HEALTH SCHEME IN BRITAIN

Press, Volume LXXXVII, Issue 26605, 15 December 1951, Page 8

HEALTH SCHEME IN BRITAIN

MR J. J. BROWNLEE’S > VIEWS “BOTH GOOD AND BAD POINTS ” The national health service in Britain has both good and bad points, according to Mr J. J. Brownlee, plastic surgeon in charge of the plastic surgical unit at Burwood, who has returned to Christchurch after spending six months overseas. Mr Brownlee said that the scheme had provided plenty of registrars and assistants for clinical and research work, and staffs were better p'aid than they had been, but the scheme had imposed many bureaucratic restrictions on hospital activity and had tended to take away individuality from hospitals. In the old days, said Mr Brownlee, the hospital board or correspond’ ing body had the administration of a hospital completely under its control, but now any proposals for changes in administration of any kind had to go through regional committees and sq many channels that it was difficult for the senior people in a hospital to find out what was happening to a proposal, and if it was turned down to find the reason. This procedure led to a sense of frustration, he said.

“In gome instances there is as much or more delay in the bunding of hospital units than in New Zealand,” said Mr Brownlee. “The plans for the plastic surgical unit which was to replace the St. Albans plastic unit had been passed when I was in England in 1946. but the building has not yet been started, and the unit ip still working in the same accommodation as it did during the war. Other general hospitals have had the same experience.” A good feature of the health scheme was the system of making hospital appointments, said Mr Brownlee. Appointments were made through a regional committee on the advice of an appointments committee, which varied in composition in accordance with the type of position to be filled. If an anaesthetist was to be appointed a senior member of the committee would be an anaesthetist appointed oy the Society of Anaesthetists, and if a plastic surgeon wag to be selected the committee would have a plastic surgeon nominated by the Royal College Of Surgeons, through the Association of Plastic Surgeons. Nursing Position

In many hospitals, Mr Brownlee said, there was a shortage of nurses, bur in the better-known major hospitals, such, as St, Thomas's, Guy’s, and Middlesex, there were long waiting lists. “The training at these places is regarded as being much harder and the status of one of their graduates, rightly or wrongly, as being higher." Mr Brownlee said he had observed m England that the hospitals endeavoured to have as big medical staffs as possible, and in particular in specialist units. The idea seemed to be that the natural competition among a number of people would bring the best out of them.

At a conference of plastic surgeons he attended it was generally accepted that the best work in repairing hands had been done by a Melbourne man, B. J. Rank, said My Brownlee. His work in tendon grafting had been phenomenal.

The number of Dominions people in the plastic field in England was remarkable. said Mr Brownlee. The head research man in Edinburgh was a Canadian and the head of the Oxford unit was an Australian, Sir Thomas Kilner, At the East Grinstead Plastic unit was Sir Archibald Mcfiidoe, of Dunedin, and two of his assistants were froip the Dominions. Sir Harold Gillies, who was regarded as the father of plastic surgery, was at Basingstoke, and his first assistant was an Australian, and Mr John Brown, a former Christchurch house surgeon, was in charge of a growing unit at Salisbury. Mr Brownlee said that through a scheme organised partly through benevolent trusts surgeons from Europe could now receive training in England in their special.fields. At present there were six foreigners, including an Indian, a Scandinavian, a Frenchman, and an Italian, at East Grinstead, Two French women were also | there, specialising in anaesthetics.