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179
practical application would be subject to variation as necessary to suit local circumstances.
In this sense, and having regard to the progressive nature of both
medical and building technique, it will be apparent that the laying down of absolute
standards is neither possible nor desirable.
The constitution and order of reference of the departmental committee, which
was appointed in January, 1932, to compile a pharmacopoeia suitable for use in the
Council's hospitals, were set out in the annual report for 1932 (Vol. IV., Part I, p. 30).
In February, 1934, Professor E. Mellanby, M.D., D.Sc., F.R.S., became a
member of the committee, and his advice, especially on matters relating to diets,
was most valuable.
The pharmacopœia.
During the year eighteen meetings were held, discussion being devoted to
revision of the formulae and to compilation of sections of the appendix.
A provisional formulary was drawn up after obtaining the comments of
medical superintendents of the hospitals, medical officers of institutions and district
medical officers, and was issued in July, 1934, for use in conjunction with the new
contract schedules for drugs and pharmaceutical preparations.
The new edition of the British Pharmaceutical Codex, which was published in
October, 1934, necessitated modifications in the provisional formulary as drawn
up. The medical superintendents of general, special and mental hospitals, as well
as the pharmacists, were accordingly asked to state their views on the suitability
of the formulary as a result of several months' experience, and their suggestions
were taken into account in compiling the final list with due regard to the alterations
occasioned by the publication of the new British Pharmaceutical Codex.
In addition to the formulary, the pharmacopoeia will contain information on
various subjects which it is desirable to make available for medical officers and
nurses. An endeavour has been made to present the information in a condensed
form convenient for ready reference, as much of it is likely to be required in emergencies
and cannot readily be found in text-books.
Hospital Staff.
The fixed establishment of medical staff in the general and special hospitals
was determined by the Council in the years 1931 and 1932, respectively. During
1934 a review of these establishments was carried out, and the conclusion was
reached that the general principles on which they were based were sound, but that
developments in the hospitals service rendered certain additions necessary.
Medical
staff—
Establishment
and
conditions
of service.
The Council was informed that a continually increasing amount of acute and
operative work had to be carried out in the general hospitals, where, moreover, the
general standard of medical care was constantly rising. Improved facilities for
pathological work created by the new laboratory service enabled more elaborate
investigations to be undertaken with a consequent increase in the demand on the
time of the clinical staff. A wider use of consultants also had the effect of raising
the standard of treatment and increasing the care and time devoted to the cases.
Developments in out-patient work, including that in ante- and post-natal and other
specialised clinics, also involved greater demands on the medical staff.
These considerations led the Council to approve an increase in the establishment
of medical staff in general hospitals to the extent of four senior assistant
medical officers, grade II, twenty assistant medical officers, grade II, and seven
positions of house physician, house surgeon or clinical assistant. At the same
time one position of assistant medical officer, grade I, was discontinued.
The survey of the medical staff employed at special hospitals also proved that
additions were necessary. The original establishment provided at most hospitals
for a normal allocation of four permanent whole-time assistant medical officers, the
numbers being increased in times of epidemic, partly by the allocation of permanent
officers employed on a floating staff and partly by the engagement of temporary
officers. In order to secure a proper balance between permanent and temporary
staff during the heavy seasonal increases in the number of patients, some increase
in the permanent establishment was deemed necessary.