B
THE HONGKONG TELEGRAPH; SATURDAY, FEBRUARY ́7, 1948.
A WORD OF WARNING ON STATE MEDICINE
The surgeon's choice
THE
OFFICE OPERATING
by
JOHN GARDHAM, M.S., F.R.C.S.
OR THE TABLE?
RITAIN is about to em- Hospitals have been en. bark on a State medical conraged to create new paid ap- service. On the nature pointments at £600 and £1,000 this service depends the year for doctors hoping to be- whole future of medicine and come consultants. surgery in the country.
of
The public has a vague idea that Mr Aneurin Bevan, the Health Minister, and the British Medical Association have failed to reach agreement on the salaries and the right to st, practions, and the public is nul very interested.
Is the public missing
thing else?
The purpose of the Art is fo create a State manupały. mandleine,
Izt
The Minister has announced his intention of taking over practically every hospital in the country on the appointed day.
Thus all hospital physicians and surgeons face an inevitable decision.
They must either leave the hospitals or become servants of
a Government department.
A PROMISE
Of little help
For some of these appoint ments the sole condition has been that the holder should ne- cept the salary; no service has been demanded in exchange.
The expenditure of pubile money on hospitals but Indeed been lavish; has it been wise in distribution honest in intention? Many hospital enasudiants think it has not,
A MONOPOLY And the result
Any arrangement, however Teavenant in public money,
or
ex-
which
resulted in all hospital consultants
becoming civil servants would sunt
the purpose of the Minkder well.
It would establish at one stroke a State monopoly.
the higher ranks of merficine and surgery, and would make it upogible for à doe- for to obtain hospital treatment for his patients except in a State con- trolled institution staffel entirely by evil servants.
What will be the result if this is →llowed to happen?
1
TREATMENT
STEREOTYPED.
WILI, BECOME
I has been stated that there will)
The Minister has given an interference with the right of verbal promise that
members a physician or surgeon to
of hospital staff's will bo allowed to continue to give their services without payment as they have done in the past.
exercise
bis own judgment in treatment of Jatients. This
dghting was not set in the
where "directives" Services, ferntinent became very common be- fore the end of the war,
There are, in fact, many ways of treatment on the foreing stereotypert staff of a State-owned institution.
I will be mex to most members of the pubtle and to mang surgeons that plans for prohibiting the mana facture of surgical justruments which do not conform to a standard There is no financial quarrel type are already well utvanced,
This will not save them from becoming civil servants, for they must in any case secure-a contract from the Government department which owns the hospitals in which they work.
here. The immediate arrange- ments proposed for consultants are generous.
THE ATTAINMENTS RE- ACHIEVE 300- QUIBED TO CESS IN THE HIGHER RANKS OF MEDICINE WILL CHANGE.
The public may think them In the past' great physicians
In State service those
Thus an able surgeon soon reaches n poist where he must chooze whether he will cense to spend his and time in the operating theatre become an organiser, or will con- tinue to practise the art of surgery with the knowledge that he will re- main subservient for the rest of his professional life to those who have chosen to become organizers.
In an organised service there is no supreme place for the man who is because of his ability in cure sick.
"The confidence of the public In the acrolee must not be un- dermined by such wild and im- probable "statements, I GUL sorry, but must refuse abao- lutely to allow them to appear in print."
This never happened because Lis ter wan' a free inan and able to think, apenic, and write for himself from and to carry his discoveries hospital to hospital until they gained Receptance.
Discouragement of brilliant men work and suppression of brilliant because they are unorthodox ean happen far too easily in a State ser- vice which is a monopoly.
I have held power over, young professional men in the Service and
know how far it goes.
They wish for a comprehensive service which is not a monopoly. They wish for the survival of great men in the profession of medicine who are free to sponk their mind.
They wish, above nil, for the sur- vival of voluntary hospitals with their record of service and discovery in the past.
nursery of great minds.
the Such hospitals have been
тел and great
there For these hospitals
assistance, inust certainly be State but need there be Stato ownership?
essential for Ownership is monopoly. I is not essential för service.
