BRITISH HEALTH SERVICE PLAN

Gisborne Herald, Volume LXXIII, Issue 21977, 22 March 1946, Page 3

BRITISH HEALTH SERVICE PLAN

ANNUAL COST OF £152,000,000

BOARDS TO CONTROL HOSPITALS

PATIENTS’ BENEFITS; DOCTORS’ CONTRACT

(By Telegraph—Press Assn.—Copyright.)

(11 am) LONDON, March 21. The Minister of Health, Mr. Aneurin Bevan, introduced the National Health Service Bill, accompanied by an explanatory White Paper. A further bill providing for Scotland will be introduced later. One of the salient features is that the bill imposes duties on the Minister of Health, local health authorities and on various new bodies to be established. This is in contradistinction to the existing legislation, which is largely permissive. The bill provides that all hospitals, except teaching hospitals, will come under the administration of regional hospital boards. It prohibits the buying and selling of practices and allows compensation of about £58,500,000 in England and Wales and £7,500,000 in Scotland.

Private practice will be permitted except by specialists engaged in wholetime service.

All or any of the services will be available to everyone. This will not be conditional on any insurance qualification and there will no waiting or qualifying periods. No Fees Payable by Patients

No fees will be payable by patients except for few special cases, though it is open to people who wish to do so to pay for special amenities, for example. more expensive appliances and additional privacy. Free choice by patients of doctors, and vice versa, will continue. It is hoped the scheme will begin to operate at the beginning of 1948. The estimated total cost in the early years is about £152.000,000 annually. The Government will bear the full cost of hospital and specialist service, (£87.000.000.) and also family doctor, dentist, pharmaceutical and eye services (£45.000,000), and pay about half the cost of various local authority services (£6,000,000). Allowing for a contribution of £32,000,000 from the National Insurance Fund (at the rate of lOd weekly for a man and 8d for a woman) and the savings on existing grants, the net additional cost to the Exchequer is estimated at £95,000,000. Administration of Hospitals

At present British hospitals are broadly in two classes: First, the socalled voluntary hospitals, ranging from the great teaching hospitals to cottage hospitals staffed by local general practitioners. and, secondly, public hospitals provided by the local authorities. The bill provides that the premises and equipment of all these hospitals (but not endowments of voluntary hospitals) shall be transferred to the Minister, except where he is satisfied that transfer is unnecessary. Special provisions are made_ for teaching hospitals, but the administration of all others which are transferred to the Minister will be entrusted to between 16 and 20 regional hospital boards, charged with management and planning. Each region will be formed so that its services can conveniently be associated with a medical university school. The boards will appoint local hospital management committees for each large hospital or related group of hospitals, forming a reasonable self-contained hospital service unit. Although the regional boards will look to the Exchequer for finance, they will be given as much financial freedom as possible for local initiative and enterprise. Attached to the ability of patients to pay extra for greater privacy is a condition that patients needing such accommodation on medical grounds will have it without payment. The Minister is empowered to provide separate payrooms or blocks for which people can pay the whole cost privately and in which part-time specialists within the service can treat private patients, again subject to the above condition. Private patients using the accommodation will * pay their own specialists’ fees within a prescribed maximum. Public Health Centres Under the heading “general personal health care by doctors and dentists whom the patient chooses,” the bill provides for the establishment of publicly equipped health centres under municipal control. These services will be available both from health centres and practitioners in their own surgeries, but the centres will also provide for many special clinical services

and serve as bases for health education.

Every man. woman and child will have placed at his or her disposal at home, doctor's surgery or health centre, even when away from their home district, a free comprehensive health service, including hospital and specialist services for the prevention, diagnosis. and treatment of illness, together with drugs, medicine and appliances. People will chose their doctor from the list of those joining the service, subject to the doctor’s consent. Thereafter the relationship between them will be the same as at present, except that the doctor’s remuneration will come from public funds and not from the patient direct. The doctors may arrange to treat privately a person wishing to remain outside the service. Remuneration of Doctors

The detailed .terms of remuneration for doctors joining the service have sjtill to be negotiated, but they will consist of a fixed part salary, varying according fo experience and circumstances, plus a yearly fee for each person whose care undertaken, plus, in the case of established doctors, interest on the computed compensation value of the practice which is payable normally on death or retiremtn.t. The contract of service will be no.t with the Government or local authorities, but with the executive councils to be established in each county or borough, half of whose members will represent the local doctors, dentists and chemists, one third appointed by the local authority and the remainder by .the minister. The bill establishes a medical practices’ committee for the regulation and succession io old practices. The opening of the new remuneration conditions for dentists who enter the scheme have still to be settled. Dentists working in their own surgeries' will submit claims for payment, but for certain forms of treatment will have to submit estimates to a dental board. Opthalmic Clinics The bill stipulates that opthalmic clinics, when operating, will be under the charge of medical opthalmologists. Spectacles may be obtained at clinics or premises of dispensing opticians taking part 'in .the service. Any chemist may join. It will be the duty of local health authorities to provide for the care of expectant and nursing mothers and also children under five years no.t attending school There will be a priority dietary supplement to the scheme under which codliver oil and fruit juices, etc., will be provided at pro rata charges. The local health authorities must provide a complete midwifery service for mothers confined in their own homes and also provide free vaccination and diphtheria immunisation, if desired. . Compulsory vaccination, which was introduced in Britain in 1853, is abolished under the bill. Provision of Domestic Help Domestic help will be provided for householders where it is needed on the grounds of ill-health, maternity, old age or child welfare. Blankets and extra comforts will also be provided in special cases.

The remuneration and conditions for all staffs are to be fixed through appropriate machinery ,and they will enjoy a superannuation scheme. A special .tribunal will hear cases where, it is claimed, the inclusion of a particular doctor, dentist or optician is prejudicial to the service. Where anybody under the bill is not carrying out his functions satisfactorily, the Minister may take over temporarily or permanently. The Minister will' be given professional and technical guidance by a Central Health Services’ Council, including people chosen from the main fields within the service and with standing committees of experts.