SIR,—Before the general public comes to a judgement on the distrust shown by many medical practitioners of the intentions of the Govern- ment towards them, it would be as well if it is given some reasons for this distrust. If certain medical men are to be paid on the basis of their earnings during the past few years, they are sure to be underpaid—because they have been underpaid for certain services for many years under the National Health Insurance scheme. Before the war country doctors received an allowance for mileage. This may have been too much or too little, but, while their expenses in this matter have been increased by too per cent., ,their actual payment has been increased by less than so per cent., and the "capitation fee "—or annual sum per patient— remains lower than it was In 1913. In my case, I consider that I am really owed a great deal of money, and cannot compute how much time, worry and hard work have been expended upon the one problem of "keeping on the road." We have throughout been charged taxes as if our cars were for, private use, whereas, of course, they were allowed to remain on the road at all only because of the essential need for them. Although one dodos can only drive one car at a time, the necessity of having to possess two cars merely doubled our taxation. In order to be sure of a reliable car I used to change to a new one every twelve to eighteen months, but I found that it was absolutely necessary to have two old cars dining the war if one was constantly requiring repairs.
Throughout the, same period the allowance for mileage for military and R.A.F. work has been 6d. per mile one way, without payment for the first two miles. This works out at is. 6d. for a visit to a place five miles away ; ten miles—is. 6d.! Personally, I have worked under contract rates, but,.those doing casual work had to use their cars for this dreadfully inadequate compensation ; and I believe that this rate still persists.
My computation of too per cent. increase in motoring expenses does not include the annual sum allotted to "depreciation" ; and to add a further load to our already breaking backs we are still forced to pay heavy purchase tax, if buying a new car I Taxation has even gone so far as to make dispensing doctors pas' purchase tax upon essential drugs. The future should not be built, and cannot fairly be built, on the sacrifices of the past. Thotsands of "medical certificates," for all sorts of reasons and commodities, are demanded, for which few doctors make any charge —because they are needed by people who can no more help requiring them than the tailor can avoid giving them. But free work can be pushed too far, and certainly should never be demanded by the Govern- ment. The secrefaiial side of the new- insurance scheme has not yet
been discussed. What national scheme can avoid being loaded with paper by the ton, and records and reports by the million? Will doctors receive any help in this drudgery?—Yours truly, F. 0. TAYLOR. Kirkhill, Coldingham, Berwickshire.