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NAME NOT ERASED

Patrick Laurence Lyons, registered as of Highland Lodge,Kilkelly, co. Mayo, L.A.H. Dubl. (1948), L.R.F.P.S. Glasg. (1948),appeared in May, 1953, after convictions in 1951 and 1952involving drunkenness. Judgment was then postponed forone year. In view of testimony to his conduct, the Registrarwas not directed to erase his name.

MOTORING OFFENCES

Graham George Robertson, registered as of 22, North Ridge,Bedlington, Northumberland, M.B. Edin. (1934), appeared ona charge of having been convicted at the magistrates’ court,Whitley Bay, on March 4, 1954, of driving a motor-car whileunder the influence of drink and driving in a manner dangerousto the public. In May, 1946, his name was erased from theRegister. It was restored in November, 1948. The committeepostponed judgment for one year. -

NAME ERASED

Hugh Ley Puxon Peregrine, registered as of The Orchards,Twyford, Winchester, M.R.C.S. (1915), admitted being finedno at Winchester magistrates’ court after pleading guilty tosending an indecent written communication through the post.

Mr. N. Leigh Taylor, solicitor, of Messrs. Hempsons, whorepresented Dr. Peregrine in his private capacity, asked forhis evidence to be taken in camera. He wished to call a doctorand read the report of another psychiatrist. Both had saidthat as part of the information on which their evidence wasbased was obtained from persons other than Dr. Peregrine,under the seal of professional confidence, they felt unable togive that evidence other than in camera. The Legal Assessorsaid that he proposed to advise the committee that if theythought it right there was no reason why the public shouldnot be excluded. The press and members of the public,by direction of the committee, withdrew.

The committee directed that, by reason of the conviction,the Registrar should be directed to erase from the Registerthe name of-Hzcgh Ley Picxon Peregrine. When Mr. Widgerysaid that the police had asked for the return of the letters putin as exhibits, the chairman pointed out that Dr. Peregrinehad twenty-eight days in which to lodge an appeal against thecommittee’s decision. The letters must remain during thatperiod.

POSTPONED JUDGMENTS

Florence Joseph O’Driscoll, registered as of 8, Moss Lane,Orrell Park, Liverpool, 9, M.B. N.U.I. (1928), had had judgmentpostponed for one year in May, 1953, to give him one furtheropportunity of overcoming his tendency to drink to excess.The Registrar was not directed to erase his name. ’

Judgment had been postponed for one year in the case ofJoseph Henry Bentley, registered as of Littlewick, Limpsfield,Surrey, L.M.S.S.A. Lond. (1935), following convictions under theDangerous Drugs Regulations, 1937, and the DangerousDrugs Act, 1951. The Registrar was not directed to etaseDr. Bentley’s name.

DRUG OFFENCES

James Ross, registered as of the Public Health Department,Town Hall, Barnsley, M.B. Edin. (1943), admitted eight con-victions at Southend-on-Sea magistrates’ court on Oct. 23,1953, for offences concerning dangerous drugs. The committeepostponed judgment for one year.

JUDGMENT POSTPONED

Patrick Stephen Gerrard Cameron, registered as of 14, KirtonPark Terrace, North Shields, Northumberland, M.B. Aberd.(1918), appeared in respect of five convictions. The first wasin 1929, when he was convicted of being drunk in charge of amotor-car ; the last was in 1953, for driving when under theinfluence of drink and in a manner dangerous to the public.Judgment was postponed for one year.

Parliament

Shortage of House- officersIN the House of Commons on May 28, Dr. A. D. D.

BROUGHTON called attention to the shortage of residentmedical staff in the smaller hospitals in remote areas andindustrial districts. Applicants preferred posts in largerhospitals, where they gained a wider clinical experience.They were attracted to hospitals situated in the morepleasant parts of the country. Salaries for these appoint-ments ranged from £425 to 2525 a year from which 2125was deducted for residence. The work of these doctorswas thus less profitable to them than that of a medicalofficer on National Service in the R.A.M.C., while anassistant in general practice might be paid £1000 a yearor more.

He also believed that the increase in the actions fornegligence brought against junior hospital staff wasdeterring newly qualified men and women from exposingthemselves to the danger of such charges. In largerhospitals, where responsibility was shared and the worksupervised by senior medical staff, the danger of legalaction was considerably less. Was the Minister, heasked, prepared to allow the hospitals which had difficultyin obtaining junior medical staff to offer a higher rate ofsalary, as was done by the smaller hospitals before theflat rate of pay was introduced under the health service ?Or would the Minister allow hospital beds to be used forpatients under the care of general practitioners ?

