MEETING: JULY 19-27

British Medical Journal Supplement SATURDAY JUNE 23 1962 CONTENTS

Annual Meeting, Belfast: Programme - - - 283 Correspondence - * - -* 303 Annual Conference of Representatives of Local Diary of Central Meetings - - - - 304 Medical Committees - - - 292 Branch and Division Meetings 304 British Medical Association ANNUAL MEETING-BELFAST, JULY 19-27, 1962

President-Elect: IAN FRASER, D.S.O., O.B.E., M.D., M.Ch., F.R.C.S., F.R.C.S.I., F.A.C.S., F.R.S.Ed., D.L. Joint General Secretaries: D. L. W. CHAPmAN, M.B., B.Ch., B.A.O., and H. I. McCLuRE, M.B., B.Sc., F.R.C.S.Ed., F.R.C.O.G., M.P., B.M.A. House, 609 Ormeau Road, Belfast 7. Joint Science Secretaries: M. G. NELSON, M.D., F.R.C.P., F.R.C.P.I., D.T.M.&H., and Professor R. B. WELBOURN, M.A., M.D., F.R.C.S., Institute of Clinical Science, Grosvenor Road, Belfast 12. Assistant Secretary, Northern : N. S. DICKSON, M.B., B.Ch., B.A.O., L.D.S., B.M.A. House, 609 Ormeau Road, Belfast 7. (Tel.: 649065-7.) Executive Officer: Miss B. E. MIDDLEMISS, B.M.A. House, 609 Ormeau Road, Belfast 7. PROGRAMME The 130th Annual Meeting of the British Medical Associa- The Annual Scientific Meeting and associated functions tion will be held in Belfast from Thursday, July 19, to occupy the period from the morning of Tuesday, July 24, Friday, July 27, 1962, inclusive. The Annual Meeting of to the afternoon of Friday, July 27. the Association was previously held in Belfast in 1884, The Annual Dinner of the Association will be held in 1909, and 1937. the King's Hall, BAlmoral, on the evening of Tuesday, The Annual Representative Meeting will be held in the July 24. Sir William Whitla Hall, Queen's University, on Thursday, A Civic Reception and Ball will take place in the City Friday, Saturday, and Monday, July 19, 20, 21, and 23. Hall on Wednesday evening, July 25. The A.R.M. Inquiry Office will be open from 2 p.m. on There will be a University Reception at 4.15 p.m. on Wednesday, July 18, in the Entrance Hall to the Whitla Thursday, July 26, followed by a Special Graduation Hall, Queen's University. Ceremony at 5.30 p.m. On the evening of Wednesday, July 18, a welcome party The Overseas Luncheon will take place on Friday, for Representatives and their Ladies will be arranged in the July 20, and the Overseas Conference on Tuesday afternoon, King's Hall, Balmoral, Belfast, by the July 24, at B.M.A. House, Belfast. Branch. The Annual Breakfast of the Christian Medical Fellow- A combined dinner for Representatives and their Ladies ship will be held at 8.15 a.m. on Tuesday, July 24, at the' will take place in the King's Hall, Balmoral, Belfast, on Wellington Park Hotel, Belfast. Thursday, July 19, followed by a Dance, which will be open A Ladies' Club will be situated at 21 University Square, also to members of the Northern Ireland Branch. opposite Queen's University, and will be open throughout On the evening of Saturday, July 21, there will be a the Meeting. Many special visits and excursions are being Concert sponsored by Ciba Laboratories Ltd. in the Whitla arranged for ladies accompanying members, and details are Hall, Queen's University. given in the time-table. The Official Religious Service will be held in Belfast The usual Golf Competitions will take place. Cathedral at 10 a.m. on Sunday, July 22. The sermon The Registration Bureau for the Annual Scientific will be preached by the Most Rev. J. McCann, D.D., Ph.D., Meeting will be open in the grounds of Queen's University Archbishop of Armagh. on Monday, July 23, at 9 a.m. There will be two excursions on the Sunday: one via the The programme of the Annual Scientific Meeting will Antrim Coast Road to the Giants' Causeway and Portrush, consist of plenary sessions, symposia, panel discussions, and an alternative afternoon excursion to the Spelga Pass medical films, and visits to local medical institutes. There and the Mourne Mountains. will also be a programme shown in colour television on a A Government Garden Party will be held at the Parlia- closed circuit; the technical arrangements are sponsored ment Buildings, Stormont, on Monday afternoon, July 23. by Smith Kline and French Laboratories Ltd. There will The Adjourned Annual General Meeting and President's be no Sections. Address will take place in the Whitla Hall, Queen's Univer- Three sessions will be open to the public: the Dawson sity, Belfast, on the evening of Monday, July 23, and will Williams Memorial Lecture entitled " Paediatrics in Classical be followed by the President's Reception in the University Art" on Tuesday afternoon, July 24; a symposium entitled Buildings. "The Doctor in the Prevention and Treatment of 2996 SUPPLEMENT TO THE 284 JUNE 1962 BELFAST PROGRAMME 23, MEETING: PROGRAMME 284 JUNE 23, BRITISH MEDICAL JOURNAL Delinquency" on Wednesday afternoon, July 25; and the A.R.M. Inquiry Office, Whitla Hall, Queen's University, on Sir Charles Hastings Lecture entitled " The Doctor's Code" July 18, 19, 20, and 21, and for ladies at the Ladies' Club, on Thursday evening, July 26. 21 University Square. The detailed programme of the Annual Scientific Meeting Tickets for functions and excursions occurring after is given below. Sunday, July 22, will be available from Monday, July 23, Both the Scientific Exhibition and the Exhibition of for members and overseas visitors at the Registration Pharmaceutical Products, Instruments, Appliances, and Bureau, Queen's University, and for ladies at the Ladies' Medical Publications will be held in the grounds of Queen's Club, 21 University Square. University and will be open daily from July 23 to 27. Further details are given below. ACADEMIC AND EVENING DRESS The functions at which academic dress is appropriate are TRAVEL ARRANGEMENTS the Official Religious Service, the Roman Catholic Mass, Any members who have not yet made their travel the Adjourned Annual General Meeting, the President's reservations to Belfast are advised to write to the Financial Reception, the Civic Reception, and the University Recep- Comptroller, B.M.A. House, Tavistock Square, London tion and Graduation Ceremony. W.C.1, giving details of their requirements. Robes may be hired from Messrs. Ede and Ravenscroft, Ltd., 93 Chancery Lane, London W.C.2, or through their Agent in Belfast, Mr. S. Nelson, Steward, Queen's University. HOTEL ACCOMMODATION AND PRIVATE Early application is advised, as the supply of gowns is HOSPITALITY limited. In order to assist members, particularly those Accommodation at all the main hotels and University travelling by air to Belfast, arrangements have been made Halls in Belfast has now been allocated. with Messrs. Ede and Ravenscroft for gowns to be sent All members still requiring accommodation should apply direct to the Steward at Queen's University, and members at once to Dr. N. S. Dickson, B.M.A. House, 609 Ormeau wishing to take advantage of this facility should specify this Road, Belfast 7, giving details of their requirements. when ordering gowns. Such members should inquire about their gowns on registration. If preferred, gowns can be sent to the home address of the individual concerned. CARAVAN PARK The functions at which evening dress (tails or dinner Arrangements have been made for a caravan park in the jacket) with decorations is appropriate are the Adjourned grounds of the Royal Agricultural Society, King's Annual General Meeting, the President's Reception, the Hall, Balmoral (21 miles from the University), for members Annual Dinner, and the Civic Reception. Evening dress who wish to bring caravans to Belfast. Applications for without decorations should be worn at the Representatives' space should be made to Dr. N. S. Dickson at the Belfast Dinner and Dance, and the Closing Dance. Office. CHANGING TOURIST INFORMATION FACILITIES Changing facilities will be available during the meeting at Members wishing to have tourist information about 1 Wellington Park, Belfast 7 (about five minutes' walk from Northern Ireland are advised to write to the Tourist Infor- the University). mation Centre, 6 Royal Avenue, Belfast 1, or 13 Regent Street, London S.W.1, and about the Irish Republic to the TRANSPORT ARRANGEMENTS Irish Tourist Association, 14-15 Upper O'Connell Street, , or 71 Regent Street, London W.1. A service of special buses has been arranged through the Belfast Corporation Transport Department to convey members and their ladies to and from the A.R.M., Ladies? REGISTRATION Club, scientific meetings, and social functions. Details of It is important that all members and their ladies attending these services, including a special transport map, will be the Annual Meeting should register. displayed on registration and in hotels. "Season tickets" (price 10s.) for the use of this special Members of the Representative Body (that is, Representa- transport will be on sale at the A.R.M. Inquiry Office, the tives and Members of Council) should register at the A.R.M. Registration Bureau, and the Ladies' Club. The ticket will Inquiry Office, Entrance Hall, Sir William Whitla Hall, cover: Queen's University. This office will be open from 2 to 6 p.m. on Wednesday, July 18, and from 9 a.m. to 6 p.m. (1) Daily transport to and from Queen's University from on Thursday, Friday, and Saturday, July 19, 20, and 21. the city centre and specified hotels. All other B.M.A. members and overseas visitors should (2) Transport to and from the following functions: register at the Registration Bureau, Forecourt, Queen's Welcome Party .. .. July 18 University, Belfast, which will be open daily from 9 a.m. Representatives' Dinner and to 6 p.m. from Monday, July 23, to Friday, July 27, Dance .. .. July 19 Representatives' Concert July 21 inclusive. Official Religious Service July 22 All ladies accompanying B.M.A. members and visiting Government Garden Party July 23 ladies from overseas should register at the Ladies' Club, 21 President's Address and University Square (opposite Queen's University), which will Reception .. .. July 23 be open from 2 to 6 p.m. on Wednesday, July 18, and from Annual Dinner .. .. July 24 9 a.m. to 6 p.m. from Thursday, July 19, to Friday, July 27 Civic Reception .. .. July 25 (excluding Sunday). (3) Transport to and from the following Ladies' functions: BADGES Fashion Show .. .. July 19 Members will not be admitted to any of the Scientific Gallahers ...... July 19 Meetings, Exhibitions, or Social Functions unless wearing Ormeau Bakery .. .. July 19 and 24 a membership badge, which may be obtained on Belfast Harbour Cruise .. July 19 and 20 registration. *Belfast Ropeworks .. July 25 Ladies are also requested to wear their badges throughout *Short Bros. & Harlands July 24 the Meeting. *Harland & Wolff .. .. July 26 TICKEITS (4) Transport from the University to the local medical institutes on July 27, and back to the All tickets for functions occurring up to and inciuding University. Sunday, July 22, will be available for Representatives at the *Open to members also. SUPPLEMENT TO THE 285 JUNE 23, 1962 BELFAST MEETING: PROGRAMME BRrTISH MEDICAL JOURNAL

CORPORATION TRANSPORT REPRESENTATIVES' SUNDAY EXCURSIONS In addition to the special transport described above, All-day Excursion to Giants' Causeway and Portrush members and their ladies wearing badges may travel frec An attractive excursion has been arranged for Representa- of charge on the Corporation buses, by courtesy of the tives and their ladies, leaving Belfast by coach at 12.15 p.m. Belfast Corporation. on Sunday, July 22, and proceeding via the Antrim Coast Road to the Giants' Causeway and Portrush. CAR PARKING Representatives will be entertained by the Northern Parking space in central Belfast is limited, but adequate Ireland Branch to lunch at Larne and to tea at the Giants' car-parking facilities are available at Queen's University and Causeway. The North-East Ulster Division will entertain at the King's Hall, Balmoral. Windscreen labels may be the Representatives at a Cocktail Party at the Northern obtained on registration. Counties Hotel, Portrush, where dinner will be taken. The return journey will be made by the inland route. MAP OF BELFAST The cost of the excursion, including dinner and transport, will be 30s. per person and ticket forms for advance book- A map of Belfast showing the city centre and surround- ings have been sent to Representatives. ing area and principal places of interest will be available on registration. Afternoon Excursion to Mourne Mountains An alternative afternoon coach tour has been arranged CATERING ARRANGEMENTS leaving Belfast at 2 p.m. on Sunday, July 22, for New- Arrangements have been made to provide coffee, lunch, , Co. Down, and the Mourne Mountains. and tea in Queen's University. Luncheon tickets may be Representatives will be entertained to tea at Rostrevor obtained at the Registration Bureau, where full details will by invitation, and dinner will be taken at Ballymascanlon be available. House by invitation of the Northern Ireland Branch. The Light refreshments will also be available in the licensed inclusive cost of this excursion will be 15s. per person. bar adjoining the Registration Bureau and in the Ladies' Club. REPRESENTATIVES' CONCERT An Evening of Irish Song and Dance arranged by Dr. LADIES' CLUB Havelock Nelson and sponsored by Ciba Laboratories Ltd., The Ladies' Club, information bureau, and registration will be given in the Sir William Whitla Hall, Queen's desk will be open from 2 to 6 p.m. on Wednesday, July 18, University, Belfast, on Saturday, July 21, from 8.30 to and from 9 a.m. till 6 p.m. from July 19 to 27 (except 10.30 p.m. The artists will include: Brendan O'Dowda Sunday) at 21 University Square (opposite Queen's (tenor), Mary McEvoy (songs with Irish harp), Patricia University, Belfast). A lounge, a writing-room, a powder- Mulholland Dancers, and David Curry and his Orchestra. room, changing-rooms, and ironing facilities will be pro- Tickets will be available at the A.R.M. Inquiry Office. vided. There will also be facilities for light refreshments and a licensed bar. Transport for the various excursions EDINBURGH GRADUATES' DINNER will leave from the Ladies' Club. The Edinburgh Graduates' Dinner will be held at Stormont, Belfast, on Friday, July 20, at 7.30 for 8 p.m. LADIES' PROGRAMME All Edinburgh graduates attending the A.R.M., or residing The Local Ladies' Committee has arranged a varied in the Belfast area, together with their ladies and guests, programme which will give visitors ample opportunity to wiU be welcome. Tickets (£2 2s. each, including apdritifs see the beautiful Ulster countryside and many of the local but not wines) may be obtained by application, with industries, and to partake of private hospitality. A fashion remittance, to Dr. J. T. Baldwin, B.M.A. Scottish Office, show, a tour of the city, and cruises around Belfast Harbour 7 Drumsheugh Gardens, Edinburgh 3. are also included in the programme. Of particular interest should be the visits to the Glens of GLASGOW GRADUATES' DINNER Antrim, the Mourne Mountains, and Lough Erne. The Glasgow Graduates' Dinner will be held in the Grand The Coffee Party on Saturday morning at Hillsborough Central Hotel, Belfast, on Friday, July 20, at 7.30 for 8 p.m. Castle, the residence of the Governor of Northern Ireland, The dinner is open to all Glasgow graduates attending the H.E. Lord Wakehurst, and Lady Wakehurst, should be a A.R.M., or resident in the area, together with their ladies very popular occasion. The Castle is situated in the quaint and guests. Tickets (37s. 6d. each, including cocktails but little village of Hillsborough, which is half an hour's journey excluding wines) may be obtained on application, with from the Ladies' Club. remittance, to Dr. J. T. McCutcheon, 7 Drumsheugh Gardens, Edinburgh 3. (Dress-Dinner jackets.) ANNUAL DINNER IRISH GRADUATES' DINNER The Association's Annual Dinner will take place on Tuesday, July 24, at 7.30 for 8 p.m. in the King's Hall, The Irish Graduates' Dinner will be held in the Midland Balmoral. The price of the dinner, including apdritif and Hotel, York Road, Belfast, on Saturday, July 21, at 7.30 wines, is £2 Ss., and evening dress with decorations will be for 8 p.m. Graduates of all Irish Medical Schools and their worn. The hall will seat 1,000 at tables for 20. wives are welcome. Tickets (32s. 6d. each, excluding wine) Any member wishing to attend the Dinner is invited to may be obtained by application, with remittance, to Dr. apply for tickets as soon as possible and not later than H. W. Dunn, B.M.A. House, 609 Ormeau Road, Belfast 7. July 16. Guests will be welcome and members wishing to be seated with friends should give particulars when applying. WELSH DINNER Applications, with the appropriate payment, should be The Welsh Dinner will be held at the Windsor Hotel, made to the Financial Comptroller, B.M.A. House, Tavistock Knocknagoney Road, Belfast 4, on Friday, July 20, at 7.30 Square, London W.C.1, and will be dealt with in the order for 8 p.m. All Welsh Representatives, Welsh graduates, in which they are received. Cheques should be made and others with Welsh associations, accompanied by their payable to the " British Medical Association." ladies, will be welcome at this dinner. Tickets (32s. 6d. Note: Representatives, Members of Council, and each, excluding wines) may be obtained by application, Members of the Northern Ireland Branch have been sent with remittance, to Dr. S. J. Hadfield, B.M.A. House. a special application form for this dinner. Tavistock Square, London W.C.1. 