Making Medical History Charles W Brook 1946

Soon after I had qualified as a medical practitioner in 1925, my father gave me a copy of Fielding H. Garrison’s “History of Medicine.” This gift not only provided me with a valuable reference book, but it also whetted my appetite for reading Medical History.

Over fifteen years later, correspondence with Guy A. Aldred, LL.D., of Glasgow, who, among many other activities, became the biographer of Richard Carlile the great English Libertarian, led to some interesting discoveries about well-known surgeons with whom Carlile was acquainted. This resulted in my “Carlile and the Surgeons,” followed by “Battling Surgeon,” a somewhat unorthodox biography of Thomas Wakley, founder of the “Lancet” and Radical Member of Parliament. Thus I found that I had not only read Medical History, but that I had even written a little about it.

Early in 1946 I read in the Press a report of a speech by Professor Harold Laski, then  chairman of the Labour Party. “In the short period of fifteen years,” said Laski, “the Socialist Medical Association has done much to change the perspective and methods of one of the most conservative professions in the world. It has captured the Labour Party; indeed it may be said to have made the Labour Party its instrument in its great adventure.”

This tribute to the Socialist Medical Association led me to the conclusion that I had not only read Medical History and written a little about it, but that possibly I had even contributed something towards making it!

It was during the early summer of 1930 that I received a letter from Dr. Ewald Fabian, a Berlin dental surgeon, in which he stated that in many European countries there existed organisations of Socialist members of the medical profession and that the one in Berlin had a membership of several hundreds and published a widely circulated journal ” Der Sozialistiche Arzt” (“The Socialist Doctor”) of which he was the editor. He greatly regretted that there was not a similar organisation in Britain and expressed the hope that I might be able to do something about it.

Soon afterwards Dr. Fabian visited London and we met, but con­versation was somewhat difficult for I knew no German and Fabian’s knowledge of English was very limited. However, I spent a half-day with him visiting London voluntary and municipal hospitals and finishing up  by  entertaining  him  to   dinner  at the  typically  English   “Cheshire Cheese ” and to an equally typical English blood-and-thunder melodrama at the old Lyceum Theatre.   I think he enjoyed his experiences, but the set-up  of the British voluntary hospital system  seemed  quite  incompre­hensible to  him.   Incidentally,  Fabian was  a man of heavy  build  and when he got in my fragile car, which was contemptuously referred to by my friends as “The Dung Cart,” the front passenger seat collapsed. Despite Fabian’s persistence, the prospects of being able to get a Socialist Medical organisation started here seemed very remote indeed, for I not only had my hands full with my professional duties and various political activities, but  I  was  also  acting  as  Honorary  Secretary of  the  Tooting  Housing Survey Council, which I had convened in the previous year, in order to focus  public  attention on  a comparatively  new  slum  area  in  Tooting and to create a local agitation for the removal of a large dust destructor from the centre of that district.    I shall always regard it as the most effective piece of practical social work that I ever undertook, for a de­vastating report compiled by a well-known journalist Clifford Troke, who had been a fellow-student of mine at Bart’s but who had discarded the scalpel  for  the   pen,   caused   such  an  outburst  of  indignation  that  the houses were repaired, the dust destructor removed and the vacated site utilised for the construction of large blocks of flats by the Wandsworth Borough Council.

The   impetus for  starting the  Socialist Medical Association  was, strangely enough, provided by   Sir   Ernest Graham-Little,  M.D.,   Independent M.P. for London University.  He had made some disparaging comparisons between State and Voluntary hospitals, and being thoroughly irritated,  I  there and then decided that it was time  to get busy with the creation of the organisation which Dr. Fabian had suggested.   The procedure which I adopted was to write a letter to the “Daily Herald” inviting medical practitioners who might be interested in such a project to communicate with me.    Among the few favourable replies I received was  one from  Dr.  Alfred  Welply,  General Secretary   of   the   Medical Practitioners’ Union, who asked me to call and see him at his office in Russell   Square.  This  I did and   Alfred   Welply  told me that he had felt for a long time that an organisation of Socialist  doctors was most necessary and that if launched it was bound to be a success.  He then proceeded to give me valuable advice as to the initial steps which should be taken.  I drafted  a letter which Welply had  duplicated  at his office and a copy was dispatched to the Secretary of every Labour Party in the country, asking for the names of doctors who were known to be members of the Party or thought to be sympathisers,    The result was sufficiently encouraging for me to convene a meeting on a Sunday afternoon late in September,  1930, at the now defunct National Labour Club  at Tufton Street, Westminster.   About twenty attended and the chair was taken  by Miss   Esther   Rickards,   M.S.,  F.R.C.S.,  who  was then an Alderman  of the  London  County  Council.  Esther Rickards,  who had suffered  victimisation  for her  political  views  when  she  sought  surgical appointments  at  London  hospitals,  is one  of the  ablest  women  in  the Labour   Movement.   A  brilliant  debater and first-class administrator, she had been content to confine her political activities to local govern­ment, at first in London and now in Berkshire.

