendation for a two-way extension of the panel system would seem to preserve the evils both of crowded panel practice and competitive private practice, while the recommendation that the development of health centre practice should wait until experimental centres have been tried out may result in indefinite
postponement.
We would urge the council of the BMA to reconsider their timid programme not in terms of prewar 1938, but in the light of present aspirations and postwar opportunities. The medical profession resisted the introduction of National Health Insurance in 1911. Today it appears that our biggest organisation, the BMA, may resist the introduction of a comprehensive medical service as required for the Beveridge plan of social security. Are we as a profession, to be blamed for trying to put the clock back twice in a generation ? T. H. ALMOND. JOHN PEMBERTON. A. SMITH. M. ATKIN. C. H. BÖSENBERG. H. J. WHITELEY. UNA M. CAMPBELL. ANDREW WILSON. F. R. ZADIK. BALBINA DROLLER. M. MIDDLETON.
,
Klempamn.
Sheffield.
MEMORIAL TO PROF. WARRINGTON YORKE.-The council of the Liverpool School of Tropical Medicine is to use Sir Robert Rankin’s gift of t500 to commemorate the scientific work of the late Prof. Warrington Yorke. They will award a memorial medal twice yearly on the result of the examinations held for the diploma in tropical hygiene.
Captain Edward Raymond Stone, MD, Washington, was posted as killed last March (Lancet, 1943, i, 448). But we are glad to learn that his English namesake, Captain Ernest Richard Stone, MB CAMB, R1C, of Coulsdon, Surrey, is alive and well. RAMC,