286 JUNE 23, 1962 BELFAST SUPPLEMENT TO THz MEETING: PROGRAMME BRITISH MEDICAL JOURNAL There will be a Kiddush after the service in honour of ORDER OF ST. JOHN LUNCHEON the visitors, who will be welcomed by the Rabbi and the A Luncheon for members of the Order of St. John of President of the Congregation. Jerusalem, in the presence of the Lord Prior of the Order (H.E. The Governor of Northern Ireland, Lord Wakehurst), MEETING FOR DOCTORS AND CLERGY will be held on Thursday, July 19, at 12.30 for 1 p.m., at Representatives and their ladies and medical men and Woodboume House Hotel, Suffolk, Dunmurry. Tickets, women in Belfast are cordially invited to a meeting of price 25s., may be obtained by application, with remittance, doctors and clergy to be held in the Whitla Hall of the to Dr. George Gregg, c/o B.M.A. House, 609 Ormeau Road, Methodist College (opposite Queen's University) on Friday, Belfast 7. July 20, at 8.30 p.m. This meeting is arranged annually ROYAL NAVAL LUNCHEON during the A.R.M. by the Churches' Council of Healing. A Luncheon for past and present Officers of the Royal The speakers will be the Most Rev. George Otto Simms, Naval Medical Services (R.N., R.N.R., R.N.V.R., and D.D., Ph.D., Archbishop of Dublin, and Professor Harold Commonwealth Navies) will be held in H.M.S. Caroline, Rodgers, O.B.E., F.R.C.S., with Dr. Ronald Gibson, O.B.E., Pollock Dock, Belfast, on at 12.30 in the chair. The subject under discussion will be "Illness Wednesday, July 25, for and 1 p.m. Tickets, price 22s. 6d., may be obtained by applica- Recovery." tion, with remittance, to Dr. R. A. McKeown, c/o B.M.A. House, 609 Ormeau Road, Belfast 7. CHRISTIAN MEDICAL FELLOWSHIP BREAKFAST The Annual Breakfast of the Christian Medical Fellow- R.A.M.C. LUNCHEON ship will be held in the Wellington Park Hotel, 21 Malone A Luncheon for past and present Officers of the R.A.M.C., Road, Belfast 9, at 8.15 a.n on Tuesday, July 24. The Regular, A.E.R., T.A., War Emergency, etc., will be held at chairman will be Mr. Ian Fraser (President-Elect of the B.M.A. Northern Ireland House, 609 Ormeau Road, B.M.A.). The speaker will be Mr. H. J. Seddon, C.M.G., Belfast 7, on Tuesday, July 24, at 12.30 for 1 p.m. Tickets, D.M., F.R.C.S. (London). Subject: "'The Christian's price 25s., may be obtained by application, with remittance, Responsibility in Medicine Overseas." The proceedings to Colonel Martin Rea, c/o B.M.A. House, 609 Ormeau will terrninate at 9.15 a.m. Tickets will be available, free Road, Belfast 7. of charge, at the Registration Bureau. R.A.F. LUNCHEON GOLF COMPETITIONS A Luncheon for past and present Officers of the Royal Tuesday, July 24, 10 a.m.-Ladies' Golf Competition for Air Force and R.A.F.V.R. will be held on Tuesday, July 24, the Notts Ladies' Challenge Cup at Royal Belfast Golf at the Midland Hotel, York Road, Belfast, at 12.30 for Club, Craigavad (open to women members of the Associa- 1 p.m. Tickets, price 22s. 6d., may be obtained by applica- tion and wives and daughters of members). tion, with remittance, to Mr. V. A. F. Martin, c/o B.M.A. Tuesday, July 24, 10 a.m.-Golf Competition for the House, 609 Ormeau Road, Belfast 7. Treasurer's Cup at Belvoir Park Golf Club, Newtownbreda (divisional winners only). SOROPTIMIST CLUB OF BELFAST Thursday, July 26, 10 a.m.-Golf Competition for the The President and Members of the Soroptimist Club of and Childe Cups at Royal Belfast Golf Club, Belfast invite any visiting B.M.A. Soroptimist to luncheon Craigavad. on Monday, July 23, at 12.30 p.m. at the Wellington Park Further particulars available from the Golf Secretary, Hotel, 21 Malone Road, Belfast 9. Further details available Dr. Reginald Hall, c/o B.M.A. House, 609 Ormeau Roadt from Dr. Kathleen Cathcart, 41 Harberton Drive, Belfast 9 Belfast 7. (Tel. 667559). SAILING OFFICIAL RELIGIOUS SERVICE Facilities will be available for members wishing to sail in and around . Further particulars may be The Official Religious Service will be held in St. Anne's obtained from Dr. N. S. Dickson at the Belfast Office. Cathedral on Sunday, July 22, at 10 a.m. The preacher at this service will be the Most Rev. J. McCann, D.D., Ph.D., Archbishop of Armagh and Primate of All Ireland. DAILY SCHEDULE OF SCIENTIFIC MEETINGS Academic Robes, if available, should be worn at this Tuesday, July 24 service and members should assemble and robe in Robin- son's Hotel, Donegall Street, not later than 9.30 a.m. The 9.30 a.m. to 12.45 p.m.-Symposium: "Virus Diseases," rest of the congregation is requested to be seated by 9.45 Methodist College (Whitla Hall). a.m. 9.30 to 1 1 a.m.-Panel Discussion: " Adrenal Steroid Therapy," History Lecture Theatre, Q.U.B.* ROMAN CATHOLIC SERVICE 11.30 a.m. to 12.45 p.m.-" What's New." I: New Physics Dialogue Mass in the Chapel of the Mater Infirmorum Lecture Theatre, Q.U.B. Hospital on Sunday, July 22, at 10.30 a.m. will be celebrated 2 to 4 p.m.-Plenary Session: " The Management of by the Rev. Michael Kelly, Dean of Residences, Queen's Advanced Cancer," Methodist College (Whitla Hall). University, and Chaplain to the Guild of St. Luke, SS. 2 to 5.30 p.m.-Medical Films: New Physics Lecture Cosmas and Damian. Theatre, Q.U.B. His Lordship the Bishop of Down and Connor will preside 4.30 to 5.30 p.m.-Dawson Williams Memorial Lecture: at the Mass. The Most Rev. William Conway, Bishop of "Paediatrics in Classical Art," Sir William Whitla Hall, Neve and Auxiliary to His Eminence Cardinal D'Alton, will Q.U.B. (Open also to the public by invitation.) preach. Academic dress will be worn and members should assemble and robe in the Out-patient Department not later Wednesday, July 25 than 10.15 a.m. 9.30 a.m. to 12.45 p.m.-Symposium: " Psychiatric Illness JEWISH SERVICE in General Practice," Sir William Whitla Hall, Q.U.B. Doctors of the Jewish faith attending the B.M.A. Meeting 9.30 to 11 a.m.-Panel Discussion: " The Care of the will be welcome at the Sabbath morning service at Belfast Physically Handicapped Child," History Lecture Theatre, Synagogue, Carlisle Q.U.B. Annesley Street, Circus. The service 11.30 a.m. to begins at 9.15 a.m. and visitors are requested to be in their 12.45 p.m.-"- What's New." II: New seats not later than 10 a.m. Rabbi Dr. A. Carlebach will Physics Lecture Theatre, Q.U.B. preach the sermon. * Q.U.B.: Queen's University, Belfast. SUPPLEMENT To THE 287 JUNE 23', 1962 BELFAST MEETING: PROGRAMME BRMSH MEDICAL JOURNAL 2 to 4 p.m.-Plenary Session: " The Doctor in the Aspects; Professor W. T. IRVINE (London), Chemotherapy; Prevention and Treatment of Delinquency," Sir William Dr. J. W. DUNDEE (Belfast), Relief of Pain. Official Whitla Hall, Q.U.B. (Open also to the public by invitation.) Reporter: Dr. M. BOoALLIL. 2 to 4 p.m.-Clinical Demonstrations on Closed Circuit 4.3G to 5.30 p.m. (Sir William Whitla Hall, University). Colour Television, Methodist College (Whitla Hall). Dawson Williams Memorial Lecture (open also tt the public 2 to 4 p.m.-Medical. Films: New Physics Lecture by invitation): Dr. B. E. SCHLESINGER (London), Theatre, Q.U.B. "Paediatrics in Classical Art." 4.30 to 5.30 p.m.-Jobson Home Memorial Lecture: "Hypophysectomy for Breast Cancer and Other Diseases," Wednesday, July 25 New Physics Lecture Theatre, Q.U.B. 9.30 a.m. to 12.45 p.m. (Sir William Whitla Hall, Thursday, July 26 University). Symposium: "Psychiatric Illness in General Practice." Chairman: Dr. W. MCCARTAN (Belfast). Hon. 9.30 a.m. to 12.45 p.m.-Symposium "Accident and Secretary: Professor J. G. GiBsotN (Belfast). Speakers: Casualty Services," Sir William Whitla Hall, Q.U.B. Dr. A. DENIs LEIGH (London), Psychosomatic Illness; Dr. 9.30 to 11 a.m. Panel Discussion: " Bleeding in D. L. DAVIES (London), The Treatment of Chronic Pregnancy," History Lecture Theatre, Q.U.B. Alcoholism; Dr. D. J. C. DAWSON (Londonderry), The 11.30 a.m. to 12.45 p.m.-" What's New." III: New Recognition of Psychiatric Problems in General Practice; Physics Lecture Theatre, Q.U.B. Dr. C. B. ROBINSON (Belfast), Problems of Management; 2 to 4 p.m.-Plenary Session: "Use and Abuse of Dr. J. P. HORDER (London), Place and Scope of Psycho- Antibiotics," Sir William Whitla Hall, Q.U.B. therapy in General Practice. Official Reporter: Dr. 2 to 4 p.m.-Clinical Demonstrations on Closed Circuit OSWALD PROCTOR. Colour Television, Methodist College (Whitla Hall). 9.30 to 11 a.m. (History Lecture Theatre, University). 2 to 6 p.m.-Medical Films: New Physics Lecture Panel Discussion: " The Care of the Physically Handicapped Theatre,. Q.U.B. Child." Chairman: Professor R. S. ILLINGWORTH (Sheffield). Friday, July 27 Hon. Secretary: Dr. W. I. FORSYTHE (Belfast). Panel: Mr. 9 a.m. to 9 p.m.-All-day Tour to Londonderry, visiting ALEXANDER INNES (Birmingham), Orthopaedics; Dr. MARY Altnagelvin Hospital. D. SHERIDAN (London), Seeing and ]Hearing; Dr. E. ELLiS 9.30 a.m. to 12.45 p.m.-Plenary Session: "Coronary (Newcastle upon Tyne), Education; Dr. K. S. HOLT Occlusion," Sir William Whitla Hall, Q.U.B. (Sheffield), Home Care. 2 to 4 p.m.-Medical Films: New Physics Lecture 11.30 a.m. to 12.45 p.m. (New Physics Lecture Theatre, Theatre, Q.U.B. University). " What's New " II. Chairman: Dr. R. S. 2.15 to 5 p.m.-Visits to local medical institutes (for ALLISON (Belfast). Hon. Secretary: Dr. J. H. D. MILLAR details, see p. 288). (Belfast). Speakers: (1) Dr. A. CRAMPTON SMITH (), Treatment of Tetanus; (2) Dr. L. J. HURWITZ (London), SCIENTIFIC MEETINGS-JULY 24-27, 1962 Treatment of Cerebrovascular Insufficiency; (3) Surgeon Captain STANLEY MILES, R.N. (Alverstoke), Health Hazards All sessions will be held in the Queen's University or in in Atomic Submarines. Official Reporter: Dr. F. PREscoTr. the Methodist College (opposite the University) 2 to 4 p.m. (Sir William Whitla Hall, University). Plenary Tuesday, July 24 Session: "The Doctor in the Prevention and Treatment of 9.30 a.m. to 12.45 p.m. (Whitla Hall, Methodist College). Delinquency" (open also to the public by invitation). Symposium (with associated Colour Television programme): Chairman: Mr. IAN FRASER (Belfast). Hon. Secretary: Dr. " Virus Diseases." Chairman: Sir CHRiSTOPHER ANDREWES J. D. W. PEARCE (London). Speakers: Mr. J. P. WILSON, (Salisbury). Hon. Secretary: Professor G. W. A. DICK Solicitor and Clerk to the Justices, Sunderland; Dr. (Belfast). Speakers: Professor M. G. P. STOKER (Glasgow), ALEXANDER REID MARTIN, Psychiatrist, New York City The Nature of Viruses; Dr. D. A. J. TYRRELL (Salisbury), Youth Board; Mr. D. Q. R. MULOCK HOUWER, Secretary- Clinical Clues in Virus Infections; Dr. D. M. S. DANE General of the International Union for Child Welfare, (Belfast, The Use of the Virus Diagnostic Laboratory; Geneva; Dr. J. D. W. PEARCE, Physician-in-Charge, Professor G. W. A. DICK (Belfast), The Prevention of Virus Departments of Psychiatry, St. Mary's Hospital and Queen Diseases in the Community. Official Reporter: Dr. S. P. Elizabeth Hospital for Children, London. LocK. 4.30 to 5.30 p.m. (New Physics Lecture Theatre, 9.30 to 11 a.m. (History Lecture Theatre, University). University). Walter Jobson Horne Memoral Lecture: Mr. Panel Discussion: "Adrenal Steroid Therapy." Chairman: J. ANGELL JAMES (Bristol), " Hypophysectomy for Breast Dr. R. I. S. BAYLISS (London). Hon. Secretary: Dr. 1. A. Cancer and Other Diseases." WEAVER (Belfast). Panel: Dr. D. A. D. MONTGOMERY (Belfast), General Medicine and Endocrinology; Dr. J. Thursday, July 26 MARTIN BARE (Belfast), Dermatology; Professor E. G. L. 9.30 a.m. to 12.45 p.m. (Sir William Whitla Hall, BYWATERS (London.), Rheumatology; Dr. M. G. NELSON University). Symposium: " Accident and Casualty (Belfast), Haematology; Mr. J. H. DOGGART (London), Services." Chairman: Professor F. A. R. STAMMERS Ophthalmology; Professor R. B. WELBOURN (Belfast), (Birmingham). Hon. Secretary: Mr. NORMAN C. HUGHES Surgery. Official Reporter: Dr. DAVID HADDEN. (Belfast). Speakers: Mr. H. OSMOND-CLARKE (London), 11.30 a.m. to 12.45 p.m. (New Physics Lecture Theatre, Organization and Communications; Professor K. E. KALLIo University). "What's New" I. Chairman: Professor G. M. (Helsinki), Accident Services; Professor WILLIAM GiSSANE BuLL (Belfast). Hon. Secretary: Dr. R. A. WOMERSLEY (Birmingham), The Central Accident Unit; Dr. JOHN HUNT (Belfast). Speakers: (1) Dr. A. G. BAIKE (Edinburgh), (London), The General Practitioner and the Accident Chromosomes and Disease; (2) Professor G. A. SMART Service. (Newcastle upon Tyne), Autoimmune Disease; (3) Air 9.30 to 11 a.m. (History Lecture Theatre, University). Commodore W. K. STEWART, R.A.F. (Farnborough), Space Panel Discussion: "Bleeding in Pregnancy." Chairman: Medicine. Official Reporter: Dr. F. PREscorr. Professor C. H. G. MACAFEE (Belfast). Hon. Secretary: Mr. 2 to 4 p.m. (Whitla Hall, Methodist College). Plenary G. B. GIBSON (Belfast). Panel: Dr. J. N. JAMISON (Belfast), Session (with associated Colour Television programme): General Practice; Dr. J. K. FEENEY (Dublin), Obstetrics; "The Management of Advanced Cancer." Chairman: Dr. A. A. SHARP (Oxford), Clinical Pathology. Official Professor J. HI. BGART (Belfast). How. Secretaries: Dr. Reporter: Dr. J. MAcD. GRJHAIf HARLEY. A. R.. LYONS (Belfast), Dr. G. Lvrcsr (Belfast); Speakers: 11.30 a.m. to 12.45 p.m. (New Physics Lecture Theatre, Do. R' G. GISn (Winchester), Ethics and General Manage- Uners&ityA. "What'sNew# III. Chairman: Mr. I. S. ment;: Professor H. J. B. AmKss (London), Endocrine LOUG*RIBGE (Belfast>. Ron. Secretary: Mr. D. MILLAR SUPPLEMENT TO THE 288 JuNE 23, 1962 BELFAST MEETING: PROGRAMME BRTUISH MEDICAL JOURNAL BELL (Belfast). Speakers: (1) Professor M. F. A. WOODRUFF The programmes, which are sponsored and produced by (Edinburgh), Tissue and Organ Transplantation; (2) Dr. Smith Kline and French Laboratories Ltd., will be relayed V. D. ALLISON (Belfast), Central Sterilization; (3) Mr. F. J. to the Whitla Hall of the