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In common fairness one asks,"Why should the medical profession be asked to render such
immense serv ices as it does to the sick public with the return which is totally inadequate and which
is expected of no other profession or trade ?" Why, for instance, should not a number of butchers,
equal in number with the doctors on the staff, provide, with a similar proportion of remuneration
from the hospital funds, all meat for the hospital, or why not a similar number of grocers, under
similar circumstances, provide provisions? The public has still an extraordinary idea of what it
may expect from the medical profession. It will go to a doctor and ask for attendance and for the
provision of advice, physic, dressings, etc., which cost the doctors a considerable sum, with no other
means of paying whatever than an overdraft on the bank of hope. A similar demand made to the
butcher, the baker, or the grocer would be met with a reply which would be distinctly more forcible
than polite.
I ask again, "Why should the medical profession give in the way that no other profession
or trade does ?" It is urged, of course, that the doctors are getting something out of it. True,
they get experience, but that is the result of enthusiasm. They may get a little kudos by reason
of being on the staff, but as for instance, at Wembley, where every member of the profession in the
district is on the staff, that kudos means nothing, and such experience they get is all to the good
of the sick public of the district. I am certain that is not the point. The medical profession as a
whole is still to a large extent imbued with the monastic ideal which actuated it in the middle ages,
that of relieving the sufferings of the sick poor, but it is getting tired of being exploited by all and
sundry.
To look at things from a business point of view, it surely is not sufficiently realised how important
to the State adequate medical attention is in the early stages of disease.
It is still insufficiently realised that, not only to the working man, but to 95 per cent of the
population, their health is their capital. It is still insufficiently realised how a family may be handicapped
under present circumstances by the presence in it of a chronically sick member. Take two
families living side by side with the same income. One man marries a wife who goes sick after a
confinement or some serious illness and becomes a chronic invalid, or one of the children gets rheumatic
fever with subsequent heart trouble, and the doctor in both cases is, to use a colloquialism, never
off the doorstep.
It seems to be lost sight of so often, that whereas the neighbour who has no illness in the house
can afford to give his children of his best, the others are handicapped in the race for life as compared
with their neighbour, by the fact that the sick member demands that attention which means a continual
series of doctors' bills, and all the additional expenses consequent on illness. Be it said that
these are almost without exception gladly paid where circumstances will permit it, and the gratitude
one remembers in the days when one was in practice was, and is still, a very precious thing ; but the
fact remains, the children of the family with the sick member are not going to get their chance in
life in the same manner as the children of their neighbour will.
The time is coming, and in my opinion coming rapidly, when there will be a very wide extension
of the system of insurance against not only the doctor's bill, but all that goes with sickness.
It is now nearly a quarter of a century ago since I tried to do something in that direction in
connection with tuberculosis. The way in which the Post Office solved a certain portion of their
difficulty by means of a contribution of a half-penny a week throughout the service and the erection
of their own sanatorium, stimulated the attempt to do something further. My idea was, on somewhat
similar lines, to insure for a year's sanatorium treatment, and also to ensure that during that
period of treatment the insurer's income, or at least 50 per cent of this amount, was continuing to
the family. I took this up with the Prudential Assurance Company, and finally had a long interview
with the Officers and Actuaries at Holborn, but, as might be expected, the absence of a national
compulsory insurance made the whole thing impossible.
There will have to be a general improvement in all the medical services, widened in my opinion
to take in all the specialised services on an insurance basis, but that basis will have to be what it has
never been hitherto, that is, an equitable one to the medical profession. There must be, in my opinion,
for the bulk of the population by some insurance method, the elimination of the dread of the doctor's
bill, and the feeling that the best possible attention is theirs by right of insurance paid.
Those who have been in practice know how often a doctor is not called in by the working
classes, and what one terms the " black coated worker," and to-day even by the professional classes,
because of that dread of the unknown amount that they may be called on to pay, and so they put it
off and put it off until they are finally compelled to call in medical aid, the patient in the meantime
having a well established condition which might have been dealt with quite easily had the patient
been seen earlier.
There must be, in my opinion, the understanding that it is wisest to call a doctor in at the
earliest departure from health.
In my opinion these medical services can never be provided by the working classes on an
adequate scale, including, as they must, hospital accommodation, unless they arc subsidised by
the State or Municipality. Take the hospitals, for instance ; what is the position for the bulk of them
at the present time ? Every device imaginable is dragged in to induce the public to part with the
necessary funds to keep them open. Horse shows, Baby shows, Dog shows, Cat shows, Flag days,
Comic parades, Bazaars with all sorts of child-like side shows, are brought into play to extract small
sums from humble folk.