Having listened to a statement by me as to the needs for a Socialist Medical organisation the meeting agreed that immediate steps should be taken to establish such a body, and a committee was then appointed, with myself as Acting Honorary Secretary, to draft a Constitution. I came away from that small gathering firmly convinced that something really important had happened, something which might possibly influence the whole future of Medicine in this country.

The provisional committee met on the following Sunday at the offices of the Medical Practitioners’ Union and I asked J. S. Middleton, then the Acting Secretary of the Labour Party, to come along and help us draft the Constitution. I took this step, not only because of Jim Middleton’s vast experience, but I was particularly anxious to secure the Labour Party’s friendly interest id this new body and subsequently to accept its affiliation as a Socialist Society. In order to give effect to this objective a clause was inserted in the Constitution, stating that the, new organisation was to be confined to those who accepted the rules of the Labour Party. Personally, I disliked this narrow discrimination, but although I recognised that it would mean that we should lose the assistance of many keen potential members, I regarded affiliation to the Labour Party as the primary essential. Incidentally, six years later this clause was deleted and the Constitution was so amended that every brand of Socialist in the medical and allied professions became eligible for membership.

There was some difference of opinion as to the name to be given to the new organisation. Some thought that it should be a Society, others a League, but finally it was agreed that the most appropriate name was “The Socialist Medical Association.” Of the original Constitution the three first and main objects still remain, viz:—

  1. To  work for a Socialised Medical  Service both  preventive  and curative, free and open to all.
  2. To secure for the people the highest possible standard of health.
  3. To disseminate the principles of socialism within the medical and allied   services.

At first full membership was restricted to medical practitioners, but dentists, pharmacists, nurses, midwives and other health workers, together with medical students and students of the ancillary services were admitted to associateship, with limited representation on the Executive Committee. Subsequently these associates were admitted to full membership, although medical members retained a controlling interest in the Association’s governing body.

As soon as the draft constitution was ready, I convened a further meeting of supporters at the National Labour Club on 2nd November. On this occasion Mr. Somerville Hastings, M.S., F.R.C.S., at that time surgeon-in-charge of the Ear and Throat Department of the Middlesex Hospital and Labour M.P. for Reading, was in the chair. When I invited the support of Somerville Hastings for the new organisation, he was placed in a somewhat difficult position, for just before I had convened the initial meeting of the S.M.A., a body known as the State Medical Service Association had been revived. This organisation had been started largely through the influence of members of the Fabian Society before the 1914—1918 war, but it had a one plank platform and was open to non-Socialists. Somerville Hastings, after much careful thought, decided to throw in his lot with the S.M.A. and it was not long before the State Medical Service Association went out of existence. It was indeed fortunate that Somerville Hastings made this choice, for he not only devoted a tremendous amount of time to the detailed work of the S.M.A., but he and Mrs. Hastings were always ready to provide hospitality at their home in Devonshire Street for the Executive Committee and for many social functions which were arranged for the Association’s membership. Without the quiet efficiency and perseverance of this shrewd and kindly man, I doubt whether the S.M.A. would ever have made such rapid progress. His subsequent service to the health of the people of London was suitably recognised in 1944, when he was elected Chairman of the L.C.C. To Somerville Hastings, as Labour M.P. for Barking in the present Parliament, it must have been a tremendous satisfaction to have spoken in the House of Commons in support of the National Health Service Bill— a fitting reward for years of struggle against heavy odds.

