National Health Service

Dr. D. Stark Murray (Socialist Medical Association) moved the following resolution :—

In view of the increased number of doctors and other health workers necessary for the successful running of the new National Health Service, this Conference urges the complete democratisation of recruitment to this Service, by providing free education with maintenance for all suitable students irrespective of sex: It also considers that in order that there may be a maximum of democracy within the new National Health Service, provision should be, made for the establishment of Hospital and Health Centre Committees, of which elected representatives of the staffs should, be members.

He said: Three Conferences ago we brought before you a resolution supporting the White Paper issued by the Coalition Government. We recognised that in supporting that White Paper we were departing to some extent from the ‘previous policy of this Party, but we decided then, and you unanimously agreed, that the correct thing to do at that stage was to support the proposals of the Coalition Govern­ment. No sooner had the Conference passed that resolution than Mr. Willink, the Tory Minister, of Health, attempted, with the help of the B.M.A., completely to change the whole policy which the Coalition Government laid down. At the next Party Conference we had to come before you and ask the Conference to go back to its original policy and pass a resolu­tion in favour of the original proposal of the Labour Party itself. We asked the Conference to pass the composite resolution which con­tained a great many pf the suggestions which have become the policy of the Party, and which we emphasised just before the General Election. They became the Health section of “Let Us Face the Future’

Mr. Attlee has spoken about the vigorous activity that has taken place in this Government and Parliament, but I do not think that this Conference yet realises quite how vigorous and how important the action of the Government with regard to health legislation has been: The passage of the National Health Service Bill will bring, in due time, to full fruition an ideal that has been in the minds of the Socialist Medical Association for a great many years. We in that Association have always taken a stand for a complete national health service of a particular kind. The particular points which we are placing before the Conference to-day concern a much more distant future than is envisaged in the present Bill. We look forward to a larger health measure in a future time. We should have liked the Minister of Health to have gone further; and we in the Socialist Medical Association still believe that there should be one single standard of medical care for the whole population. While we have accepted a compromise which still allows a certain degree of privilege to remain within this health service, we shall watch the position exceedingly carefully and we shall be prepared to come before you at any given moment if we find that that privilege is being abused, and we shall ask you to reaffirm the basic principles of Socialist policy in this matter, namely, that there shall be no position of privilege for those who can afford to pay for it.

The motion before you is so simply worded that I may leave you to read it for yourselves and not attempt to elaborate it at all. We feel that in order to democratise the Service we want Staff Committees in every hospital and health centre. The Minister, if he is to provide all the workers necessary for this Service, must see that all forms of education—medical, dental, nursing, auxiliary, and technical—are open to the whole population. As we have drawn a brilliant Cabinet from working-class ranks, so the Minister of Health must begin to draw the doctors for his Service from the ranks of the working-class of this country.

Mr. J. Wilkinson (Oxford City Labour Party); As I am asked to be very brief I would like to point out that in this particular Bill with regard to the National Health service all the Committees are appointed and not one of them is elected. I think that the Conference will agree that there should be more election from the general body of the public and less appointments than there has been up to the present. I formally second the resolution.

Dr. Somerville Hastings M.P. (Barking): At an Annual Conference some fourteen years ago I had the honour, of moving, on behalf of the Socialist Medical Association a resolution in favour of a National Health service. Now I want to thank the Party for accepting that resolution, and especially to thank the Labour Government for introducing a Bill to implement the resolutions then passed, but, like Oliver Twist, we are asking for more. Within the framework provided by the Bill for a National Health service, there is room for personnel which must be much better than any personnel previously provided. We want a personnel recruited from not one class only, the better off, but from every class of society. We want a personnel conten: to play its part, realising that its experience and knowledge can be placed at the service of those responsible for the organisation of such a State service as is pro­vided under the Bill.

We want all youths and girls who have the interest and the capacity to be given the opportunity to join the medical profession. We want selection to be made, not only by a few scholarship tests, but also we want to select those who are desirous of service and those who have the sympathetic temperament which is so necessary. I know some of the best doctors who started as chemists and nurses, and we want to provide for all health workers the possibility of being trained as doctors if they have the capacity and desire.

In the hospital with which I am connected, at the beginning of the war the Medical Super­intendent called together representatives from all the workers in the hospital—not only the doctors and the nurses, but the engineers, the ward maids, the porters, and so on—and asked them to consider how the hospital service could be made more efficient during the national emergency. That “Soviet,” as they called themselves, met, and it has met at frequent intervals since, and they have been very useful indeed. Matters such as wages and conditions of service, which are much better left to the Trade Unions, have, of course, not been con­sidered. What has been considered is in what way the services of that hospital could be made more easily available to the patients with a view to benefiting them more.

