Entry into practice : special committee report / Medical Practitioners' Union.

Date:
[1950?]
Catalogue details

Licence: Public Domain Mark

Credit: Entry into practice : special committee report / Medical Practitioners' Union. Source: Wellcome Collection.

    18/24 page 18
    It must be admitted, however, that such a scheme, although theoreti- cally sound, would be difficult to apply equitably in the lower income range. There are some doctors who from age, inclination or because they still have private practices, wish to restrict their lists to a few hundred, and it would be manifestly unjust to pay them large expense allowances at the expense of their colleagues, or from the public purse. The Medical Practitioners’ Union considers that a graduated capita- tion rate offers in practice the easiest method of correcting the present anomalies. First proposed by the Union the graduated rate has now been approved by the British Medical Association and the “Lancet.”’ Our proposal is that doctors should be paid 30/- a head for the first 2,000 patients and 20/- a head for the remainder; the Association proposes 35/- a head for the first 1,000 and the present capitation rate for the rest. Either scheme would be an improvement upon the present flat rate, but it should be noted that the size of the Central Pool must first be increased so that more money is made available for distribution; otherwise one group would merely benefit at the expense of another. The graduated capitation rate, if accepted, would go a long way to solve the financial problems of the new entrant to practice. ENTRY INTO SPECIALIST PRACTICE When comparing the potential earnings of the young general practi- tioner and the specialist we assumed that the latter would be appro- priately graded and that he would be employed upon a whole-time salaried basis. As matters now exist neither of these assumptions is correct, and it would be fair to say that the future of the aspiring specialist is as uncertain as that of the young man entering general practice. In some respects it is more uncertain, for whereas the latter can be reasonably sure of receiving £1,000 per annum as an assistant the former knows neither how he will be finally graded nor whether there will be a job for him once graded. The circumstances of the trainee specialist holding a job as a registrar are quite intolerable. There are hundreds of these young men all over the country who are receiving salaries of less than £1,000 per annum as trainee specialists while doing the work of full specialists. This would matter little if they could be sure of promotion in a reasonable period to the full status, but they have no such certainty. The Assessment Committees of the Regional Hospital Boards, whose function it is to grade the applicants, appear to be influenced by considerations which should not be their concern. It would be impossible otherwise to explain of the very large number who have been relegated to the quite inappropriate grade of Senior Hospital Medical Officers. These include both senior registrars of many years experience, con- sultants who entered the specialist field from general practice and long established specialists upon the staffs of some of the municipal hospitals.
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