After the Constitution of the Association had been approved, the Officers and Executive Committee were elected. Somerville Hastings became President, Alfred Welply Treasurer and myself Honorary Secretary. Two Trustees were elected, although there was no property to be held in trust. They were Dr. V. H. Rutherford, a former Liberal M.P. who had later contested Sunderland as a Labour candidate, and Dr. Hector Munro, a pioneer Socialist, with somewhat unorthodox views on Medicine, who had been a lifelong friend of Keir Hardie. Members of the Executive Committee included Dr. Alfred Salter, M.P.; Dr. Robert Forgan, M.P.;  Dr. John Powell-Evans, .who shares with Somerville Hastings the distinction of still being a member of the Executive Com­mittee after sixteen years valuable and uninterrupted service; Dr. Caroline Maule, a medical graduate of the University of California; Dr. A. V. R. Menon, an Indian practitioner; Dr. S. W. Jeger, a former Mayor of Shoreditch who is now M.P. for South-West St. Pancras, and Dr. Frank Bushnell.

Alfred Salter, who as M.P. for West Bermondsey was one of the few who survived the anti-Labour landslide in 1931 and remained in the House of Commons until shortly before his death in 1945, was the most militant Pacifist and the most dictatorial Democrat I have ever known. In his fight for Peace and Prohibition he was completely dogmatic and uncompromising. To his Borough of Bermondsey he gave devoted service as a great general practitioner, and as a practical crusader against slums and .disease, for he not only established a model Co-operative and Labour Bakery, but he was instrumental in getting the Bermondsey Borough Council to build a great Municipal Health Centre, to carry out vast schemes of slums clearance and to erect many blocks of modern flats, which remain a fitting local memorial to his magnificent pioneering efforts.

Robert Forgan had entered Parliament in 1929 as a youngish man of great promise and apparently assured of a brilliant political career, but at the time when the S.M.A. was founded Forgan was becoming increasingly irritated with the leadership of the Labour Government, and, with John Strachey, he followed Sir Oswald Mosley into his “New Party,” but subsequently retired from politics.

Frank Bushnell had contested London University as a Labour candidate in 1924 and a Birmingham constituency in 1929. After retire­ment from his post as Tuberculosis Officer of Plymouth, he had been elected to that City’s Council and had founded the Plymouth Workers’ Health Committee. This organisation was in 1931 expanded into the Socialist Workers’ National Health Council, and Bushnell became its Honorary Organising Secretary with his headquarters in London. His work has never received the recognition it deserves, for the underlying; idea was magnificent. Advancing age was his great handicap and it was, difficult to follow his line of argument, either in private conversation or in public discussions. In his efforts to make the workers of this country “health-conscious” he organised Health Exhibitions and took parties round laboratories, nursery schools, medical museums and municipal, undertakings, such as sewage plants and water works. Shortly before his death in 1941 he announced the establishment of the “Bushnell Bequest.” The income of the fund he created was to be used ” to further the knowledge of the Socialist application of Medicine to public health and well-being and to demonstrating that the full advantage of socialised medicine can be enjoyed only in a socialist state.

  1. by engaging from time to time lecturers and speakers to give addresses and lessons in Great Britain at such places and times and upon such conditions as the managers shall in their absolute discretion determine. The lecturers and speakers shall be duly qualified medical practitioners, dentists, or pharmacists, or health or sanitary inspectors, qualified midwives, radio­logists, biologists or other such suitable persons as the managers shall select.
  2. by printing,  publishing  and  distributing  for  sale  or  free  dis­tribution such books, pamphlets, leaflets or other literature on or  connected  with  socialised  medicine   as  the  managers  shall determine.”

He then proceeded to lay down a curriculum of the addresses and lectures which were to be given and nominated a number of organisations including the S.M.A., who should appoint endowment trustees. It is not possible for the whole scheme to become operative until after the death of Mrs. Bushnell, but she has already made a generous gift to the S.M.A., in order to give some effect to her husband’s wishes during her lifetime.

The Executive Committee of the S.M.A. met for the first time at the House of Commons on November 19th, 1930, and as it was agreed that a detailed policy for the Association must be defined as speedily as possible, a Research Sub-Committee was formed in order ” to devise practical measures for a Free Socialised Medical Service.” Invitations were sent to a number of organisations to submit evidence to the Sub-Committee and among the first to accept was the British Medical Association, its spokesmen being the late Sir Henry Brackenbury, who was then Chairman of the Representative Body, and the late Dr. G. C. Anderson, Secretary of the B.M.A. I must confess that I had a feeling of great satisfaction when the powerful B.M.A. so readily agreed to meet representatives of our tiny and very young organisation.

