Medical scheme
Sir: The proposals that are floating around about finding the money for the Health Service by having people pay LI for a surgery visit and E2 for a home visit may make economic sense, but they are most alarming for the many people in this country who cannot afford to pay them. Certainly if the Conservative Party adopt such a policy, poorer people (and not only working-class people) who have been considering voting Tory are likely to be frightened into voting Labour after all. The fear of a Communist takeover is rather more distant than the fear of one's children, or husband or wife, being ill and oneself unable to call a doctor because one could not pay.
Whatever arrangements should be made about hospitals, is it not more sensible to do something like' the following for general practice? Let everyone choose a doctor, who is free to accept or reject them as he wishes, but must not take more than two thousand patients. They should each PO him El 0 per annum, which, giving him an income of £20,000, should be enough to PO the expenses of a practice and still leave the doctor a good income. Anyone who could not afford to pay because of low income or large family should be able to get assistanCe towards paying part or all of it. It might be as well for this assistance to be in the forni of a voucher which only the doctor could cash, instead of a patient receiving MnoeY, or a cheque which conceivably could be span on something else. There would have to be working rules, as for instance what happened when one moved house, but these should not be difficult to formulate. They should not, however, be left to civil servants, for the tend to formulate tortuous rules which need a large secretariat to sort out. A second suggestion concerns th°se ancillary services which at the moment are located in either large hospitals or ser called 'health centres.' A health centre should not be a congregation of GPs with, an assortment of ancillary workers. It al! smacks of charity, and makes an individual into a unit—a number instead of a narne' What it should be is a centre about the size of a cottage hospital, patronised (and I us! the word patronised deliberately) by abou.l thirty doctors who each contribute saY per patient per annum to the cost of thet centre, giving it an income of £60,000. V4/hd it cost over and above that figure could be met by a grant from the Health DePaLtment, but some at least of the cost would borne by the consumer. Such a centre could do most of the work that a hospital casualty service does. Ow, casualty patients are at death's door, all' not many need the use of expensive ecluiP: ment that only makes economic sense in 7 large hospital. It could also do the tYPe work that is ordinarily done or suppose be done in health centres by nurses, PhYsi°,; therapists, chiropodists, social workers an" soon.
Irby, Wirral, Merseyside posed to
be done in health centres by nurses, PhYsi°,; therapists, chiropodists, social workers an" soon.
M. Lavender 87 Thingwal I Road, Irby, Wirral, Merseyside posed to
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