Letter addressed to the members of the House of Commons on poor law medical relief : with a proposed Bill, and commentary &c., &c. / by Richard Griffin.

  • Griffin, Richard, 1806-1869.
Date:
[1866]
Catalogue details

Licence: Public Domain Mark

Credit: Letter addressed to the members of the House of Commons on poor law medical relief : with a proposed Bill, and commentary &c., &c. / by Richard Griffin. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    tlio individual officers from 3d. to G8s. A list of unions is next given where the extra medical fees have been commuted, which shows that notwithstanding the commutation the salaries in some unions average less than Is. per patient and that the variations are from Is. to 15s., and that in the case of individual medical officers the range is from M. to 37s., clearly proving that the commu- tation was founded on no reliable data. The witness enters into the question of the medical fees, and 6liows that in all cases they ought to he allowed, or if commuted that it should be on a triennial calculation. That the list of extra medical fees should be enlarged, and as the Poor Law Board are not medical men, that a fresh list should he drawn out under the advice of the Medical Council, aud that the Medical Officers of workhouses should participate in these fees. The cause of the commutation is shown to he a desire on the part of the guardians to shift the burden from the individual parish, and fix one-half of it on the common fund of the union, and the other half on the parliamentary grant. The subject of payment in^regard to population is next considered, and it shows that the medical relief ill*that respect varies considerably in the different divisions of the kingdom, it being 1 GleZ. in the northern division and 5-7d. in the eastern, and therefore that mode cannot with fairness he adopted. (See Table 25, p, 78 of evidence.) An account of the average amouut of sickness amongst the paupers is next given, and it is shown that although the average amongst the out-door poor is 1 to 2'8, and the in-door poor 1 to 2‘6, still they vary considerably in the different divisions. Amongst the out-door poor it is in the South Midland Counties as 1 to 1'4, whilst in the Eastern Couuties it is 1 to 4'4, with variations between these extremes in the other divisions. Amongst the in-door poor it is in the North Western Counties as 1 to 1'8, whereas in the South Eastern Counties, the Eastern, North Midland, and the Northern, 1 in 3. (see Table 25, B.,) hence a payment in proportion to pau- perism cannot be adopted. Mr. Griffin, in his Evidence, recommends a payment in proportion to the number of patients and distance to he travelled, and proposes a fixed salary on a triennial calculation of the number of patients attended, and fixes it at not less than 5s. per patient for the first 300 patients, and 2s. for each additional patient. There can he no doubt that it would be desirable to have a uniform plan of payment for all, but as this would entail upon the Guardians in the metropolis, and large towns and cities, very much larger payments than at present, it is actually necessary that there should be some such arrangement as this Bill now proposes, and as the expenses of a medical man for his house, his horse, and servants are not very greatly increased whether he has 300 or 1,000 patients, this arrangement might be effected without much opposition, particularly as amongst a very large number of patients many of the cases are trivial, and are on the books but a short time, which is proved by the fact that the average duration of illness in the metropolis is above three weeks, whereas in the country it is five weeks (see Table 1 app. Fifth Keport Poor Belief [England,] and Lord Klclio’s Eeturn,) besides in towns where the larger number of patients are situated, they reside close together, aud may be quickly seen, and therefore the smaller payment would afford a moderate compensation. Mr Cane, in his Evidence, has stated that “Formerly the Medical Officers were very frequently paid by the per-case system, but that mode ol payment is extremely distasteful to the Guardians.” No doubt sucli is the fact, for by it they are prevented obtaining half the cost of the medical relief out of the Parliamentary grant; lot, however, the law on the subject be altered, and then
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