Volume 2 Number 1 August 1933

The Official Organ of the Socialist Medical Association.

OURSELVES

THE introduction of any new journal to the public at the present time can only be justified by a growing need for the expression of new ideas. In no field are new ideas more prevalent than in that of health. Everywhere changes in the public attitude towards disease are becoming linked up with private desires for better health, and these are finding expression in a demand that the health problem of the nation should be faced in a new and rational fashion.

“The Socialist Doctor” has appeared in a brief and irregular form as a document for members of the Socialist Medical Association. It is now recognised that a wider public need information about the Socialist attitude towards medical and allied matters. To give that information and to keep our members, associates, and friends informed of our progress towards a State Medical Service is the function of this journal. Our primary concern will be with showing how the chaotic medical methods of to-day can be replaced by a comprehensive State service, but we hope also to give space to all that concerns human disease.

The issue of this number has been made possible by the generosity of members of the Executive, who have subscribed to a special fund for publication purposes. We do not wish to use the funds of the S.M.A. for this journal, and we are therefore opening a “Socialist Doctor” fund, to which all our readers are invited to contribute. A small contribution from each member will not only guarantee the regular appearance of “The Socialist Doctor,” but will enable us to enlarge and improve it. Contributions should be sent to the Editor. We believe we have a useful function to perform, and hope our readers will enable us to do so efficiently by freeing us from immediate financial worry.

GREETINGS.

We have received warm wishes for success from many quarters. We have particular pleasure in printing the letter of Mr. George Lansbury, Leader of the Parliamentary Labour Party, whose interest in the health of the working class has been shown, in many practical ways. He says :—

Dear Comrade,

I am glad to hear that Socialist doctors are bringing out a quarterly publication. I should like to wish it every success.

We need State, medical services more than ever. I think the business of health is one of those which essentially need removing from the sphere of pure money-making and exploitation.

Yours sincerely,

House of Commons.

GEORGE LANSBURY.

SOMEDA

THIS is not the latest patent “cure-all.” To those who do not already know, it is the name given to one of the best social functions ever held in the socialist movement in London. The Socialist Medical Association Annual Dinner and Dance (Someda), held at Thames House on Saturday, May 20th, 1933, was a brilliant prelude to the annual general meeting. The executive had placed the organisation in the hands of Dr. Edith Summerskill, but even those who knew that lady’s flair for organising felt that she excelled all previous efforts on this occasion. Over 200 guests sat down to dinner and enjoyed every course, but especially an “extra” which came as a pleasant surprise. The guests of the evening were Dr. Christopher Addison and Lord Marley, whose speeches were received with keen appreciation. Dr. Brook and Dr. Summerskill spoke for the Association, and we had a witty intervention by Mr. Arthur Greenwood, ex-Minister of Health.

The dinner was followed by a dance, to which about 400 people came, and the evening was further enlivened by a cabaret, which included the Margaret Morris Dancers. So many people of note in the socialist movement were present that it is impossible to mention them, even in part.

The social success of Someda was reflected in the very satisfactory financial statement the organiser was able to make to the Executive Committee. Dr. Summerskill fully deserves the compliments for “Someda” that have been paid to her.

THE THIRD ANNUAL GENERAL MEETING

ON Sunday, May 21st, the Third Annual General Meeting was held at the Craven Hotel, Mr. Somerville Hastings, M.S., F.R.C.S., L.C.C., being in the chair. The President opened the proceedings with an address, reported on another page. The address was received with warm interest. The report of the Executive Committee and the Balance Sheet having been accepted, the meeting unanimously re-elected Mr. Somerville Hastings as President for the year. Dr. Brook having been re-elected Secretary, it was agreed to appoint Drs. Summerskill and Tobin to assist as organising secretaries, and the constitution was altered to permit this. The E.C. was elected as follows, after a vote: Drs. Bensusan-Butt, Ellman, Maule, Menon, and Murray, Miss Rickards, Drs. Samuel, Salter, Shah, and Warren. The representatives of the Associates elected were Mr. Bennet, Mrs. Brook, Miss Le Geyt, Miss Mann, and Miss Sayle.

The chief discussion of the meeting centred round a motion to widen the basis of membership so that socialists serving on Public Health bodies might be admitted. But after a lengthy debate this was heavily defeated. It was felt necessary to preserve the essentially medical nature of the Association.

