16 JANUARY 1948, Page 2

The Doctors' Objections

The considered attitude of the medical profession towards accept- ance or rejection of the National Health Service Act conditions will not be known until the result of the plebiscite to be taken on January 31st is known, but meetings at present being held under the auspices of the British Medical Association in London and "the provinces suggest that a fairly heavy vote is likely to be cast against acceptance of the proposals. Apart from the general atmosphere of mutual hostility there are three principal questions at issue. On the first, the right of a doctor to carry an appeal not merely to the Minister but to the courts, there is at least as much to be said on the Minister's side as on the doctors' ; none the less Mr. Bevan could well afford to make a concession here in the' interests of general conciliation. In setting his face against the sale of practices which will no longer be private practices he is on strong ground, and in the matter of so-called "direction," which, in fact, is not direction at all, the doctors are taking an untenable position ; it is perfectly reasonable to prevent the influx of more doctors into areas adequately. provided for already. But the ambiguity about partnerships should certainly be settled by an amending Act, not left to the issue of subsequent litigation. There remains the question of the basic salary of £300. The objection to it among doctors is widespread, based on the fact that once the principle is conceded a Minister will be able by administrative action so to change the proportions of basic salary and capitation fees as to make doctors full-time salaried servants of the State. The last word on this has not been said. National Insurance has worked well on a purely capitation basis. A stronger case than has yet been made for the £300 is needed.