START AGAIN? Chance for Bevan
not to political
THOSE GREAT PROFES- The public and the profession are SIONAL HODIES, THE ROYAL not of variance. They both want a ministers to public COLLEGE OF PHYSICIANS AND service which THE ROYAL COLLEGE OF SUR- well-being and the
GEONS, WILL LOSE THEIR INDE- ideals. PENDENCE IN THAT THE INDI- VIDUALS CONCERNED IN THEIR MANAGEMENT
to
will go The highest honours
organisers. cominlitee men and the
they Such
valuable, but men are w not compensate us for the loss craftsmen of the thinkers and the when these are gone.
ORIGINALITY WILL HE SUT- PRESSED.
Young ch
During the war many articles in the medical Press written by promising
concluded with these words: "I am indebted to the Director of Medical Services and to Colonel, commanding the Hospital. for permission to publish,
this article"
The present Act cannot produce work AND POLICY what is required. But the WILL BE PAID AND PENSION which has gone into framing it and ABLE GOVERNMENT SERVANTS. into the discussions on its provisions There will be nothing in England has not been wasted. Both sides have outside the State service qualified to learned much. Jevel criticism at it.
THE TRAP Attractive conditions
The possibility of making a fresh start and producing ah Act worthy of its purpose provides an opportu nity for the Minister to prove that be is n
man and not a poli- Kreat tival time server. let him take it.
writer of
(Mr. Gordham, and article, Is a distinguished surgeon. The Medical Directory lists his
રા
11
SIDE GLANCES
By Galbraith
12-ka
COPE, 1947 SY WEA SERVICE, INC. T. M. REN, IT, & TAT, OFF,
"Pop's stalling he's afraid mother will do
threatens and pick up part of the tip!"
43 sha
The Emir
this
re-
asks us to
The dunger is real and Immediate. May physiclans and surgeons be- Heve that the Minister has recognis- ed that the shortest way to a State through the cotisul- monopaly is iant branch of the profession. hus sel out to make conditions of service in this branch attractive for cord as- sentence. It seems an innocent
M. S. Lond. 1926; M.B., B.S., 1923: 1921: might have this reason alone,
Es
1934. but let us
M. FR.CS. ser what
f'raj. Lond.. 1921: Hunt happened In the year 1867 If typical
Mem.
Exam. R.C.S. antiseptle had been a civil servant.-
Court
Fell. Roy. Soc. way to a State monopoly, and thus Fell, Assn. Surga, condemn medicine and surgery in Med. Mem, Counc. Surg. Sect.); late this country to a long periort of Exam, in Sarp. Dent. Bd. R.C.S.:
Cons. Surp. 14th Army and stagnation.
"No.
Mr Lister, I am Bort|}, but pour theories are in conflict with the established picws of the profession. To publish them now would not only be uscires, it we be posltirely
dan
They believe that if they accepted L.R.C.P. the conditions they would open the 1939
19
Fast What do the physicians and sur- Command, India, Author; "Operats. Jase, Mouth and Tongue." grons who oppose the Act wish
Turner's Mod. Operat, Surg.1 put in its place?
FOOTBALL POOLS
MONEY
It's time the facts were known
By BERNARD HARRIS
gave con-
them
is that
hold
come in.
BENGHAZI
HEN I look out of my window I look right down. The Americans tell us into Benghazi Harbour.
W
that this is the answer to the Communist threats to the independence of non-Communist Greece.
I am looking at the harbour now. I see the black rusting hulls of five Halian steamers lying on their sides, firmly silted into the strategic positions which they have occupied for the lust five years.
1 see the outer mole of the harbour in a shambles. Bombs, shells, and the weather have broken great gaps in it. Every day new bits crumble away as the breakers crash over it.
