Of course, any service provided, whether partial or complete, will need to be kept free from “political pull.” This spells inefficiency; and inefficiency means disease and death. “Political pull,” although not in the official list of Causes of Death, is among the potent causes of excessive mortality; and for this, every one of us must bear his individual share of responsibility, insofar as we have abstained from active support of sound and clean government, when we were unable to take an actual share in government.
FOOTNOTES:
[9] The Wesley M. Carpenter lecture delivered October 2, 1919, before the New York Academy of Medicine.
[10] Thus Mr. Bishop Harman, an ophthalmic surgeon, and a member of the Council of the British Medical Association, says:
“In my out-patient clinic 60% of the patients are insured persons who attend for treatment that is essential to their industrial efficiency.... A scheme of medical benefit which does not provide for specialist service and for institutional treatment is no scheme, it is poorer in status than the Poor Law provision which does all these things.” (British Medical Journal, Mar. 15, 19).
Dr. R. Sanderson, of Brighton, writing on behalf of medical practitioners, says:
“We are the victims of a half-fledged, inadequate piece of legislation which is founded apparently on the supposition that disease can be dealt with effectually by giving bottles of medicine or liniment to the sick, or that if this fails and the sick get worse, they can be sent to one of the overcrowded voluntary hospitals with which the legislature has nothing whatever to do. Anything more unsatisfactory to the sick, or demoralizing to us as a profession, it is hard to imagine.”
He then proceeds to advocate an urgent need of the profession, viz: the establishment of an adequate number of auxiliary hospitals throughout the country, staffed by teams of general practitioners, to which all practitioners can have access, and to which they can send cases requiring clinical observation of any kind, rest or treatment that cannot be carried out in the sick person’s home. (British Medical Journal, July 19, 19.)
Dr. Howarth, Medical Officer of Health of the City of London, and Dr. B. A. Richmond, Secretary of the London Panel Committee, affirm “the limitation of medical benefit to insured persons alone cannot continue. Another service has been added to the many competing classes of state treatment”; and they bring out the fact that personal contributions of insured persons are swallowed up in supplying the sickness and disablement benefit, and contribute nothing to the cost of the sanatorium benefit, maternity benefit, or medical benefit.
Dr. H. S. Beadles, Secretary of the Stratford & West Ham Panel Committee, says: “The British Medical Association should fearlessly acknowledge that the attendance under the National Insurance Act, which is itself a part-time State service, is an absolute failure and amounts to little more than first aid, carried on at an enormous cost.”