SIR,-Dr. W. C. Watson (6 August, p. 359) is justifiably concerned at the apparent unwillingness of the University Grants. Committee and the Government to ...
our Government's actions precipitate an "immediate resignation issue." The junior hospital doctors have already borne the brunt of the disappointments induced by the new deal for the profession, and in our cases the only course of action is emigration to the better conditions abroad.I am, etc., Orsett Hospital, Orsett.
BRmM
Correspondence
20 August 1966
J. D. GODDARD.
SIR,-As a junior hospital doctor, I wish to express my disgust with a Government which has so dishonourably broken an agreement with the medical profession. While I reluctantly accept that the profession must go along with a wage freeze at this particular time, I can never accept the cowardly retrospective action which the Government has taken, and I am disappointed that our representatives allowed themselves to be fobbed off yet again. However, disgust and disappointment are ineffective gestures against a Government which stoops so low as to deliver a belowthe-belt blow to the medical profession. Surely recent events provide the bright green light for the profession to take the very positive step of informing the Government of its intention to withdraw completely from the National Health Service, as soon as the profession can organize an alternative scheme of its own ? The present situation is such that one wonders whether the Government is doing its utmost to force the profession to take this step, because it has not the political courage to reorganize the National Health Service rationally on its own. If it did, of course, yet another myth of socialist policy would explode in its face. Week after week the B.M.Y. contains many letters from dissatisfied doctors. I wonder how low morale has to sink before the profession will wake up, organize its own service, and throw off the yoke of Government control. If this positive step is taken perhaps we shall read of the immigration of our colleagues for a change-I am, etc., PHILIP V. SEAL. The Royal Infirmary,
time was divided between one activity and the other, and the universities would be able to compete effectively in the medical labour market for their rightful share of the best qualified leaders of this profession. The usual argument that clinical work carries with it more responsibility and stress and should be more highly remunerated than medical teaching is not particularly convincing to those of us who have had experience of both. The responsibility for seeing that our successors inherit something more than a tumble-down house is, under existing circumstances, quite as wearing as the day-to-day work of the average N.H.S. consultant.-I am, etc., P. E. BROWN. The University, Sheffield 10.
SIR,-The feelings of dissatisfaction among university medical teachers in the West of Scotland which Dr. W. C. Watson expressed in his letter (6 August, p. 359) are also strongly felt by the non-professorial teaching staff of the Welsh National School of Medicine, Cardiff. At a meeting here at the end of June it was suggested that in view of the reluctance of the university authorities to deal with the anomalies in our terms of service an approach be made to similar groups in other medical schools with a view to jointly making our case known, and if necessary taking more positive action to achieve a satisfactory salary structure and conditions of work.-We are, etc., E. E. PAYNE. K. M. LAWRENCE. A. M. GEORGE. J. P. D. THOMAS. C. C. ENTWISTLE. A. JACOBS. T. D. BROGAN. A. W. ASSCHER. H. CAMPBELL. S. W. WILLIAMS. G. M. MITCHELL.' J. L. WITHEY. J. H. LAWRIE. J. G. LEOPOLD. M. SUSSMAN. J. M. PEXTON. JOHN F. BATES. H. J. WHITELEY. Members of the Whole-time Teaching Staff. The Welsh National School of Medicine, Cardiff.
Non-Rrofessorial
Preston.
Medical Teachers SIR,-Dr. W. C. Watson (6 August, p. 359) is justifiably concerned at the apparent unwillingness of the University Grants Committee and the Government to equate salaries of medical teachers with those in the N.H.S. There is one point, however, which he might reconsider. He asks: " If the universities cannot pay us fully equivalent salaries, why cannot the N.H.S. make up the difference ?" But the N.H.S. can only be expected to pay, at N.H.S. rates, for the sessions actually worked by university teachers. Thus, the teacher who works half-time for the Health Service will receive a salary half-way between that paid by the N.H.S. and that paid by the university. Those who have fewer sessions will be correspondingly worse off. This does not solve the problem of equality. The only lasting solution is for university teaching and research to be paid for at the same rate as clinical work in the hospitals. Then it would not matter how the teacher's
Breach of Faith SIR,-My four partners and I had barely recovered from the shock of the Government's chicanery over the Charter when the junior partner announced that he was quitting the practice to go to Australia. Anyway, he said, if he weren't accepted in Australia he would not remain in the Health Service. I do not for one moment imagine that he is the only young general practitioner who will take this step, and we who are older can only sympathize with him, albeit somewhat enviously. Having spent some considerable time and energy trying to find a sixth partner, without success, we have no hope whatsoever of finding a replacement for this young man, whose going will seriously affect the partnership and the community. How can the medical profession ever again trust the politicians ? We have been sold down the river too often in the past to believe that they really care about an efficient Health Service.
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What about our resignations now ?-I am,
etc., Hemel Hempstead, Herts.
J. G. A. GILRUTH.
SIR,-After all the militant trumpeting of resignation threats the B.M.A. produced in so weak a position held after the sixth Review Body report, and before negotiations for a new contract were accepted by the Minister of Health, I am astonished at the alacrity with which our representatives have relinquished a position of strength the like we shall never see again. The image we had previously acquired of grasping self-seekers blackmailing the community, and used openly as an encouragement for others-for example, the seamen-has now been replaced by that of a paper tiger. Either our representatives did not believe in the " desperate " plight of general practice or have demonstrated a naivety of action which makes us a laughing stock in the eyes of the Government. Is it not true that had this pay position, as it now stands, been explained to the profession in May 1966 by the Prime Minister, and had he then insisted that we wait until January 1967 for the first quarter of the Review Body award paid out of a resurrected Pool, with no guarantee as to when we should get the rest, we as general practitioners would have walked out and not torn up the 16,000 resignation threats ? I would like to know: (1) Why need the B.M.A. have given a decision on so momentous an issue before referring it to the periphery ? (2) Why the need for such inordinate haste to give Mr. Wilson an answer ? (3) Did the B.M.A. seek legal advice on the enforcement by law of a contract solemnly entered into and accepted ; and, if obtained, could this be published, for I cannot see why the profession should not have sued the Government for breach of contract-an equivalent contract of that made with the dentists and which has already been honoured ? (4) Why was it more difficult administratively to pay a simple agreed rise to junior hospital doctors, who are paid a monthly salary, than to pay the increases to dentists, which they have already received, and which were awarded by the Review Body at the same time ? One cannot escape the suspicion that this delay was cynically deliberate and not just bureaucratic inefficiency. What explanation has the B.M.A. wrested from the Government for this 11-week delay in implementing a monthly salary increase ? (5) Do our representatives really believe that on 1 April 1967 the economic position is going to be improved, and that with probably two million unemployed the Prime Minister will have compassion at last on the poor doctors and grant the Review Body award in full as a social priority ? (6) Why did the B.M.A. not insist on a pledee in writing of this implementation which could be actionable in the courts before acquiescing to the present freeze ? We should by tough bargaining have extracted at least this, and not just made it a pious recommendation of policy. (7) Why should it be assumed, when it comes to gathering the crumbs from the Minister's table, that the greater hardship falls on the general practitioner, who, since
