in england now

1401

would be prejudicial to its efficiency. 14 doctors had beenreferred to the tribunal since the start of the National HealthService; 8 were either excluded from further participation inthe service or were allowed to resign on undertaking not topractice under the National Health Service. The names of £these doctors were published.

QUESTION TIME

Central Purchase of DrugsMr. ROBINSON asked the Minister why he had instructed

hospital authorities to discontinue the purchase of all patenteddrugs from unlicensed sources, in view of the fact that he pro-posed to invite tenders centrally for only three groups of suchdrugs. Mr. POWELL: Because it is better that the procedureshould be applied centrally. Mr. ROBINSON: Do I take it fromthat reply that it is the Minister’s intention to invite tenders forall the drugs which some hospital authorities have been buyingfrom continental sources in the past ? Mr. POWELL: I have notlimited my action in advance to the three drugs for which I haveasked for tenders, and, whenever I see reason to think that theprocedure would be appropriate, I shall consider its application.Mr. ROBINSON: There are other groups of drugs which arebeing bought now. Is the Minister aware that he has now saidthat the action taken by individual hospital authorities was per-fectly proper and within the terms of the Patents Act ? In thatcase, why has he stopped them purchasing in advance of histaking centralised action himself ? Mr. POWELL : In the Govern-ment’s view, this is the only appropriate way in which drugscould be purchased from unlicensed sources. Whenever it is

brought to my attention that there is a case for applying section46, I shall consider it, without prejudice.

Treatment Charge for Road CasualtiesMiss JOAN VICKERS asked the Minister if he would require

the regional hospital boards to arrange for notices to be placedin the outpatient departments of hospitals stating the amountthat may be charged to casualties under the Road Traffic Actof 1934.-Mr. PowELL replied: The emergency treatmentcharge is payable by the vehicle user, not by casualties as such.Miss VICKERS: Then why is the actual patient quite oftenasked to pay 12s. 6d. before he leaves the hospital ?-Mr.POWELL: There is no right to ask anyone but the vehicle-userto pay 12s. 6d.Mr. HENRY HYND: Is it not worth while reconsidering this

charge, which is made at a very awkward time and is verymuch resented ?-Mr. POWELL : Yes, Sir. In logic, I thinkthat this charge is probably not entirely consistent with

legislation since it was first imposed, but it does, of course,involve legislation to alter it.

Prison Medical Service

Mr. ROBINSON asked the Home Secretary what was thepresent number of full-time medical officers in the prisonmedical service; what had been the total wastage since 1945due to normal retirement, death, or ill-health; how many hadresigned for other reasons; how many had joined the servicein the same period; and how many he estimated were requiredto implement the policies for penal reform already announced.- mar. R. A. BUTLER replied: The number of full-time medicalofficers in the service is 56. Since Jan. 1, 1945, 13 officers havebeen lost to the service through normal retirement, death, andill-health; 26 have resigned for other reasons, and 67 havejoined. No estimate can be given at this stage of the totalnumber of full-time medical officers who will ultimately beneeded to implement the current programme of penal reform.

Tobacco and Taxation

The revenue yielded by the taxation of tobacco products inthe twelve months ending on May 31 was E823 million, com-pared with E801 million in the previous twelve months. Thisduty is the largest single source of revenue from all the customsand excise duties.

In England Now

A Running Commentary by Peripatetic Correspondents

WHEN Ruskin opened the Bradford Exchange, he said that ifthere was beauty in the hearts of the citizens it would appearin the beauty of their public buildings. Some such feelinginspired these devoted people who built our Royal Infirmary,a building worthy of the city, of real not artificial stone, to lastfor generations. I am sure it is the child of many prayers.

This is all changed today. If our fine Infirmary cost extra,in those days it was the affair of the subscribers and injuredno-one. But today all the money for the new hospitals mustcome from the public purse. It will be many a long year beforethe public purse (so many and heavy are the claims upon it)can adequately tackle this very big task. Therefore hospitalbuildings should be utility buildings. They need not be ugly,but it is wrong to spend the money on fine and costly buildings-it can only delay the erection of other necessary ones. Theonly exception, perhaps, that might be permitted is the greattraditional hospitals-the show-places for visitors from abroad.

* * *

Dr. Comfort seems to me to have something in his remarklast week 1 on the immaturity of many of today’s parents. Inour suburb most of the mothers are obsessed with the numberof invitations secured by, or for, their children. Thus, onemother meeting another will say: " Do you know, Joan is

going out every night this month ", or " My dear, Jimmy hasthree invitations for a single evening ". The brave few whoresist this convention can reply with How popular Joanmust be!" or " Good heavens, my John hasn’t three invitationsin the whole holidays ": which turns the conversation else-where, but marks the speaker as a suspect nonconformist. Ihave a strong feeling that many of the youngsters who are thepawns in this puerile game are uneasily aware that they arebeing used to offset parental feelings of inadequacy.

* * *

A doctor’s life is rarely dull in foreign lands. As the un-official mayoral adviser I was lately asked by His Worship tohave a look at the travelling fair being set up in the municipalpark. He said that the main attraction was to be the burial,after hypnosis, of a local man who would lie in the grave forfive days.

" An ordinary and rather old bit of showmanship," I

remarked, but the Mayor would not accept that. Over thirtyyears ago, he explained, when a similar side-show was staged,the volunteer had died of suffocation, and his relatives hadbrought an action for damages against the former mayor andcouncil. Our Mayor was determined no such accident shouldmar his term of office. After a friendly chat with the showman,an old Coney Island hand, about the tricks of the trade, and aninspection of the equipment and the volunteer, I was able tomake a report which satisfied the Mayor.Our townsfolk are as morbid as people anywhere else.

Every afternoon and evening large crowds lined up to gaze inhorror through the glass panel at the " corpse " lying peace-fully in the grave. On the fifth day a capacity crowd watcheda realistic display as the man was brought out of his grave andhis hypnotic trance. Fear and relief were the predominantemotions of the crowd when the revived man fought wildlywith the four bearers holding him down while he gasped andmoaned, "Water, water ". Fortunately nobody except meseemed to notice that whereas at his burial the subject had beenclad in a white shirt, at his resurrection he wore a blue one.

* * *

She was admitted with an undoubted coronary thrombosis,and told us that for some months she had felt a bad pain in herchest when she took her dog out on the common. We askedif the dog was a big one which struggled. "No," she said," he’s only a little one, but, you see, he has valvular heartdisease, so I have to wheel him in a basket."My dog-loving friends see nothing odd in this story.

1. Lancet, June 17, 1961, p. 1335.