A useful piece of work was undertaken by the Executive Committee towards the end of December, 1930, when Lewis Silkin, now Minister. of Town and Country Planning, suggested that we should prepare a Memorandum on a Health Policy for London for the 1931 L.C.C. Election. This was speedily completed, and I well remember spending all Christmas Day in my home at Balham, which was for a long time used by the S.M.A. as its office, laboriously typing out copies of the document. But the labour was worth while, for the Memorandum provided the basis of the hospital policy of the L.C.C. when Labour won control of the Council in 1934. ,

So, by the end of 1930, the Socialist Medical Association, less than four months from its birth, was well on the way to frame that policy which was ultimately to bring about revolutionary changes in the Health Services of this country, but it was not until late in the following year that the Association became affiliated to the Labour Party. At many Annual Conferences of the Labour Party, Somerville Hastings was the S.M.A.’s delegate and at the Leicester Conference in 1932 he moved a successful resolution calling for the establishment of a State Medical Service. Two years later at the Southport Conference unanimous approval was given to the Party’s official policy on a National Health Service, which had been drafted by a Committee on which the S.M.A.  had considerable representation.

The S.M.A. also became affiliated to the short-lived International Socialist Medical Association, which had been constituted at the Con­ference held at Carlsbad in the spring of 1931, and at which the S.M.A. was represented by Somerville Hastings and V. H. Rutherford. The Secretary of the International Association was Ewald Fabian, who within two years had to leave Berlin and take refuge from the Nazis in Prague. In the autumn of 1938 he had to move the headquarters of the Inter­national Association to Paris, and soon after the outbreak of the war he went to New York, where he still lives.

The report of the Research Sub Committee on a Socialised Medical Service was presented to the Second Annual General Meeting in May, 1932, and after a full day’s debate and despite Dr. Bushnell’s determined opposition to what he regarded as a “Reformist” policy, the report was adopted with some minor amendments, and was published as a twopenny booklet. While there were subsequently many changes in the Policy of the S.M.A. it is of interest to note that it was in a “Socialised Medical Service” that Regional Administration and the provision of “General Practitioner Health Centres ” were first advocated.

It was at the Second Annual General Meeting of the Association in. May, 1932, that a woman doctor, subsequently to become a well-known figure in British politics, made her first appearance. She was Dr. Edith Summerskill, now Parliamentary Secretary to the Ministry of Food, who, with her husband, Dr. Jeffrey Samuel, had joined the Association a few weeks previously. Edith Summerskill for a number of years organised the ”Someda” Dinner and Dance which was held at the time of the Association’s Annual General Meetings, and such well-known political leaders as Clement Attlee, Herbert Morrison, Christopher Addison, J. R. Clynes, Arthur Greenwood, Ellen Wilkinson and J. B. S. Haldane were among the principal guests of the Association, at these highly successful gatherings.

Another institution at the earlier Annual General Meetings was “The Popular Lecture” to which the public were invited. At the Third Annual General Meeting Esther Rickards spoke on the need for a National Maternity Service, and so important was the subject considered that a Special General Meeting was convened in the following November and a detailed policy was elaborated. This started the campaign for safer motherhood in Britain, and thus it can be reasonably claimed that the S.M.A. was the organisation primarily responsible not only for making the Nation conscious of the needlessly high rate of maternal mortality and morbidity, but for providing the initial drive for the subsequent legislation which had such remarkable results. For this achieve­ment special credit must go to Esther Rickards for her detailed planning and to Edith Summerskill for her popular platform appeal. The S.M.A.’s Memorandum was published as a supplement of its then official journal “The Socialist Doctor,” whose Editor was the now very well-known medical journalist and broadcaster, Dr. David Stark Murray, son of a former Scottish Labour and Co-operative M.P. and poet. He had, attended the inaugural meeting of the S.M.A. and had been elected to the Executive Committee in 1931 and when it was decided to establish the “Socialist Doctor” he soon became its Editor. Owing to financial stringency very little money could be spared for this publication and eventually, through lack of support, it slowly petered out. But Murray did not despair for he considered that there was room for a new journal with a wider public appeal and so, with very little financial backing, “Medicine Today and Tomorrow” was launched in October, 1937. As a work of reference for future students of Medical History during the third and fourth decades of the twentieth century, “M.T.T.” will undoubtedly prove to be a mine of information and the contribution which David Stark Murray has made as leading chronicler of the agitation which led to the National Health Service Bill, cannot be under­estimated.