Methodist College, Belfast GILLINGHAM (Edinburgh), Surgical Treatment of Parkin- (opposite Queen's University), from the Royal Victoria sonism and Other Dyskinesias. Official Reporter: Dr. F. Hospital, Belfast. PRESCOTr. Tuesday, July 24 (Whitla Hall, Methodist College). Colour 2 to 4 p.m. (Sir William Whitla Hall, University). Plenary television transmissions will supplement the Symposium on Session: " Use and Abuse of Antibiotics." Chairman: "Virus Diseases" from 9.30 a.m. to 12.45 p.m., and also Professor R. E. 0. WiLLIAMS (London). Hon. Secretary: the Plenary Session on "The Management of Advanced Dr. P. C. ELMES (Belfast). Speakers: Dr. MARY BMBER Cancer" from 2 to 4 p.m. (London), Antibiotic Hazards; Dr. E. J. L. LOWBURY (Birmingham), Antibiotics for Superficial Lesions; Dr. P. C. Wednesday, July 25, 2 to 4 p.m. (Whitla Hall, Methodist ELMES (Belfast), Hospital Antibiotic Policy;, Dr. G. I. College). Moderator in the hall, Dr. J. JOHNSTON. WATSON (Peaslake), Antibiotics in General Practice. Official Respiratory Disability: (a) Clinical Assessment, (b) Labora- Reporter: Dr. S. P. LocK. tory Investigation, Dr. ALAN GRANT, Dr. B. KNOX, Professor 9 p.m. (Sir William Whitla Hiall, University). Sir Charles OWEN WADE, Dr. T. KINO, Miss D. BELL. Congenital Clefts Hastings Lecture (open to the public): Professor Sir DAVID of Lip and Palate, Mr. NORMAN C. HUGHES, Mr. WILLIAM R. CAMPBELL (Aberdeen), " The Doctor's Code." DICKIE, Mr. Roy WHITLOCK, Dr. PETER FROGGATT. Colour- ful Dermatology: (a) Toxic Epidermal Necrolysis, (b) Ring- worm in Pet Mice, (c) Skin Diseases are Seldom Contagious, Friday, July 27 Dr. MARTIN BEARE, Dr. DESMOND BuRRows, Dr. DONALD 9.30 a.m. to 12.45 pm. (Sir William Whitla Hall, MACKENZIE. University). Plenary Session: " Coronary Occlusion." Thursday, July 26, 2 to 4 p.m. (Whitla Hall, Methodist Chairman: Professor Sir GEORGE PICKERING (Oxford). Hon. College). Moderator in the hall, Dr. J. JOHNSTON. Methods Secretary: Dr. EVAN FLETCHER (Belfast). Speakers: of Urinary Diversion and the Treatment of Uraemia, Mr. Professor T. CRAwFoRD (London), Mechanism of Coronary JOHN MEGAW, Dr. MARY MCGEOWN. The Treatment of Occlusion; Dr. TAGE HILDEN (Copenhagen), Treatment of Congenital Hydrocephalus, Mr. A. R. TAYLOR, Mr. C. A. the Acute Phase and Acute Coronary Insufficiency; GLEADHILL, Mr. D. S. GORDON, Dr. W. H. T. SHEPHERD. Professor R. B. HuNTER (Dundee), Management after the Psychological Aspects of the Relief of Pain in Childbirth, Acute Attack; Professor P. A. OWRFN (Oslo), The Place of Mr. GAviN BOYD; Miss R. C. PERKES, Matron, Royal the Anticoagulants; Professor J. MCMICHAEL (London), Are Maternity Hospital; Mrs. I. BisHoP, Sister Tutor, Royal Anticoagulants Worth While? Official Reporter: Dr. Maternity Hospital; Mrs. R. MERCER, Physiotherapist, J. A. C. BALL. Royal Maternity Hospital; Mrs. R. BARRY, Physiotherapist, 9 a.m. Visit to New General Hospital. Altnagelvin, Royal Maternity Hospital. Londondlerry (lunch, tea, and buffet supper by invitation) (limited to 80) (transport ticket 20s.). 2.15 to 5 p.m. Visits to Local Medical Institutes. Special MEDICAL FILMS transport will leave Queen's University at 2.15 p.m. The following films will be shown in the New Physics (1) Nuffield Surgical Block and Central Sterile Supply Depot, Lecture Theatre. Musgrave Park Hospital. (2) Windsor Psychiatric Unit, Belfast Tuesday, July 24.-2 p.m., Open Heart Surgery. 2.22 p.m., City Hospital. (3) Wakehurst House, Geriatric Unit, Profound Hypothermia. 2.55 p.m., External Cardiac Belfast City Hospital. The following exhibit will be on view: " Massage. 3.15 p.m., Femoro-Popliteal By-pass with Teflon Appliances for Use in the Nursing of Patients with Prosthesis. Urinary Incontinence," Mr. S. VINCENT. (4) Institute of 3.25 p.m., Pericardiectomy for Constrictive Clinical Pericarditis. 3.45 p.m., Fungus Infection Treated with Science, Queen's University, Belfast (for details see Griseofulvin: Part 1, Skin: Five Cases. Part Nail: below). (5) The New Wing at the Royal Belfast Hospital 2, for Sick Children. (6) New Ulster Hospital for Women and Time-lapse Study (Gold Medal Winner, B.M.A. Fllm Children, Dundonald. (7) Muckamore Abbey Special Care Competition, 1961, Non-commercial category). Unit, Antrim. (8) Malone Place G.P. Maternity Unit, Wednesday, July 25.-2 p.m., Anaemia. 2.25 p.m., The Belfast Anatomy, Function, and Repair of the Internal Inguinal Ring. 2.35 p.m., Stress Incontinence of Urine Treated by Tbe following exhibits will be on view at the Institute of Suburethral Fascial Sling. 2.50 p.m., Management of Twins Clinical Science: in Pregnancy and Labour. 3.15 p.m., Investigation of Department of IMicrobiology.-Laboratory Diagnosis of Virus Female Sterility. 3.45 p.m., The Artificial Uterus. Diseases. Immunization Against Virus Diseases. Thursday, July 26.-2 p.m., The Treatment of Thyrotoxi- Department of Anaesthetics.-Peripheral Vascular Changes cosis. 2.20 of Partial During Inhalational Anaesthesia. Sequelae of Tracheotomy. p.m., Technique Thyroidectomy. Clinical Trials of Drugs under Controlled Conditions. Prize-winning Films in B.M.A. Film Competition, 1961: Department of Therapeutics.-Respiratory Function Tests. 2.35 p.m., Anterior Spinal Fusion for Spondylolisthesis by Department of Surgery.-Peritoneoscopy. Gastroscopy. Transperitoneal Route (Silver Medal, Commercial category). Diagnosis of Liver Disease. Portal Vein Obstruction. 3 p.m., Operation for Ventricular Septal Defect (Silver Department of Pathology.-Porphyria. Chiari's Disease. Medal, Commercial category). 3.25 p.m., Spontaneous Structure of the Hepatic Veins. Abortion (Silver Medal, Commercial category). 4 p.m., Department of Clinical Pathology.-Automation in the Kielland's Forceps Delivery (Bronze Medal, Commercial Laboratory. Steroid Excretion Patterns in Diseases of the Adrenal Cortex. category). 4.20 p.m., Infant Anaesthesia (Bronze Medal, Department of Radiology.-Arteriography. Non-commercial category). Department of Surgical Science.-Surgical Endocrinology. Friday, July 27.-2 p.m., The Last of the Drum. Automatic Bladder Irrigation Apparatus. 2.25 p.m., Hip Surgery in the Aged. 2.40 p.m., Urological Department of Obstetrics.-Some Interesting Lesions of the Surgery. 2.55 p.m., Apraxia in a Patient with Hemiplegia. Vulva. 3.05 p.m., Gastro-Duodenal Fibrescopy. 3.15 p.m., The Treatment of Acromegaly. 3.30 p.m., Experimental Pressure MEDICAL COLOUR TELEVISION PROGRAMMES Chamber. 3.50 p.m., I Dress the Wound. Clinical demonstrations presented by members of the Request Films.-A repeat showing of any of the films staffs of the Royal Victoria Hospital, the Belfast City mentioned above will be given on Tuesday, July 24, from Hospital, the Royal Belfast Hospital for Sick Children, and 4.30 to 5.30 p.m., and on Thursday, July 26, from 5 to the Medical Faculty of the Queen's University of Belfast. 6 p.m., when the following films may also be requested: SUPPLEMENT TO THE 289 JUNE 23, 1962 BELFAST MEETING: PROGRAMME BRITISH MEDICAL JOURNAT. Stripping of Varicose Veins; Free Tendon Graft to a Royal Victoria Hospital, Plastic and Maxillo-Facial Thumb; That They May Live: Mouth-to-Mouth Resuscita- Centre, Northern Ireland. Plastic and maxillo-facial tion; Recognition and Treatment of the Depressed Patient; teaching models. Resection of Maxilla for Carcinoma. EXHIBITION EXHIBITION OF PHARMACEUTICAL PRODUCTS, SCIENTIFIC INSTRUMENTS, APPLIANCES, AND MEDICAL Exhibitors and Titles of Exhibits PUBLICATIONS, QUEEN'S UNIVERSITY, Northern Ireland Radiotherapy Centre and Department of BELFAST Neurosurgery, Royal Victoria Hospital, Belfast. Hypo- physectomy combining intrasellar radiation with surgery. List of Exhibitors Belfast City Hospital. Metabolic electrocardiography- Stand the myocardosis. No. Royal College of Surgeons in Ireland. (1) The determina- AUen and Hanburys Ltd. 67 tion of the radiosensitivity of carcinomata. (2) Treatment Beecham Research Laboratories Ltd. Boots Pure Co. Ltd. 41 of secondary deposits in bone from carcinoma of the breast Drug . .. 41 Bowater Scott Corporation Ltd. 63 with P"2 and durabolin. John Bradbury .. 16 Belfast City Hospital. Incontinence of urine. British Medical Association 48 Clinical Pathological Department, Royal Victoria Hos- British United Provident Association 44 pital, Belfast. Busulphan treatment of chronic granulocytic Butterworth and Co. (Publishers) Ltd. 50 leukaemia. Cambridge Instrument Co. Ltd. 51 Department of Child Health, University of Liverpool. Camden Chemical Co. Ltd. 19 The Liverpool Congenital Abnormalities Registry. S. H. Camp and Co. Ltd. 23 Ciba Laboratories Ltd. 2 Research Department, Boots Pure Drug Co. Ltd. The Consumers' Association Ltd. 66 search for antiviral antibiotics. Cresco Ltd. 24 College of General Practitioners, Northern Ireland Crookes Laboratories Ltd. 5 Faculty. (1) Coronary thrombosis survey study in Down Bros. and Mayer and Phelps Ltd. 34 Northern Ireland. (2) Anticoagulant treatment in general Duncan Flockhart and Co. Ltd. 21 practice. Energen Foods Co. Ltd. 45 X-ray Department, Royal Victoria Hospital, Belfast. Ethicon Ltd. 3 "Radiography in a lighter vein." F.A.I.R. Laboratories Ltd. 36 Royal Army Medical Corps. High-velocity missile Family Doctor 10 Geigy Pharmaceutical Co. Ltd. 65 wounds and splinting of fractures. Genito-Urinary Mfg. Co. Ltd. 14 Children's Hospital, Dublin. Treatment of phenyl- Glaxo Laboratories Ltd. 54 ketonuria, with particular reference to the newborn. Hirtz and Co. Ltd. .. 28 Royal Air Force Medical Branch. Research in the Royal Hospital Service Plan 52 Air Force-cancer chemotherapy. Imperial Chemical tndustries Ltd. 17 Guy's Hospital and Guy's Hospital Medical School. Johnson and Johnson (G.B.) Ltd. 40 "Waiting to see the consultant." Kinpax Surgical Ltd. 56 Institute of Orthopaedics Poiomyelitis Centre and Physics Leo Laboratories Ltd. 46 Department, St. Thomas's Hospital. Myoelectric control H. K. Lewis and Co. Ltd. 22 E. and S. Ltd. 6 and powered aids for the disabled. Livingstone London Hospital (Ligature Dept.) Ltd.. 4 College of General Practitioners, S.E. Scotland Faculty. London Rubber Co. Ltd. 13 Colour photography in a clinical trial. Louis Newmark Ltd. 35 Department of Medicine, University College and St. May and Baker Ltd. 25 Vincent's Hospital, Dublin. Hyperadrenal corticalism due Metal Box Co. Ltd. 37 to pelvic tuberculosis. Nestle Co. Ltd. .. 32 The National Maternity Hospital, Dublin. "The case N.O.T.B. Association 29 47 for symphysiotomy." Parke Davis and Co. 18 University of Bristol, Department of Anaesthetics, Royal Reckitt and Sons Ltd. 58 Infirmary, Bristol. Some consideration of the physiology Riddell Products Ltd. 20 and control of pain. Riker Laboratories Ltd. 55 University of Liverpool, School of Dental Surgery. The Robinson and Sons Ltd. 42. morphological basis of cleft lip and palate conditions. E. S. and A. Robinson Ltd., 7 Department of Gynaecology, Royal Victoria Hospital, Roche Products Ltd. 53 Belfast. Interesting and rare lesions of vulva. G. D. Searle and Co. Ltd. 12 Gordon Hospital and Westminster Medical School. A Short and Mason Ltd. 57 Smith and Nephew Ltd. 30 drug trial-oxethazaine on gastric function. E. R. Squibb and Sons Ltd. 27 Dumfries and Galloway Royal Infirmary. Long-term Fred Storey Ltd. .. .. 39 anticoagulant control in a rural area. Chas. F. Thackray Ltd. .. 26 Departments of Neurological Surgery and Neuroradiology, Ulster Bank Ltd. .. .. 64 Royal Victoria Hospital, Belfast. The role of surgery in Vitamins Ltd. .. .. 49 the treatment of strokes. W. Vinten Ltd. .. .. 49 Medical Departments of the Royal Navy and the United John Wyeth and Brother Ltd. 33 States Navy. Medical aspects of the nuclear submarine. Chelsea Hospital for Women. The Stein-Leventhal MEETINGS syndrome. TIME-TABLE OF, University Department of Surgery at Western Infirmary, R.-Events for Members of Representative Body and Ladies of arterial accompanying them. Glasgow. Use hyperbaric oxygen in insufficiency. L.-Events primarily arranged for Ladies. Department of Surgery, Our Lady of Lourdes Hospital, U.-Events for all Members and Ladies accompanying them. Drogheda. The supra-inguinal approach to femoral hernia. *-Academic Robes should be worn, if available. Dr. John R. Lee, Gransha Hospital, Londonderry. Instrument for measuring the resistance to air-flow through Wednesday, July 18 the respiratory tract (asthma, chronic bronchitis, etc.). 2.00 to 6.00 p.m.-Annual Representative Meeting Inquiry Biochemistry Department, loyal Victoria Hospital, Office open for registration in the Entrance Hall to Belfast. Simplified urine testing. the Sir William Whitla Hall, Queen's University. SUPPLEMENT TO THE 290 JUNE 23, 1962 BELFAST MEETING: PROGRAMME BRITISH NEDICAL JOURNAL 2.00 to 6.00 p.m.-Ladies' Club open for registration of ladies 7.30 for 8.00 p.m.-Glasgow Graduates' Dinner at the Grand at 21 University Square, opposite Queen's Univer- Central Hotel, Belfast. (Ticket 37s. 6d.) sity. 7.30 for 8.00 p.m.-Welsh Dinner at the Windsor Hotel, Belfast. 8.30 to 10.30 p.m.-R. Welcome Party (by invitation of the (Ticket 32s. 6d.) Northern Ireland Branch), King's Hall, Balmoral, 8.30 p.m.-U. Meeting for Doctors and Clergy in the Whitla Belfast. Hall of the Methodist College (opposite Queen's Thursday, July 19 University). 9.00 a.m.-Annual Representative Meeting Inquiry Office open in the Entrance Hall to the Sir William Whitla Hall. Saturday, July 21 9.00 a.m.-Ladies' Club open at 21 University Square, opposite 8.25 a.m. to 7.00 p.m.-L. All-day tour to Enniskillen and Queen's University. cruise on Lough Erne. Coffee on route. Lunch 10.00 a.m.-Annual Representative Meeting starts at the Sir by invitation of the Tyrone Division. Tea at William Whitla Hall, Queen's University. . Guests will be receiwd at - 10.30 a.m. to 12.30 p.m.-L. Tour of Gallahers (Tobacco) court by the, Duke and Duchess of Abercorn. Ltd., Virginia House, York Street, Belfast. Coffee (Transport ticket 40s.) (Limited to 80.) by invitation. (Limited to 40.) 9.00 a.m.-Annual Representative Meeting Inquiry Office open 11.00 a.m.-Welcome by the Lord Mayor of Belfast in the Sir in the Entrance Hall to the Sir William Whitla Hall. William Whitla Hall. 9.00 a.m.-Ladies' Club open at 21 University Square, opposite 11.00 a.m.-Fashion Parade in the Fashion Theatre (third floor), Queen's University. Robinson and Cleaver Ltd., Donegall Place, Belfast. 9.15 a.m.-Jewish Service at the Synagogue of the Belfast A display of garments manufactured in Northern Hebrew Congregation, Annesley Street, Carlisle Ireland, presented by Robinson and Cleaver Ltd., in Circus. conjunction with Strelitz Ltd. (Limited to 120.) 9.30 a,m.-Annual Representative Meeting in the Sir William 12.30 for 1.00 p.m.-Order of St. John Luncheon, Woodbourne Whitla Hall, Queen's University. House Hotel, Dunmurry. (Ticket 25s.) 10.00 a.m. to 12.30 p,m.-L. Visit to and 2.00 to 5.30 p.m.-L. Cruise around Belfast Harbour on Gardens. Coffee by invitation of H.E. The Q;overnor board the Sir Thomas Dixon. Tea by invitation of of Northern Ireland, Lord Wakehurst, and Lady Belfast Harbour Commissioners. (Limited to 65.) Wakehurst. (Transport ticket 5s,) (Limited to 100.) 2.00 to 5.30 p.m.-L. Visit to Mountstewart House and 10.00 a.m. to 12.30 p.m.-L. Visit to Castle. Gardens. Tea by invitation of Viscountess Bury. Coffee by invitation of the Northern Ireland Bnch. (Transport ticket 5s.) (Limited to 80.) (Transport ticket 3s. 6d.) (Limited to 40.) 2.30 to 5.30 p.m.-L. Visit to Courtaulds Ltd., Carrickfergus, 1.30 to 6,30 p.m.-L, Tour to tbe Glens of Aetrim. Tea by Co. Antrim. Tea by invitation. (Transport ticket invitation of the Northern Ireland Branch. (Trans- 3s. 6d.) (Limited to 40.) port ticket 12s. 6d.) (Limited to 80.) 