Telephones MUSEUM 5626 -7- 8 W. 105 Telegrams: UFFABRINI. WESTCENT LONDON.

Medical Practitioners Union

General Secretary: ALFRED WELPLY M.D

55&56 Russell Square, London, W.C.1.

APRIL, 1944.

A National Health Service“-thus runs the title of the White Paper. The Union is disappointed to find that the Minister’s plan, so far from providing a true national service, proposes a service that completely excludes the Industrial Medical Service and many other salaried services, Governmental and otherwise. The Minister even urges that these exclusions are justifiable, although with arguments which can carry no weight with those who had hoped that he would at least well and truly lay the foundations upon which Time could build a really national service, in which all specialities, and all practitioners would be proud to have a place. Even more startling is the complete exclusion from the new service of the treatment of children of school age. A little consideration of the preposterous duplication of machinery and of loyalties which this proposal would entail makes it almost impossible to believe that the Government, as a cardinal feature of its post-war planning, proposes to set up two national health services, one for children of school age, and the other for the rest of the community.

The pitiable tale of timidity and lack of enthusiasm is continued, in the failure of the White Paper to suggest that we should at last have a Ministry of Health whose officials could give their whole time to questions of health, instead of spreading their activities over all the business of the old Local Government Board, as is the case to-day.

Finally, the tale is completed by a total lack of provision for encouraging the maintenance of health rather than the treatment of disease. This White Paper plan proposes and arranges for the treatment of more sick people than ever. It is scarcely concerned to prevent their being sick except by so much constructional suggestion as is contained in the words: “It is to be hoped that doctor and patient will not wait always till the latter falls ill and urgently requires treatment.” Those who look for any practical scheme for liaison between preventive and curative services will be disappointed.

The Union, therefore, records with particular regret the following four fundamental defects in the White Paper scheme :

  1. The exclusion of the Industrial and various other health services from the so-called ” National” health service.
  2. The exclusion of all school children from the national service.
  3. The failure to propose a Ministry of Health able to give its whole time to health questions.
  4. The absence of any practical measures to promote the study or promotion of good health, as contrasted with the treatment of established disease.

The White paper is undoubtedly an honest attempt to bring general practitioner and hospital treatment, as these things are understood to-day, within the reach of everyone. It is a skilful compromise between conflicting interests. Its authors may even have allowed themselves some vision of the newer and better world which enthusiasm and courage could produce. Unhappily, there is little sign of this. There is vision and enthusiasm in the Beveridge Report, and it has seized upon the imagination of the people. It ought to be implemented by those who can see the vision and conjure up the same enthusiasm. This White Paper, this timid extension of faulty and over-lapping services, this mass of unhappy compromises, may possibly soothe the vested interests concerned into allowing some poor instalment of what might have been; but if the Minister would appeal beyond these interests (too many of them are medical, alas) to the people of these islands, he might be remembered by posterity as the founder of a truly national health system, worthy of the blood and sweat and tears which have given him his unique opportunity.

Surely we do not need a third World War before this country can produce rulers capable of realising that planning for the maintenance of health is the most important function of good government !

Many months ago the Union urged upon the Minister that the White Paper should be sent to every practitioner in the country as soon as it was published as a token that the Minister looked for the personal interest and co-operation of each practitioner. The Minister has issued the White Paper to every practitioner, we are very pleased to find that the Minister adopted our suggestion.

Lest it should be accused of shirking the practical issue, the Union sets out what it would have the Minister do in order to lay sure foundations for the building up by health workers of their share in a better world.

A BETTER SCHEME FOR A NATIONAL HEALTH SERVICE.

On a certain day all workers in our Health Services able and willing to give their full time, in return for adequate wages and honourable opportunity. should become members of the National Health Service, owing allegiance to that service above all.

From this initial step many important consequences would follow :

(1) The Service would see to it that advancement by merit was open to all, doctors, administrators and auxiliaries, and that none need any longer be forced by circumstances to be content with such promotion as might be possible in the restricted sphere of some particular municipality, in the occupation of general practice, or in any other sphere of limited opportunity.

(2) There would be opportunity to change from one branch of the service to another, from general practice to research or from sanitary inspector to administrator. Suitable members of the service could be trained and tested in new spheres, according to the promise they showed, without risking their livelihood, as they would have to do to-day.

(3) The Local Government and other services of to-day would become branches of the service under their own officers, and largely autonomous, subject to the over-riding needs of the service .as a whole.

(4) The White Paper plan would be seen in its proper perspective as a mere reorganisation of a part of the service, and not as a plan for a complete new service.

(5) It would be a first duty of the new Service to elaborate plans for promoting health, for example, through its members in the school medical services and through those who had specialised in what is known as Public Health work.

This brief outline indicates, the Union believes a sound basis upon which a National Service worthy of this nation might be built. It could not all be built in a day; it would change and develop as new circumstances had to be met; but it would combine all health workers in one Service for one end. It would not destroy existing services, but would raise them all above the level of vested interests to a sphere of co-operation in which many of our dreams must in time come true

THE UNION’S POLICY.

The Medical Practitioners’ Union is primarily interested in the status and welfare of general practitioners under whatever medical service is finally adopted by Parliament, and intends to press among other things for :

  1. Complete independence for every practitioner to exercise his medical skill in the interests of his patients without interference.
  2. Elimination of control of administration of health centres by Local Authorities.
  3. Adequate remuneration for every practitioner engaged in the service.
  4. Adequate compensation for loss of capital value of practice and other things incidental thereto.
  5. Adequate pension on retirement.

It is hoped that the diagram overleaf will assist in the study of the White Paper.

Henry Willink talks about the plans

A HEALTHIER BRITAIN

Willink's proposal for a health service

Willink’s proposal for a health service

 

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