the general council of medical education and registration

1
1458 THE GENERAL COUNCIL OF MEDICAL EDUCATION AND REGISTRATION. inscribed only to obtain statistical information as to the family liability to appendicitis, for at present it cannot be laid down that the disease is specially prone to attack certain families. In the " declaration " also the insurer has to state that he has no reason to believe that he is speci- ally liable to the disease. There is one important condition attached to these policies : the liability of the company does not commence until one month after the proposal has been accepted and the premium has been paid, so that it will not be possible for anyone who experiences symptoms which he thinks may be due to appendicitis to rush off and to insure. The utility of the scheme depends entirely on the liability there is to an attack of appendicitis. Should the disease arise the loss of money incurred by medical, surgical, and nursing expenses would certainly be very troublesome to many and anyone attacked would be very glad to have insured against this sudden expense by the payment of such a small premium and if anyone feels inclined to insure there cannot be any harm in doing so. From the amount of the premium we see that the company estimates the probability that any individual will be attacked by appendicitis in any one year as at most less than 1 in 400 and we should feel inclined to think that the risk is very much less than this, but no statistics exist to show the percentage of attacks in the general population though they may be obtainable for such bodies of men as the army and the navy. As many cases, in this country at least, are not submitted to operation disputes might easily arise as to the accuracy of the dia- gnosis. Moreover, it has not rarely happened that appendi- citis has been diagnosed, the abdomen has been opened, and some other lesion has been found. If the patient had been insured we can imagine his disappointment when he found that the fees and other expenses were payable out of his own pocket. We would not in the least dissuade anyone against insuring, but we must confess that in our opinion a wider policy to ’include any similar severe illness would prove much more useful in practice. At present it is possible to insure against sickness and accident, but the sum paid is so much per week and does not necessarily cover the expenses I incurred. ____ NOTIFICATION FEES. NOTWITHSTANDING the fact that the Notification Act has now been in operation for many years the subject of the fees payable under its provisions seems to be a never- ceasing topic for discussion and dispute. This is, we I! expect, partly due to the fact that a copy of the Act itself is possessed by few medical men and partly to the absurd fee of Is. which is paid to those who I notify cases of notifiable diseases in their capacity as I officers of public institutions or bodies. We can quite ( understand that district medical officers under the Poor- law and others who are not quite familiar with the statutes are unwilling to believe that the legisla- ture has provided no further fee than Is. for the trouble of notifying the cases of infectious disease with which such officers are brought into contact during the performance of their official duties. We have recently had a case brought to our notice of a district medical officer who is content with the customary Is. for cases concerning which he has received a relieving officer’s order but who claims 2s. 6d. in respect of subsequent cases occurring in the same house but as to which no order has been given. We are afraid, however, that, assuming that the cases were treated by the district medical officer in his official capacity, the smaller fee is the only one that can be legally paid. The words of the Infectious Disease (Notification) Act, 1889, which govern the situation, are: ’’ and of one shilling if the case occurs in his practice as medical officer of any public body or institution." Unless, therefore, the cases to which refer- ence has been made were attended by the district medical officer in his capacity of a private practitioner he is not entitled to the larger fee of 2s. 6d. It would seem improb- able, seeing that an order had been procured for one member ; of the family, that any other member thereof could be - regarded as employing a medical man as a private practi- i tioner, and it would seem more probable that there has been ; some omission on the part of the relieving officer or the L district medical officer, in the one case in supplying an order , or in the other of notifying the fact of attendance without an ! order. So far as we are in possession of the facts we do not think that the case to which we refer is one in which a fee of 2s. 6d. could be reasonably claimed. THE GENERAL COUNCIL OF MEDICAL EDUCA- TION AND REGISTRATION. I THE Council opened its summer session on Thursday, May 21st, at 2 P.M , Sir William Turner, E.C.B., the President, being in the chair. The session this year is being held somewhat earlier than usual in order that Whitsun-week may be avoided. After hearing the President’s address the Council proceeded to the consideration of various matters of medical education. Our usual report of the pro- ceedings will be commenced in our next issue. THE PHARMACEUTICAL SOCIETY. THE annual dinner of the members of the Pharmaceutical Society of Great Britain and their friends was held under the chairmanship of the President, Mr. G. T. W. Newsholme, in the Whitehall Rooms of the Hôtel Metropole, London, on May 19th. After the usual loyal toasts had been duly honoured Mr. Newsholme from the chair proposed the toast of "The Houses of Parliament," which was replied to by Mr. J. F. Remnant, M P., who, referring to the new Pharmacy Bill, said that he had heard some criticism in the House in regard to that clause which says that a director of a company must be a qualified druggist before he can deal with the ordinary business of a druggist. Concerning that matter there was an opinion given in the House of Lords that the Act could not apply to directors of limited liability companies. This toast was also acknowledged by Mr. E. Marshall Hall, M.P., who declared that the new Pharmacy Bill could not pass into law in anything like its present form and he advised the society to accept half a loaf as better than nothing at all. He suggested that the Pharmaceutical Society should obtain powers over its members in the same manner as the General Medical Council has over medical men. If it could bring the power, in. fluence, and prestige of the society thus to bear on its members then it would have a remedy against the evils which it was anxious to eradicate. Mr. Marshall Hall bluntly told his audience that a large portion of the business of a druggist as now carried on could be intrusted to unqualified assistants and even to shop lads. So long as the public made no discrimination between a qualified druggist and a salesman of sundries so long would it be difficult for Parliament to deal with the evil. But the Pharmaceutical Society armed with the powers which he had suggested could undertake the matter. In regard to the companies trading as druggists the department particularly concerned with the business of the druggist should be managed by a properly qualified druggist. The toast of ’’ The Medical Profession " was proposed by the chairman and responded to by Sir William S. Church who drew attention to the embarrassing multiplicity of the compounds turned out for the use of medical men by the synthetical chemist. If physicians needed to be careful in the use of drugs the public ought to be careful in the use of the so-called chemical foods, though if one half of the advertisements about these foods could be believed not only would they ward off disease but they