Two motions put forward by the Liverpool Branch were then dealt with. The first asked that “On all matters affecting general policy where a branch has made an official contribution to the discussion this should receive due consideration by the E.C.” This was accepted. The second was more controversial, and many members spoke for or against it. It declared “That all schemes submitted to bolster up the voluntary hospitals should be condemned by the S.M.A. as perpetuating substantially the evils which the Association desires to remove.” The general feeling of the meetings was that this motion covered too wide a field and might present individual problems impossible of solution. The motion was heavily defeated.

Nazi prosecution of doctors in Germany next called for much discussion, and it was finally left to the E.C. to take the best action they could devise both on general lines and with regard to the General Medical Council. Discussion followed on a motion by Dr. Fernandez, calling on the Labour Party to formulate a policy to control Tuberculosis. This was referred to the Executive (who have since asked Dr. Ellman to prepare a memoranda on the subject as a basis for future action).

THE DOCTORS’ CONTROL IN A STATE MEDICAL SERVICE

The President’s Address

MR. Somerville Hastings’ address to the Annual General Meet­ing has already been printed in full in the “Medical World,” and we give only a summary here. The subject he had chosen, he said, was of importance because the success of a State Medical Service must always depend to a large extent on the attitude of mind of the men and women who are working it, and unless these individuals are satisfied with the conditions of their service, and feel that they are really assisting in its development, and unless they are free from any sense of grievance, they cannot be expected to do their utmost to make the Service a success.

The consideration of this problem had recently received prominence through the dispute between the L.C.C. and the British Medical Association regarding the appointments of consultants under the Council. The B.M.A. felt that they should have some voice not only in the fixing of conditions of employment, but also in the actual selection of consultants. The machinery of the L.C.C. and similar bodies does not permit of such an arrangement. An officer employed by it can only reach the controlling committee through the Medical Officer of Health.

Continuing, Mr. Hastings summarised the position in Russia, where the doctors appear to have no greater control over their destiny except so far as their representatives can put their case before the Supreme Council of National Economy.

In a State Medical Service it is desirable

(1) that the medical staff have the sole voice in deciding as to treatment. It will be the duty of every doctor to do his very best for each individual patient.

(2) The Public Authority employing a medical officer must have the sole voice in his appointment.

(3) The doctors themselves or their representatives must always have direct access to the public representatives administering the service.

(4) The medical personnel must have power to tender advice to the public representatives responsible for the service, as to its development. As to the direct machinery of approach opinions may differ. My own view, said the President in conclusion, is that the doctors should report to the committee by means of memoranda or deputations. But the point I feel strongly about is that by some channel or other they should have the power of direct communication with the committee in charge of the service in which they are engaged.

BOOK PRIZES OFFERED

IN the pamphlet “A Socialised Medical Service” it is stated that ”The officers of the service or any branch thereof should have power to form committees, to discuss, advise, and present recommendations to the local health authority.” This is the point discussed by Mr. Somerville Hastings above, and we invite opinions (a) as to its desirability, and (b) as to the best method of carrying it out. For each of the two best 250-word opinions submitted to the Editor, whose decision will be final, a volume selected from the Everyman Library will be presented.

MOVEMENTS

(Under this heading we propose in each issue to summarise whatever movement we can trace for and against a State Medical Service)

A STATE Medical Service that is to be really successful must first gain the adherence of the majority of medical practitioners. Faced with a Government willing and powerful enough to put such a scheme into operation, it is certain that most doctors will accept it (as they have accepted other schemes they at first opposed). But it is heartening to be able to trace any real advance in the attitude of medical organisations. Last year the best meeting of the B.M.A. of which we have record was that at Colchester, where a motion in favour of a socialist service was almost carried. The Medical Practitioners’ Union discussed a similar motion at its annual meeting, and this was only lost by one vote. How many of our members who are also members of that body were present?

Even the Royal Society, in the section of State Medicine, has listened to an address on the subject. Dr. Wm. Butler, late of the L.C.C., gave his views on the dangers of Bureaucracy in a State Medical Service. He appears to have taken it for granted that a State Service would operate before long, and was anxious to show how medicine must be safeguarded from bureaucracy.

The foundation of the new Post-Graduate School at Hammersmith has at last been laid; and with it the L.C.C. and the Ministry of Health enter the field of medical education. The voluntary hospitals do not appear to recognise that this is the most severe blow they have yet received in their capacity of educational centres. Incidentally the whole scheme was only made possible by the Labour Government.