Dr. Edith Summerskill, M.P. (National Executive): I feel that it is appropriate that I should be a substitute for Mr. Aneurin Bevan, because I represent the Ministry of Food and I feel that the food service is complementary to the health service. After being in practice for twenty years, I would say that in most cases a patient derives more benefit from one good meal than from a whole bottle of medicine. For many years I have sat with Hastings and Stark Murray on the back benches of this Conference and come forward to the rostrum and made my little contribution to the health service debate. Last year I had the honour of expounding the Labour Party’s health policy, from this platform and telling you what we would do if we obtained power. Few of you can realise what a supreme satisfaction it is, to stand here and say that, although the Bill is not yet on the Statute Book, it has already received its second reading, and, in a comparatively short time, this country will enjoy a health service second to none in the world.

Let us not underestimate the value of this service to the community. Disease is more deadly than war. In the future nobody will be denied, the best specialist service in the world. No mother need look in her purse to see if she has enough money to call in the doctor for her child. No housewife need neglect symptoms or disease until she is past medical aid. Every man, woman and child will qualify for treatment. As for the doctors, I say deliberately that this Bill is a charter of independence for every medical man and woman in the country. In the future no doctor need prostitute his talents by pandering to the hypochondriac. The malingerer will find short shrift in the Health Centres. The doctor of the future will be judged, not by the size of his bank balance, his house and his car, but by his capacity to prevent, and cure disease.

Our opponents in the House of Commons charged us with denying, both to the doctor and the patient, his freedom. With regard to the doctor, as I have said, for the first time in his life he will enjoy intellectual freedom and for the first time in his life know the meaning of economic security. With regard to the patient, what freedom has the patient in a village, or, in a small town? Those who talk about freedom forget that when a patient goes to the hospital it is quite common for him to have a major operation performed by a man or woman of whose name he is ignorant. It is quite common, in London, for me to send a woman to a hospital for an operation although she does not know who will perform it. What we are going to establish is faith in the new medical service, and then, if a patient has a doctor at night who is a stranger, he or she will have faith in him.

So far as the voluntary hospitals are con­cerned—I remember that the Mayor of Bourne­mouth mentioned this in his opening remarks— when the nation takes over the voluntary hospitals, the prestige of these hospitals will be enhanced. Their value will be increased. Modern medical science can no longer rely upon charitable contributions. Furthermore, when the all-in insurance contributions come to be paid it will be found that 80 to 90 per cent, of the revenue of the voluntary hospitals comes out of the pockets of the public. Therefore, can anybody logically argue that they should not be controlled by the people?

The Minister of Health does not under­estimate the magnitude of the task. The machine that he sets up must work efficiently, in the interests of both the patients and the workers, whether they be doctors, nurses or others ancillary to the work of the hospital and health centre. Moreover, it is of primary importance to perfect the machine in order that the principle of one standard of service for all is definitely carried out.

I come now to education. I agree with Dr. Somerville Hastings that medical education in the past, has been the monopoly of the middle classes. It will now be necessary to encourage more boys and girls to enter the medical profession. The Minister of Education recently made a statement that more scholarships would be available and that a medical education would be brought within the reach of all, whatever the parents’ income may be. There will be free tuition and maintenance for any boy or girl who is anxious to enter the medical profession, and this will be irrespective of sex.

By a curious coincidence I find that the chairman of the hospital at which I was trained is in the hall to-day. It gives me great satis­faction to learn from him that in the future it is to be the ruling of his hospital to admit 50 per cent of women students. This is a reversal of policy because, soon after I left, women were excluded. The “serious” reason given to me was that we distracted the male students—that, of course was twenty years ago—-and that, therefore, the football of the hospital deteriorated. For the last twenty years I have followed the football scores of my old hospital, and there has been no noticeable improvement.

On the question of Hospital Committees I want to remind my medical colleagues that these Committees are, of course, functioning in many hospitals throughout the country. They advise, and make very useful recommendations to the Medical Superintendent, and I see no reason why these should not be extended.

On the question of nurses I want to say a word. We do not, of course try to justify the appalling conditions under which nurses worked in the past, but I must say this to the Conference: the nurses themselves are not entirely blameless. While doctors have formed one of the most powerful professional organisa­tions in the country, the British Medical Association, the nurses have remained un­organised and inarticulate. The time has come when nurses must learn the value of organisation and the power of collective action.

Finally, let me assure those delegates who have spoken that we shall bear in mind the points they have raised. We are determined to establish a service which will command the respect and trust of the whole nation, and we shall succeed, for it is politically wise, financially sound and morally right.

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