THE DOCTOR'S FREEDOM
Snt,—There was a time when The Spectator held aloft the torch of freedom, and freedom is the real issue between the doctors and the State. Changes are necessary, and advance is necessary, but not advance with the times when the times are out of joint. Here is a profession with great traditions of service which is now threatened with loss of liberty without corresponding benefits to patient or doctor, and with complete ultimate dependence on a Minister who is the servant of an idea which puts the State before the individual. Medicine, which has been hitched to an ideal, must now be hitched to an ideology ; party politics, which have destroyed individualism in local government, must now do the same for medicine.
Public attention is centred on the sale of practices, remuneration, the right of appeal, partnership agreements, direction and distribution ; these are details which could be adjusted but which pale into insignificance alongside the spectre of State medicine under a party boss. " Divide and rule " is no prerogative of the patricians ; and we are in the midst of an attempt to get support from the medical profession by appealing to the financial interests of the large number of general practitioners who earn less than £1,000 a year and by placating the influential body of consultants and hospital staffs. The best doctor is not always the one with the most names on his panel nor the one who can dispose of the greatest number of cases in sixty minutes, and yet the Act puts a premium on this kind of threepenny doctoring. Capitation fee and basic
salary are both wrong, and the only way to run a medical service which respects the needs of the patient and the traditions of our profession is to divorce its management from politics and to put it in the hands of an independent corporation. We are told that "democracy has spoken" and that the Act must be implemented, but democracy nowadays means nothing without geographical qualifications, and the Act contains " no compulsion whatever " to join the service ; even if it did, there might still be found in this country some few who dared to defy it. Ten generations ago our ancestors thought nothing of disregarding the law when freedom was at stake, and their witness has given us a heritage both of privilege and duty.
In reality the whole issue is religious rather than political ; Christianity respects the individual, totalitarianism the State ; and successive Govern- ments of this country have tended to move not so much to Right.and Left as towards totalitarianism. All around us we see the bulwarks of freedom crumbling and nobody bothering to build them up again, because they interfere with our long-term planning for economic survival. There is, however, quite a chance that the doctors may take the right decision for the wrong reasons, and, even so, deliverance may yet come by the few.
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