LETTERS TO THE EDITOR
Health Means Test?
Sta,—Sir Ronald Davison's article is most opeorhme. I fear however that he only touches the fringe of the problem—I nearly wrote scandal. Throughout the country there were a large number of hospitals, voluntary and municipal, which were with very few excep- tions swept into the control of Regional Hospital Boards. These hospitals had managed their affairs well and with strict economy, but with the advent of the new control a host of salaried non-medical posts were established. The cost was enormous, and efficiency was in inverse ratio to the numbers. At the same time there was a spate of young consultants—men who had taken the Membership of the College of Physicians or the Fellowship of the College of Surgeons and were eager to cash in on these higher qualifications. Private practice was allowed in every case, and it must be remembered that the minimum fee of a consultant was not the five shillitags of the general practitioner but three guineas.
It must be admitted that the doctors were themselves largely res- ponsible for this chaotic condition because they refused to abandon the long since dead "doctor and patient relationship," to which. was firmly fixed "free choice of doctor." There is no room in a Welfare State for medical practitioners to indulge in a scramble for patients irrespective of their capacity to treat them adequately.
What is the remedy ? Firstly, the abolition of all private practice, general practitioners' and consultants' alike. Secondly, a whole-time salaried medical service with proper arrangements whereby doctors would work definite hours, and enjoy their leisure off duty, and thirdly, the abolition of "doctors' surgeries" and the establishment in their stead of organised health-centres. The consultant class would fight tooth and nail against this curtailment of their liberty and fees, and they would use every means to make the G.P.s follow their lead; but that is the only solution of a problem which will progressively become less soluble. It must come in the end, but when ?—Your
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