2.30 to 5.30 p.m.-L. Visit to Ormeau Bakery Limited, 2.30 to 5.30 p.m.-L. Visit to Rowallane Gardens, Tea by Ormeau Road, Belfast, Tea by invitation. (Limted invitation of Dr. and Mrs. J. S. McKelvey. Sherry to 40.) by invitation of Major and Mrs. D. M. Anderson 7.30 for 8.00 pm.-R. Dinner -for Representatives and Ladies at Creevy Roeks. (Transport ticket Ss.) (Limited in the King's Hail, Balmoral, Belfast, (Ticket, inclu- to 40.) sive of Dance, 35s.) Followed by: 2.30 to 5.30 p.m.-L. Tour to Groyabbey and Ards Peainsula. 10.00 p.m. to 2.00 a.m.-R. Representatives' Dance in the Tea by invitation of the Northern Ireland Brnch. King's Hall, Balmoral. (Open also to members of (Transport ticket 5$.) (Liauts to 40.) Northern Ireland Branch.) (Ticket, inclusive of 5.00 to 6.30 p.m.-Medical Women's Federation Sberry Party, Supper, 21s.) Riddel flall, Stranmillis Road, Belfast. 7.30 for 8.00 p.m.-lrish Graduates' Dinner at the Midland Friday, July 20 Hotel, Belfast. (Ticket 32s. 6d.) 9.00 a.m.-Annual Representative Meeting Inquiry Office open 8.30 p.m.-R Representatives' Concert in the Sir Wiliam in the Entrance Hall to the Sir William Wtla Hall. Whitla Hall, Queen's University. 9.00 a.m.-Ladies' Club open at 21 University Square, opposite Queen's University. 9.00 a.m. to 12.30 p.m.-L. Tour of Gallahers Ltd., Lisnafillan Sunday, July 22 Factory, Gracehill, Co. Antrim. Coffee by invita- 9.30 a.m.-* Robing for Official Religious Service at Robin- tion. (Transport ticket 8s.) (Limited to 40.) son's Hotel, Donegall Street, Belfast. 9.00 a.m. to 5.30 p.m.-L. All-day tour to Mourne Mountains, 10.00 am.-U.* Official Religious Service At St. Anne's Newcastle, Tollymore Forest Park, and Silent Cathedral, Belfast. Valley. Lunch by invitation of the Northern Ire- 10.30 a.m.-* Dialogue Mass in the Chapel of the Mater land Branch. Tea by invitation of the Chairman, Infirmorum Hospital. H. Trevor Montgomery, Esq., F.C.A., and members 12.15 to 10.00 pm.-R. All-day tour to Portrqsh and Giants' of the Belfast Water Commissioners. (Transport Causeway via the Antrim Coast Road. Lunch at ticket 15s.) (Limited to 80.) Larne and tea at the Causeway by invitation of the 9.30 a.m.-Annual Representative Meeting in the Sir William Northern Ireland Branch. Dinner at the Northern Whitla Hall, Queen's University. Counties Hotel, Portrush, preceded by cocktails by 10.00 a.m. to 12.30 p.m.-L. Tour of the City. Coffee by invitation of the North-east Ulstr Divson. invitation of the Chairman of the Belfast Division, (Ticket 30s.) (Limited to 200.) Dr. J. M. Hunter, and Mrs. Hunter, at Belfast 2.00 to 10.00 p.m.-R. Tour to Newcastle and Mpurn Moun- Castle. (Transport ticket 2s. 6d.) tains. Tea at Rostrevor by invitation. Dinner at 12.45 for 1.00 p.m.-Overseas Luncheon at B.M.A. House, 609 Ballymascanlon Hotel by invitation of the Northern Ormeau Road, Belfast. (By invitation only.) Irela-nd Branch. (Transport ticket 15s.) (Limited 1.30 to 6.30 p.m.-L. Tour to Armagh. Visiting Armagh to 80.) Cathedral and the R.C. Cathedral. Tea by invita- tion of Sir Norman and Lady Stronge at . (Transport ticket 10s.) (Limited to 40.) Monday, July 23 2.00 to 5.30 p.m.-L. Cruise around Belfast Harbour on board 9.00 a.m.-Official Opening of the Exhibition of Pharmaceutical the Sir Thomas Dixon. Tea by invitation of Belfast Products, Instruments, Appliances, and Medical Harbour Commissioners. (Limited to 65.) Publications in the grounds of Queen's University 2.30 to 5.30 p.m.-L. Exhibition of Linen at Linen Industry by the President-Elect, Mr. Ian Fraser. Research Association at Lambeg. Tea by invitation. 9.00 a.m.-Registration Bureau open, Queen's University. (Transport ticket 2s. 6d.). (Limited to 120.) * 9;00 a.m.-Scientific Exhibition open, Queen's University. 5.30 p.m.-Cocktail Party for Overseas Guests at Government 9.00 a.m.-Ladies' Club open at 21 University Square, opposite House by invitation of H.E. The Governor of Queen's University. Northern Ireland. 9.30 a.m. to 1.30 p.m.-L. Tour of Ards Peninsula. Coffee 7.30 for 8.00 p.m.-Edinburgh Graduates' Dinner at Stormont, by invitation of Dr. and Mrs. A. M. Young, Porta- Belfast. (Ticket £2 2-s.) ferry. (Transport ticket 9s.) (Limited to 80.) SUPPLEMENT TO THE 291 JUNE 23, 1962 BELFAST MEETING: PROGRAMME BRirisH MEDICAL JOURNAL 9.30 a.m. to 1.00 p.m.-L. Visit to Downe Cathedral and Inch Abbey, Downpatrick. Coffee by invitation of Wednesday, July 25 the Down Hospitals Group. (Transport ticket Ss.) 9.00 a.m.-Registration Bureau and the Exhibition of Pharma- (Limited to 80.) ceutical Products, Instruments, Appliances, and 10.00 a.m.-Annual Representative Meeting in the Sir William Medical Publications open at Queen's University. Whitla Hall, Queen's University. 9.00 a.m.-Scientific Exhibition open, Queen's University. Council Meeting (on conclusion of Annual Repre- 9.00 a.m.-Ladies' Club open at 21 University Square, opposite sentative Meeting), Senate Room, Queen's Univer- Queen's University. sity. 9.15 a.m. to 5.30 p.m.-L. All-day tour to Mourne Mountains, 3.30 to 5.00 p.m.-Garden Party at Parliament Buildings, Stor- Newcastle, Tollymore Forest Park, and the Silent mont, by invitation of the Northern Ireland Govern- Valley. Lunch by invitation of the Northern Ireland ment. (Afternoon Dress.) Branch. Tea by invitation of Sir Graham Larmor, 8.15 p.m.-U.* Adjourned Annual General Meeting and Ardnabannon, Annsborough. (Transport ticket 15s.) President's Address, Sir Wiliam Whitla Hall, (Limited to 80.) Queen's University. 9.30 a.m. to 12.45 p.m.-Symposium on " Psychiatric Illness in 9.30 to 11.00 p.m.-U.* President's Reception, Queen's Uni- General Practice," Sir William Whitla Hall, Queen's versity. University. Tuesday, July 24 9.30 to 11.00 a.m.-Panel Discussion on " The Care of the 8.15 a.m.-Annual Breakfast of the Christian Medical Fellow- Physically Handicapped Child," History Lecture ship, Wellington Park Hotel, Malone Road, Belfast. Theatre, Queen's University. 9.00 a.m.-Registration Bureau and the Exhibition of Pharma- 10.00 a.m. to 12.30 p.m.-L. Visit to Cyril Lord's (Carpets) ceutical Products, Instruments, Appliances, and Ltd., . Coffee by invitation. (Trans- Medical Publications open at Queen's University. port ticket 5s.) (Limited to 40.) 9.00 a.m.-Scientific Exhibition open, Queen's University. 10.00 a.m. to 12.30 p.m.-U. Visit to Belfast Ropeworks. 9.00 a.m.-Ladies' Club open at 21 University Square, opposite Coffee by invitation. (Limited to 40.) Queen's University. 11.30 a.m. to 12.45 p.m.-" What's New " II, New Physics Lec- 9.30 a.m. to 12.45 p.m.-Symposium on " Virus Diseases" ture Theatre, Queen's University. (with associated colour television programme), 12.30 for 1.00 p.m.-Royal Naval Luncheon in H.M.S. Caroline, Whitla Hall, Methodist College (opposite Queen's Pollock Dock, Belfast. (Ticket 22s. 6d.) University). 1.30 to 5.30 p.m.-L. Visit to Wade Potteries, Portadown. 9.30 to 11.00 a.m.-Panel Discussion on " Adrenal Steroid Tea by invitation. (Transport ticket 7s.) (Limited Therapy," History Lecture Theatre, Queen's Univer- to 40.) sity. 2.00 to 4.00 p.m.-Plenary Session on " The Doctor in the Pre- 10.00 a.m.-Golf Competition for the Treasurer's Cup at Belvoir vention and Treatment of Delinquency," Whitla Park Golf Club, Newtownbreda. Hall, Queen's University. (Open also to the public 10.00 a.m.-L. Ladies' Golf Competition for the Notts Ladies' by invitation.) Challenge Cup at Royal Belfast Golf Club, 2.00 to 4.00 p.m.-Colour Television, Whitla Hall, Methodist Craigavad. College, opposite Queen's University. 10.00 a.m. to 12.30 p.m.-L. Visit to Carrickfergus Castle. 2.00 to 4.00 p.m.-Medical Films, New Physics Lecture Theatre, Coffee by invitation of the Nortbern Ireland Branch. Queen's University. (Transport ticket 3s. 6d.) (Limited to 40.) 2.00 to 5.30 p.m.-L. Visit to Rowallane Gardens and White- 10.00 a.m. to 12.30 p.m.-U. Tour to Short Bros. and Harlands rock. Tea by invitation of the Rt. Hon. J. L. 0. Ltd. Coffee by invitation. (Limited to 40.) Andrews and Mrs. Andrews at Maxwell Court, 10.00 a.m. to 12.30 p.m.-L. Tour of City. Coffee by invitation Comber. (Transport ticket 5s.) (Limited to 40.) of the Chairman of the Belfast Division, Dr. J. M. 2.30 to 5.30 p.m.-L. Visit to Berkshire Knitting Co. (Ulster) Hunter, and Mrs. Hunter, at B.M.A. House. Ltd., . Tea by invitation. (Transport (Transport ticket 2s. 6d.) ticket 3s. 6d.) (Limited to 40.) 11.15 a.m.--President's Tour of the Scientific Exhibition, Queen's 2.30 to 5.30 p.m.-L. Visit to Old Bleach Linen Co., Randals- University. town. Tea by invitation. (Transport ticket 6s.) 11.30 a.m. to 12.45 p.m.-" What's New" I, New Physics Lec- (Limited to 40.) ture Theatre, Queen's University. 4.30 to 5.30 p.m.-Horne Memorial Lecture on "Hypophys- 12.30 for 1.00 p.m.-R.A.M.C. Luncheon at B.M.A. Northern ectomy for Breast Cancer and Other Diseases," New Ireland House, 609 Ormeau Road, Belfast 7. Physics Lecture Theatre, Queen's University. (Open (Ticket 25s.) also to students and nurses.) 12.30 for 1.00 p.m.-R.A.F. Luncheon at the Midland Hotel, 6.00 to 7.00 p.m.-Reception for Pharmaceutical and Scientific York Road, Belfast. (Ticket 22s. 6d.) Exhibitors, Queen's University. 2.00 to 4.00 p.m.-Plenary Session on "The Management of 8.30 p.m.-U.* Civic Reception and Ball, City Hall. Advanced Cancer " (with associated colour tele- vision programme), Whitla Hall, Methodist College Thursday, July 26 (opposite Queen's University). 9.00 a.m.-Registration Bureau and the Exhibition of Pharma- 2.00 to 5.30 p.m.-Medical Films, New Physics Lecture Theatre, ceutical Products, Instruments, Appliances, and Queen's University. Medical Publications open at Queen's University. 2.00 to 5.30 p.m.-L. Tour to Mountstewart Gardens. Tea 9.00 a.m.-Scientific Exhibition open, Queen's University. by invitation. (Transport ticket 5s.) (Limited 9.00 a.m.-Ladies' Club open at 21 University Square, opposke to 40.) Queen's University. 2.30 p.m.-Overseas Conference, B.M.A. House, 609 Ormeau 9.30 a.m. to 12.45 p.m.-Symposium on " Accident and Road, Belfast. Annual Report by the secretary of Casualty Services," Sir William Whitla Hall, Queen's the Committee on Overseas Affairs, followed by University. general discussion. 9.30 to 11.00 a.m.-Panel Discussion on "Bleeding in Preg- 2.30 to 5.30 p.m.-L. Tour to Groomsport, Orlock, and nancy," History Lecture Theatre, Queen's Univer- Bangor. Visiting James Mairs Ltd., Tweed Manu- sity. facturers, Newtownards. Tea by invitation of Dr. 10.00 a.m. to 12.30 p.m.-U. Visit to Harland and Wolff Ltd. and Mrs. J. Bleakley, Seacourt, Bangor. (Transport Coffee by invitation. (Limited to 40.) ticket Ss.) (Limited to 40.) 10.00 a.m. to 12.30 p.m.-L. Visit to Anny Lewinter (Knitwear), 2.30 to 5.30 p.m.-L. Visit to Ormeau Bakery Ltd., Belfast. Newtownards. Coffee by invitation. (Transport Tea by invitation. (Limited to 40.) ticket 3s. 6d.) (Limited to 40.) 4.30 to 5.30 p.m.-Dawson Williams Memorial Lecture on 10.00 a.m.-Golf Competition for the Leinster and Childe Cups "Paediatrics in Classical Art," Sir William Whitla at Royal Belfast Golf Club, Craigavad. Hall, Queen's University (open also to the public by 11.30 a.m. to 12.45 p.m.-" What's New " III, New Physics Lec- invitation). ture Theatre, Queen's University. 4.30 to 6.00 p.m.-Reception for Overseas Visitors at B.M.A. 2.00 to 4.00 p.m.-Plenary Session on " Use and Abuse of House, 609 Ormeau Road, Belfast, by invitation of Antibiotics," Sir William Whitla Hall, Queen's Uni- the Commonwealth Medical Advisory Bureau. versity. 7.30 for 8.00 p.m.-Annual Dinner in the King's Hall, Balmoral, 2.00 to 4.00 p.m.-Colour Television, Whitla Hall, Methodist Belfast. (Ticket, inclusive of wine, 45s.) College, opposite Queen's University. SUPPLEMENT TO THE 292 JUNE 23, 1962 BELFAST MEETING: PROGRAMME BRITISH MEDICAL JOURNAL 2.00 to 6.00 p.m.-Medical Films, New Physics Lecture Theatre, 9.00 a.m.-Ladies' Club open at 21 University Square, opposite Queen's University. Queen's University. 4.15 p.m.-U.* University Reception (Garden Party), Queen's 9.00 a.m.-U. All-day tour to Londonderry. Visiting the University. Guild Hall Altnagelvin and Londonderry and 5.30 to 6.15 p.m.-U.* Graduation Ceremony, Sir William Gransha Hospitals. Lunch by invitation of the Whitla Hall, Queen's University. Mayor and Corporation at the Guild Hall. 9.00 p.m.-Hastings Lecture on "The Doctor's Code," Sir Tea and buffet supper by invitation of Hospital William Whitla Hall, Queen's University. (Open Management Committee at Altnagelvin.- (Transport to the public.) ticket 20s.) (Limited to 80.) 9.30 a.m. to 12.45 p.m.-Plenary Session on " Coronary Occlu- sion," Sir William Whitla Hall, Queen's University. Friday, July 27 2.00 to 4.00 p.m.-Medical Films, New Physics Lecture Theatre, 9.00 a.m.-Registration Bureau and the Exhibition of Pharma- Queen's University. ceutical Products, Instruments, Appliances, and 2.15 p.m.-Visits to local medical institutes (see p. 288). Medical Publications open at Queen's University. 8.30 p.m.-U Reception and Closing Dance (by invitation of 9.00 a.m.-Scientific Exhibition open, Queen's University. the Belfast Division), Belfast Castle.

ANNUAL CONFERENCE OF REPRESENTATIVES OF LOCAL MEDICAL COMMITTEES The Annual Conference of Representatives of Local believed that better clinical work could be achieved Medical Committees was held in B.M.A. House on June by altering the method of payment so as to compel 6 and 7, with Dr. C. J. SWANSON in the chair. A part adherence to an approved routine of attendance. The of the proceedings was reported in last week's profession had disapproved of that. It was a doctor's Supplement. ethical duty to practise his profession uninfluenced by motives of profit, and for the profession to try to ANNUAL REPORT OF G.MS. COMMITTEE produce good obstetrics by changing the method of payment was a betrayal of all it stood for. Dr. A. B. DAVIES moved the reception of the Annual Dr. DAVIES replied that what the G.M.S. Committee Report of the General Medical Services Committee. His had done spoke for itself, and he was prepared to stand speech was reported in last week's Supplement (p. 267). by the results. On controversial matters it seldom obtained a direct majority of 75%. To introduce rules Con g Local Medical Committees of the kind suggested in the motion would render the Dr. G. WYNN THomAs (Berkshire) moved: G.M.S. Committee's work, done in a democratic way, That as a result of tIe-neeet negotiations on the maternity ineffective. medical services this Confesgce recommends that the The motion was lost, as was also a motion by Berk- General Medical Services Committe skould not accept any shire that the GQM.S. Committee should send a prdcis material alterations to the National Health Service regula- of its minues to the secretaries of local medical tions without having received the approval of Om majority committees under confidential cover. of local medical committees. He said that no criticism of Dr. Davies was intended, PRACTITIONERS AND HOSPITAL but when a major alteration in the terms of service was GENERAL contemplated the G.M.S. Committee should keep local SERVICE medical committees informed so that the matter could Dr. DAVIES moved that the paragraphs of the report be discussed beforehand. It would save a great deal of dealing with the general practitioner and the hospital heart-burning later on. service be approved. Dr. DAVIES said that if 'the motion were accepted there would be no need for a G.M.S. Committee. Dr. Closure and Change of Use of Hospitals WYNNE THOMAS replied that Berkshire simply asked the