1
96 Following the frank discussions which had taken place with the Ministry, an arrangement, acceptable to the defence societies, had been suggested to the Ministry which, if adopted, seemed likely to. restore the good relations between hospital authorities and their staffs and allow the latter to cooperate fully with the authorities without jeopardising their own position. The Joint Committee approved the action taken, and decided that further consideration should be given to the question of medical reports, and particularly their accessibility to parties outside the hospital. The committee again considered the position of s.H.M.o.s who were still dissatisfied with their grading, and decided to accept the suggestion of the Central Consultants and Specialists Committee that the latter committee should raise individual cases of alleged injustice directly with the Ministry. It was agreed that it should be made clear to the Ministry that the Joint Committee itself was far from satisfied with the position and that in pursuing the matter the Central Consultants and Specialists Committee had its full support. The committee learnt with regret that, contrary to the advice which it had given to the Ministry, hospital boards had been told that in certain circumstances medical students might be employed for short periods. The committee felt that it could not condone this practice, nor advise the profession to accept any responsibility for . students so employed. Among the other matters discussed were the right of dental practitioners to call in dental consultants for domiciliary consultation, the disclosure of information to the Ministry of Labour regarding young men liable for National Service who had a history of tuberculosis, the principle that existing and newly appointed consultants should so far as practicable be allowed the option for whole-time or part-time service, and medical advisory machinery at regional-board level. The following were appointed to constitute the Staff Side of Committee B of the Medical Whitley Council : Mr. A. Lawrence Abel, Mr. H. Arthure, Prof. W. G. Barnard, Sir Harold Boldero, Sir Russell Brain, p.B.c.p., Mr. J. Bruce, Dr. J. D. S. Cameron, Mr. W. W. Galbraith, Mr. A. A. Gemmell, P.R.C.O.G., Dr. T. Rowland Hill, Mr. H. H. Langston, Dr. A. Lyall, Mr. D. W. C. Northfield, Sir Arthur Porritt, Mr. T. Holmes Sellors, Sir Cecil Wakeley, Dr. S. R. F. Whittaker, and Dr. A. Macrae. 1. The members of the committee are Dr. A. F. WILKIE MILLAR (chairman), Dr. I. D. GRANT, Dr. WALTER JOPE, Mr. A. I. MILLAR, Dr. C. STEWART SANDEMAN, and Mr. H. A. SREWAN, Q.C. GENERAL PRACTICE IN SCOTLAND THE fifth report of the Scottish Medical Practices Committee 1 states that at the end of last June there were 2505 doctors undertaking to provide general medical services in Scotland, compared with 2424 in 1952 and 2339 at the start of the National Health Service. Since then the number of people on the lists of doctors has increased by about 244,000. DISTRIBUTION OF DOCTORS According to information supplied to the committee by the executive councils, at Oct. 1, 1952, when the total of principals stood at 2369, there were 1100 single- handed doctors of whom 896 practised without an assistant. In rural areas the proportion of single-handed doctors was about twice what it was in semirural or urban areas and there was only one three-doctor and one four-doctor partnership. This is in contrast to England and Wales, where 68% of the doctors in rural areas practise in partnerships, of which nearly half are partner- ships of more than two doctors. 138 single-handed doctors had fewer than 500 patients on their list; at the other end of the scale there were 72 single-handed doctors with more than 3000 patients. Only 2 had more than 4000 patients. During 1953 the new arrangements for doctors’ remuneration gave an impetus towards a more ’even distribution of medical care. The considerable increase in the number of partners was largely due to the notional. list payments. Thus during March and April, 1953, the number of new partnerships formed was 51, compared with 10 in the same period in 1952. The committee doubt whether there will be any con. siderable immediate redistribution of patients as a result of the reduction of maximum numbers on lists from 4000 to 3500. They believe that entry into an existing partnership, with the use of partnership premises and a guaranteed share of the profits, will prove more attractive to many doctors than an attempt to build up a single. handed practice. ENTRY INTO PRACTICE During 1953 the committee granted 241 applications for admission to medical lists. Of these, 35 applications were from doctors selected to fill practice vacancies (including 13 to fill vacancies in partnerships), 106 applications were from doctors who wished to practise in partnership, 25 from doctors who wished to set up a new and independent practice, and 75 from doctors already on a medical list who wished to expand their practices into neighbouring executive-council areas. During the year 82 doctors died or resigned. 14 applications for inclusion in lists were refused ; appeals to the Secretary of State against these refusals numbered 7. 2 appeals were withdrawn by the appellant before a decision was given, and 1 is still under consideration ; in the remainder the deeision of the committee was upheld by the Secretary of State. The committee have noted that it is becoming increas- ingly difficult for a doctor already established in one practice to move to another, should he so wish. One possible method, which has been little used, is by arranging an exchange with another established doctor. Provided that the executive council in each area were satisfied with the proposed arrangements, the committee would normally raise no objection and would grant the applications by the two doctors for inclusion in the respective medical lists. Despite the increase in the number of principals, the committee are conscious that many doctors are unable to become established as principals, whether in single-handed practice with the assistance of the initial practice allowance or in a partnership. 1. Hospital Endowments Fund Account 1952-53. H.M. Stationery Office. Pp. 11. 6d. HOSPITAL ENDOWMENTS FUND DURING 1952-53 regional hospital boards and hospital management committees received from this fund :E666,000, amounting to 28s. a bed.l This was the full amount due for the year. No part of the capital of the fund has so far been transferred to the boards and committees. The transfer of assets to the fund is still incomplete. It is estimated that with the settlement of outstanding matters a further f48,000 will be added to the fund, giving a. gross total of about S31,600,000. The transferred liabilities of the non-teaching hospitals, which have to be met out of the fund, are estimated at 11,600,000. Assets in excess of those earmarked for the fund have been realised from time to time and the proceeds used to meet transferred liabilities. During 1952-53 f600,000 was used in this way, bringing the total payment in discharge of liabilities to 10,400,000 at the end of the financial year.

