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in the limited field of a profession, it is not enough tosay that we want a status and privileges enabling us todo as we like: we must answer the question " freedomfor what " The only convincing answer, as I see it,is that we need freedom to serve : we need it because itis indispensable if we are to do our work as it shouldbe done. On a short view there are often advantagesin interfering with the doctor’s freedom ; but the com-

munity will buy these advantages very dear if it dis-

courages any member of our profession from bringinghis own judgment to his patient’s problems and to theadvancement of his art and science. Much of the reputa-tion. and much of the value, of medicine rests on thewillingness of many doctors to take unlimited troublebecause they feel responsible for the patient’s life or

happiness ; and wherever this personal feeling is weakenedthe work of these doctors-though it may look much thesame-is done on a lower level of effort. Abolish it

altogether, and the standards become quite different.I suggest therefore that what we seek is not so much

professional freedom (which has a selfish ring) as pro-fessional responsibility. Not in our own interest but inthat of the community, it is essential that every memberof the profession past the stage of instruction shall beable to do his work without hindrance, as a physicianfully responsible to whatever patient is before him andfor the moment in his care."Liberty," said Bernard Shaw, " means responsibility.

That is why most men dread it." 16 It is because libertyalone permits responsibility that our profession mustretain it, or, as some would say, regain it.

(To be concluded)

Special Articles

CENTRAL HEALTH SERVICES COUNCILTHE Minister of Health has made the following appoint-

ments to the Central Health Services Council and standingadvisory committees for the period ending March 31,1954 :

CENTRAL HEALTH SERVICES COUNCIL

MedicalPractitioners.-H. Guy DAIN, F.R.C.S. (Birmingham);HORACE JOULES, F.R.C.P. (London) ; W. G. MASEFIELD,M.R.C.S. (Eastbourne) ; W. N. PICKLES, M.R.C.P. (Yorkshire)Sir HARRY PLATT, F.R.C.S. (Manchester).Persons with Experience in Hospital Management.-Sir

BASIL GIBSON, J.P. (Sheffield); H. N. LINSTEAD, PH.C., M.P.(London).Persons with Experience in Local Government.-Dame

GWENDOLINE TRUBSHAW, J.P. (Llanelly) ; Alderman W. E.YoRxE, J.P. (Sheffield).Dental Practitioner.-Prof. R. V. BRADLAW, M.D.S., F.R.C.S.

(Newcastle upon Tyne).Person with Experience in lt2ental Health Service.-Sir

CECIL OAKES (Woodbridge, Suffolk).Registered Nurse.-Miss KATHERINE G. DOUGLAS, S.R.N.

(London).Certified Midwife.-Miss NORA B. DEANE, S.R.N. (Bristol).The Central Health Services Council has re-elected Mr.

FRED MESSER, M.P., as its chairman, and Sir HENRY CoHEN,F.R.c.P., as its vice-chairman for the current year.

STANDING ADVISORY COMMITTEES

MedicalH. GUY DAIN, F.R.C.S.; HORACE JOULES, F.R.C.P.; W. G.

MASEFIELD, M.R.C.S. ; W. N. PICKLES, M.R.C.P.; Sir HARRYPLATT, F.R.C.S. ; ; SOMERVILLE HASTINGS, F.R.C.S., M.P.

(London).Dental

Prof. R. V. BRADLAW, M.D.S., F.R.C.S. ; C. V. ARMITAGE,F.D.S. R.C.S. (Stockton-on-Tees); Prof. H. F. HUMPHREYS,M.D.s., M.B. (Birmingham) ; D. E. MASON, L.D.s. (Nottingham-shire) ; J. A. MOODY, M.B. (Essex);...; T. G. WARD, L.R.C.P.., ,F.D.S. R.C.S. (East Grinstead).16. Cited by N. Hilditch. In Praise of Freedom. London, 1949;

p. 50.

PharmaceuticalPAUL DOBSON, PH.C. (Leeds) ; ; JOHN GILMOUR, M.P.S.

(Liverpool) ; ; J. C. HANBURY, B.PHARM., (Herts) ; ; J. B.LLOYD, M.P.S. (Manchester) ; J. H. WooD, M.P.S. (London).

Ophthalmic .

0. M. DUTHIE, F.R.C.S. (Manchester) ; R. AFFLECK GREEVES,F.R.c.s. (London) ; S. M. WELLS, F.S.M.C. (Reading) ; F. M.WISEMAN (London).