The voluntary hospitals also received a blow at Barrow-in-Furness last month, when the staff of the local hospital, backed by the B.M.A., refused to act any longer on a voluntary basis. Hospitals, they say, now exist almost entirely on weekly contributions from the working class; contributions which are really a form of insurance from which the doctors should receive some payment. It is interesting to compare this action with that of American doctors who, at Kern General Hospital, California, have been trying, through a legal injunction, to force the hospital to shut out all but those unable to pay for medical treatment. The Kern County Labour Council has prepared an alternative plan which, by the appointment of some full-time officers, would enable all classes to be dealt with.

Meantime even that Conservative journal, “The Spectator,” is interested in the question of State Hospitals. In the issue of June 16th there appeared an article by Mr. Somerville Hastings on ” The Case for State Hospitals.” This was answered the following week by Dr. Eric Pearce Gould. There does not seem to be much answer to the concluding sentence of Mr. Hastings’ article—”It is wasteful and uneconomic to have two independent hospitals catering for the same-types of case in nearly every locality, and it should be easy to devise a scheme whereby without loss of dignity or efficiency the voluntary hospitals could be absorbed by the municipal.”—D. S. M.

“THE SOCIALIST DOCTOR”

will appear quarterly, and we welcome comment on or criticism of each number. Copies can be obtained from the Secretary, 72, Balham Park Road, London, S.W.12, price 3.d., post free. The Editor, 74, Brim Hill. London, N.2, will welcome communications from any reader. Our aim is to assist the nation to a better and more healthy life through the placing of medical science on a foundation of free and equal service to every citizen.

A NATIONAL MATERNITY SCHEME

Autumn Conference to Discuss a Definite Proposal

THE Association is to discuss in the autumn a scheme which has been placed before it for a complete national maternity scheme. This is the outcome of the lecture given by Miss Esther Rickards, M.S., F.R.C.S., following the Annual General Meeting. As is usual, an hour after tea was given to an address on a popular subject. Miss Rickards gave so complete and so original a summary of the subject that those who heard her felt that it might almost have been accepted in its entirety.

Dealing first of all with the statistics on Maternal Mortality, she showed how they varied according to the type of Service existing in different areas and among different classes. It could be shown that 50 per cent, of maternal deaths occurring under the haphazard competitive methods of to-day could be prevented. The need for a national maternity service was therefore obvious, and it only remained to devise a suitable scheme.

Miss Rickards went on to discuss the place of midwives in such a service, the question of hospitalisation, the need for home-helps, and the best method of linking ante-natal attention with after-care. Finally she outlined the ideal service. We do not propose to give it here, as we have invited her to prepare it for our next number. The E.C. have also invited her to submit a memorandum on the subject, and it is proposed to make this the basis for discussion at an autumn conference of the S.M.A. The conference will be held on November 19th, and it is hoped to precede it with a dance on Saturday, November 18th.

The next issue of “The Socialist Doctor” will be published at the end of October, and will contain a discussion of a national maternity scheme, with articles by various writers.

NEW STATESMAN & NATION

A SELECTION OF RECENT CONTRIBUTORS :

  • H. E Bates
  • Stella Benson
  • Lawrence Binyon
  • Augustine Birrell
  • Francis Birrell
  • Edmund Blunden
  • H. N. Brailsford
  • Roy Campbell
  • G. K. Chesterton
  • Richard Church
  • G. D. H. Cole
  • A. E. Coppard
  • E. Gordon Craig
  • Sir Stafford Cripps
  • E. H. Davenport
  • W.H. Davies
  • Walter de la Mare
  • T. W. Earp
  • E. M. Forster
  • Roger Fry
  • David Garnett
  • Flora Grierson
  • Philip Guedalla
  • J. L. Hammond
  • J. A. Hobson
  • Norah Hoult
  • Laurence Housman
  • Richard Hughes
  • Graham Hutton
  • Aldous Huxley
  • Llyn LI. Irvine
  • C. E. M. Joad
  • J. M. Keynes
  • Stephen King-Hall
  • Ronald A. Knox
  • Constant Lambert
  • Harold Laski
  • W. J. Lawrence
  • C. M. Lloyd
  • Robert Lynd (” Y. Y.”)
  • Rose Macauley
  • Desmond MacCarthy
  • S. P. B. Mais
  • Kingsley Martin
  • H. J. Massingham
  • Hamish Miles
  • Naomi Mitchison
  • Raymond Mortimer
  • Henry W. Nevinson
  • Harold Nicolson
  • Hubert Phillips
  • Eileen Power
  • V. S. Pritchett
  • Peter Quennell
  • S. K. Ratcliffe
  • G. J. Renier
  • Lionel Robbins
  • Dr. Harry Roberts
  • R. Ellis Roberts
  • A. L. Rowse
  • Bertrand Russell
  • George Rylands
  • Michael Sadleir
  • Sir Michael E. Sadler
  • Dr. C. W. Saleeby
  • Siegfried Sassoon
  • R. A. Scott-James
  • J. C. Squire
  • G. W. Stonier
  • Lytton Strachey
  • L. A. G. Strong
  • H. M. Tomlinson
  • R. C. Trevelyan
  • W. J. Turner
  • H. G. Wells
  • Humbert Wolfe
  • Leonard Woolf
  • Virginia Woolf

