i ¡1h / I ¡ i lE T . A iw ust 1St], % in.i

THE TABLET A WEEKLY NEWSPAPER AND REVIEW

PRO ECCLESIA DEI, PRO REGE ET PATRIA

VOL. 198, No. 5804

LONDON, AUGUST 18th, 1951

SIXPENCE

FOUNDED IN 1840

PUBLISHED AS A NEWSPAPER

THE PROTESTANT MINISTRY Some Changing Social and Economic Conditions and Their Effect

STALIN’S HUMAN CIRCUS An Eye Witness at the Berlin Youth Rally. By Auberon Herbert

TRANSITION IN YUGOSLAVIA The Conclusion of a Correspondent’s Enquiry

TOWN AND COUNTRY THE SENTIMENTAL ICONOCLAST

A Catholic Rural Congress

By Arnold Lunn

THE DOCTORS’ NEW OPPORTUNITY M

R. MARQUAND as Health Minister has gone some way towards the doctors on the question of their pay under the health scheme. They must meet him, and the occasion will be a crucial one ; and all those who were sadly disappointed at the way the medical profession showed itself lacking in self-confidence and fundamental unity and resolution to protect its independence as a profession will attach an unusual importance to the new opportunity for a revision. What is at issue is much more than money, and the amounts of the remuneration under the Act in the light of the cost of living. So viewed the doctors assimilate themselves to other trade unions, and must expect to meet with the same argument that everybody must show restraint and patience. Where the doctors as a profession are on an entirely different footing from any Trade Union, and where they will plainly be acting in the interests of the whole nation is in stipulating to the Minister that the pattern of their activities under any organized National Health system must be one which renders easy and not difficult the maintenance of the highest standards of conscientious medical care.

think they may as well have it, since they are compelled to pay for it. From this point of view, a small initial charge for visits and prescriptions would have solid advantages over the present system where everything is left to the individual doctor's ability to temper his habitual courtesy, to change gear and become not the helpful friend of the individual patient, but the representative on the spot of the Ministry of Health, determined to see that public facilities are not being abused. Perhaps the biggest disappointment of the health scheme so far has been the often heart-breaking delays, the queues for beds and operations, many months ahead if they are to be under the Health Act, but possible next week if the patient is prepared to resume the status of a private and paying patient. As with education, so with health, the available facilities have been over-strained in the search for political prestige. The Example of the Miners

The greatest merit that can be claimed for a national system is that it enables doctors to dismiss from their minds considerations of what the patient and the patient’s family can afford in the way of prolonged expensive treatment. Even so, a doctor still has,to take into account a man’s circumstances, in the sense that where earnings stop during illness or treatment, that may give rise to anxieties and family privations which may counteract the benefits of extended rest. There has undoubtedly been a gain in that people are readier to face the idea of operations and treatment where previously financial considerations strongly reinforced the natural human tendency to optimistic procrastination in such matters. For this reason Mr. Marquand was ill-advised ever to have suggested to the doctors that it might be possible for the State to give them more money if it was found that their prescriptions were costing less. Only too easily could rumours spread, that National Health patients only get the cheap medicines, a rumour which would undo so much of the psychological benefit which the medicine bottle can bring.

If the doctors are inclined to waver they will do well to follow closely how the miners deal With the Government. Last January the National Coal Board granted a wage increase to the lower paid miners in an agreement through the National Union of Miners, which included the stipulation that there should be Union support for the importation of a limited number of Italians. Now that the Italians are here the men in a number of pits in the Yorkshire coalfields are refusing to let them work, for one reason or another. One colliery has charged its branch officials to see that no efforts are made to persuade the men to change their minds. The kind of reasons adduced for disowning the January agreement are trivial enough. One colliery says that the money spent training the Italians could have been used to attract Englishmen— another that there is not enough room in the colliery face, and another that Italians often leave. Yet this is at a time when coal has never been more important. We approach a winter in which millions of tons have to be imported ; and so it is much more economical to bring in men to cut the coal which is under our feet rather than to import the coal from the United States for dollars.

The profession and the Ministry of Health have to work in common towards such changes as will cease to make it particularly profitable for a doctor to have the largest possible number of patients, and to become adept in disposing of them with a lightning dexterity, of which there are many circumstantial stories in all parts of the country. The doctor must be restored to the position that he is the judge of how much time and care he will expend on one particular case, without there being a murmuring among the people that he, their paid servant, is showing favouritism at will. What is most of all wanted is some better way of distinguishing between those who really need his attention and those who

The great strength of the miners, in contrast with the doctors, is that the miners have their own community life, and are very much less sensitive to what the general public may think. Whereas the medical profession has had for generations a singularly highly-developed sensibility. Under the old conditions it was the local public opinion which made or marred the private doctor's practice, and it was a system which worked very well, and had brought into existence a high type of general practitioner in this country. I f the profession negotiates on more equal terms with Whitehall now, that will itself be a reflection, a barometer rriarking a changed public opinion, and a growing realization that the nation