For some time I had felt that greater interest should be taken by the S.M.A. in the industrial side of the Labour Movement, and the Medical Practitioners’ Union appeared to provide the best medium. The M.P.U. had been founded at the time of the passing of the National Health Insurance Bill, but the majority of the membership had always been strongly opposed to its affiliation to the Trades Union Congress. I sounded Alfred Welply as to the possibility of changing this attitude and at his request I sent him a long letter, setting out in detail the reasons why the Union should seek affiliation to the T.U.C. Apparently so convincing were my arguments that the Council of the M.P.U., although containing some staunch Conservatives, agreed to my suggestion and in December, 1934, the Union became affiliated to the T.U.C. This action completely nonplussed the leaders of the B.M.A., who for once were completely out-manoevred, for up till then the B.M.A. had always regarded the M.P.U. as rather a nuisance, but of little consequence. Now a position had been reached, whereby the M.P.U. had gained entry into a very large and powerful body to which the B.M.A. by reason of its constitution, could never obtain access. The next move made by the M.P.U. was to approach every major local authority in the country, asking for recognition of the Union as a negotiating body. This was too much for the B.M.A. and its Secretary, the late Dr. G. C. Anderson, rather unwisely sent out a confidential circular, in which he suggested that secretaries of all branches and divisions of the B.M.A. should contact their Medical Officers of Health and persuade them to use their official positions to influence Town Clerks and Clerks of County Councils to boycott the M.P.U.

A copy of this circular came into Welply’s possession, and he conveyed the information to me by telephone on 19th January, 1935. I suggested that he should immediately contact the “Daily Herald” and on the following Monday these headlines were splashed on its front page :—

” B.M.A’s AMAZING LETTER Trying to Smash Doctors’ Union.”

“Big Fight over link-up with T.U.C.”

” Boycot’ Call to Councils.”

Welply followed up this initial tactical victory by approaching every local authority with which the B.M.A. was in dispute over non-adherence to the Askwith Committee’s recommendations for salaries of Local Government Medical Officers. This drove the B.M.A. to further action and its officers went scurrying about the country, trying to get. these old-standing disputes settled.

I naturally expected the full co-operation of the S.M.A. in this extremely important development in medical politics, and I was, therefore, most surprised when at the next meeting of the Executive Committee of the S.M.A. I had to face what amounted ‘to a vote of censure for my action. It was, in fact, only with some difficulty that I managed to secure the rejection of a resolution protesting against the action of the T.U.C. in granting affiliation to the M.P.U. I was most disappointed at the absence of co-operation between the two organisations, but although I regarded my-efforts at the time as a dismal failure, there were certain compensations. For one thing, the affiliation of the M.P.U. enabled me to be the first medical delegate to the T.U.C. at Margate in September, 1935. It was on the opening day, while delegates from the Amalgamated Society of Wire Drawers who had been involved in a prolonged strike against the use of the Bedaux System of Labour Measurement, were appealing to Congress for support, that Dr. H. B. Morgan, medical adviser to the T.U.C., came up to where I was sitting and said, ” Brook, you ought to get in on this.” When I announced to Congress the organisation which I represented, there was a terrific outburst of applause and John Bromley, the locomotive men’s leader, afterwards exclaimed, “This is a red letter day in the history of the T.U.C.” I think he was right, because the entry of the M.P.U. into the T.U.C. paved the way for affiliation by technical organisations such as the Association of Scientific Workers. My brief intervention in the debate was an extemporary effort but I think that it might be here recorded, as it was the first speech made at Congress by a medical delegate.