A big, Gibraltar-like naval
base in Benghazi, complete Sefton Delmer's
with docks and forts? Well, it could be done. But the present depth of the harbour much more than 15
the Littlewoods Ale you will get no Arm elue to the wealth which the rajoys.
the All you will earn company was formed in 1928 with a ten up controller, and
and that Independent
capital of £4,000, NE of the last acts form wide powers to prevent
years later £269,072 of the undivid and too generous: for even HOW
which Mr Dalton will be crated charges and profits at the ex d profits was capitalised and ap-deep channels suitable for big surgeons have made their fame by before the Act has come into their work tri Fist:
plied in paying out a share bonus and wards
remembered as Chancel pense of the trust investors,
Want to "The companies
play of that amount. operation, a consultant may re- operating theatres and not round for of the Exchequer is that he
crickel." the head of one of
These honus shares are all ecive if he cares to do go committee-tables.
doctors made the people in Britain sit, and we want to have an um- by Victoria Street Nominees. Lid, large sums of public money in who plan and supervise must neces-sleeping partner in the football pire to see that we do."
the foot- and the rest of the capital is divided do not know whether respect of services for which he sarite control those who examine, pools.. has not previously been paid. dingnose, and operate on patien
Now it is a curious and im- ball pools have an umpire in their between the Moores brothers, who
But it would nearly be are the only directors. portant fact that no one
out-association.
a good idea now that we are all con- side the pools directorate cerned in the pools. knows much about the financial He could tell us something about the rules of the game and we would Iside of the pools.
Eren Mr Dalton did not
know that they were being observed. At the moment we have to take it know how much his proposed on trust. 10 percent tax will produce for the nation. The best he could the estimate that do was to
·
Publish accounts
it
NEWSMAP
comes today from North Africa
GREECE
ITALY
Mediterranean,
-MALT.
TURKEY
To Palmatian
TOBRUK
LIBYA
EGYPT
MILES 3:00
is not fert.
To build new moles, dredge
ships, and construct deep docks in the present shallow would cost caplane hase roughly £10,000,000 and take Four years, that is, counting TRIPOLI BENGHAZI the best part of four years.
from the moment that
all the gear arrives and is in Now that the Government has replace, and the Italians have finished fishing up their sun- Cognised the pools to the extent of participating in them. I think might go a step further and require ken merchant ships.
Certainly balance sheels
the guerilla war in total Tripolitania population of the publication of
Greece has now been going on for 800,000, is unlikely to constitute and profit and loss accounts,
It might well go further and im-the best part of four years. Never problem.
theless, there is a fair chance in my pose some form of supervision.
will be settled befor and mind that
condition of So far as I can ascertain only two
"The big, efficiently-run
clearly like Little-Benghazi can be dressed up to play things in Libya has
bren No guards were on duty and no receipts from the dog totes and or three pools guarantee that a de-
its part as a
noted in London and in Washington. bees were fanning the hivi although
giant Gibraltar. be finite percentage of the stake money honestly-mamagari pools the pools combined would
10 "investors." The woods can hardly have any serious
But make no mistake, this wreck- objection to about £15,000,000 in a full year. is returned
this. But the absence
A War Office working party has SMALL bees and large bees, the weather was hot.
control over the ed port, together with Tripoli and
visited emerald green, striped But
and there proportion in these cases is 80 per- abject during the night their loud
Cyrenaten i have seen it stated that
of any farm of
opportunities Tobruk and the whole of this former recently
Tripolitanin and made recommenda- us awake, and We are 800 pools in Britain, that they cent. blue and grey bees worked the buzzing kept
Italian of Libya, is both by insects employ 100,000 people,
out Doubtless other pools conform to movement toes offer
both tons for the development of carpet of wild flowers at our wondered what manner of
arrangement, but it has been to the unscrupulous.
enterprise its cop situation and its poil-
The new plans go well 10,000,000 coupons a week, and take this
Though I favour trea pools feet, and hummed among the
reported to me that smaller
the beyond the modest care and main- sweet-scented guava
morn-about £50,000,000 a year.
have been known to return only 50 in most things, I think this is a case tical circumstances ideally suited to these areas
where too much freedom carries too become an. Important base of
British and American forces in the tenance programe originally pre- percent.
