Dr. W. Lowry, chairman of the West Middlesex Medical Defence
Committee, contributes a remarkable letter to Monday's Times. He points out that four weeks of medical benefit imply thirty-one days of actual medical attendance per year and, if such attendance is to be worth anything, not fewer than fourteen visits or consultations. For this the State arranges to pay 4s. 6d. Now the rate actually experi- enced for the mean age between sixteen and seventy among 700,000 selected males by the Manchester Unity is eleven days, the discrepancy being due to the fact that the actuary has allowed for the difference between the "health expecta- tion" of the voluntary and the compulsory patient. Sup- porters of the Government scheme lay stress on the fact that any working-class doctor can have 1,000 insurance patients, and so earn 2225 a year. But even on this basis the doctor must pay 14,000 visits a year to the totally invalided, leaving the partially invalided out of account. This works out, deducting surgery hours from a twelve hours' day seven days a week, at thirty-eight 'visits of six minutes a day, or nearly double the number to which a doctor can give proper attention. Financially 14,000 visits a year pre- clude any private work whatever, and must necessitate a carriage, horse, and man, with a surgery, telephone, and servant—all to come out of 2225 a year.
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