The State Medical Service Association

A Few Reasons For Advocating a State Medical Service


Operating Theatre about 1912
Operating Theatre about 1912

1. The present want of organisation in the medical profession, the overlapping of the functions of its various branches, and the competition amongst its members lead to great waste of the national medical resources, and of the time and energies of the individual members of the profession.

2. Modern legislation tends to create on the one hand an extension of disjointed State or municipal service, and on the other a vast system of modified contract practice, both of which in the interests of the profession, as well as the public, should and could be easily converted into a State Service.

3. The time has come for freeing a large section of medical men and women from such distasteful and incongruous work as the assessing and collecting of fees for services rendered.

4. It is in the interest of the Public as well as of medical men and women, that the profession should be firmly established as a scientific calling, which can only be made possible by rendering its members free from the pecuniary uncertainties and anxieties of private practice, and establishing a system for their certain and adequate remuneration.

5. The great need of the present time being the expenditure of large sums of money on scientific investigations for the further prevention and cure of disease, it is obvious that such work on the necessary scale can only be carried out under State auspices.

6. Under existing circumstances many of the most able and willing researchers are compelled by economic conditions to desert the centres of investigation in order to earn a living in practice; moreover vast stores of the most useful material are neglected, because, in the struggle to obtain a livelihood, the busy general practitioners have no time to utilise it.

7. The evils at present due to long hours and irregularities of work, the unavoidable waste of time in the building up of practices, and the financial dependence of the practitioner on the patient, can only be remedied by the organisation of the profession as a branch of the nation’s Civil Service.

8. Owing to the unequal distribution of doctors, (in 1910, Bermondsey with a population of 130,760 had 32 doctors, and Hampstead with a population of 81,942 had 168 doctors), and owing to poverty or other causes, for a very considerable portion of the poorer class no proper medical supervision is available.

9. In spite of, and partly because of the advance that has already been made in the science of medicine, surgery and therapeutics, the provision of adequate attendance and appliances for a large section of even the more comfortable classes is wholly inadequate and can only be rendered available by a State Service, accompanied by the right of every one to professional help and advice.

10. The present Hospital system, well equipped and staffed though it is, is still at the mercy of uncertain and inadequate voluntary charity, which does not keep pace with the demands of modern scientific methods. Under a State regulated system these Hospitals would at once be put on a firm financial basis, their staffs would be properly remunerated and their doors would be open to all, thus saving the practitioner from the present anomalies of “Hospital abuse” and competition, whilst enabling him to utilise them as a help rather than a hindrance in his work.

11. Under existing circumstances practitioners, who work at a distance from the centres of education and Hospital activities have neither time nor opportunity to refresh their knowledge, and become acquainted with modern methods and the ways of applying them in practice. Opportunities could be given under a State Service.

12. At the present time every practitioner is performing many State services without remuneration, and is doing a large amount of work amongst his patients gratuitously, or incurring “bad debts,” impositions with which no other profession is inflicted to anything like the same extent, and which can only be removed under a State Service.

13. The time has come when every medical practitioner, man or woman, should be guaranteed an adequate and certain salary during the active years of service, coupled with a system of gradual promotion and followed by a generous pension.

For all information apply to:-

The Hon Secretary 24 Upper Wimpole Street London W