Dr Charles Wortham Brook probably 1943

It is becoming increasingly difficult, owing to the growing shortage of civilian practitioners, for emergency or urgent calls to be attended, and this is undoubtedly causing unnecessary, preventable complications and possibly the loss of many lives which could be saved.

The already overworked general practitioners are suffering severly from mental and physical overstrain. No other body of men and women in the country are liable to continuous duty for 24 hours of the day for 365 days of the year. The possibility of epidemics is a constant nightmare to them and many will break down under the strain. It is indeed not surprising that some have decided to live away from their practices, so that they may enjoy a few hours undisturbed sleep (but in doing this they are contravening a rule of the Insurance Committees which insists that they or a deputy shall always be available).

A suggestion that a group of G.P.s can themselves organise an emergency service is quite unworkable (this is my own experience). There are some, like myself, who are compelled, in order to meet their patients’ needs, to open their surgeries on Sunday mornings and evenings. An emergency call in the middle of a surgery session irritates the numerous patients who have already been compelled to wait for a long period (occasionally I check up on this and I find that it is often 1 1/2 to 2 hours) and the necessity for dealing with the emergency to harasses the doctor, that in order to make up for lost time, he tends to become careless in his examinations and treatment for the remainder of the surgery session and this combined with the fact that his patients are irritable causes general dissatisfaction to both doctor and patients.

At the present time, there is only one immediate solution of the problem and that is by the establishment of an Emergency Domiciliary Medical Service under the direction and control of the Ministry of Health and organised as part of the Emergency Medical Service.

Just as an emergency call can be made by the general public in the case of Fire, or when needing the services of the Police or an Ambulance, so similar facilities should be arranged for calling a Doctor in the case of sudden illness. This call could be transmitted by telephone to the nearest Emergency Medical Service Control Centre (already established) after the messenger had given very brief particulars as to the nature of the emergency, so that it could be ascertained whether a Nurse and light ambulance would be required in addition to the Doctor.

A doctor, who would be on special duty at an Emergency Medical Service Hospital, would then be sent out by car to the case, and if necessary in a light ambulance with a nurse, driver, attendant and all necessary equipment.

The doctor, after giving the necessary emergency treatment, would either take the patient to Hospital, or (and this would happen probably in the majority of cases) he would refer the patient to his own Doctor lor further attention on the following day, with a note as to treatment given.

When a general practitioner is unable to deal with urgent cases, owing to pressure of routine work (a heavy surgery, or a long visiting list) or if he is absent from his practice through illness, attendance at Courts of Law, on Sundays, etc., then he should be entitled to make use of the Service. It might also be made possible for general practitioners who are unable to obtain locums, to get assistance from the Service, paying for the privilege and facilities provided.

LETTER TO THE MEDICAL WORLD JANUARY 15th, 1943

Last Sunday afternoon a primipera in the late thirties gave birth without warning to twins.

Her own doctor is now absent on war service, and an attempt was made to contact me but I was out on visits.

A hospital was then telephoned and the mother and twins were after some delay removed by ambulance. Unfortunately both the babies were dead.

Early last Wednesday morning a dying cat was found on the mat outside my front door.

Having no knowledge of veterinary medicine I telephoned the police. Not very long elapsed before a constable arrived, followed shortly afterwards by a veterinary surgeon in a car. The cat was removed and although I offered to pay the vet’s fee, it was declined as I understand that this service is provided by the R.S..P.C.A.

I cannot do better than quote from an essay by Richard Carlile, the great English Libertarian, the centenary of whose death will be celebrated on February 10th next (but not by the B.B.C.!)

This essay was written in 1827, and is included in Carlile’s “Jail Journal,” edited by Guy A. Aldred, and recently published by the Strickland Press, Glasgow.

Carlile wrote: “Men and women subscribe money for the prevention of cruelty to animals, but forget to include their own species, the animal man, in the common benefit. This animal nature is a strange mystery.”

Yes, Richard Carlile, whose greatest talent was his plain downright English commonsense, wrote those words; in 1827; and yet while in 1943 there is an admirable emergency service for dumb animals, there is no domiciliary emergency medical service for human beings.

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