1403

and then went out to work around London to further hiscareer in medicine. He was also senior house-officer tothe cardiothoracic surgical unit of the SouthamptonUniversity hospital group. It was apparent that he had anexcellent career in front of him.

" He always had an optimistic and buoyant attitude tolife. He was a keen squash-player and an enthusiasticsupporter of the drama society at King’s. He is a greatloss to medicine, and we shall miss his charm, enthusiasm,and creative interest."

The staff of the Western Hospital, Southampton,have sent the following tribute:" Those of us who worked with Tim Radcliffe at the

cardiothoracic unit in Southampton were shocked to hearof his tragically early death and wish to record this apprecia-tion of the young man we knew. Within a very shorttime of his arrival at the Western Hospital it becameclear to all that this new senior house-officer was not onlyan outstanding doctor but a most delightful colleaguewith a great zest for life; the tireless and well-judged careof his patients was matched by a sense of humour and anenjoyment of life that in turn enhanced the lives of thosearound him. His contribution to our unit at a time whenits work load was steadily increasing was substantial and,in retrospect, remarkable for a man in a relatively juniorpost."

HARRY CHAPMAN SINDERSON

K.B.E., C.M.G., M.V.O., M.D.Edin., F.R.C.P.E., D.T.M.&H.

Sir Harry Sinderson Pasha, emeritus professor andformer dean of the Royal College of Medicine of Iraq,died at his home in Sussex on Nov. 20. He was 83.The title of pasha was conferred on him in recognitionof his services to the Sherifian dynasty.Sinderson studied medicine in Edinburgh, qualifying in

1914, the start of the war, service in which was to givehim his first sight of the country which became his placeof work for so many years. After the war he returned toBritain, obtaining the Edinburgh membership in 1921.He went back to Baghdad as the best qualified doctor in thecountry, and his qualities were quickly, recognised in asuccession of appointments as physician, health adminis-trator, and teacher. He was adviser and inspector-generalof health services, at the Ministry of Social Affairs, pro-fessor of medicine and dean of the Royal College ofMedicine in Baghdad, and, throughout the period 1921-46,was physician to H.M. The King and the Royal Family ofIraq. The dynasty he had served so long came to anabrupt end in 1958, but Sinderson had returned from Iraqtwelve years earlier. His services were recognised inhonours heaped on him by many countries. In his auto-

biographical Ten Thousand and One Nights (1973) hedescribed his extraordinary experiences as old-fashionedcourt physician in the setting of the difficult birth and earlyyears of the independent State of Iraq.

AppointmentsGORE, C. P., M.D.DubI., F.R.C.P.I., F.R.C.PSYCH. : consultant psychiatrist,

Napsbury Hospital (North West Thames R.H.A.).GRAY, K. E., M.B.Cantab., M.R.C.P.: consultant physician with experience

in cardiology, Barnet General and associated hospitals (North WestThames R.H.A.).

Mu-,ta, I. S., M.B.Cantab., F.F.A. R.c.s.: consultant anesthetist, York-shire R.H.A.

PHILPOTT, R. M., M.B.Lond., M.R.C.PSYCH.: oonsultant psychiatrist,Yorkshire R.H.A.

SINHARAY, H. S., M.B.Calcutta, M.R.C.PSYCH.: consultant psychiatrist,Halton district, Cheshire A.H.A.

WILLIAMS, H. M. M.B.Lond., M.CH.ORTH.L’pool, F.R.C.S., F.R.C.S.E.:consultant orthopaedic surgeon, Yorkshire R.H.A.

Notes and News

MONITORING BY PATIENTS FOR PATIENTS

LIKE Parkinson’s law, Finagle’s laws were propoundedonly half in jest, and they apply to areas of human endeavourfar away from their original context. Sir Richard Doll ’

mentioned them during his Somerville Hastings lectureearlier this year 1 with reference to morbidity data, buthe might have applied them to any aspect of medical in-formation. What we have is not what we want; what wewant is not what we need; and what we need is not whatwe can obtain. Doll describes a few tools for obtainingwhat we need. Record linkage, developed in the Oxfordregion, should be extended for the whole country " ifwe are to make any serious attempt to assess the results ofthe component parts of the service". The controlledtrial, now well established as a device for answeringclinical questions, has been neglected by health-serviceadministrators. If doctors can do it for drugs then, saysDoll, " medical administrators should be prepared to

allocate services similarly to different areas for a trial periodbefore providing them for the country as a whole". Butboth record linkage and controlled trials are devices im-posed upon patients-if the patient is the right unit formonitoring health services, why not involve him morepersonally ? Doll would do this too, by extending theidea behind the General Household Survey to the regionaland area level and by public-opinion surveys. However,the health questions asked in the General HouseholdSurvey and by King’s Fund workers (" supper satis-

factory ?") will need drastic reconstruction if they are toserve a useful monitoring function. Whether or not

Somerville Hastings was the " father of the N.H.S. ",this stimulating lecture in his memory is a fitting tribute.

