THE MEDICAL SCHEME.

Evening Star, Issue 24004, 1 October 1941, Page 6

THE MEDICAL SCHEME.

Speaking in the second reading debate on the doctors’ Bill, Mr Nash is reported strangely to have said that the criticism of the measure by Archdeacon Bullock had hardly any relevance to its principles. We should have thought that it referred to nothing else. If it was meant to imply that the principles of the Bill were not such as were condemned by the archdeacon that suggestion would be difficult to reconcile with the proposals which the Government now makes to improve them, making them less susceptible to those particular criticisms. As the Bill was first drafted it made it an offence for a doctor to demand or accept a fee if he did not work under its narrow provisions. The plain implication was that he could accept the scheme or starve. That aspect of the measure will be considerably modified, in accordance with democratic principles, by the amendments now proposed.

A main amendment of the measure which is now volunteered was not asked for by the doctors. The basic fee has been appreciably increased. That proposal would imply that a chief concern of the doctors in their opposition to the Bill was the pecuniary effect that it would have for them, which was never the case. The doctors objected to the Bill because it would make them, by compulsion, servants of the State without the privileges or advantages of other State servants, and because they bad reason to fear that it would bring about a worse, instead of better, service for the people. No fault was ever found with the fees as they were fixed, and

the fact that, for practice outside tho scheme, they would have been too small was irrelevant when such service for fees was debarred. Doctors had a right to ask their trade union critics, as a correspondent does ’ to-day in our columns, how they would like for themselves conditions that meant “tho alternative of compulsory work or unemployment, wages and conditions under absolute control of a Minister and no right of arbitration.”

The aspect of State servitude is weakened by an amendment which provides that whore a doctor does not wish to claim directly from the Social Security Fund tho patient may pay him tho amount of his fee and recover from that fund at his local post office tho amount fixed as the fee in the Bill. Again, it is proposed to strike out the words which prohibit demanding or accepting a fee, except under tho scheme, and make this clause road, “ that no medical practitioner shall be entitled to recover from a patient or any other person any fees in respect of any general medical services or pharmaceutical requirements.” Fees may not be sued for—they have seldom been—but if a patient chooses to pay without reference to the scheme that will concern nobody except the parties. It becomes conceivable that some older, more established practitioners might be able to carry on their practices as they have always done, standing outside tho system, or they might combine both methods, A token fee for all patients, to discourage unnecessary calls, and recourse to arbitration for the doctors where adjustment of conditions is required, would go much further to improve the scheme. Tho object should be the largest, not the smallest, freedom for doctors, compatible with that service for all which forms tho desire of both parties.