“DR. C. W. Brook (Medical Practitioners). I might not have intervened in this early stage had I not felt that perhaps I might possibly be of assistance because of the conversations I have had with various medical men who have made some preliminary investigations into the Bedaux system. The conclusion one has had to draw so far from conversations one has had with psychological experts is that the Bedaux system, at any rate at the moment, is being employed to cover up inefficiency in the management and direction of particular industries. But what I want to point out is that we are not merely presented with an industrial problem, but rather with what is essentially a medical and psychological problem with an industrial basis, and if my suggestions are worth anything I feel that while the Bedaux system may not be beaten industrially, it can be beaten if it is tackled on a medical and psychological basis. As far as my own organisation is concerned, we, together with those who are experts in psychological medicine, would be quite willing and able to undertake an investigation into the Bedaux system, and its psychological effect on those who are obliged to submit to it. Therefore, in conjunction with my colleagues and with the help of those who are engaged in what is essentially a psychological investigation, we may perhaps be able to give assistance to those who are at the present moment being imposed upon by what I regard as an iniquitous system. Perhaps it might be possible for those unions which are at the moment being affected by the introduction of the system to have consultations with us and by some co-operative action deal with the problem.”

Ernest Bevin had decided not to speak on the report of the General Council on Occupational Diseases, as he had an important statement to make on the International Situation and consequently I was asked to deputise for him. When the report was reached I made the following prepared statement and I can remember that I was extremely disappointed that owing to lack of time it provoked no discussion and the report was agreed to without further comment.

“Dr. Charles Brook (Medical Practitioners’ Union), referring to paragraph 93 of the Report, said: 1 should not like this paragraph simply to be passed by delegates as a matter of routine, because I think it affects the health and welfare of the majority of the workers in this country who are represented in Congress to-day. While much has been done in the past, and while much is being done at the present time to secure the necessary evidence in order to link up the connection between certain industrial occupations with industrial health damage, there is much more to be done in the future. I could to-day mention many industrial hazards, which for lack of 100 per cent, medical evidence and owing to the limitation of the present legislation, are not compensatable. But what I would like to draw the attention of Congress to is the lack of knowledge of industrial diseases among the mass of the medical profession. I do not want any aspersions to be made on the body of the profession, because doctors cannot be expected to know what they are not taught, and it is indeed a deplorable fact that in this highly industrialised country with a long history of industrial struggle, there is at the present time no professorship in any British University and scarcely any lectureship devoted to industrial medicine. There is one lectureship at Birmingham and a professorship in Wales which have been stretched to cover industrial medicine, but it is regrettable that the great industrialists who in moments of philanthropy have endowed professorships and lectureships at the Universities have over-looked this very important branch. There are no endowed beds in any voluntary institution for the study of industrial medicine, but the worst feature of all is that industrial medicine is not taught in the medical schools of this country, and there are very few facilities for the post-graduate side of industrial medicine. It is true to say that at this moment knowledge of industrial medicine is mainly confined to a few specialists, to the medical inspectors of the Home Office, and the Social Insurance Department of the Trades Union Congress which, whenever the opportunity arises I always proclaim to be one of the greatest bulwarks of preventive medicine that we have in this country. I should like to pay tribute to the wonderful work of Mr. Smyth, and the Medical Officer, Dr. Morgan. Dr. Morgan, who is a fellow member of the Council of my Union, has not only done much in advising Congress, but has also done much in advising my own union as to the importance of this question.

Now what I hope we shall insist upon is, firstly, the extension of the schedule of industrial diseases; secondly, the inclusion of industrial disease in the medical curriculum; thirdly, the provision of facilities for post-graduate study of industrial disease; and fourthly, the establish­ment of research stations as and when they may be required. I hope this beneficial work of Congress will be regarded not just as a side issue, but an integral and valuable part of our industrial machinery.”

In 1936 the S.M.A. scored two notable successes. The first was when it submitted evidence to the Voluntary Hospitals Commission, whose chairman was Viscount Sankey. Somerville Hastings dealt with the need for properly equipped and adequately staffed convalescent hospitals, Esther Rickards urged the necessity of establishing an appoint­ments system in hospitals out-patients departments, while I advocated the creation of a central bureau for arranging for the immediate admission to hospital of urgent cases and the pooling of beds for this purpose. As a result of the Commission’s report the Emergency Bed Service for London was inaugurated and an appointments system was eventually established in many London hospitals. Adequate convales­cent hospitals will, I hope, be an important development of the National Health Service.

