A social health service without social doctors.

Abstract

During the period before the onset of the Second World War there was increasing support for the ideas of social medicine, in which the promotion of health and the prevention of disease were to be coupled with an accessible and fairly distributed medical service. To realize such a service the basis of medical practice had to move from cure towards prevention, and so did the attitudes of teachers and students in medical schools. While planning for a national health service proceeded, a determined effort was made to reform medical education to produce doctors capable of practising social medicine. Certain individuals, led by William Wilson Jameson and wielding power provided by the Nuffield Provincial Hospitals Trust and the Interdepartmental Committee on Medical Schools (the Goodenough Committee), made firm proposals for change before the end of the war. After the war, with a Labour government in power, the National Health Service came into being. However, reaction in the teaching hospitals and in the General Medical Council (GMC) resulted in the setting aside of the proposals for change in medical education, and the chance to train future doctors for a different kind of practice was lost. Consequently, doctors in the NHS have continued to see their role in overwhelmingly curative rather than in social and preventive terms.