The most vitally interesting weekly review in the Country

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Postal Subscription 30/- per annum 10, Great Queen Street, London, W.C.2

BOOK REVIEW.

” THE HEALTH OF ENGLAND,” by T. W. Hill (Cape, 6s.)

IT is a happy coincidence that brings the publication of this book in time for review in the first enlarged issue of this periodical. Seldom does a book come to us so complete in the presentation of an intricate problem and so satisfying in its conclusions. But Dr. Hill is a public servant who combines a thorough knowledge of his practical work with a philosophy and who has not allowed the routine of public health administration to blunt his enthusiasm or his ideals. The book sets out to accomplish three things: To give an outline of the vast machinery of public health administration and to point out its salient defects; to suggest proposals for its reform; and finally to deal with the all-absorbing problem of how to build a healthy and vigorous race.

In reviewing the national administration, Dr. Hill proves conclusively that a system under which six Government departments deal with the problems of health leads to overlapping, waste, and confusion. He therefore proposes to transfer all the medical services to the Ministry of Health. For instance, the School Medical Service of the Board of Education would be linked with the Maternity and Child Welfare Scheme of the Ministry of Health to form a department of Child Hygiene. Similarly the Factory Medical Service of the Home Office would form with the National Health Insurance Scheme a department of Industrial Hygiene.

Locally there are about 1,820 authorities varying in size and powers. Frequently these powers are permissive, which in reactionary and back­ward areas often means total neglect. Out of the chaos of local government he would bring order by a drastic reduction of the units of administration. The County Borough seems to be the most effective unit, since it possesses wider powers, is able to bring equality in the burden of rates, and can ensure a uniform system over a large area. The suggested reforms include the reorganisation of communities of 50,000 persons as County Boroughs. London would be divided into ten local areas coincident with the administrative areas of the Public Assistance Committees, under the supervision of the London County Council. All the health and medical services—Maternity and Child Welfare, School and Factory medical services, National Health. Insurance— would be centralised under a Model Health Centre of the Local Authority.

The voluntary hospitals existing at present largely on a degrading system of organised begging would become State-controlled. The public assist­ance hospitals would be reorganised, and the Relieving Officer severed from the scheme. A County Hospital unit would be established, with special departments and medical schools, while satellite hospitals, clinics, and welfare centres would work in conjunction with it.

The foregoing summary will give some idea of the thoroughness of Dr. Hill’s work, and how nearly his point of view approximates to the Socialist attitude. Until something on these lines is done, we shall continue to waste large sums of money in providing inefficient services. Including an estimated expenditure of £50,000,000 on private medical service, prevention and treatment of disease costs, the nation nearly £200,000,000 annually. An intelligent reorganisation of health services would reduce unnecessary expenditure, promote efficiency, and be of lasting benefit to the race.

And what of the race? When every possible provision has been made for the prevention and treatment of disease, there remains the problem of the permanently unfit, the mass of mental and moral defectives, psychotics, and epileptics. Where the defects are proved to be transmissible a policy of sterilisation is advocated for the safe­guarding of the race. In considering the allied problem of birth control, Dr. Hill takes the refreshing point of view that the children of the well-to-do are not necessarily of more value to the community than the children of the working classes. It has always appeared to us that in a class system such as ours, propaganda deploring the lack of reproduction in the middle classes is shallow snobbery. It is well to remember Plato’s fable of the golden baby produced by the silver parents. The average doctor is a busy and much harassed person. For his comfort let me assure him that this book, packed with information and practical suggestions, is as thrilling and as easy to read as a best seller.

Oscar Tobin.