DO WE KNOW WHAT OLD PEOPLE WANT?

SiNcE the beginning of the century a great deal ofprogress had been made in providing for the elderly; theywere now a

"

perceived group ", and their numbers madethem a political force to be reckoned with. This was thecheering thought with which Mr Robin Huws Jones openedhis Eileen Younghusband lecture at the National Instituteof Social Work on Nov. 28, but he quickly went on to saythat many old people still suffered extreme hardship, andmuch remained to be done. In the first place, pensionsin the United Kingdom were still low in comparison withthose paid in other European countries; there was a strongcase for substantially raising the real value of the pension,especially in extreme old age, and also for protectingpensions from inflation by quarterly reviews, index-linking,or some other method. The cost would be great, and infairness some measure of selectivity would be needed toensure that the most help went to those most in need-perhaps through the tax-credit system, or by bringingmeans-tested assistance with housing within the pensionscheme. A lot of humbug was talked about old age, MrHuws Jones went on to say, as was illustrated by euphem-isms such as " the golden age " and " senior citizens ".Old age was a hard time, when people had to accept theirloss of earning power and health and strength, and thewaning of their influence over the events and people aroundthem. Society must try to clarify its attitude to old age, sothat it might ask the right questions and do the rightresearch.Many people assumed that old age was a time of with-

drawal from society, which was symbolised by retirement;

1. To Measure NHS Progress. By RICHARD DOLL. Obtainable fromthe Fabian Society, 11 Dartmouth Street, London SW1H 9BN.15p.

1404

but the elderly should be able to choose how much to retire,as well as when. It was no good forcing activity on oldpeople, or giving them mindless hobbies with which topass the time; it was, on the other hand, vitally importantthat they should feel that they had something useful tocontribute, and for this reason they should be given realjobs to do in homes and hospitals. Old people should alsobe able to feel of use within the family situation-asbaby-sitters, or as the focus of family parties, or simply asan oasis of serenity. Good health in old age often lastedas long as old people felt that they were needed. Societytoo often assumed that it knew what the elderly wanted-community care, for example, had become a sacred cow,and so priority was given to domiciliary support, althoughmany old people actively preferred to live in communities,for example in residential hotels. In any event, the elderlyshould always be given the basis on which to make a realchoice about their future-for example, by being shown anumber of different kinds of accommodation before havingto commit themselves. Plenty of research into old age wasgoing on, but few practical applications seemed to emerge,or at any rate to be acted upon. Perhaps what was needed- especially now that money was shorter than ever-wasa comprehensive survey of the elderly in a small areawhich would discover exactly what their needs were andwhether they were met, and how effective the help givenactually turned out to be. It must, however, be borne inmind that the amount of money spent on a service was notnecessarily indicative of the good it had done; moreover,some things were good in themselves, although they mightnot rate at all on whatever measures of effectiveness wemanaged to devise.

Kidney Donor CardsA revised kidney donor card, which will carry for the

first time the written agreement of the donor’s next-of kinto the removal of the donor’s kidneys for transplantation, isto be distributed to the public through the health authori-ties. Family-practitioner committees have also been askedto arrange for chemist contractors on their pharmaceuticallist to display posters and make kidney donor cards availableon their premises.

Grants for Undergraduate TeachingThe Nuffield Foundation has introduced a new grant

programme designed to support promising developmentsin undergraduate teaching, with the object of making iteasier for academic staff in universities, polytechnics, andcolleges to improve the quality of their undergraduateteaching in spite of the severe economic difficulties whichthey face. There will be a limit of E2000 on any onegrant. Application forms and further details may be hadfrom the Director, Nuffield Foundation, Nuffield Lodge,Regent’s Park, London NW1 4RS.

Acro-osteolysisThe Secretary of State for Social Services, Mrs Barbara

Castle, has asked the Industrial Injuries Advisory Councilto consider whether acro-osteolysis should be prescribedas an industrial disease under the National Insurance

(Industrial Injuries) Act 1965, and, if so, to what specificoccupations it should apply. There has recently beenanxiety regarding occupational risks among people em-ployed in the P.v.c. manufacturing industry; it is thoughtthey may be at risk of acro-osteolysis. The Council wishesto receive evidence from any interested persons or organisa-tions, and will supply an explanatory memorandum onrequest. Evidence should be sent (before Feb. 28) to theSecretary, Industrial Injuries Advisory Council, 10 JohnAdam Street, London WC2N 6HD.