The other activity with which the S.M.A. was so closely associated and which, without the help of the Association, would never have achieved much success, was the establishment of the Spanish Medical Aid Committee. My friend, Arthur Peacock, has given an excellent account of the development and the achievements of the Committee in his recently published book, ” Yours Fraternally.” Let me quote one paragraph:—

“One afternoon in July I had a visit from Dr. Charles Brook, L.C.C., who was secretary of the Socialist Medical Association. ‘Do you think,’ Charles asked me, ‘it would be a good idea if we Socialist Doctors sent some medical supplies to Spain as a gesture of sympathy and good fellowship?’ I told him that I thought it would be magnificent and promised to arrange for him to have a room at the National Trade Union Club on the following Saturday so that he and his friends might discuss the project.” Actually it was at lunch-time on Friday, July 31st, that I discussed the matter with Clifford Troke, and immediately afterwards there was the conversation with Arthur Peacock. The meeting which I convened for the following afternoon by hurriedly written post-cards and by telephone calls, was. very well attended despite the fact that it was on the Saturday prior to August Bank Holiday.

After I had made a statement setting out my reasons for convening the meeting it was there and then decided to constitute “The Spanish Medical Aid Committee,” and although I was hopeful that I might then be allowed to retire into the background, the Honorary Secretaryship of the Committee was thrust upon me.

The majority of the Committee were members of the S.M.A. Christopher Addison was the President, H. B. Morgan the Chairman, and Somerville Hastings the Vice-Chairman. Among the other medical members were: Harry Boyde, Michael Elyan, J. A. Gillison, L.C.C., D’Arcy Hart, Tudor Hart, S. W. Jeger, R. L. Worrall and Professor J. R. Marrack. Non-medical members included Ellen Wilkinson, Leah Manning, Isabel Brown, Arthur Peacock, and the Joint-Treasurers, Viscount Churchill and Viscountess Hastings, now the Hon. Mrs. Wogan Phillips. Lord Addison was not called upon to take a very active part in the work of the Committee, but he showed great courage when, contrary to the advice tendered by some people in high places, he presided at a great meeting at the Albert Hall in support of the work of the Committee. As Chairman H. B. Morgan proved himself to be an extremely able and tactful negotiator. Being a Roman Catholic he was able to neutralize the powerful pro-Franco elements in his Church, while as Medical Adviser to the T.U.C. he was an invaluable go-between when certain awkward situations arose. To Somerville Hastings I was especially indebted. Many volunteers came into the Committee’s office to lend a hand, but it was impossible to check their bona-fides and, as much of my correspondence was strictly confidential, I was in urgent need of the services of a private secretary. When I put the position to Somerville Hastings, he immediately handed me £25 in order to help defray the cost, without it being a charge on the Committee’s funds.

Within a few days of the Committee being established, the public response was so generous and there were so many volunteers for service in Spain that my original idea of sending some medical supplies was replaced by a far more ambitious project—the dispatching of a fully-equipped and adequately staffed Medical Unit to the battle front.

Soon after this project was agreed to, I made up my mind that the first British Medical Unit had got to , be ready to leave by Sunday, August 23rd, and on that day thousands of Londoners were stirred by the sight of a. procession of vehicles going from the Committee’s Head­quarters to Victoria Station, where in the presence of a vast crowd and many London Mayors, Arthur Greenwood and Alan Findlay, then Chairman of the General Council of the T.U.C.. delivered valedictory speeches.

This was just three weeks after the Spanish Medical Aid Committee had been constituted, and it was the first real practical demonstration of support for the Spanish Republicans which sympathisers in this country had provided.

I remained Honorary Secretary of the Committee until the end of 1936 when George Jeger, now M.P. for Winchester, was appointed full-time Organising Secretary and I was able to relinquish my office.

The time was now approaching for me to give up temporarily the greater part of my political activities, in order to devote more attention to my professional duties; but it was not until the Eighth Annual General Meeting of the S.M.A. in May, 1938, that I was able to relinquish the Honorary Secretaryship and hand over the active direction of the organisation to two able and energetic young members, Dr. Leslie Hilliard and his wife, Dr. Elizabeth Bunbury. They have since given uninterrupted and devoted service to the S.M.A. and they are now respectively Treasurer and Honorary Secretary of the organisation.