Dr. WILLIAMS (Denbigh and Flint) moved: G.M.S. Committee to consult local medical committees That this Conference requests the Ministry of Health to before making a major decision so that they could help ensure that hospital management committees and boards the Committee in its difficult decision. shall inform local medical committees of all proposed The motion was lost. changes in general-practitioner hospitals and/or bed alloca- Dr. D. L. WILLIAMS (Denbigh and Flint) moved that tion and sIill not come to a final decision until the local local medical committees should be consulted whenever medical committees' views have been ascertained and fully the General Medical Services Committee failed to carry considered. a 75% majority on a controversial issue. Hospital authorities made up their minds first and The purpose of the Conference, he said, was to went through the motions of consultation afterwards, represent accurately the views of ordinary general said Dr. Williams. General-practitioner hospital beds practitioners. There was little doubt that at one period and hospitals were an extension of general practice, and last year the G.M.S. Committee had pursued a policy local medical committees should be consulted at the which was opposite to the wishes of the majority of outset about proposed changes. general practitioners. The policy had been described The motion was carried. by Dr. Davies when he informed the Council (Supple- Dr. E. H. PARKINSON (Dorset) moved that the system ment, December 16, 1961, p. 254): "We are out to of general-practitioner hospitals should be preserved in raise the standard of obstetric care by the application the interests of patients and of the continued efficiency of a better content of service. However great the of general practitioners. difficulties we may meet, let us not deviate from that He said that the main source of contact with fellow fundamental purpose." The G.M.S. Committee doctors was the cottage hospital. The district hospital JUNE 23, 1962 LOCAL MEDICAL SUPPLEMENT TO THE JUNE23,162LOCALMEDICALCOMMITTEESCOMMITTBRmsH MEDICAL JOURNAL 293 was often some 30 miles away, and the rural practitioner number of general-practitioner beds on paper but take could rarely go there to meet- the consuiltants. away maternity hospitals from rural practitioners. Dr. R. V. GOODLIFFE (Surrey) said that general-practi- The motion was carried unanimously. tioner hospitals and general-practitioner maternity units were an essential element of good general practice. For Representation on Hospital Magement Committees too long the Ministry had regarded general-practitioner Dr. S. REVELS (Derby) moved: and cottage hospitals as an untidy excrescence on the That this Conference reiterates the 1961 resolution and hospital system. They were not: they were the long rejects the Ministry's view that the appointment of a general arm of general practice which enabled the general practitioner is adequately safeguarded through consultation practitioners to follow their patients through their more between the regional hospital board and the executive serious illnesses. It was lamentable that the new scheme council. for hospitals planned to wipe out every general-practi- He recalled that the Conference in 1961 had resolved tioner hospital in the next ten years. The Ministry did that the Minister of Health should be urged to press not realize that general practitioners did their best work upon regional hospital boards the desirability of in general-practitioner hospitals, where patients were including in hospital management committees at least under their control with the assistance of specialist one general practitioner in active practice in the area. cover. General-practitioner beds in general hospitals Derby thought that pressure should continue to be were no substitute. exerted to get the terms of the resolution implemented. Dr. A. J. WHITAKER (Surrey) said that when general- The G.M.S. Committee's report indicated that the practitioner hospitals had been lost general practitioners Ministry had pointed out that the Act required that would be given beds in general hospitals, but they would the members of the hospital management committee not be in charge of them. They would be under con- should include persons appointed after consultation sultant supervision and gradually general practitioners with the executive council, and considered that that would lose their clinical independence. adequately safeguarded the position. and If the principle Dr. R. M. S. MCCONAGHEY (Devon Exeter) said of general-practitioner representation were a sound one he spoke for the patients. There were many conditions the local medical committee should be among those these days which were within the competence of the bodies which the regional hospital board consulted general practitioner to treat and which could be treated before making appointments. in the smaller hospitals nearer the patients' homes than Dr. DAVIES said he had no objection to the Confer- the big hospitals. ence reiterating the 1961 resolution, but there had been Dr. C. E. FRISKNEY (Lincs (Lindsey)) suggested that considerable improvement. The G.M.S. Committee was the Committee might point out to the Mimistry that the informed that almost every hospital management com- retention of cottage hospitals would help to overcome mittee in the country had a general-practitioner member. the shortage of doctors and nurses. Dr. A. M. MAIDEN The motion the motion. It was carried. (G.M.S. Committee) also supported was Dr. A. GOLDTHORPE (Southend) moved that steps obvious, he said, that where distances were great general- should be taken to ensure that hospital medical advisory practitioner beds would have to be left, but by and large committees should contain general-practitioner repre- the normal cottage hospital would go for ever. New sentation. entrants to general practice were attracted to practices One of the unfortunate results of the National Health that had access to cottage hospital beds. The Ministry Service, he said, had been to separate the specialist said it wanted to encourage doctors to enter general (designated consultant in the Service) from the advice practice and at the same time it produced a national and control if of his natural employer the general practi- hospital plan which, implemented, would do away tioner; to elevate his status and income relative to the with general-practitioner hospitals. general practitioner to a differential unheard of in this Dr. J. C. ARTHUR (G.M.S. Committee) said it looked country before the Service.; and at the same time as though the Minister would have to take wider powers virtually to exclude the general practitioner from the over regional boards. Between the Ministry and regional wards, common-room, and board-room of the hospital, boards the general practitioners got nowhere. Regional when previously he had been an honoured visitor and boards could always slide out their obligations on the participant. Much help could be given to the hospital ground that they had no money. staff by general practitioners able to bring a breath of Dr. G. P. WILLIAMS (G.M.S. Committee) suggested reality from outside into the esoteric atmosphere of the that the speakers were preaching to the converted. He institution. Particularly would that be so if and when urged representatives to approach their Members of the new regional " supermarket" hospitals were Parliament on the question. established under the ten-year plan. The motion was carried unanimously. Dr. P. R. SAVILE (London) supported the motion. In The following motion, moved by Dr. PARKINSON on his own group of hospitals general-practitioner repre- behalf of Dorset, was carried unanimously: sentation on the hospital medical advisory committee That this Meeting affirms its opinion that general-practi- was due simply to the individual whims of a few of the tioner beds should be provided in all district hospitals. consultants on the committee. Dr. DAVIES thought that the motion should be Dr. P. A. T. LOWDEN (Hampshire) asked for maternity supported, but at the same time it would be wrong to homes to be included in the Dorset motion, and this stress that there was a continuous conflict between was agreed to. consultant colleagues on the hospital medical advisory Moving a motion by Derbyshire "that this Con- committees and the local medical committees. There ference deplores the proposed closing of maternity was increasing co-operation and many hospital medical hospitals in country districts as envisaged in the hospital advisory committees consulted local medical committees plan," Dr. R. A. A. R. LAWRENCE said great care must on an ad hoc basis on special matters. be exercised not to allow the Ministry to show a large The motion was carried. 294 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES SUPPLEMfENT TO THE BRITISH MEDICAL JOURNAL Each local authority had its own scheme of Sterile Syringe Service immunization, Dr. Dawes said, and laid down its Dr. S. G. BUDD (Cardiganshire) moved: "That this own requirements for notification. Conditions of work Conference advocates that a free sterile syringe service and remuneration should be consistent, and the object be extended to all general practitioners and strongly of the motion was to ensure that. objects to any charge being made for this service." Dr. K. S. MAURICE-SMITH (G.M.S. Committee) With the increasing use of parenteral medication it informed Conference that the Infectious Diseases was hardly fair, he said, that the supply of syringes Subcommittee of the Public Health Committee had should be part of ordinary surgical equipment. Dr. discussed the question of the unevenness of payment MCCONAGHEY (Exeter and Devon) supported the motion. throughout the country, and in due course its report If the Ministry wanted general practitioners to use would be sent to Council recommending that the sterilized syringes the surest way of stopping them from Ministry be asked to set up a national policy on using them was to charge 5d. each. payment. Dr. E. V. KUENSSBERG (G.M.S. Committee) said it The motion was carried. was ludicrous that, in the face of the Medical Research A motion by Pembrokeshire, moved by Dr. C. L. Council's advice on the matter, general practitioners PERRY, calling for an amendment of the International should, owing to the difficulties, be prevented from Certificate of Vaccination against smallpox so that the having properly sterilized syringes available. Until they result of revaccination was recorded was carried as a were available patients would not be safe. reference to the G.M.S. Committee. Dr. H. C. PALIN (Lancashire) said that doctors in his Similarly, a motion moved by Dr. J. C. KNOX, of area had had a free syringe service but had just been Tynemouth, to the effect that general practitioners told that in future they would be charged for them. should be in possession of the forms of international Providing sterile syringes to general practitioners did certificate of vaccination was also carried as a reference not increase hospital costs and the 5d. charge was not to the G.M.S. Committee. warranted. Dr. F. M. ROSE (G.M.S. Committee) said that and by PRESCRIBING AND large all practice expenses were paid in the long run by DISPENSING the Ministry, and it seemed very short-sighted for the Dr. DAVIES moved that the part of the report dealing Ministry to deny practitioners the provision of the with prescribing and dispensing be approved. service. Quite a number of practitioners had already supplied themselves with disposable sterile syringes. List of Appliances The Ministry would not in the long run save one penny A motion in the name of Ipswich, moved by Dr. by being awkward in the matter. J. D. HALFORD, asking Conference to recommend that The motion was carried. surgical belts and lumbosacral supports should be A motion in the name of Berkshire, moved by Dr. prescribable on Form E.C.10 was lost. WYNNE THOMAS, urging Conference to recommend that Dr. J. HENNEmAN (Bournemouth) moved: disposable sterile syringes should be provided free for general practitioners for taking blood for pathological That this Conference deplores the attitude of certain investigations was carried. hospital management committees who, in order to reduce the hospital drug bill, are exceeding the Minister of Health's Dr. P. R. WILSON (Norfolk) moved: directive, contained in H.M. Circular (61)78, which states That this Conference considers that gamma-radiated that " quantities prescribed for an out-patient should not disposable syringes should be supplied at the cost price exceed what is needed for the period until either the hospital of bulk buying, as all other forms of syringe sterilization doctor or the general practitioner is likely to see him," depend on absolutely perfect cleansing immediately after. with the result that consultants are sending out-patients back use. to the practitioner for the supply of drugs even though the patients have not been returned to his care. Apart from He said that if practitioners could not have a free the principles involved, this will result in a considerable syringe service at least they should have gamma- increase in the national drug bill and a detrimental effect radiated syringes at no extra cost. on general practitioners' prescribing figures, and this Confer- Dr. FRISKNEY (Lincs (Lindsey)) suggested that the ence therefore instructs the General Medical Services motions were simply asking that general practitioners Committee to make strong representations to the Ministry should become part of a salaried medical service. It of Health that steps be taken to require hospital manage- was the general practitioner's job to provide the tools ment committees to fulfil their obligations to treat and of his or otherwise-and prescribe for out-patients until such time as the patients trade-disposable syringes it are returned to the direct care of the general practitioner. was his job to see that they were sterile. The motion was carried as a reference to the G.M.S. He said that the disadvantages of such a practice were Committee. inconvenience to the patient, inconvenience to the doctor, and waste of time. If a patient was not well enough to attend the surgery the doctor had to go and VACCINATION AND IMMUNIZATION see him to give a prescription. Apart from that, the Dr. DAVIES moved that the part of the report dealing general practitioner was not prescribing off his own bat with vaccination and immunization be approved. but was writing out what another doctor had told him Dr. A. C. DAWES (Smethwick) moved a motion to do. It was a disgraceful state of affairs deploring the widespread differences in the conditions Dr. FRISKNEY (Lincs (Lindsey)) said he was horrified laid down by local authorities for payment for records to see such a motion. Did referring a patient to a of vaccination against smallpox submitted by general specialist or consultant imply that the general practi- practitioners, and requesting the G.M.S. Committee tioner abrogated his responsibility towards that patient ? to take whatever action was, necessary to achieve Did he send a patient to the consultant for advice or uniformity throughout the country. treatment ? Surely the practitioner should refer the JUNE 23, 196) LOCAL MEDICAL COMMITTEES SUPPLEMENT TO THE 295 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~BRITISH MEDICAL JOURNAL patient to the consultant, receive the latter's advice, There were suggestions in the following motions that and then carry out any necessary and recommended different items should be taken out of it. These motions treatment if