Evening star., 1949-02-27

tect medicine from becoming a
state monopoly. The fellowship
is committed in principle to State
medical services covering the en-
tire population. There are right
means and wrong means of
achieving this end. The means
adopted by the government have
produced chaos.
That standards of doctoring
have deteriorated is certainly not
the fault of the profession. The
blunt fact is that doctors are
now desperately overworked. Why
Mainly because the bureaucrats
who devised the National Health
Service either have no knowledge
whatever of human nature or pre-
tend that nothing of the sort eX-
lists. The natural inclination of
most people when told they can
have something for nothing" is
to ask for rather too much of it.
If, when the state took over
British railways it had been an
nounced that everybody must con-
tribute pound year and could
then travel ad libitum, millions
would have been journeying to
Lands End for no reason at all.
That is precisely the kind of thing
that is happening under the Ma
tional Health Service.
Deserving Gases Suffer
1t is not uncommon nowadays
for the urban general practitioner
to have a queue of so at each of
his surgeries daily consultation
sessions at his own rooms. Be-
fore the introduction of the serv-
ice the average attendance per
surgery would be a dozen to
score. OF the so registered
patients in the doctors queue now
it often turns out that perhaps
half are not really i'll at all. Their
complaints are trivial. They
have been attracted by the pros
pect of free treatment and free
medicine. The surgery is increas-
ingly regarded as state gift
shop. People drop in to get a
prescription for a truss, or a
sleeping draught. or roll of
medicinal cotton wool. The
harassed doctor is often tempted
to make out prescriptions not be-
cause they are needed, but to save
time.
The longer the surgery queue.
of course, the harder the lot of
the really i'll. who. if they happen
to be at the wrong end, have to
wait until the more superficial
cases in front have had their triv-
ialities attended to. Insofar as
the scheme is insuring treatment
for those who previously could not
we'll afford it. the fellowship re-
ioices; but in the present congest-
ed state of the surgerieS it is
often the deserving cases who get
the worse deal Most general
practitioners hold two surgeries,
one in the morning and one in
the evening, with home visits be-
tween. In the old days, when
private practice went hand in
hand with a limited state health
insurance scheme (for wage earn
ers Of relatively modest means
only, this routine worked smooth
ly and efficiently enough. Now
adays it has become slavery. In
trying to cure other people the
doctor Is in danger of killing
himself. What is more serious,
he no longer has the time for
careful and considered diagnosis,
the groundwork of all medicine.
Examines Entire Family
The 9 am. surgery, which once
lasted for perhaps an hour and a
half, commonly goes on till noon.
The $50 pm. surgery may not be
over till 10 pm. The home visits
which complete the general prac-
titioner's day used to average, per-
haps, 10 minutes each. The Ma
tional Health Service has changed
all that. Not only is the wage
Garner Cor professional mani en-
titled to free medical attention;
so also are his wife and children.
This, agree, is a wholly admira-
BILE provision, but more often than
not, it means that the doctor. once
he put his head around patients
door, cannot get away in under
half an hour He is usually asked
to examine the entire family. In
one way and another he is on the
stretch for 13 hours day. After
bedtime there are the usual birth
and emergency calls. Should
there be any odd half hours of
spare time. these are devoted to
the endless clerical work which
the scheme entails. Every surgery
now has its filing cabinet of "rec-
ord cards." On these every illness
of every registered patient is en-
tered-for inspection, if need be.
by authorized government Off
cials. There are also stacks of Of
fetal forms. The doctor has to
issue two certificates before sick
man can stay away from his job
for fortnight and third author
izing him to return when better.
There are forms to fill for people
who want free milk, extra milk,
exemption from jury service, extra
ALLEGATIONS of coal, free transport
to the polling booth and other
benefactionS. The ruling and
schedules of the Ministry of Health
have to be studied with care. If.
distracted by pressure of work, the
doctor makes out a prescription
for nerve food which happens
not to be on Whitehall's latest free
list, the patient is duly supplied
by his druggist, but it Is the doctor
who must foot the bill.
Many doctors find that the desk