DISSIDENT DOCTORS
By GORDON MALET SILENCE is often -the most effective answer to a vociferous and misguided minority. When, however, this minority is succeeding in persuading a substantial number of worthy people that there is something in what it says, the time for silence has passed. Such a situation has arisen inside the British Medical Association, which is soon to hold its postponed annual representative meeting. This meeting may well be the most important in the hundred years of the Association's existence, since here will be determined the policy which the organised mediO.l profession is to adopt towards the Government's proposals for a comprehensive national health service. If the delegates reflect the views expressed by the doctors in reply to the B.M.A. questionary, the hands of the negotiators will be greatly strengthened. They will be able to face the Ministry of Health with proposals which are designed to preserve the pro- fessional freedom of the doctors rather than to prejudice the working of the service ; 'proposals which (perhaps on lines indicated by Lord Dawson of Penn in a recent notable letter to The Times) could certainly be incorporated in the Government scheme without any serious detriment to it.
But there is a small but active organisation, calling itself the Medical Policy Association, which is making a determined attempt to capture the B.M.A. in order to oppose the White Paper lock, stock and barrel. Its methods are to circularise a large number. of doctors, urging them to elect as delegates to the annual representa- tive meeting members pledged to support the following resolution: That this meeting affirms its 'desire to see the extension of the full facilities of medical care and 'attention to the whole community, under conditions of privacy, freedom of contract, and personal responsibility of doctor directly and solely to patient, subject only to the Common Law and the ethical tradition.
This meeting is, however, totally opposed to control of doctors by any form of central authority that has statutory or other power to alter the private contractual relationship between doctor and patient. In consequence, it rejects both the proposals of the White Paper and those of the Council of the B.M.A. specified in para. 4o of the Council's Report on the White Paper. It therefore instructs the Council that the White Paper provides no basis for negotiation, and directs the Council to take the necessary steps so to inform the competent authorities. This meeting holds the Council responsible for carrying out this our policy, and will repudiate any other policy and any personnel representing it.
Furthermore, the delegates chosen are called on to refuse to vote on any question of administration, for fear they may be tricked by the executive of the B.M.A. into choosing between two alternatives, when in fact they would prefer neither. Finally, if the resolution is carried, Mr. A. Rugg-Gunn, F.R.C.S., a member of the Medical Policy Association, is prepared to convey the profession's policy for freedom to the appropriate authorities. The reason for mentioning him here will appear later.
There is a specious reasonableness about the M.P.A. resolution, and already certain branches of the B.M.A. have carried resolutions on the lines it advocates. It is known that the M.P A. has on its mailing list some 7,ocka doctors who are more or less in sympathy with its objects. Furthermore, the appeal is made in the name of the doctor's professional freedom in relation to his patients ; it is a condemnation of bureaucracy, and it gives an opportunity of having a hit at the B.M.A. headquarters, which, like most political bodies, is never as popular as it might be with the rank and file of the electorate.
The catch in the appeal is, of course, the fact that it neglects entirely the fundamental fact that the Government is pledged to a comprehensive health service. covering the whole population, based on some method of payment other than patients' fees. If the resolu- tion were carried, the B.M.A. would be in the fantastic situation of watching the Minister negotiate with the local authorities, the voluntary hospitals, and presumably the medical Royal Colleges, while being itself debarred from playing any part in the shaping of the new National Health Service.
The Medical Policy Association is catholic in its dislikes. Its main. enemies are the Ministry of Health, the executive of the B.M.A., P.E.P., the " Fabian Socialist Society " and the London School of Economics, all of whom are held directly or indirectly responsible for the Health White Paper. Its latest manifesto prudently omits reference to the crude anti-Semitism of some of its earlier documents. Of one of these the Minister of Information has said: " The com- plaints against individuals said to be in control of international finance might have been lifted from a speech by the German Fiihrer. But as the anti-Semitic ravings of the latter have never made any im- pression on the British people, I think the Ministry of Information may be forgiven if they regard ' the bulletin mentioned by my Honourable Friend as requiring no counteracting propaganda from them " (Hansard, February 23rd, 1944).
In the early days of the war The Lancet published a dignified obituary of Sigmund Freud. A few weeks later a letter appeared in The Lancet columns under the signature of Mr. Rugg-Gunn—the champion designated to throw down the gauntlet in Whitehall. It ran as follows: There are occasions when it is wise to disregard the old counsel de mortuis nihil nisi bonum, and this is one of them. It is both appropriate and necessary to record that Freud's unhealthy obsession with sex has been responsible to an overwhelming extent for the depravity of mind and perversity of taste that has affected, among others, English people, and particularly English women, since the last war. In itself a sufficiently grave evil, this result has had consequences immeasurably malignant, for it undoubtedly paved the way for wide acceptance of that complete Jewish ideology out of which sprang Bolshevism, Nazism, and the present war.
So Mr. Rugg-Gunn. He is no doubt sincere, both in his belief that Nazism sprang out of Jewish ideology, and that a central health autho:ity will destroy the practice of honest medicine. The two beliefs are of about equal value. But it is high time the doctors, particularly those who normally take no part in medical politics and to whom the Medical Policy Association makes a superficial appeal, should be warned. With the best intentions in the world, they may too easily deceive themselves into throwing over a professional asso- ciation which has guarded doctors' interests for generations and giving support to a body which, in the words of Mr. Brendan Bracken, is " prostituting the name of a great profession."
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