THE NATIONAL HEALTH SERVICE SIR, — Since you appear at last to
have grasped the significance of the NHS, the title of your leading article should have surely been 'The Cost of the Medicine-Bottle.'
That expensive bone of political contention. the NHS, is of course managed by committees of local politicians who have themselves been brought up in the superstition of the medicine-
bottle; their medical advisers are men who have achieved their eminence by exploiting it. So that even if a thoughtful section of the public were to start on a change of mind now, there might be some hope for the next genera- tion but one.
In 8 years £250.000,000 has been expended on what Mr. Aneurin Bevan himself ventured to call the 'cascade of useless nostrums,' and of this huge expenditure there is little doubt that a hundredth part would have amply covered the cost of all drugs having any strict therapeutic indication. The most expensive antibiotic capsules are I7s. 6d. each (two to be taken 4-hourly) and there is an ointment at about £5 per ounce : until something more expensive comes along these will be de rigueur. Should a patient die before he has consumed the week's supply it is unlawful to take these costly pills back into stock and they must be destroyed in the presence of the doctor. The old Egyptian civilisation ended up as a para- dise for undertakers, ours is dedicated to the pharmaceutical industry. A pyramid equal to that of Cheops could doubtless he constructed with the unconsumed and unidentifiable pills that have escaped their statutory tate.
Drugs, operations, etc., are of course eagerly sought by the sick who, unable or unwilling to understand the real nature of their illness, enthusiastically embrace the figments of a mechanistical explanation. Sometimes indeed their symptoms are relieved or varied by hocus-pocus unsupported by time-consuming emotional rehabilitation, but rarely for long; indeed it is more likely that their chances of spontaneous remission are reduced by the sort of therapeutic solicitude afforded under the Health Act. But the Monthly Sickness Rates can be left to speak for themselves.
That there is no attempt to prevent sickness of the kind you correctly judge to be prevalent or to deal with the real causes in the individual case is the inevitable consequence of the system by which the doctors are remunerated.—Yours
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