GENERAL PRACTICE IN SCOTLAND

  • Upload
    duongtu

  • View
    214

  • Download
    0

Embed Size (px)

Citation preview

Page 1: GENERAL PRACTICE IN SCOTLAND

96

Following the frank discussions which had taken placewith the Ministry, an arrangement, acceptable to thedefence societies, had been suggested to the Ministrywhich, if adopted, seemed likely to. restore the goodrelations between hospital authorities and their staffsand allow the latter to cooperate fully with the authoritieswithout jeopardising their own position. The JointCommittee approved the action taken, and decided thatfurther consideration should be given to the question ofmedical reports, and particularly their accessibility toparties outside the hospital.The committee again considered the position of

s.H.M.o.s who were still dissatisfied with their grading,and decided to accept the suggestion of the CentralConsultants and Specialists Committee that the lattercommittee should raise individual cases of alleged injusticedirectly with the Ministry. It was agreed that it shouldbe made clear to the Ministry that the Joint Committeeitself was far from satisfied with the position and that inpursuing the matter the Central Consultants and

Specialists Committee had its full support.The committee learnt with regret that, contrary to the

advice which it had given to the Ministry, hospital boardshad been told that in certain circumstances medicalstudents might be employed for short periods. Thecommittee felt that it could not condone this practice,nor advise the profession to accept any responsibility for

.

students so employed.Among the other matters discussed were the right of

dental practitioners to call in dental consultants for

domiciliary consultation, the disclosure of informationto the Ministry of Labour regarding young men liable forNational Service who had a history of tuberculosis, theprinciple that existing and newly appointed consultantsshould so far as practicable be allowed the option forwhole-time or part-time service, and medical advisorymachinery at regional-board level.The following were appointed to constitute the

Staff Side of Committee B of the Medical WhitleyCouncil :

Mr. A. Lawrence Abel, Mr. H. Arthure, Prof. W. G. Barnard,Sir Harold Boldero, Sir Russell Brain, p.B.c.p., Mr. J. Bruce,Dr. J. D. S. Cameron, Mr. W. W. Galbraith, Mr. A. A. Gemmell,P.R.C.O.G., Dr. T. Rowland Hill, Mr. H. H. Langston, Dr. A.Lyall, Mr. D. W. C. Northfield, Sir Arthur Porritt, Mr. T.Holmes Sellors, Sir Cecil Wakeley, Dr. S. R. F.Whittaker, and Dr. A. Macrae.