Miss PATRICIA HoRNSBY-SMITH, parliamentary secre-tary to the Ministry of Health, said that the over-allshortage of junior hospital staff had been reduced from15 % at December 31, 1952, to less than 10 % at December31, 1953. Thus in 1952 there were 7212 officers of thevarious grades, and in 1953 the number had risen to 7815.The establishment was 8499. But much of this improve-ment might be due to the pre-registration year.. Univer-sities selected the hospitals where this year should betaken, and in the main they included only the largeregional hospitals and the teaching hospitals. Theshortage was particularly felt at the smaller peripheralhospitals, especially those dealing with a narrow rangeof work such as infectious disease, tuberculosis, and mental

and orthopaedic work. The substantial increase in demandin the last few years was often due to the up-grading ofthe smaller local peripheral hospitals with- additionalspecialties. Compulsory military service took awaydoctors who when they came back were married and notprepared to take resident hospital appointments.The Ministry, she continued, had no evidence that claimsfor damages arose more particularly in the peripheralhospitals than elsewhere.The earlier grades of pay might compare less favourably

with those in other spheres, or elsewhere in medicine, butit must be remembered that the houseman’s first yearparticularly was a continuation of his training as a

qualified doctor. The Ministry did not believe that it waspracticable to increase the number of qualified doctors.At present about 2000 a year qualified. Medicine hadto compete with the demands of other professions, andthe capital cost of increasing the medical schools wouldbe a real deterrent and cause delay. At present thenumber of probable vacancies in " career " posts appearedto be fairly well balanced in relation to the intake, whicha little while ago was a source of great concern. It wouldbe wrong to turn out qualified doctors in excess of thosewho could have a reasonable prospect of a satisfactoryand secure career. The number of doctors called upcould not be reduced.The most hopeful line of dealing with the shortage, she

suggested, was to encourage general practitioners to sharein hospital work and to encourage men returning fromNational Service to work in hospitals for a period ratherthan to go straight into general practice.At the start of the health service it was open to the

Ministry to approve an additional payment of £50 a yearfor house-officer posts which were difficult to fill. But themethod had not been found efficacious, since it tended toblacklist a hospital. The Ministry looked with con-

siderable reserve on the idea of incentive pay for whatshould be a comparable job and also on any suggestionthat posts should be graded above their true worth-forexample, that house-officer posts should be treated assenior house-officer posts solely because they were

difficult to fill. ’

,

The problem was difficult, but direction was an

impossible solution. Doctors must have freedom ofchoice, within limits, of jobs offered to them. Yet the

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Ministry must see that these difficult and in some waysless attractive hospitals were adequately staffed. TheMinister would be only too happy to support anythingwhich could be done to facilitate negotiations to meet theshortage either by the extended use of general-practitionerservices or by other means.

Pharmacy BillIn the House of Lords on May 25 the Pharmacy

Bill, a consolidation measure, was read a second time.

QUESTION TIME

Diesel-engine Fumes and CancerMr. L. W. B. TEELING asked the Minister of Transport

and Civil Aviation if he was aware that there was evidenceto suggest that diesel-oil fumes might be a cause of cancer,and that research into this problem was being conducted bythe Medical Research Council; and if he would give a generaldirection to the British Transport Commission to defer thesubstitution of all their trolley-buses by diesel buses untilsuch time as the M.R.C. had made their report.-Mr. A. T.LENNOX-BOYD replied : I am not prepared to interfere inthe commission’s commercial decisions except for reasons ofoverriding national importance. So far as I am aware, nosuch reasons exist in this case.

Evaporated MilkReplying to Mr. SOMERVILLE HASTINGS, Major GWILYM

LLOYD GEORGE, Minister of Food, said he understood thatthere was no loss of vitamin A or riboflavine in evaporatedmilk stored at room-temperature; and (as judged by investi-gations on sweetened condensed milk) no change in biologicalvalue of the proteins after one year and only very slightchanges after two to five years.

Reablement of EpilepticsReplying to Mr. W L.- WYATT, Sir WALTER MONCKTON,

Minister of Labour, said that epileptics were admitted in

appropriate cases to the Ministry’s industrial rehabilitationand vocational training courses and special efforts were madeto find them employment. A leaflet (D.P.L.5) has been issuedto facilitate their acceptance by employers and fellow-workers.Remploy Limited were employing over 400 epileptics.

Mr. HASTINGS : Will the Minister consult the Minister ofHealth to see if many of these epileptics can be employed inconnection with hospital work, where people with whom theycome in contact will be much less likely to be frightenedby these comparatively harmless fits ?-Sir WALTER MONCK-TON : I will certainly bear that suggestion in mind.