NursingMiss NORA B. DEANE, S.R.N. ; Miss KATHERINE G. DOUGLAS,

S.R.N. ; J. D. BENTON, S.E.A.N. (London) ; Miss ELIZABETH M.DOWNER, S.R.N. (London) ; Miss LucY A. D. EvANS, S.R.N.(Shrewsbury) ; Miss EvA M. HILLIER, S.R.N. (Manchester) ;Miss JANE E. THOMAS, S.R.N. (Cardiff).Maternity and Midwifery

Miss NORA B. DEANE, S.R.N.; E. W. SCORER (Lincoln) ;ARNOLD WALKER, F.R.C.O.G. (London) ; Miss MARY WILLIAMS,s.R.N. (London).Tuberculosis

Sir BASIL GIBSON J.P. ; Sir HARRY PLATT, F.R.C.S.; MissMARGARET S. COLTART (London) ; FREDERICK HALL, M.D.(Preston) ; J. C. H. MACKENZIE, M.D. (Leicester) ; WILFRIDSHELDON, F.R.C.P. (London).Mental HealthW. G. MASEFIELD, M.R.C.S. ; Sir CECIL OAKES ; Dame

GWENDOLINE TRUBSHAW ; CLAUDE BARTLETT (South Devon) ; ;JOHN BOWLBY, M.D. (London) ; ; Mrs. KATE F. MCDOUGALL(London).Cancer and RadiotherapyHORACE JOULES, F.R.C.P.; Sir HAROLD BOLDERO, F.R.C.P.

(London) ; ; CUTHBERT E. DuKES, M.D., F.R.C.S. (London);Sir STANFORD CADE, F.R.C.S. (London) ; J. A. STALLWORTHY,F.R.C.S., M.R.C.O.G. (Oxford) ; ; C. J. L. THURGAR, F.R.C.S.

(Newcastle upon Tyne); Prof. R. MILNES WALKER, F.R.C.S.(Bristol); Prof. B. W. WINDEYER, F.R.C.S., F.F.R. (London).

GENERAL MEDICAL COUNCILMEDICAL DISCIPLINARY COMMITTEE

THE Medical Disciplinary Committee of the GeneralMedical Council, with Prof. DAVID CAMpBELL, the

president, in the chair, held a special sitting on July 10and 11 to consider the case of Jack Michael Sinclair,M.R.C.S. (1940), registered as of 52, Heaton Road, New-castle upon Tyne.

Dr. Sinclair was charged with having, " during theperiod beginning in or about December, 1948, and endingin or about May, 1949," behaved improperly to andcommitted adultery with Mrs. Peggy May Kennedy,with whom he stood in professional relationship. The

complainant was Chief Petty Officer Kennedy. Mr.Gerald Howard, K.c., M.p., with Mr. J. -MacGregor,instructed by the solicitors to the council, presented thefacts to the committee. Dr. Sinclair was represented byMr. N. Leigh Taylor, of Messrs. Hempson, solicitors,.on behalf of the Medical Defence Union. The case washeard by 14 members of the committee. It originallycame before the committee at the May session ; the

proceedings at that hearing were not published becausethe committee, unlike a court of law, does not allowreports to appear before a case has ended.When the case opened in May, Mr. Taylor objected to the

charges on the grounds of want of particularity. In addition,he objected to one charge embracing two matters-improper-behaviour and adultery. Mr. Howard did not think that thecommittee was bound by the laws governing the criminal-courts ; "on a day unknown" " between two dates was aperfectly good count. The committee accepted the advice of-the legal assessor (Mr. C. P. Harvey, E.c.) that there was nosubstance in the objection at that stage.

Mr. Howard then outlined the case and stated that Mrs.Kennedy was not present. Mr. E. C. Coles, the first witnessto give evidence on oath under the Medical Act, 1950, describedattempts to serve a subpoena on her. Mr. Howard submittedthat the transcript of the evidence which she had given oricommission in the case of Goodman v. Sinclair (in which.

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Mr. Justice Vaisey in the Chancery Division granted Dr.Harold Goodman a dissolution of his partnership with Dr.Sinclair on the grounds of the latter’s conduct with Mrs.Kennedy and other matters) and the judgment were admissibleunder the dicta in the case of Spackman and rule 63 of theDisciplinary Committee’s rules. Mr. Taylor contended thatthe committee was not entitled to accept -the deposition ofMrs. Kennedy, and, if they were, they ought not to do so. Healso objected to the judgment. The legal assessor advisedthat the judgment was prima-facie evidence of the facts whichMr. Justice Vaisey found. With regard to the evidence, itseemed that the Kennedys were in England and subpoenascould be served. Mr. Taylor could apply for an adjournmentfor this. After protesting that he should not be put to electionas to whether to ask for an adjournment by reason of thefailure of the complainant to produce evidence, Mr.’Taylorasked for.an adjournment, which was granted.

At last week’s hearing evidence was given by Mrs. Kennedyon subpoena. In evidence Dr. Sinclair denied that he had evercommitted adultery or acted improperly with her. Mr. Taylorsubmitted that the ruling of the legal assessor that the tran-script of evidence in the Chancery Division was admissiblewas wrong in law. Because of that ruling he had been put toelection as to whether to ask for an adjournment. Thechairman said that it was open to the committee to decidewhether they should adjourn a case to hear the best availableevidence, and the legal assessor said he did not think this couldbe taken further before the committee ; it might be a matterfor the Privy Council. Mr. Taylor next submitted that thejudgment of Mr. Justice Vaisey was inadmissible, and that thereading from it hopelessly compromised the case. It dealtwith matters not in evidence before the committee and withdifferent issues between different parties. The legal assessorintimated that this also was a matter which might be dealtwith elsewhere. Mr. Taylor then addressed the committeeon the evidence, saying that his whole case was thatMrs. Kennedy had been lying.The committee found the facts alleged against Dr.

