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figure should be agreed upon, such capitation fee to be increased
as the death rate became lower, or decreased as the death rate
became higher during any period. In this way medical men
would be more definitely encouraged to take advantage of all the
various means at their disposal for dealing with the different
classes of diseases. In my opinion the general health of the
public would be materially improved because the natural desire of
medical men to increase their fee would encourage them to be
active disseminators of preventive health measures, and the
machinery which is already provided under the Insurance Act
for making backward Authorities financially responsible for
insanitary conditions leading to increased sickness and ill-health
would be much more likely to be put into operation. Certain
suggestions on these lines have been placed before the medical
profession generally in various ways, but up to the present the
idea has not received much favour.
Sir Arthur Newsholme, K.C.B., M.D., F.R.C.P., in an
address before the Derby Medical Society said " I have said
enough I trust, to make it clear that the progress of the application
of preventive medicine depends predominantly on the attitude
of the medical profession. It has even been said that doctors
constitute a chief obstacle to this progress ; but this can only
be true in those instances in each community in which there is,
for instance, failure to use every available means for prompt
diagnosis and for adequate treatment of, say, tuberculosis and
syphilis ; when the duty of pre-natal care of every expectant
mother whose name is on a doctor's list has not been realised ;
and when, for instance again, the doctor fails to fulfil his duty
as doctor or teacher, in respect of the prevention of rickets, the
avoidance of unhygienic habits, and especially in regard to the
consumption of alcoholic drinks. In view of the habit-forming
risks involved, the doctor who flippantly and without serious
reason prescribes alcoholic drinks to an ailing patient is definitely
open to the accusation of anti-social action.'"
Sir Alfred Watson, K.C.B., in a paper before the Royal
Statistical Society comparing sickness experience for the vears
1921 and 1923 with 1893 and 1897 shewed that the sickness
rate amongst men had fallen on the average by about 20 per cent.
Lord Cozens Hardy in an address to the National Association
of Insurance Committees in dealing with this question said:—
" The principal burden of malady belonged to the category of
preventible disease. It was in the interests of the medical
faculty as much as of the approved societies that insured persons
should be kept well. Long spells of sickness were not profitable to