15 AUGUST 1952, Page 16

The Speirers

SIR,—Mr. Ochiltree has touched on a very unpleasant aspect of modern bureaucratic control. It reminds one of the old jingle:

"Big fleas have little fleas upon their backs to bite 'em,

And little fleas have lesser fleas and so ad infinitum."

Fleas are very irritating, and so is this horde of snoopers who run about in Government cars to see that the harness is well and truly fitted to our backs.

Under the National Health Scheme we find ubiquitous "health visitors," usually in the form of smart young women who visit our patients in shiny cars without as much as "by your leave," and who question them about their progress, and as to whether the doctor has been to see them. The object presumably is to make sure that the doctor is not keeping them away from work too long. The doctor cannot be relied on to use his own judgement in the matter.

Such a visitor recently visited one of my patients who was too lame to get out of bed. In the course of conversation he elicited the fact that I had not visited the patient to certify her incapacity for work on the day on which I had -givgn her a certificate, although it was perfectly obvious that the patient was quite incapable of walking. The health visitor accordingly secured a signed statement from the patient to that effect. All this without my knowledge. The result was a fine of £5. This method of investigation is despicable, and it is small wonder that Mr. Ochiltree sees in the situation grounds for