Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees.
- Great Britain. Parliament. House of Commons. Select Committee on Estimates
- Date:
- [1951]
Licence: Public Domain Mark
Credit: Eleventh report from the Select Committee on Estimates : together with the minutes of evidence taken before sub-committee E and appendices, session 1950-1951: regional hospital boards and hospital management committees. Source: Wellcome Collection.
76/348 page 36
![1 February, 1951.] [Continued. 358. So there are cases where the up- grading of general practitioner hospitals should be looked at in view of the availability of consultants’ services in their area?—-That is so. 359. In your opinion economies could be obtained by reviewing a number of such cases?—Yes, I think that is possible. I do not know that they would be very substantial economies, but at the same time the staffing has been a little extravagant here and there throughout the country. Mr. Diamond. 360. Do I gather that would mean a reduction in the number of consultants employed in the Hospital Service?—I should think it would more likely mean their transfer. The total number of con- sultants in the country to-day is inadequate to give the country a full consultant service as meant by the Act. We have 5,200 consultants, most of whom are part-time, and it has been estimated that to give the country a proper consultant service it needs 7,500 on a whole-time basis. So I do not think it would mean a reduction in the total number of consultants. It would probably mean they would be transferred elsewhere, or offered alternative posts elsewhere. Mr. Turton. 361. I am speaking in non-technical language, but do you think one of the effects of the Act has been that certain small hospitals in rural areas, where prior to the appointed day they dealt with operations, now no longer are allowed to deal with operations, but all their patients have to be sent to a central hospital? — In various parts of the country I think that is true, and has occurred. 362. Has that meant a certain increase in expenditure by reason of their unneces- sary transfer?—Yes, I think so, a small increase. I think what has happened moie commonly than that has been that at the type of hospital you have mentioned they have decided they will attach consultants to it, and the consultants—this has been undoubtedly an additional cost—have had to travel from a large centre out to that hospital to do the work there. (Professor Hartfall.) I could cite a typical example of that. At Skipton in Yorkshire, where there was a well-run cottage hospital, the work of operations, medical work, obstetrics and gynaecology was done by the general practitioners who occasionally called in a consultant, either from Bradford or Leeds, to deal with the more difficult problems. On the appointed day the whole character of that hospital was altered. The general practitioners were forbidden to attend, and a series of appointments were made to that hospital of consultants doing a certain number of sessions. That is a striking example in our part of the world, and it created so much unrest that I think it has been, or it is being, reversed and the hospital is now going back into the hands of the general practitioner largely. Chairman. 363. You have competing needs, of course. You have got the need for the general practitioner bed, and you also pre- sumably have some considerable need for the specialist bed?—Yes, that is so. 364. The question to be decided is which is the greater need?—That sort of need could be much better judged by the pro- fession than by the administrator. 365. You are saying the profession was not properly consulted?—-I am quite sure it was not. (Dr. Rowland Hill.) That is quite true. No doubt inadequate consulta- tion with the profession resulted in some of these mistakes. 366. I fancy there may have _ been a difference of opinion within the pro- fession on that question?—Yes. That is why it is so important that it should always be a representative opinion of the pro- fession which is taken, and not the opinion of one man or two men. Mr. Diamond. 367. As’ T am not quite clear about Doctor Hill’s previous answer about the transfer of consultants could I ask this: in the case of Skipton Cottage Hospital what were the consultants doing prior to their appointment to this cottage hospital and what have they been doing since?— (Professor Hartfall.) It varies a little. Some oo were newly appointed to do the work. 368. They would be additional consult- ants?—-Yes, not only working in this one hospital but doing sessions there, going out a certain number of days per week ; others ‘were already established in the area, in Bradford or Leeds, and were asked to do certain additional sessions. 369. Do I gather that in: this case of the Skipton Cottage Hospital the upgrading has meant either the engagement of addi- tional consultants or an increase in the use of consultants’ time at of course the appro- priate charges?—It did. (Dr. Rowland Hill.) 1 think I should like to emphasise here that what is wanted is a balance, a skilfully judged balance. One could not get a worthwhile economy by downgrading a lot of hospitals and turning them into general practitioner hospitals again when in fact the circumstances are such that they should be consultant staffed hospitals. Mr. J. Enoch Powell. 370. In your opinion that balance has by now been exceeded, the balance is tipped against the general practitioner?—It has](https://iiif.wellcomecollection.org/image/b32182478_0076.jp2/full/800%2C/0/default.jpg)