Cost of Medical Education

Replying to Dr. A. D. D: BRouGHTON, Miss FLORENCEHORSBRUGH, Minister of Education, said that the number ofstudents taking medical courses in the current academic yearwith Ministry of Education grants was 1948, of whom 1121held State scholarships and 827 held awards under the further-education and training scheme. She estimated the cost infees and maintenance for the year at approximately £574,000.In addition, the Ministry admitted for grant the expenditureof local education authorities on making awards to studentstaking medical courses.

Hospital Pay-beds in ScotlandReplying to Mr. WILLIAM HANNAN, Commander T. D.

GALBRAITH said that in Scotland during the year ended March31, 1953, the proportion of section-5 pay-beds that were

unoccupied averaged less than a quarter of the total. Therewere 913 such beds-1½% of all staffed beds.

National Service Medical Officers

Replying to Dr. BROUGHTON, Mr. ANTONY HEAD, Secretaryof State for War, said that a doctor joining the R.A.M.C.for the period of National Service was commissioned in therank of lieutenant and got basic pay of E401 a year. Afterone year he was promoted captain and got £511 a year, andafter a further six months £593 a year. He might gettemporary promotion to the rank of major, and there wereat present 20 National Service officers holding this rank.For this rank basic pay was £785 a year in the first eighteenmonths’ service, and £912 a year in the last six months. Inaddition to basic pay, marriage allowance of £117 a yearfor an officer under 25 and of £228 a year if he was older,and specialist pay of 173 a year, were paid where appropriate.

Advertising for Applicants for R.A.M.C. Commissions

Replying further to Dr. BROUGHTON, Mr. HEAD said thatup to last year advertising to invite applications for R.A.M.C.commissions was mainly for specialists; and the yearly costwas under £300. Last year just under £1000 was spent onspecial publicity for the new terms of service of officers ofthis corps.

Resident Medical Staff in HospitalsDr. BROUGHTON asked the Minister of Health the total

number of resident medical officers in hospitals in Englandand Wales ; and how far below the establishment figurethis number had fallen.-Mr. IAIN MACLEOD replied : I regretthat information in this form is not avaliable ; but at Dec. 31,1953, there were in hospitals in England and Wales thewhole-time equivalent of 7815 medical officers other thanspecialists and senior registrars, compared with an establish-ment on Dec. 5, 1952, of 8499.

Deaths of Disablement Pensioners

Replying to Mr. A. J. McKiBBiN, Mr. OSBERT PEAKE,Minister of Pensions and National Insurance, said that thenumbers of deaths for each year since 1945 of disablementpensioners of the first and second world wars, were as follows :

Medical Officers in Northern NigeriaReplying to Mr. JOHN TiLNEY, Mr. OLIVER LYTTELTON,

Secretary of State for the Colonies, said that the establishmentof medical officers for the Northern Region of Nigeria was 91and there were at present 25 vacancies.Mr. TiLNEY : Will the Minister bear in mind the importance

of seconding not only specialists but also general practitioners,and look into the matter of their salaries as compared withthose paid in this country ?-Mr. LYTTELTON : We regard

- this matter as one of considerable concern, and we are doingour very best to get these vacancies filled.

Public Health

The Minister on Health and Welfare ServicesADDRESSING the County Councils’ Association in London

on May 26, Mr. lain Macleod, the Minister of Health, madea plea for the better use of the domiciliary services, torelieve pressure on hospitals. It was, he said, not only aquestion of cost. Many types of patient were bettercared for in their own homes than in hospital-thisapplied particularly to many children and old peopleand to most maternity cases. Local health authoritiesshould make sure that there were enough home nursesand home helps for all patients whose condition did notnecessitate admission to hospital. He would likeauthorities to consult general practitioners in their areas,to find out the extent to which doctors felt compelledby the shortage of home nurses and home helps to sendpatients to hospital who might otherwise stay at home.No old person-no patient of any age-should be removedto a hospital or institution solely for lack of such careas a home help could give. Here, too, was a greatfield for voluntary work.

Turning to the prevention of illness, the Minister saidthat at present less than 31 % of children under 1 yearof age were being immunised against diphtheria, com-pared with a target of 75 %. A slightly greater proportionof newborn infants were vaccinated against smallpox,but the target should be the vaccination of every healthyinfant. ’

Mr. Macleod concluded : " The aim is to place at thedisposal of the patient nursed at home the same kindof coordinated team working under unified medicaldirection as would care for him in hospital." Withoutencroaching on the administrative responsibilities of themedical officer of health or other local-authority officers,the clinical responsibilities of the general practitioner