Among other outstanding members of the S.M.A. who greatly assisted its subsequent development should be mentioned Professor J. R. Marrack, Dr. Horace Joules and Mr. Aleck Bourne. The last named, who was for a short period, Hon. Secretary of the S.M.A., through his courageous attitude and subsequent trial at the Old Bailey, was instrumental in getting the Abortion Laws re-interpreted. These three distinguished members of the medical profession joined the S.M.A. towards the close of the period of my Honorary Secretaryship and therefore it must be left to others to record the great contribution which they have made to the success of the organisation.

Although I was for a very long time unable to attend any meetings, as I was completely tied down to my practice, the resulting isolation provided me with new outlets, for I was now able to devote the little spare time I enjoyed to writing articles, letters to journals, memoranda and even books. I had made a start with an article which had been published in the “Star” in 1936, and which is here re-published by kind permission of the proprietors!. I think that this article had some temporary effect, for questions were asked in the House of Commons and although nothing came of it at the time, one can look forward to better distribution of hospitals in Greater London as part of the coming National Health Service. Incidentally, Charing Cross Hospital is to move to Middlesex and there is even a rumour that St. George’s may eventually be rebuilt on the Springfield site.

Post-War Problems of the General Practitioner” was an address given to the Tenth Annual General Meeting of the Socialist Medical Association in 1940 and, although some of my proposals were at the time strongly criticised, yet one of them—the remunerating of general practitioners by basic salary and capitation—is one of the essential features of the coming National Health Service. The suggested method of widening the entry to the medical profession still merits urgent con­sideration, for shortage of medical manpower is the reason why a full-time salaried service is not yet practicable. My prophecy that there would be a post-war boom in the value of practices has fortunately not materialised, but it might have done so if the Tories had won the General Election of 1945.

The article on the planning of the post-war medical services had for me quite an interesting beginning. It was during the height of the Blitz in the winter of 1940—1941 that, in order to pass the time away during a particularly heavy bombardment, I scribbled some notes on how a service based on Health Centres might be operated. These I sent to Dr. Charles Hill, now Secretary of the B.M.A., for his observations and he suggested that they should be expanded. They were then vetted by Somerville Hastings and by Sir Allen Daley, Medical Officer of Health of the L.C.C., and were finally presented as the first memorandum to be considered by the General Practices Committee to the Medical Planning Commission of the B.M.A. and subsequently published in “The Medical Officer.”

I wrote not only letters to the Medical Press, but also memoranda for private circulation on a variety of subjects and two of them I have selected for publication. One dealt with certain aspects of the Coalition Government’s White Paper on a National Health Service and the other provided a plan for a war-time Domiciliary Emergency Medical Service which should be established as part of a National Health Service. My views were endorsed by a letter to “The Medical World.” I have also included an article recently published in “The New Leader,” which was written at a time when the campaign of the B.M.A. against the National Health Service Bill was reaching its most vocal stage. I do not know whether Lord Moran read this article, but soon afterwards he made an important speech in the House of Lords, defining his approval of the. nationalisation of hospitals. One prominent member of the B.M.A. who had read this article told me that he was personally in complete agreement with my concluding remarks and that it was one which he felt would be generally acceptable to the B.M.A. Whether it would have provided a better plan is difficult at the moment to say, but only time and experience will show.

The other letter to “The Medical World” contains, what is still in my opinion, a commonsense approach to at least a partial solution of the problem of providing adequate personnel to meet the ever increasing dental and optical needs of the people.

I can honestly claim that all the ideas contained in these writings originated from my own thoughts and were not as far as I can recollect derived from the study of the written work of others.

Finally I have selected one of several articles written, not by myself, but by my wife, prior to the establishment of the Rushcliffe Committee. She was among the first members of the nursing profession to join the S.M.A. and through her individual, political and trade union activities she has done much for the betterment of nursing conditions in this country. Many of the suggestions contained in this article have since been put into operation, but her excellent proposal to divide the preliminary examinations has yet to be made effective.

The publication or republication of these articles, etc., will, I hope, encourage others to do likewise, for collectively they should be of considerable assistance to those who will in the future desire to study how progressive members of the medical and allied professions were thinking and acting during the agitation which culminated in the passing of the National Health Service Act of 1946.

Personally I am proud to know that the source of this agitation was in no small measure due to the Socialist Medical Association, in whose creation I had taken some share and “which has done much to change the perspective and methods of one of the most conservative professions in the world.”