he approved of it. conceived the pool as somewhat like a sandwich cake of Dr. MCCONAGHEY (Devon and Exeter) supported Dr. different layers, and they variously proposed taking out Friskney. "Our patients are our patients," he said, different layers and putting them on one side. If that " and the hospital is there to serve us and the consul- were done the basic part of the cake would be smaller. tant to advise us what he thinks might be given. It is The Committee had received warnings from expert for us to treat our patients in the light of the advice advisers about the possible effects of certain changes in as we think best." the method of calculating the central pool. It might Dr. J. A. PRIDHAM (G.M.S. Committee) supported affect the practice expense calculation. The Committee the motion. He agreed that the general practitioner had also been warned about the possible effect on was responsible for his patients, but the facts of life income-tax assessment. There were other implications were that certain patients were sent to hospital And such as the possible effects on superannuation. The disappeared from the care of the general practitioner. G.M.S. Committee was fully seized of all the difficulties It was a question of ethics. Dr. J. S. HAPPEL (Hants) and was trying to ascertain the best future method of opposed the motion. He said for several years he had payment. It had set up a special subcommittee on been the chairman of the drugs and medicines remuneration, and it might be as well if the motions committee of a hospital management committee, and to do with calculation of the central pool were referred the margin in the hospital drug budget was very small to the G.M.S. Committee. indeed. Dr. S. Noy Scorr (G.M.S. Committee) also Dr. B. CARDEW (G.M.S. Committee) agreed that the opposed the motion. An out-patient department should implications of any change in the pool system must be be consultative and consultative only, he said. studied with the greatest possible care; but what worried Dr. D. WILLIAMS (Anglesey) suggested that the him was that the case to be put before the Review Body motion be referred to the G.M.S. Committee for had to be prepared this year. Did it mean that in consideration. He pointed out that the hospital had approaching the Review Body the profession were tied access to new drugs which were not yet available to to all previous Conference decisions on the structure of the chemist or to the prescribing doctor. Secondly, the pool, and was it necessary, therefore, to wait for patients were seen at awkward times which made it another three or four years before possible changes in difficult for them to see the general practitioner and the pool system could be considered, or would it be obtain a prescription. The hospital should be possible to show the Review Body some of the anomalies responsible for supplying drugs which were new and which arose from the present working of the pool not available, and for those patients who were unable system ? over a period of a few days to attend their doctor to Dr. DAVIES said that if there were to be a radical get a prescription. alteration of remuneration policy obviously it would Dr. DAVIES said that of course the general practi- have to have the support of the profession before the tioner would always have the responsibility whatever G.M.S. Committee or Council could take it to the the consultant or the hospital might order. Unfortu- Review Body, and that could mean a special Conference nately various regions had differ At policies, and it and special Representative Meeting. It might well be might be an advantage to obtain a greater degree of that when meeting the Review Body some indication uniformity amongst the hospitals. could be given to it of the direction in which the The motion was carried as a reference to the G.M.S. profession's wishes lay. Committee. Dr. GOLDTHORPE (Southend) appealed to those local medical committees which had tabled motions dealing REMAINDER OF REPORT ON REMUNERATION with the calculation of the central pool to follow the sound advice given by Dr. Davies-that was, to refer Dr. DAVIES moved that the remainder of the report them for further consideration by the G.M.S. Committee. under " Remuneration " be approved. The amendment referring the motion to the G.M.S. Committee was carried. Calculation of Central Pool The following motion by Norfolk was also carried Dr. D. P. FITZGERALD (Wolverhampton) moved: as a reference to the G.M.S. Committee: "That this Conference considers that maternity fees That this Conference considers that, inasmuch as they should be paid from a separate fund and not from are public health measures, payments for vaccination and the pool." immunization should be made by local health authorities He pointed out that, if maternity fees continued to be and not deducted from the central pool. paid out of the pool, with a rising birth rate capitation fees would decrease. Remuneration for Hospital Work Dr. M. L. HUDSON-EVANS (London) moved by way of amendment that the motion be referred to the G.M.S. Dr. ARTHUR (Gateshead) moved: Committee for consideration. He said that the motion That this Conference considers that the central pool under discussion, and subsequent motions, affected the should suffer no diminution because of general practitioners' whole pool system, and the issue could not be dealt hospital remuneration, and that the most satisfactory way with from the point of view of maternity services alone. to achieve this would be to exclude such remuneration from Dr. Hudson-Evans produced some figures which, he the pool. said, showed the disadvantages of changing to any other He said that he would be prepared to have the motion system than that of the pool. referred to the G.M.S. Committee if the Conference Dr. DAVIES said he was prepared to accept the amend- agreed. ment on behalf of the G.M.S. Committee. The pool Dr. H. DICKIE (Northumberland) said that his system was not sacrosanct; it could and had been varied. committee agreed with the Gateshead motion, but was SUPPLEMENT TO THE 296 JuNEJUNE 23, 1962 MEDICAL 23, LOCAL COMMITTEES BRITISH MEDICAL JOURNAL opposed to it being referred to thb G.M.S. Committee. The motion was carried as a reference to the G.M.S. One of the senses of frustration to-day in general Committee. practice was the-lack of any possibility of earning any- A motion by Soke of Peterborough to the effect that, thing extra by doing extra work. " ff we as doctors are having regard to the possibility of the future decrease in prepared to work a little harder than the man round the the number of principals, and also the increasing drain corner to keep ourselves more up to date by working in on the pool under the heading "Remuneration from hospitals, then we jolly well ought to be paid for doing other sources," the special subcommittee be asked to it, and I do not think the G.M.S. Committee should sit consider sympathetically a fixed capitation fee for on this egg until it is addled." general medical services, retaining the notional-list prin- Dr. FRISKNEY (Lincs (Lindsey)) supported the ciple but treating " other sources " as extras, was carried. Gateshead motion and the reference to the G.M.S. Committee, but said he felt that Conference should give some direction to the G.M.S. Committee on it. The Future Level of Remuneration payment of maternity fees and fees for notification of Dr. BREACH (Belfast) moved: inoculations closely concerned general practitioners, but That this Conference considers the present relative hospital work was something outside the ordinary run average general-practitioner remuneration to be so low as of general practice. The present method of remunera- to endanger the future of general practice and calls for tion was inequitable. vigorous representation to be made to the Review Body Dr. KNox (Tynemouth) opposed referring the motion for radieal reconsideration and upgrading of general- to the G.M.S. Committee and suggested that the Con- practitioner remuneration. ference should come out with a clear-cut statement As devaluation of the general practitioner continued about what general practitioners wanted and what they recruits to general practice would continue to diminish, were prepared to put up with. Hospital work was new he said, and work would increase with an ageing work and had nothing to do with the central pool as population without any compensating rise in remunera- hitherto constituted. Dr. R. W. RAE (Staffordshire) tion. With increasing pay in the Forces and the better said that the work done by the general practitioner for conditions obtaining in the hospital service, the trend hospitals should be paid for by the hospital service and would undoubtedly continue. should not come out of the pool. Dr. CAamEw (G.M.S. Committee) reminded the Dr. R. B. L. RIWE (G.M.S. Committee) asked the Conference that it had been reported that five "wise Conference to think carefully before it turned down the men " had been appointed to approach the Review Body reference to the G.M.S. Committee. He reminded the on the question of remuneration. He would like to Conference that on the previous day a strong plea was know whether they intended to make out a case for a made that general-practitioner hospitals and maternity percentage increase for the whole profession or whether units should be retained for the reason that they were an they intended to argue the case for general practitioners essential and integral part of general practice. Now, on its own merits. " I do not accept that there should from the same platform, representatives were being be a differential, as there now is, of £2,000 a year asked to take hospital payments out of the pool because between the averag general practitioner and the average it was a special part of general practice. The profes- consultant," said Dr. Cardew. " I consider the time has sion's representatives had to argue with the same people come when this body, representing general practitioners, on both those topics. should say that it wishes this differential to be Dr. GOODLIFFE (Surrey) said his committee felt very narrowed." The general practitioner had no certitude in strongly that any extra work which was to supplement his job, whereas the consultant, once appointed, had a work of hospitals should not be paid for by general firm future. There was an unassailable case for an practitioners' own money. increase in general-practitioner remuneration, but if Dr. C. L. PERRY (Pembrokeshire) supported the remuneration were to be tied solely to the cost of living reference of the motion to the G.M.S. Committee. Any and reference to other professions the general-prac- instruction to the Committee, he said, would lead to a titioner case would not be made out on its own merits. premature killing of the pool system. The amount of Dr. D. McL. DEENY (County Armagh) supported the hospital work in future would be so large that there motion. He said that the great increase in general- would be a case for the central pool to be substantially practitioner work was not taken into account in increased. Dr. CLAY (Buckinghamshire) thought that remuneration. A basic change in the method of the- G.M.S. Committee should have a clear-cut instruc- remuneration was needed, and in his view the only tion from the Conference. The regional hospital board method which would meet the situation was payment for should pay general practitioners and not the general items of service. practitioners themselves out of) the pool. Dr. J. F. Dr. J. M. LEES (Walsall) said that in this day and BREACH (Belfast) also thought that the G.M.S. Com- age it seemed ridiculous, when compared with the mittee should be given an instruction. rewards of industry, that no general practitioner was Dr. HuDSON-EVANS (London) moved an amendment capable of earning a net income of £5,000 a year. That that the motion be referred to the G.M.S. Committee should be the target. for consideration. The amendment was carried. Dr. DAVIES said he would accept the instruction that The motion standing in the name of Gateshead, as representations to the Review Body should be vigorous, amended, was carried. but he did not accept entirely Dr. Cardew's statements. Dr. M. T. SHAW (Newcastle upon Tyne) moved: Dr. Cardew had overlooked the substantial amount in and That negotiations be entered into by the appropriate remuneration represented by practice expenses bodies with a view to revising the construction of the superannuation. When those two items were added on central pool so that remuneration from local authorities to the £2,425 they brought the gross general-practitioner and Ministry departments for professional services may be average income to the region of £4,000. the direct responsibility of the Treasury. The motion was carried. SUPPLEMENT TO THE 297 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES BRITsH MEDICAL JOURNAL He reported that the Minister of Health had agreed Final Settlement 1960-1 to receive a deputation to discuss practice compensation. Dr. A. J. RUSSELL (West Suffolk) moved: " That this Matters to be discussed would include the immediate Conference deplores the delay in payment of the final funding of the outstanding amount due, the possibility settlement for 1960-1 and urges that the recommenda- of increasing the present rate of interest, early repay- tion of the Royal Commission with regard to prompt ment of the appropriate proportion of the compensation distribution of the pool balance be implemented forth- due when a share was transferred to a partner, and a with." He pointed out that distribution at present took further extension of the grounds on which an advance 15 months. Dr. D. L. COOKE (Manchester) supported of the compensation could be made-because of hardship. the motion. Dr. Mathias said he was prepared to accept the Dr. DAVIES said it appeared that West Suffolk did not following two motions standing in the names of Kent quite understand how the final settlement was worked and Canterbury and Middlesbrough respectively: out. It used to be two years and nine months in arrears. That payment of compensation should now be made and As a result of the G.M.S. Committee's representations that the G.M.S. Committee should again press the Minister the time was steadily shortened and the amount held to receive a deputation to put the claim of the profession over substantially reduced. The Royal Commission to the immediate payment of compensation in respect of laid down that if as much as £lm. remained outstanding the loss of the right of the sale of practices. it should be regarded as bad budgeting. The practice That this Conference urges the G.M.S. Committee to for a reassessment of compen- expenses portion of general practitioners' income could press the Ministry of Health and interest thereon at present-day monetary values. not be worked out until the Inland Revenue returns for sation the previous year had been analysed, and a final settlement earlier than 15 months was impossible. SUPERANNUATION The motion was lost. Dr. Mathias moved that the part of the report under "Superannuation " be approved. Payment for Late Calls The Conference would, he said, note that for the last A motion by Tynemouth, moved by Dr. KNox, three years representations had been made to the number- Ministry about practitioners' superannuation, and in recommending that, owing to the increase in the that connexion "practitioners" included not only of unnecessary late calls, a fee be paid by the patient general practitioners but specialists engaged in hospital for all domiciliary calls after 10 a.m., excluding genuine