A national health service : the White Paper proposals in brief.

Date:
1944
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Licence: Public Domain Mark

Credit: A national health service : the White Paper proposals in brief. Source: Wellcome Collection.

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    that access will be had to the many other forms of medical care which the National Service will provide. If there is to be that high degree of confidence between doctor and patient on which the success of the new scheme will depend, two principles must be observed. First, everyone must be free to choose the doctor whom he consu'ts. Absolute freedom of choice is, of course, impracticable and does not exist now; the number of doctors in any one neighbourhood is necessarily limited. But there must be freedom to choose from among the doctors available. a Second, there must be no such regimentation in the scheme as will prevent a doctor from exercising his professional skill in whatever way he believes to be in the best interests of his patient. Yet, if the State is to provide a universal service of family doctors, there must be some degree of State intervention. The Government. believe that their proposals preserve the right degree of balance in this. Developments in medical practice st Another important point is the need to give free range to modern ideas as to the best form of general medical practice. To this problem much thought has been given in recent years, particularly by the profession itself. The idea of grouped practice—of individual doctors collaborating with each other in teams in. which “ many heads are better than one ’’—has received great prominence in professional and other discussions of late. The draft Interim Report of the Medical Planning Commission (organised by the British Medical Association) summarises the problem as follows :— “ Diverse as are the views on the organization of medical services, there is general agreement that co-operation amongst individual general practitioners in a locality is essential to efficient practice under modern conditions, theugh views vary on the form of the co-operation. The principle of the organization of general practice on a group or co-operative basis is widely approved.” The Government fully agree that “ grouped”’ practices, to which numerous privately arranged partnerships point the way, must be placed in the forefront of their plans for the National Health Service and their proposals are designed with this in view. But the conception of grouped practices cannot represent the whole shape of the future service. In the first place, there has not yet been enough experience of the idea translated into fact. Not enough has been found out, by trial and error, to determine the conditions under which individual! doctors can best collaborate or the extent to which in the long run the public will prefer the group system. Secondly, it is certain that the system could not be adepted everywhere simultaneously. The change, even if experience shows that it should be complete, will take time. The Government propose, therefore, that the new service shall be based on a combination of grouped practice and of separate practice, side by side. Grouped practices are more likely to be found suitable in densely populated and highly built-up areas and it is there particularly
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