Mediterranean.
scribed. The 20 percent. retained by the great dangers. that promoters covery
Bees and ants battle for hive
ESSEQUIBO (British
Guinnu).
we had. in the hive.
a
We examined them in the blossoms overhead, but not one domestic in. All seemed well, although
few bees had injured wings.
Nights of this noise was more than
honey-bee was to be seen.
send
'Over-estimates'
Pool promoters assure me
Pool Returns
office expenses,
I
As we watched we realised we could staul, so we investigated these are gross over-estimates. They staff wages, cost of coupons, postage, that we needed a hive of bees with a storm lantern. badly.
is and other outgoings. I leaves, JESTS AND
1
JEERS
The war is ended, but the malady
•
+
GEOGRAPHICALLY, because air bases here cou
could command the Cen-
tral and Eastern Mediterranean, give
This
favourable
Best bot
*
And best
in some
bet. For
assert that the number of pools
air cover to fleet operations and at TRIPOLI HARBOUR is also com- about 200; numbers employed under am told, a net profit "not exceeding
ing in for a dredging and deve- the sume time have immense strik- five percent." black 25,000: coupons sent out, 7,000,000 a We saw a mass of minite
What is the function of a football
ing power in South-Eastern Europe. topment scheme.
ROLITICALLY, because the Arab ways this is the ants scurrying up and down one leg week; and incorne roughly £35,000,- pool? It seems to me to boll down The days are warm and
of the stand on which the hive sat. 000 year.
population of this area, unlike that Tripoli has a substantial population, sunny with a
noft dew in the These small ants like sweet things, Even on this basis it is apparent simply to the redistribution of a sum
have both in the town and In the hinter- of the other Arab countries I
would obviate man- early morning. Flowers grow in and were carrying down the honey, that the pools have become one of of money of rootball match outcome lingers on.
of a series of matches.
Some women show a lot of back-visited in the Middle East, is un- land. This Another ler was alive with larger Britain's major industries.
questionably friendly to the British. power shortage, as at Tobruk. profusion.
Some may think that to take rank Judged by turnover they
ser-bone in their choice of evening
Tripoli hns cxcellent airfields black ants bringing down bits of
vice of this sort is liberal. Certain- Kowns. comb, while red ants were racing up seventh. And, according to Mr Dal- et profit of five percent for a
Key man
which, unlike Tobruk, are not liable ton, their formidable growth has re-
ly a stockbroker would look with n third post.
sulted in
in them "absorbing far 100
envy on it.
sandstor and mist, much labour, paper, and postage."
If he invests £1,000 for you in People who say they need a newHIE Emir of Cyrenalen, Sir Sayldte nuut of action frequently by
THE But the absence of reliable statis-
Mohamed Idris el Senussi, whose charge religion really want something that]
I think it in significant that the tics about the pools becomes most Government stack he will
crampitut their style. marked when you inquire precisely you £2 10s, and pay his expenses will soothe their conscience without stencilled portraita kindly prophet what happens to the £35,000,000 or out of that.. so that the public subscribes to them *ench year.
What more ideal spot could you imagine for honey-bees?
So
bought WO
A rather young- neglected hive with a
luying queen. Italian bees are
EATING THE HIVE They nipped off the young bees' rather larger than those. In wings as they fell exhausted to the Britain and more golden in floor and crept out to the alighting colour, with an almost entirely board. golden queen.
+
QUEEN WAS LAYING The hive was an ordinary box with a flat lid for a roof and a long opening along the front.
The promoters are
Multi-millionaires
But apparently if you invest
the like this?"
A narrow tunnel ran up the In-
under 110 side of one of the posts, and in the obligation to tell us. The only pro- darkness of this tunnel small election the public has, so far as 1 £1,000 over a period in the football
mites were creeping up to ent live, for they live on wood.
the
with
Moores
·
•
·
•
woman no longer finds
husband, she's
1
In tarboosh, spectacles and beard Americans seem now to be turning has replaced the dernognogue bull- their attention to Tripoli rather than on the walls of Cyrenaica. Not at single American head of the Duce Benghazi, confirmed this when I called has visited Cyrenaica recently. In
inore. Americans are to be seen. on him, at home in a former gambl- Tripoll, on the other hand, more and Ing casino outside Benghazi.