In 1959 Government to be left to the discretion of the doctor, work on a nine-session basis. the emergencies said it was unwilling to discuss the matter until the Royal was lost. Commission had reported. In July, 1960, the B.M.A. Patients in Part II1 Accommodation put a scheme to the Ministry which would give proper A motion by Surrey, moved by Dr. R. C. R. GETHEN: values to superannuation in the future.: In 1961, after "That this Conference requests the General MedicaL further discussion, this scheme was revised. After Services Committee to investigate the new circumstances repeated letters and telephone calls an interview with surrounding the changes which are occurring in the use the Ministry was requested. In March, 1962, a B.M.A. of accommodation provided under Part III of the deputation was told that the scheme was unacceptable. National Assistance Act by welfare departments of local A letter from the Ministry, received two weeks ago, authorities, and to negotiate a satisfactory case of stated that it rejected the B.M.A. scheme. No reasons remuneration for doctors caring for the patients," was were given except that there were decisive objections to carried as a reference to the G.M.S. Committee. principles. Nevertheless, said Dr. Mathias, the Ministry Also carried as a reference to the G.M.S. Committee made an offer which had been accepted without was a motion by Devon and Exeter, moved by Dr. B. H. prejudice to further negotiation. The Ministry's offer LLOYD, " That the General Medical Services Committee was that, while leaving the present total contribu- be instructed to take up with the Ministry of Health an tions unchanged, the superannuation regulations would anomaly in the Health Service in that there appears to be amended, subject to Parliamentary approval, so as to be no provision for a fee to be paid to a general medical provide that practitioners who became entitled to practitioner who is called to arrest haemorrhage pension benefits on and after the date on which the following dental extraction at a local hospital, although amending regulations came into operation, which would such a fee may be claimed where the extraction was be the first of the month following that in which they made by a dental practitioner under the General Dental were made, should have 11% instead of 11% applied to Service." their remuneration received on and after that date. There would be corresponding increases to lump-sum REVIEW BODY benefits. The changes would apply not only to new Dr. DAVIES moved that the part of the G.M.S. entrants but to existing practitioners. Committee's report dealing with the Review Body be The arrangement was somewhat complicated, approved. continued Dr. Mathias. The profession's representatives Dr. B. H. PENTNEY (London) moved: "That while were by no means satisfied with it. The net effect would regretting the delay in the setting up of the Review be that current pension rates would be increased by Body, the Conference nevertheless hopes that it will be 8.4%. It was proposed to reopen discussions with the able to present its first report before the end of 1962." Ministry at a suitable time. The motion was carried as a reference to the G.M.S. Committee. Inequity of Ministry's Proposals COMPENSATION The Ministry's proposals failed to meet the equity Dr. A. N. MATHIAS (Chairman of the Compensation of the demands for some adjustment to cover the and Superannuation Committee) moved that the portion discrepancy that arose between doctors assessed for of the report under " Compensation " be approved. pension on the basis of their remuneration ruling at 298 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES SUPPLEMENT TO THE 298 JUNE 23,1962 LOCAL MEDICAL COMMITTEES~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~BRITISH MEDICAL JOURNAL the time of retirement and those assessed on the whole stayed in. The larger bonuses which they had received of their earnings during their total service, when the in recent years would compensate for the present relative fall of the value of earnings in the early years modest addition to the superannuation of those in depressed their pensions many years later. The the scheme. Ministry's answer to that was that the influence upon Dr. A. TALBOT ROGERS (G.M.S. Committee) pointed superannuation benefits of the pay increases from 1948 out that some of those who opted out did so on the to 1955 was one of the main causes of the deficiency understanding that they would take out insurance of £80m. disclosed in the 1955 valuation, which the policies to cover their own future. Even although they Treasury was making up, and it was stated that the might have had better bonuses they would have had practitioner element of the scheme contributed premiums to pay, and the premiums they paid had been materially to the deficiency. It would be remem- graded according to the refund they expected to get bered, continued Dr. Mathias, that the deficiency was from the Government in respect of 8%. disposed of by the Government writing off a notional Dr. H. J. BROWNE (Staffordshire) supported the £40m. and by crediting 1+% to the Government amendment. It was not true, he said, that in 1948 proportion of the superannuation contribution for 20 those practitioners thought they would get a better years. All practitioners were credited in the Govern- bargain. They were not given time to find out what ment accounts with a Government contribution of 91% the income of their practices would be. instead of 8% for 20 years. The Government could The amendment was carried. not, therefore, agree to adopt a new method of The motion, as amended, was carried. calculating practitioners' superannuation benefits in a Dr. M. T. SHAW (Newcastle upon Tyne) moved: way which could aggravate that tendency for the future. "That this Conference recommends that appropriate Similarly, the Ministry refused to consider the very action be taken to procure a method for calculating strong representations made on behalf of the profession superannuation directly proportionate to the total to make their present proposals retrospective, even for amount of professional work carried out by general three years. Despite the disappointment that the practitioners." B.M.A. scheme had been rejected, nevertheless some- It appeared, he said, that general practitioners who thing had been achieved, said Dr. Mathias. An increase in addition to their practice did work on medical in pension for the future on reduced superannuation boards did not qualify for superannuation for that contributions had been achieved, and it would cost the work. The payment was deducted from the central pool. profession nothing. It would cost the Treasury £9m. In theory the payment was superannuable, but it was to finance the transaction. not. If the Government insisted that fees for general Dr. GOLDTHORPE (Southend) asked how the proposed practitioners doing that type of work were to be changes would affect those who had opted out of the deducted from the central pool the profession must also superannuation scheme. Dr. MATHIAS replied that insist that the payments were superannuable, not only in there was no proposal in the new arrangements for theory but also in practice. those who had opted out. Dr. W. R. EVERArr (Dewsbury) said it was desirable A motion from the floor that a vote of thanks be to bring the superannuation of those working for accorded to Dr. Mathias and to Dr. L. A. Potter was medical boards into line with that of those working in carried with acclamation. the hospital service Dr. J. R. ROWELL (Middlesbrough) formally moved: Dr. I. M. JONES (G.M.S. Committee) said that the That this Conference urges the G.M.S. Committee to fees payable to doctors who worked for Government press the Ministry of Health to produce a better method departments were negotiated on the basis that they were of calculating the superannuation of the general practitioner not subject to superannuation, and if in fact they so that it comes more into line with the amounts other became superannuable the fees would be reduced. branches of the profession are receiving. Much of that work was done by doctors who were Dr. LOWDEN (Hampshire) asked the G.M.S. Com- retired or semi-retired. Again, it was possible, under mittee to bear in mind the problem of the elderly doctor the provisions of the Finance Act, 1956, for any doctor suffering from some form of illness. He was prepared who wished to arrange some superannuation either for to take in a younger partner, but he would have to cut himself or for his partners out of the extra money which his superannuation by half because of the practice he earned from Government departments to do so. agreement. Dr. MATHIAS replied that the difficulty Dr. M. P. WINSTANLEY (Lancashire) reminded the was being dealt with by getting an advance of the Conference that in one important capacity all practi- practitioner's compensation and buying an annuity tioners worked for ministries or local authorities when with the money. they carried out immunizations, vaccinations, and so on. Dr. L. C. W. KERSHAW (Sheffield) suggested that That was important in so far as superannuation was nothing had been done to improve superannuation, and concerned the Conference had to decide-if the Government were Dr. MATHIAS pointed out that one group who would adamant on the matter-what further steps should be be affected by the motion were doctors in private taken. practice. They would suffer considerably if the motion Dr. GOLDTHORPE (Southend) moved, by way of were passed. It was possible under the Local Govern- amendment, "That this meeting requests the Chairman ment Superannuation Regulations for any doctor in of the Compensation and Superannuation Committee regular sessional employment by a local authority to be to press for a no-detriment provision for those practi- superannuated by the authority in respect of those fees. tioners who had opted out of the superannuation The motion was lost. scheme and who would lose by the new arrangements." Dr. LEES (Walsall) moved: " That in the opinion of Dr. MATHIAS said that there was in fact no detriment, this Conference the strongest representations be made in because those who opted out at the beginning of the protest at the recent ill-timed and arbitrary 'cut ' in scheme had a very much better bargain than those who superannuable remuneration." SUPPLEMENT TO THE 299 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES BRITISH MEDICAL JOURNAL Dr. MATHIAS said that in November, 1961, the was good abnormalities were diagnosed early enough Ministry stated that it would raise the cut in the assess- for the patient to be sent to hospital for observation and ment of net superannuable income from 30 to 35%, treatment. In these cases the doctor was not paid. because practice expenses were in fact running at Dr. DAVIES said that the motion was unfortunately something like 35%. That was true. For some time phrased. The basis of payment for maternity medical now the expense factor in the pool had been over 35%. services did not encourage bad midwifery. It could However, the B.M.A. had taken exception to the change encourage it if the bad practitioner put his financial being made at a time when it was negotiating with interest before the interest of his patient. He agreed another part of the Ministry to get the pension increased. that there should be no deterrent to the good doctor It might be thought that the Government had financed sending his patient to hospital early, and if the motion the pension increase out of the money which they had so were submitted to the G.M.S. Committee he was saved; but it was not so. It was the discrepancy prepared to take it to the Ministry once again. between what they were saving on the expense factor The motion was carried as a reference to the G.M.S. and the cost of the new arrangement that was costing Committee. £9m. Dr. H. CAMERON (Kent and Canterbury) moved: The motion was lost. "That in the opinion of this Conference, when a practitioner is responsible for the antenatal care of the patient-whether or not a hospital is also giving the MATERNITY SERVICES antenatal care-he should receive the whole of the fee Dr. DAViEs moved that the part of the report dealing of £7 7s." with general-practitioner maternity services be approved. He said that if a general practitioner booked one of In reply to a question he stated that the new arrange- his patients for delivery in hospital he did the ante- ments were likely to operate from the end of July. natal care until the patient was admitted in labour, yet Dr. M. SOLOMON (Liverpool) moved: when he claimed payment he found that £2 2s. was Period I fee of £7 7s. That deduction While regarding the recommendations (Appendix III to deducted from the the G.M.S. Committee's report to the Special Conference of was quite wrong. Dr. FRISKNEY (Lincs (Lindsey)) said L.M.C.s, 1960) as appropriate standards of good obstetric that because a patient was booked for admission to practice,? this Conference does not approve of these standards hospital the doctor was in no way relieved of his being rigidly applied as minimal requirements for the responsibility. Dr. H. B. MUIR (G.M.S. Committee purposes of remuneration. Upon certification by a doctor (Scotland)) also supported the motion. There were two that the services have been completed the appropriate fee classes of patients for which the general practitioner should be paid. Any gross failure to observe the standards shared the antenatal care with the hospital. There was should be dealt with by reference to the local obstetric the patient who was farmed out to the general practi- committee. tioner apart from one initial examination and one final He asked whether, when a doctor stated that he had examination by the consultant, and there was the patient rendered full maternity care, the implication was that whose antenatal care was shared equally with the he had performed five post-natal visits, which was part hospital. Those problems required to be looked at. of the original regulations. Dr. I. H. J. BouRNE (Essex) Dr. MCCONAGHEY (Devon and Exeter) pointed out supported the motion, and expressed deep concern at the that when a patient was sent to hospital to have, say, a atmosphere of clinical disagreement among general minor fracture set there was no reduction in the doctor's practitioners which the matter had engendered. capitation fee. When a patient went to hospital for Dr. DAVIES recalled that the G.M.S. Committee had confinement the function of the hospital was surely sent a letter to local medical committees explaining the consultative and there should be no question of a position under the new arrangements for maternity deduction of fees. services, and he quoted from the letter as follows: The motion was carried as a reference to the "When these arrangements have been effected a practi- Committee. tioner providing complete maternity medical services or Dr. H. W. DONOVAN (Birmingham) moved: "That complete antenatal care or care during the confinement or this Conference deplores the delay in informing the complete post-natal care will not be required to give details profession of the results of negotiations over maternity of attendances. Instead he will certify that in providing services. It is quite unjust to present such to the such services he has had regard to and been guided by Conference when local medical committees have had no modem authoritative medical opinion such as the advice opportunity of making their representatives aware of given by the Standing Maternity Midwifery Advisory their views." Committee