OUR GERMAN COLLEAGUES UNDER HITLER

NAZI terrorism, in its attempt to remove all Jews and Socialists from active life in Germany, has compelled many doctors to flee to this and other countries. The executive of the Socialist Medical Association has been considering the position of Socialist doctors who come to Britain, and has asked the General Medical Council for a statement as to the possibility of such doctors practising in this country. The reply, similar to that given to other organisations, is that the matter is really not one for the G.M.C., as it is covered by their general rules, but for the university and other bodies who grant licenses to practise medicine. The E.C. are approaching the Conjoint Board in the matter; the greatest stumbling block is the insistence, as a rule, upon even the most highly qualified foreign doctor taking a course of study before he can practise in this country.

Meantime, those German doctors who have been actively connected with our German namesake, “Der Socialistiche Arzt,” are in particular difficulties. The following letter, written from Switzerland, has been received from Dr. Firke, probably the best known of the German socialist doctors.

” Dear Friend and Colleague,—You have up to the present received the paper, ‘The Socialist Doctor,’ regularly, but I must tell you that the . society is now in great difficulties. We need a sum of £50, which, owing to the present conditions in Germany, we are unable to pay, particularly as most of the physicians of our section have lost their positions. All members of the Union of Socialist Doctors are now excluded from the panel benefits. The Commissioner of the Press is a member of the Nazi Party, and makes things very difficult for us. Unless we find the needed money he will force a distraint. This, of course, will be a serious blow for the section. I ask you, by order of the section, to help us. I have written to all foreign countries. We are unable to help ourselves, and therefore must rely on our fellow-members abroad.

” We are very sorry to ask such a sacrifice from you, but we are sure you will appreciate our situation. Please help us by raising funds as soon as possible.”

Dr. Brook, secretary of the S.M.A., has opened a fund for this purpose, and will gladly receive any donation. The E.C. has not yet discussed the matter, but will certainly send whatever the funds of the association will permit. If this can be increased by donations from individuals Dr. Brook may be able to send a sum that will be of real assistance to our German comrades. The stories of those German socialists we are meeting leave no doubt as to the brutality of the Nazi methods.


The E.C. has sent a message of congratulation, in which our readers will join, to Mr. Wm. Bennett on his great fight in the by-election at Hitchin. Mr. Bennett is an associate representative on the E.C.

LABOUR WOMEN AND STATE MEDICINE.

THE Labour Women’s Conference at West Hartlepool discussed and passed unanimously two resolutions moved by members of the Socialist Medical Association. The first, on Malnutrition, read: —

“That this Conference declares that the present amount of money received by persons earning low wages or receiving unemployment insurance or transitional benefit or public assist­ance is totally insufficient for the maintenance of physical health and for normal resistance to disease, in themselves or their families, and urges the Labour Party to work for adequate allowances.”

The second called upon the “Labour Party to prepare detailed plans for a State Medical Service covering preventive and curative medicine and health education, free for all; and to remove the evils of the panel system. It further asks the Party to include the establishment of this Service in the programme of the Socialist Government.”

LONDON ACTIVE

THE London and Home Counties Branch has had no meeting for some time, but a new phase of activity has commenced. A meeting was held on July 3rd, and as a result a series of meetings has been arranged. Miss Esther Rickards was elected chairman, and Dr. Powell Evans continues as secretary. The opening meeting of the winter will be on October 11th, and other meetings will follow. After much discussion it was decided, on the motion of Dr. Samuel, seconded by Dr. Salter, that the meetings should be at 8-30 p.m. As a general rule the association’s pamphlet will be used as a basis for discussion. It is hoped to get an opening speaker at each meeting who is known to have strong views on various aspects of the subject.

Business being disposed of the meeting had a stimulating debate on “A Socialised Medical Service,” and it was apparent that there are still many points on which the Association members are not unanimous. In particular, many appeared to feel that the difficulties of the General Practitioner had not been adequately recognised.

The meeting closed with a vote of thanks to Mr. and Mrs. Somerville Hastings, by whose kind invitation the meeting was held at 43, Devonshire-street.

THE SOCIALIST MEDICAL ASSOCIATION.

THE Association was formed to work for a Socialised Medical Service, both preventive and curative, free and open to all. Membership is open to all qualified medical practitioners who are socialists. The Association is affiliated to the Labour Party, and all members must accept the principles of the Labour Party.

Associate members are admitted. They must be socialists, and may be members of the Nursing, Dental, and other allied services, or students of these services or of medicine.

The fees are l0s. 6d. for members, and 5s. for associates.

Applications for membership should be sent to the Secretary,

Dr. C. W. Brook, 72, Balham Park Road, London, S.W.12.

JOIN THE S.M.A. TO-DAY!

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