Nurses and Research

The research discussion group of the Royal College ofNursing is considering organising a conference for nursesengaged in collecting data for medical research projects.Those interested should write to the honorary secretary ofthe research discussion group, Royal College of Nursing,Henrietta Place, Cavendish Square, London W1M OAB.

ProstaglandinsAn international conference on prostaglandins will be

held in Florence on May 26-30. Details may be had fromthe scientific secretary of the conference, Dr G. C. Folco,Istituto di Farmacologia e Farmacognosia, Universita diMilan, Via A. Del Sartc, 21, Milan, Italy.

CORRIGENDA: Viruses and Heart-discase.-The end of thesecond paragraph of this leader (Oct. 26, p. 991) refers to somepossible conditioning factors. The reference should be 1, not 1C.

We much regret our introduction of an error iia the letter byDr Radder and Dr Terpstra (Oct. 26, p. 1011). Cal. per 100 g.should have read Cal. per 100 Cal.

Diary of the Week

DEC. 8 TO 14

Monday, 9thINSTITUTE OF LARYNGOLOGY AND OTOLOGY, 330/332 Gray’s Inn Road,

London WC1X 8EE5.30 P.M. Dr Arnold Levene: Comparative Pathology of Head and

Neck Tumours in Man and Domesticated Animals.

Tuesday, 10thROYAL POSTGRADUATE MEDICAL SCHOOL, Hammersmith Hospital,

London W12 OHS9 A.M. Dr J. T. Scott: Gout and the Crystalloses.

MANCHESTER MEDICAL SOCIETY5 P.M. (New Medical School.) Surgery. Mr R. S. Handley: Some

Thoughts on Breast Disease.MEDICO-CHIRURGICAL SOCIETY OF EDINBURGH

8 P.M. (Pfizer Foundation.) Dr Leslie Duncan, Dr Ian Campbell,Dr John Munro: Vanguard Issues in Diabetes.

Wednesday, llthROYAL COLLEGE OF PSYCHIATRISTS

8.15 P.M. (Tavistock Centre, 120 Belsize Lane, London NW3 5BA.)Dr Anthony Ryle: Psychotherapy Research-the Value andLimitations of the Repertory Grid.

ROYAL POSTGRADUATE MEDICAL SCHOOL2 P.M. Prof. E. R. Huehns: Abnormalities of Structure and Synthesis

of Haemoglobin.INSTITUTE OF UROLOGY, 172 Shaftesbury Avenue, London WC2H 8JE6 P.M. Dr G. A. Rose: Biochemical Aspects of Calculus Disease.

MANCHESTER MEDICAL SOCIETY5 P.M. (New Medical School.) Pathology. Dr A. R. Mainwaring: The

Pathology of Renal Transplantation.UNIVERSITY OF DUNDEE

1.30 P.M. (Ninewells Hospital.) Mr J. A. P. Marston: Surgical Aspectsof the Treatment of Hodgkin’s Disease. (Melville Robertsonlecture.)

Thursday, l2thROYAL SOCIETY OF TROPICAL MEDICINE AND HYGIENE, Manson House,

26 Portland Place, London WIN 4EY6.30 P.M. Dr David Morley, Dr F. T. Perkins, Dr Paget Stanfield,

Dr Alwyn Griffiths, Dr R. G Hendrickse: Measles Vaccina-tion.

MANCHESTER MEDICAL SOCIETY8.15 P.M. (New Medical School.) Ancesthetics. Dr J. G. Whitwam:

Current Concepts of Respiratory Control.UNIVERSITY OF EDINBURGH

5 P.M. (Royal Infirmary.) Prof. D. C. Simpson: On the FunctioningHand-the Human Advantage. (Honyman Gillespielecture.)

Friday, 13thROYAL COLLEGE OF SURGEONS OF ENGLAND, Lincoln’s Inn Fields,

London WC2A 3PN3 P.M. Mr Handley: Carcinoma of the Breast. (Bradshaw lecture.’

ROYAL POSTGRADUATE MEDICAL SCHOOL10 A.M. Prof. J. Leigh Collis: Dysphagia.

INSTITUTE OF LARYNGOLOGY AND OTOLOGY5.30 P.M. Mr J. E. Wright: Diseases of the Lachrymal Apparatus.