Sinclair proved to its satisfaction, and that in relationto the facts he was guilty of infamous conduct in a

professional respect. The Registrar was directed toerase from the Register the name of Jack Michael Sinclair.Dr. Sinclair has 28 days from receipt of the officialintimation of the finding in which to appeal to the PrivyCouncil.

Medicine and the Law

" Continuously under Care and Treatment "

LAST April the case of F. v. F.1 showed that the DivorceCourt took a literal view of the word " continuously

" inrelation to the period of care and treatment which wouldjustify a decree on the ground of insanity. The respondentwife had been discharged " not improved " from a mentalhospital in England on Dec. 23, 1946, and had been takenunder escort from Whittingham to Dumfries for specialtreatment. There she was, on the same day, admittedunder an emergency certificate, followed by a sheriff’sorder. On March 25, 1948, she was discharged " notimproved " and brought back to England, to St. PancrasHospital, under escort ; a three-day order was madeunder section 20 of the Act of 1890 on her arrival, and itwas followed by a reception order two days later. OnMarch 29 she was admitted to a mental hospital inSurrey. There was never any dispute that she was

" incurably of unsound mind," but had she been " con-tinuously under care and treatment " for the statutoryperiod of five years ’?

Mr. Commissioner Bush James, K.C., held that thefive-year period had suffered three interruptions-namely, on the journey from Whittingham to Dumfries,on the journey from Dumfries to St. Pancras Hospital,and during the period between the arrival at that hospitaland the making of the reception order on March 27.These interruptions meant that the statutory require-ments had not been complied with. He referred to the

1. See Lancet, 1951, i, 1077.

decision in Murray v. Murray in 1941 where Lord Greene,M.R., insisted that the legal safeguards in lunacy were tobe strictly observed. " I cannot doubt," said LordGreene, "’ that there are many cases of pauper lunaticswhere, owing to some failure to put the proper machineryinto operation, a spouse will be deprived of the benefitof the Matrimonial Causes Act and will be unable, onwhat very often must be a highly technical ground, toobtain relief." Bearing those words in mind, the Com.missioner felt himself obliged to dismiss the husband’spetition last April. It will be remembered that theHerbert Act of 1937 omitted to allow care and treatmentin Scotland, Northern Ireland, the Isle of Man, and theChannel Islands to be reckoned towards the five-yearperiod for an English divorce-a point which had to beput right by section 3 of the Law Reform (MiscellaneousProvisions) Act, 1949.On appeal the Commissioner’s decision has been

reversed. The Court of Appeal has applied a liberalinterpretation to the words of the statute. Lord JusticeSomervell took the broad view that, inasmuch as Parlia-ment had now allowed detention in Scotland to be addedto detention in England so as to make up the five-yearperiod, it would defeat the intention of Parliament andindeed would be absurd if anything that happened on thetransfer between England and Scotland were allowedto be a breach of the statutory continuity. When a

patient is removed from one mental hospital to anotherin England, there is a removal order applicable to thepatient, and he can be detained under it in transit. Ifhe is similarly transferred from England to Scotland, thereis no order under the Lunacy Acts which makes himdetainable during the journey. The Court of Appeal hasmanaged to get round the technical difficulty. It wouldseem, however, that Parliament should legislate to

prevent the difficulty from arising.

Parliament

Hospital ProblemsON the motion for the adjournment in the House of

Commons on July 9, Mr. H. M. EiNG said there was agrave shortage of doctors in the hospitals. One regionalboard had spent in advertising for hospital medical staffin one year enough to pay a doctor’s salary for two years.He believed the medical schools ought to be expanded.The hospital service was not sufficiently attractive toyoung doctors. The Armed Forces were taking a greatnumber of the younger men from the medical schools,and the Ministry of Health had not helped in the recruit-ment of hospital medical staffs by its attitude to theso-called registrars who were really trainee-specialists.The group of registrars now in the hospitals had narrowedtheir field of study from general-practitioner work tosome special subject, and they had a moral as well as amedical claim to be retained inside the hospital service.At the same time Mr. King recognised the danger of agap growing between specialist and general practitioner.The recruiting of nurses was still difficult, and he

suggested there should be more pre-nursing schools andthe maintenance grants increased for those who stayedat school in preparation for a nursing career. It mightbe a good thing if all student nurses were required to putin at least some months in a provincial hospital. Domesticwork should be taken off the shoulders of sisters andnurses. If young men were taken for national service.he saw no reason why girls should not work for a shorttime in hospitals. Regional hospital boards should havemore freedom and opportunity to show initiative, andthe boards should act similarly towards the managementcommittees.Mr. HUGH LINSTEAD agreed that if hospital manage-

ment committees were to give of their best they mustfeel they were mistresses in their own houses. The blockgrant system might have drawbacks at a time whenprices were rising, but the H.M.c.s should have the rightto carry any savings into the next financial year.