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Page 1: THE GENERAL COUNCIL OF MEDICAL EDUCATION AND REGISTRATION

1458 THE GENERAL COUNCIL OF MEDICAL EDUCATION AND REGISTRATION.

inscribed only to obtain statistical information as to the

family liability to appendicitis, for at present it cannot be

laid down that the disease is specially prone to attack

certain families. In the " declaration " also the insurer has

to state that he has no reason to believe that he is speci-ally liable to the disease. There is one important conditionattached to these policies : the liability of the company doesnot commence until one month after the proposal has beenaccepted and the premium has been paid, so that it will notbe possible for anyone who experiences symptoms which hethinks may be due to appendicitis to rush off and to insure.The utility of the scheme depends entirely on the liabilitythere is to an attack of appendicitis. Should the diseasearise the loss of money incurred by medical, surgical, andnursing expenses would certainly be very troublesome to

many and anyone attacked would be very glad to haveinsured against this sudden expense by the payment of sucha small premium and if anyone feels inclined to insure therecannot be any harm in doing so. From the amount of the

premium we see that the company estimates the probabilitythat any individual will be attacked by appendicitis in anyone year as at most less than 1 in 400 and we should feelinclined to think that the risk is very much less than this,but no statistics exist to show the percentage of attacks inthe general population though they may be obtainable forsuch bodies of men as the army and the navy. As manycases, in this country at least, are not submitted to operationdisputes might easily arise as to the accuracy of the dia-

gnosis. Moreover, it has not rarely happened that appendi-citis has been diagnosed, the abdomen has been opened, andsome other lesion has been found. If the patient had beeninsured we can imagine his disappointment when he foundthat the fees and other expenses were payable out of hisown pocket. We would not in the least dissuade anyone

against insuring, but we must confess that in our opiniona wider policy to ’include any similar severe illness would

prove much more useful in practice. At present it is possibleto insure against sickness and accident, but the sum paid isso much per week and does not necessarily cover the expenses Iincurred.

____

NOTIFICATION FEES.

