A tale of turbulent times.

Abstract

For those who were not then qualified it is almost impossible to picture high tensions and anxiety of medical profession just before inception of National Health Service. Some of flavour of those times is indicated in History of British Medical Association 1932-1981 by Dr Elston Grey-Turner and Mr F M Sutherland,1 and in a small booklet, The Medical Surrender, which was published by Lord Horder's Fellowship for Freedom in Medicine.2 It is sometimes said that most of opposition to NHS came from general practitioners rather than hospital doctors, but this is far from true. Most family doctors were strongly opposed to proposal that sale of goodwill of their practices would be made illegal under 1946 Act.* Moreover, compensation for goodwill would only be paid at time of retirement while, in mean time, interest on capital was to be paid at a pretty niggardly annual rate. Aneurin Be van, then minister of health, who seldom missed opportunity for a shrewd blow at doctors, had emotively referred to sale of goodwill as tantamount to sale and purchase of patients. In December 1946 a plebiscite of whole profession had shown a clear majority against entering into negotiations with minister on regulations to be made under Act. And on 8 January 1948 a special representative meeting of BMA unanimously declared that the Act in its present form is so grossly at variance with essential principles of profession that it should be rejected absolutely. A further plebiscite of whole profession was proposed. In mean time on 27 January consultants in London decided by 766 votes to 11 that they should not take service under Act until it had been suitably amended. The forms for that second plebiscite were issued on 31 January, and, in an 84% poll, there was more than a nine to one majority against accepting service under unamended Act.