6 FEBRUARY 1948, Page 15


SIR,—In arguments for and against the projected National Health Service there seems still to be an inadequate appreciation by the general public of the unique nature of the relation between doctor and patient. Analogies such as the relation between solicitor and client, tradesman and customer, or even that between schoolmaster and pupil, are all inadequate. A volume could be written on the psychological and ethical implications of this most intimate personal relationship, but I can only state baldly my own experi- ence of socialised medicine for over four years in the R.A.M.C. during the first world war, followed by thirty years of private practice (combined with academic work in a university). The former period of work involved

me in several serious tussles with " the powers that be " on behalf of my patients, whereas the latter years have been a pure joy to me in my com- plete freedom to make my patients' interests my own as regards treatment and advice. One's private practice is one's life, not merely one's livelihood.

I feel confident that this doctor-patient relationship, which demands personal freedom in the highest degree, is (or should be) at the core of the present controversy between the Minister of Health and the doctors— far more fundamental than questions of emoluments or terms of service. Private medical practice is in a very different position from that of medical research, medical teaching and medical administration. These latter lend themselves better to the process of socialisation, and, given adequate safe- guards, would benefit from it. But medical practice is essentially bound up with personal freedom and personal initiative and responsibility, and cannot be a matter of party politics.—Yours, &c., WILLIAM BROWN. The Athenaeum, Pall Mall, S W.z.