Volume 1

International studies on the relation between the private & official practice of medicine with special reference to the prevention of disease / conducted for the Milbank Memorial Fund by Sir Arthur Newsholme.

  • Newsholme, Arthur, Sir, 1857-1943.
Date:
1931
Catalogue details

Licence: In copyright

Credit: International studies on the relation between the private & official practice of medicine with special reference to the prevention of disease / conducted for the Milbank Memorial Fund by Sir Arthur Newsholme. Source: Wellcome Collection.

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    The caisse is advised by a medical councillor, who is a member of the Medical Society, but is not appointed by the society. He can be called in by a doctor to consult as to any case among the insured. When required by the caisse, the medical councillor examines and reports on any of the insured, especially with regard to hospital treatment. He will do this in consultation with the private doctor. He is especially called on to warn doctors as to excessive visiting, etc. From the above brief summary it is evident that the organisation of the caisse has been carefully developed. The system appears to have worked satisfactorily, except that doctors were dissatisfied with the older scale of payment per attendance. This dissatisfaction reached its climax in May 1926, when the Medical Society denounced the agree- ment with the caisse. Under the agreement the total financial allotment for medical attendance per insured child—out of which fees per attendance were paid—had been 10-50 francs. It was proposed by the caisse to increase this to 12 francs, but the doctors refused to accept any agreement making them collectively responsible for loss on their fees per attendance. The struggle reached a stage at which the Council of the State, having been appealed to by the caisse, proposed to suspend its work if an agreement could not be reached. A provisional arrangement was then made for a year, and a supplementary budget provided; and the above quoted terms may be regarded as the result of the doctors’ demand for higher emoluments. From October 1926 onwards an epidemic of influenza occurred, and in the following January 62-5 per cent, of the total insured children required medical attendance, which intensified the doctors’ objection to limitation of remuneration. Dr. Wanner’s medical report on the working of the caisse shows that of 45,529 cases of illness attended by the doctors of the caisse in the year 1926-27,11-3 per cent, were affections of the ears, nose, or throat, about the same proportion were respiratory affections^ and more than