NOTWITHSTANDING the fact that the Notification Act hasnow been in operation for many years the subject of thefees payable under its provisions seems to be a never-

ceasing topic for discussion and dispute. This is, we

I!expect, partly due to the fact that a copy of the Act

itself is possessed by few medical men and partly to

the absurd fee of Is. which is paid to those who Inotify cases of notifiable diseases in their capacity as Iofficers of public institutions or bodies. We can quite (understand that district medical officers under the Poor-law and others who are not quite familiar with

the statutes are unwilling to believe that the legisla-ture has provided no further fee than Is. for the troubleof notifying the cases of infectious disease with which suchofficers are brought into contact during the performanceof their official duties. We have recently had a case broughtto our notice of a district medical officer who is content withthe customary Is. for cases concerning which he has receiveda relieving officer’s order but who claims 2s. 6d. in respect ofsubsequent cases occurring in the same house but as to

which no order has been given. We are afraid, however,that, assuming that the cases were treated by the districtmedical officer in his official capacity, the smaller feeis the only one that can be legally paid. The wordsof the Infectious Disease (Notification) Act, 1889, whichgovern the situation, are: ’’ and of one shilling if the caseoccurs in his practice as medical officer of any public bodyor institution." Unless, therefore, the cases to which refer-ence has been made were attended by the district medical

officer in his capacity of a private practitioner he is not

entitled to the larger fee of 2s. 6d. It would seem improb-able, seeing that an order had been procured for one member

; of the family, that any other member thereof could be- regarded as employing a medical man as a private practi-i tioner, and it would seem more probable that there has been; some omission on the part of the relieving officer or the

L district medical officer, in the one case in supplying an order, or in the other of notifying the fact of attendance without an

! order. So far as we are in possession of the facts we do notthink that the case to which we refer is one in which a fee

of 2s. 6d. could be reasonably claimed.

THE GENERAL COUNCIL OF MEDICAL EDUCA-TION AND REGISTRATION.

I THE Council opened its summer session on Thursday,May 21st, at 2 P.M , Sir William Turner, E.C.B., the

President, being in the chair. The session this year is

being held somewhat earlier than usual in order that

Whitsun-week may be avoided. After hearing the President’saddress the Council proceeded to the consideration of variousmatters of medical education. Our usual report of the pro-ceedings will be commenced in our next issue.

THE PHARMACEUTICAL SOCIETY.

THE annual dinner of the members of the Pharmaceutical

Society of Great Britain and their friends was held under thechairmanship of the President, Mr. G. T. W. Newsholme, inthe Whitehall Rooms of the Hôtel Metropole, London, onMay 19th. After the usual loyal toasts had been dulyhonoured Mr. Newsholme from the chair proposed the toast of"The Houses of Parliament," which was replied to by Mr.J. F. Remnant, M P., who, referring to the new Pharmacy Bill,said that he had heard some criticism in the House in regardto that clause which says that a director of a company mustbe a qualified druggist before he can deal with the ordinarybusiness of a druggist. Concerning that matter there wasan opinion given in the House of Lords that the Act couldnot apply to directors of limited liability companies. This

toast was also acknowledged by Mr. E. Marshall Hall,M.P., who declared that the new Pharmacy Bill couldnot pass into law in anything like its present form

and he advised the society to accept half a loaf as

better than nothing at all. He suggested that the

Pharmaceutical Society should obtain powers over its

members in the same manner as the General Medical Councilhas over medical men. If it could bring the power, in.

fluence, and prestige of the society thus to bear on its

members then it would have a remedy against the evilswhich it was anxious to eradicate. Mr. Marshall Hall bluntlytold his audience that a large portion of the business of adruggist as now carried on could be intrusted to unqualifiedassistants and even to shop lads. So long as the public madeno discrimination between a qualified druggist and a salesmanof sundries so long would it be difficult for Parliament to dealwith the evil. But the Pharmaceutical Society armed withthe powers which he had suggested could undertake thematter. In regard to the companies trading as druggists thedepartment particularly concerned with the business of thedruggist should be managed by a properly qualified druggist.The toast of ’’ The Medical Profession " was proposed by thechairman and responded to by Sir William S. Church whodrew attention to the embarrassing multiplicity of the

compounds turned out for the use of medical men by thesynthetical chemist. If physicians needed to be carefulin the use of drugs the public ought to be carefulin the use of the so-called chemical foods, though ifone half of the advertisements about these foods could bebelieved not only would they ward off disease but they