2 FEBRUARY 1951, Page 18

Doctors and Drugs

SIR.—In reply to "Ex-Patient," in the Spectator of January 12th, the figure of £1,000 for a thoracoplasty operation was obtained, from a medical journal. It was produced by an eminent consultant, who also stated that it cost £50 adequately to investigate a fever of unknown origin which might be a danger to public health. In spite of a careful search I have been unable to obtain the reference, and therefore must apologise to your correspondent. I think that the figure includes preliminary and after-treatment.

As regards the comparative expenditure on drugs of town and country G.P.s, here are some exact figures from Essex. Most country G.P.s manage on a capitation rate of 6s. per patient per year with the exception of expensive drugs which are paid for separately by the State. Actually these doctors reckon their drugs to cost then 5s. per head per year and Is. can then go towards the expense of providing a dispenser and dis- pensary. We G.P.s of the towns cause the State to spend 15s. per' patient per year ; roughly 10s. for the cost of the drugs and 5s. for the overhead expenses of the chemist. In Chester 23s. 6d. per year per patient is spent on prescriptions. In comparing the cost of the country and town prescribing, one must remember that the country G.P. provides a kind of modest chemist's shop, staffs it, lights it and heats it. • We who practise in the towns should be thoroughly ashamed of ourselves. Let no one believe that the country G.P. is such a fool as to prolong his patients' illnesses and waste his own time by providing cheap and nasty, or inadequate drugs.

I am very pleased to find that at Addenbrooke's the nurses are taught the cost of drugs ; this must be due to the good influence of Dr. Ff. Roberts. to whom the whole profession is indebted for having its atten- tion called to the fact that " the sky's the limit," at present.—Yours