Doctors' awards
From Dr H. Jacobs
Sir: Dr John Linklater's article (March 22) points out to what many hospital doctors and consultants, who are far from the seats of privilege and power, consider to be an unhealthy and demoralising aspect of the British medical scene. This is the scattering of large numbers of secret awards by committees, meeting in secret, themselves all the holders of similar underground money. Everyone might favour a few large awards to such people as the discoverer of penicillin, etc. However, a system which secretly scatters large amounts and numbers of these payments, while patently not giving another large body of people the same, on what seems to be, indeed must be, to fair extent a personal preference basis, smells strongly. The people who get them are nearly always doing much better financially with private practice. They may often have the pleasure of being at a university or a large and well equipped centre. it is no surprise in view of the composition of the committees and their possible prejudices and natural feelings of greater esteem for their own immediate speciality, that there is extraordinary disproportion of awards between specialities. Whereas I would guess that at least a quarter of the senior surgeons in any provincial area get these awards the entire staff of a world famous London psychiatric institute, the Tavistock could, if I recall correctly, only muster one between them not very long ago. At a recent national conference everyone from the floor on this subject was bitterly against it. Those, however, not at the grass roots, naturally tend to support an existing order; they themselves must be pretty likely candidates. If people who knowingly becoming Professors do not realise there has always been a financial penalty, compensated by other sweets, it is surpris; ing. They should always he well and adequately paid — but not by money under the table. Any patronage system, with inherent probabilities (whatever is done to check it) of an old boy network must be bad for morale and honest straightforward dealing.
Harry Jacobs Severalls Hospital, Colchester
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