THE DOCTORS' PROTEST.

Dominion, Volume 5, Issue 1355, 5 February 1912, Page 4

THE DOCTORS' PROTEST.

It is apparent from recent cable messages that the doctors are going to make it difficult to bring Mis. Lloyd-George's National Insurance Act into operation. The Council of the British Medical Association, the Royal College of Physicians, and the Royal College of Surgeons of Scotland have refused to confcr with tie Insurance Commissioners on the working of the Act. This is the natural sequel to the proceedings of December, when it was made known by means of several large .meetings in different cities and by an informal referendum that the great majority of the medical men of the United Kingdom would refuse to carry any part of the burdens thrown upon them in this vast v and admittedly experimental scheme. Their demands for amendment of the Rill I had been formulated several months before, and the Council of the British Medical Association was empowered to confer with Mlt. LloydGkouoe, but the settlement which was arranged and embodied in the Act covered only a fraction of the demands. The Chancellor was too clever for the doctors. The only further hope for them was that they might get further concessions cither from the Commissioners or locally from tho 1 Insurance Committees. This did not satisfy the great majority of tho profession, but the final stages of the Bill were accomplished in such haste that their protests came too late. There can he no mistake about the strong feeling of the doctors. They are not, as a class, prone to gather in huge meetings, and make vehement speeches. Yet they were doing just those things all over the country a few weeks ago. And as they are men of education with a high sense of professional honour ■and public duty, they would not feel so strongly without substantial reason I he fact is that tho National Insurance system will bind them with irksome restraints and obligations, and seriously reduce their incomes. A clear view of their posi»rnn n in '■* lctter si S ned r.ii.C.o., to which the London 1 lines gives typographical prominence. and editorial approval. The writer states that nearly all medical practitioners have, entered into contracts with working men's clubs or friendly societies to attend their members in sicknessin return for a small annual payment, say, .)s. a year for each member. Such arrangements had their origin in the desire of the profession t<i bo helpful to industrious and self-iespccling people,' and it was never pretended that thev were remunerative to the doctors concerned. Xow, an essential feature ot i.l r. Lloyd-George's Act is that it will sweep thousands of people, who have hitherto willingly paid .small, but in the aggregate remunerative amounts, for medical attendance, into, tho net of contract practice; while the people so swept in will mostly he of an inferior physical type, or of more advanced age, and of greater liability to disease than those hitherto included. The restraint of having to pay the doctor for his attendance would be removed from these people, and their demands would be incessant and overwhelming. In other words, tho doctors would be crushed under unremunerative labour, and the prospects which now induce a sufficient number of young men to enter the profession would' bo almost wholly withdrawn. The pecuniary Toss to the profession, if the Act as it now stands is carried out, is. estimated by ''F.]jLC.S."-as at least one-half of trie present income of every practitioner concerned. Apart from other grievances, such as inspection by Government officials and control by friendly societies, we should think the loss of half their income would generally be considered enough to justify the doctors in their hostility to the Act. But the doctors will go on attending the sick. They will continue to be at the beck and call of their poorest fellow citizens at any hour of the twenty-four. They will not strike work, but they wijl give medical attendance on their own terms. This will, of course, not be a breach of any law, for the Act does not apply compulsion to the doctors. Before Christmas thousands of practitioners had signed tho following pledge: — Feeling' that, tho present National Insurance Act is unjust to the medical prolession, I hereby pledge my word not (o axeot any service whatsoever under it. i stipulate, however, that unless at lea-t 2.1,01)0 members of niv profession in Great Britain combine with me in this pledge, J am to l)e freed from it. It was anticipated that the 23,000 would be easily made up. The balance—there are 29,567 registered medical practitioners in Great Britain—would be negligible. There was a rumour that tho Government might engage a special staff of 1700 doctors to give their whole time to insurance work, but the recusants believed that only a comparatively small number, and those inexperienced and ill-qualified, would be obtainable. Presumably, the pledge applies only to the Act as it stands, and leaves the signatories free to accept service under it if it i s amended in accordance with the demands already made on behalf of ' the profession. Those demands arc intended to secure emancipation from the control of the friendly societies, freedom for patients to choose their own doctors, a wage limit so that a patient whose income exceeds £2 a week would not come within the contract and _ adequate remuneration for medical services. The prospect was that there would be Gs. per patient per annum to be divided among the doctor, the druggist, and tho surgical instrument maker; and the doetors considered that Ss. Gd. a year wont 1 be little enough for their rran services. It appears that some part of the doctor's demands may be conceded by the Insurance Commissioners >ami the local committees, but as the Act may not be brought into force until next .7uly, tho doctors will probably hold out for

amendments. Without medical services cm sonic terms or other, the Act cannot work.