1. The members of the committee are Dr. A. F. WILKIE MILLAR(chairman), Dr. I. D. GRANT, Dr. WALTER JOPE, Mr. A. I.MILLAR, Dr. C. STEWART SANDEMAN, and Mr. H. A. SREWAN,Q.C.

GENERAL PRACTICE IN SCOTLAND

THE fifth report of the Scottish Medical PracticesCommittee 1 states that at the end of last June there were2505 doctors undertaking to provide general medicalservices in Scotland, compared with 2424 in 1952 and2339 at the start of the National Health Service. Sincethen the number of people on the lists of doctors hasincreased by about 244,000.

DISTRIBUTION OF DOCTORS

According to information supplied to the committeeby the executive councils, at Oct. 1, 1952, when thetotal of principals stood at 2369, there were 1100 single-handed doctors of whom 896 practised without an

assistant. In rural areas the proportion of single-handeddoctors was about twice what it was in semirural orurban areas and there was only one three-doctor and onefour-doctor partnership. This is in contrast to Englandand Wales, where 68% of the doctors in rural areas

practise in partnerships, of which nearly half are partner-ships of more than two doctors. 138 single-handed

doctors had fewer than 500 patients on their list; at theother end of the scale there were 72 single-handed doctorswith more than 3000 patients. Only 2 had more than4000 patients.During 1953 the new arrangements for doctors’

remuneration gave an impetus towards a more ’evendistribution of medical care. The considerable increasein the number of partners was largely due to the notional.list payments. Thus during March and April, 1953,the number of new partnerships formed was 51, comparedwith 10 in the same period in 1952.

The committee doubt whether there will be any con.siderable immediate redistribution of patients as a resultof the reduction of maximum numbers on lists from 4000to 3500. They believe that entry into an existingpartnership, with the use of partnership premises and aguaranteed share of the profits, will prove more attractiveto many doctors than an attempt to build up a single.handed practice.

ENTRY INTO PRACTICE -

During 1953 the committee granted 241 applicationsfor admission to medical lists. Of these, 35 applicationswere from doctors selected to fill practice vacancies(including 13 to fill vacancies in partnerships), 106applications were from doctors who wished to practise inpartnership, 25 from doctors who wished to set up a newand independent practice, and 75 from doctors alreadyon a medical list who wished to expand their practicesinto neighbouring executive-council areas. During theyear 82 doctors died or resigned. 14 applications forinclusion in lists were refused ; appeals to the Secretaryof State against these refusals numbered 7. 2 appealswere withdrawn by the appellant before a decision wasgiven, and 1 is still under consideration ; in the remainderthe deeision of the committee was upheld by the Secretaryof State.The committee have noted that it is becoming increas-

ingly difficult for a doctor already established in onepractice to move to another, should he so wish. One

possible method, which has been little used, is byarranging an exchange with another established doctor.Provided that the executive council in each area weresatisfied with the proposed arrangements, the committeewould normally raise no objection and would grantthe applications by the two doctors for inclusion in therespective medical lists. Despite the increase in thenumber of principals, the committee are conscious thatmany doctors are unable to become established as

principals, whether in single-handed practice with theassistance of the initial practice allowance or in a

partnership.

1. Hospital Endowments Fund Account 1952-53. H.M. StationeryOffice. Pp. 11. 6d.

HOSPITAL ENDOWMENTS FUNDDURING 1952-53 regional hospital boards and hospital

management committees received from this fund :E666,000,amounting to 28s. a bed.l This was the full amount duefor the year. No part of the capital of the fund has sofar been transferred to the boards and committees. Thetransfer of assets to the fund is still incomplete. It isestimated that with the settlement of outstanding mattersa further f48,000 will be added to the fund, giving a.

gross total of about S31,600,000.The transferred liabilities of the non-teaching hospitals,

which have to be met out of the fund, are estimated at11,600,000. Assets in excess of those earmarked for thefund have been realised from time to time and the

proceeds used to meet transferred liabilities. During1952-53 f600,000 was used in this way, bringing thetotal payment in discharge of liabilities to 10,400,000at the end of the financial year.