"Don't you love driving on a night Yes, but I thought I'd wait until ean see, is the honesty and integrity pools you pay a commission of £50 we got further out in the country," of the promoters and their willing for the privilege. And no expenses
have to be paid out of that, The ant world was in possession,
Many a man believes in heredity It is no wonder that the We smeared the posts with sileks ness to piny fair.
It is true that the ten largest paint and sprayed the ants
an brothers, who run Littlewoods, aunti his own son starts to act like would pools are banded together in
the rest of the big promoters are ព The queen was laying, the DDT, hoping that the bees
the to association which has drawn up DDT is death
ninong the biggest taxpayers in
When a beea covered two frames of keep away, for
code of conduct for its méinbers.
fault with her The newspapers have also sought country. sealed and unscaled brood, and them.
It worked. The
estimated that widow. ants panicked, some honey and pollen was broke thele rauls, and got stuck in to do their part by insisting, among I have heard It
on au secoun- they are each worth today anything| the paint or succumbed to the DDT. other information, stored.
£30,000,000. £15,000,000 to from
When Buying goodbye, if you do regarding the dis- tant's certificate The bees became quiet and We We put the hive on a two-foot
tribution of the prize money. Maybe these Agures, like others re-not part with kissen you should part if went back to bed. stand, and sat back to see
remember before the war that lating to the pools, are on the hight with haste. Next day we stood the legs of the questions were being asked in the side, but there can be no doubt at British Gulana bees worked stand in tins of water. Now theity
It was getting late, and the young The City about the profits earned by all that the brothers are very com- like those of Britain.
ants cannot reach the bees.
the multi-millionaire couple were still in the parlour. The private management companies run fortably in
young lady's father. at last had to They were good-natured and bees are quiet at night, busy during ning the then-popular Unit Trusts, class.
Which, for a couple of ex-printers go down. In which the public invested the best. could be handled without a vell the day, and guard the
who started in pools in one, room in "Young man," he said sternly, "it's part of £100,000,000.
volun- Liverpool, Just over 20 years ago, is well past midnight. Do you think Some of these companies
you can stay here all night?" themselves not bad going. torily agreed to submit
The Italian minority in Tripoll lopment But if you But,
Bunh to a strict code of conduct.
go down to
"Gosh," came the reply, "I'll have tanic, amounting to 4,000 out of the land. Jean F. King more important, they appointed an Heuse, London, and pay la. to search to telephono mother first!!
entrance
or smoker. They built straight from intruders,
One bright East Indian assures us
white comb, but wore rather that when the moon is full the been indifferent about gathering nec- will gather lots of honey. tar.
•
tho
The assurances the Emir gave me
There is one other sign of White- are most important because in the
this БСО Bo I event which I believe most likely hall's reawakened interest in
a men taking measurements, noting, granted independence in Ing
of Tripolitola and Cyrenalea be- equntry. Everywhere
sion, he will rule over this plotting and planning. They are the federal union.
bo now independent Arab Libya. More advance party making arrangements over, his influence with, the popula- for the arrival of the troops to a
deployed here from Palestine. tion is immense.
feel confident that when donnlah The Emir, a pleasant,
Ministers or, if they man with a high thin voice, made it future of Libya is decided either by
cannot agree, by UNO-and I unambiguously clear to me that he the Foreign would
a solution which British technicians only envisage Engage and expects to help in the funds the country back to the Arabs militarists will repay their administration and develop the
the I believe we shall And that ment of his country, as well as the debt. training of his army and police.
Grant us such bases as we opening up of the country's military contributes need for the defence of our and strategic resources common interests.
to the general prosperity and deve- of the poverty-stricken
cont
1