in the memorandum on antenatal care under He congratulated Dr. Davies on the results of the Maternity Medical Services." negotiations on the maternity services, but said it was The motion was lost. wrong that the announcement of them should be made Dr. KNox (Tynemouth) moved: too late for it to be discussed by local medical com- That this Conference deplores the fact that the basis of mittees in time to frame motions for the Conference. payment for maternity medical services encourages bad The motion was lost. midwifery, and recommends that immediate steps be taken A motion in the name of Berkshire asking that proof to ensure that the general practitioner whose patient is copies of the new claim forms, E.C.24 and E.C.24A, admitted to hospital as an obstetric emergency in Period I should be vetted by all local medical committees before shall not gain financially by retaining that patient until she being accepted by the G.M.S. Committee was lost. is actually in labour. He said that if antenatal care was poor and an DEFENCE TRUSTS abnormality was not discovered early the patient was Dr. KATE HARRowER, deputy treasurer of the General admitted to hospital as an emergency and the practi- Medical Services Defence Trust and National Insurance tioner was paid. If, on the other hand, antenatal care Defence Trust, presented the report of the Trustees, SUPPLEMENT TO THE 300 1962 JUNE 23, 1962 300 JUNE 23, LOCAL MEDICAL COMMITTEES BRITISH MEDICAL JOURNAL together with a report of contributions received from Dr. E. G. WATSON (Birkenhead) moved: local medical committees up to March 31, 1962. That this Conference views with dismay certain recom- mendations circulated by the Royal College of Obstetricians DAIN FUND and Gynaecologists to some consultant obstetricians regard- The Chairman of the Trustees of the Dain Fund, Sir ing the classes of patients considered by them to be Guy DAIN, received a standing ovation when he unsuitable for general-practitioner maternity units. Such presented the report of the Dain Fund. classes include all primigravidae over the age of 30 years He said-that the Fund had filled an important position and all multiparae over the age of 35 years. in medical affairs. During the year ended April 30, It was, he said, particularly unfortunate that a recent although the number of applications to the Fund was provocative list of recommendations of the Royal slightly lower than in recent years, it was significant that College of Obstetricians and Gynaecologists should have the total amount of the grants made decreased by only appeared at a time when unity in the profession was of £440 on the previous year. The school fees of many of the greatest importance. Certain of the recommenda- the families being helped by the Fund increased during tions were acceptable, and some might be accepted with the past year and further increases in the near future reservations, but others were unacceptable. were indicated. Forty-two grants were awarded during The motion was carried. the year 1961-2 amounting to £4,715.. Sir Guy said that many messages of gratitude had been received from beneficiaries of the Fund, and the RURAL PRACTICES Trustees expressed their appreciation of the continued Dr. C. F. R. KILLICK (Chairman of the Rural Practices support of the Fund by members of the profession. Subcommittee) moved that the part of the report dealing They also wished to record their gratitude for the valued with rural practices be approved. co-operation of the Royal Medical Benevolent Fund and He recalled that the Conference last year passed the its Ladies' Guild and of the Royal Medical Foundation whole of the Rural Practices Scheme, and it had been of Epsom College. hoped that the scheme would have been implemented by April, 1962. The delay was not the fault of the Subcom- CLAIRE WAND FUND. mittee. There were certain details which had to be Dr. S. WAND presented the report of the Trustees of agreed upon before it could be implemented, and it was the Claire Wand Fund. He informed Conference that the understood that the Ministry had at last consulted Trustees were determined to conserve the capital and, if executive councils, who had stated that it would take possible, to increase it by investment or by further until April, 1963, to implement the scheme. The Mileage donation. During the past year there had been some Fund, or what was now the Rural Practices Fund, would further donations. remain at its full amount until then. During the past session, continued Dr. Wand, the Dr. H. J. HOUGHTON (Radnorshire) moved by way of Trustees had been advancing towards the projected amendment that the Rural Practices Fund be frozen permanent medical exhibition gallery at B.M.A. House. from April 1, 1962, and that the new scheme be It was a gap in Headquarters' facilities which the introduced retrospectively from that date. It was, he Trustees felt it desirable to fill. The establishment of said, difficult to see any reason why the scheme could the gallery was now being planned in some detail, and not start retrospectively from April 1. -the Trustees were proposing to make a contribution of Dr. KILLICK pointed out that some of the money had £1,000 towards it. been distributed. Practitioners had had their share of that particular fund as it originally stood. It would add MATERNITY SERVICES (continued) to the possible hardship caused to rural practitioners if Dr. DAVIES moved that the remainder of the report the money were frozen. " be The amendment was lost. under General Practitioner Maternity Services" Dr. A. K. RANKIN (Cumberland) moved that, before approved. the implementation of the revised scheme of distribution Maternity Co-operation Card of mileage moneys, local medical committees should Dr. KATHLEEN CORBISHLEY (Lincoln) moved an have the opportunity of considering in detail any amendment rejecting paragraphs 83 and 84 of the report material alterations or addition to the report of the of the G.M.S. Committee and directing the Committee Committee on the Distribution -of Mileage Moneys as to ensure that no universal maternity co-operation card accepted in 1960. He said he would be prepared to should be introduced. She said that the maternity withdraw the amendment if given an assurance that the co-operation card issued by the local health authority in scheme would be in the hands of local medical Lincoln was often unused, lost, or incorrectly used, and committees a considerable time before it was it was not considered a suitable document for a woman implemented. to carry. Personal contact, discussion, and the personal Dr. KILLICK said that there were no alterations in the letter of introduction from one doctor to another were scheme as agreed except for minor administrative points. more useful than the co-operation card. The amendment was lost. Dr. GOLDTHORPE (Southend) opposed the amendment. Dr. PERRY (Pembrokeshire) moved that maternity In his view, so long as the card was devised by the mileage should be calculated separately for Period I and G.M.S. Committee, in co-operation with any other Period II, and payment should be based on the patient's interested bodies, it would be useful. Dr. DAVIES said home address for Period I and on the place of confine- that the card was not intended to be mandatory. In the ment for Period II. He said that mileage was paid on interests of patients moving from one place to another a case basis and the distance was reckoned as from the it was desirable that there should be some degree of doctor's surgery to the patient's home. It was logical in uniformity. Period I that that should be so, but most women were The amendment was lost. confined in hospital and it often happened that the SUPPLEMENT TO THE 301 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES BRITISH MEDICAL JOURNAL distance to the hospital from the doctor's residence was in knowing what precisely was needed, the best way to considerably greater than the distance to the patient's plan them, the materials to use, and so forth, and home. Dr. F. M. RoSE (G.M.S. Committee) said that both the Dr. KILLICK said the question had been discussed College of General Practitioners and the Medical Practi- by the Mileage Committee, by the Rural Practices Sub- tioners Union had found a considerable demand for committee, by the G.M.S. Committee, and by the advice. Conference in 1961, when it was decided that the Dr. G. P. WILLIAMS (G.M.S. Committee), a member mileage should be paid from the doctor's residence to of the Group Practice Loans Committee, believed that the patient's residence. Some might gain by that and the proposed service would be of the greatest benefit. others might lose-it was a case of swings and It was a surprising fact that many architects knew very roundabouts. little about the design of surgery premises. Dr. PERRY, in reply, pointed out that so far as the Dr. DAVIES said that the Ministry was very interested swings and roundabouts were concerned it was the same in the proposal, but he wondered whether the doctors all the time who were gaining and the same profession would wan-t the Ministry to run the scheme doctors all the time who were losing. and to tell doctors how to run their practices. The The amendment was carried. G.M.S. Committee proposed that a steering committee be set up to consider all those points, and it must have Right to Continue Dispensing the right to look at all possible sources of money. Dr. WILSON (Norfolk) moved: " That this Conference Dr. MUIR (G.M.S. Committee (Scotland)) disputed considers that a dispensing doctor should retain the right the suggestion that a Ministry advisory committee would to continue dispensing for his patients if and when a direct practitioners how to run their practices. He did chemist starts a business in that doctor's practice area." not believe it for one moment. In his view there was There must, he said, be many cases of hardship a need for some committee to advise doctors on how occurring as a result of doctors being forced to give up to improve their surgeries, and if, the Ministry set up dispensing for some patients when a chemist opened such a committee doctors could either accept its advice up in the district. In one practice he quoted the loss of or refuse it. It would cost the profession nothing and dispensing for more than half the patients resulted in a would be a better way of dealing with the problem. considerable loss to the firm. Patients should have a Dr. M. E. ARNOLD (Middlesex) supported the motion. free choice in respect of dispensing. If a good scheme could be produced for practice The motion was carried. development the Ministry might be convinced that it would be a good thing if there were funds for the PRACTICE PREMISES development of practice premises readily available to the practitioner. Dr. DAVIES moved that the part of the report dealing A motion that the question be now put was carried. with practice premises be approved and the following Dr. D. L. WILLIAMS, in reply, said he agreed with recommendation adopted: what had been said about the need for such a service, That approval be given in principle to the establishment but the central pool was established for the purpose of of a Practice Premises Advisory Service under the control distributing doctors' pay and was not established as a of the G.M.S. Committee, and to the appointment of a convenient reservoir from which the G.M.S. Committee steering committee to formulate a scheme for submission could at any time take something like £20,000 per to the profession. annum. That was not the purpose of the pool. Dr. D. L. WILLIAMS (Denbigh and Flint) moved by Dr. DAVIES, in reply to a question from the hall, way of amendment that after paragraph 147 of the said that the money was not part of the pool. It was G.M.S. Committee's report (Practice Premises Advisory derived from the £100,000 per annum which had been Service) the words " provided that the money does not allocated to the Group Practice Loans Fund. come from the Central Pool " be inserted. He said that The amendment was lost. £800,000 was part of the pay of general practitioners Dr. G. M. DEWAR (Midlothian, West Lothian, East held back from them to finance the Group Practice Lothian, and Peebles) moved that a Practice Premises Loans Scheme. Sooner or later that money should be Advisory Service should include advice on record- returned to general practitioners from whom it was keeping. compulsorily borrowed. The amendment was carried. Dr. CARDEW (G.M.S. Committee) supported the The motion by the Chairman of the General Medical motion of the Chairman of the G.M.S. Committee, Services Committee was carried. because, he said, there was general agreement for the Dr. G. BARWELL (Middlesex) moved: "That this need of such an advisory service. If it were to remain Conference deplores the failure of the Government to under the control of the profession-which was essential grant tax relief on capital outlay on practice premises -the money must come from some medical source and and further deplores the refusal of the Ministry of not from the Ministry. There would be some advantage Health to support the profession in its approach to the in using some of the £800,000 because that money would Inland Revenue on this matter." never go back to the doctors who subscribed it in many He said that the fact must not be lost sight of that cases. Many of them had retired and some had died. many general practitioners, especially those in single- Dr. J. R. CALDWELL (East Sussex) said he did not handed ,practices and those not eligible for group understand the necessity for the service, and Dr. practice loans, would be only too willing to build new GOLDTHORPE (Southend) suggested that the matter was practice premises if given encouragement by way of tax one for the Annual Representative Meeting rather than relief on their capital outlay. the Conference. The motion was carried. Dr. RIDGE (G.M.S. Committee) said that many Dr. F. LISHMAN (Chairman of the Group Practice doctors had difficulty when building new surgeries Loans Committee) said that his Committee was not at SUPPLEMENT TO THE 302 JUNE 23, 1962 LOCAL MEDICAL COMMITTEES BRITISH MEDICAL JOURNAI. present hampered by lack of funds but was in some committee. The yardstick was there, and it was up to difficulty because £313,000 had been allocated and not practitioners to apply it. To abolish the scheme would yet taken up. It was somewhat astonishing that one be tantamount to admitting that doctors could not loan of £7,500, allocated in 1959, had not yet been taken administer it properly. up. He urged that there should be less delay in taking Mr. D. C. BOWIE (Chairman of the Trainee General up loans in the future. About 300 applications had Practitioner Scheme Advisory Committee) said that his now been granted and the total amount of money lent Committee had been reconstituted to look at the whole was £1,148,000, of which £328,000 had been repaid. trainee scheme. Unfortunately it had not been possible to present a report in time for the Conference. But a CERTIFICATION good deal of progress had been made, and he hoped Dr. DAVIES moved that the part of the report under that the report would be before the G.M.S. Committee "Certification " be approved. before the end of the year. The points made in the Dr. S. G. BUDD (Cardigan) moved: " That this Con- motion had been taken up by the advisory committee. ference deplores the recording of N.H.S. numbers on If the scheme were abolished there was nothing to put certificates for opticians and dentists; and that doctors in its place. are troubled unnecessarily in this respect." Dr. H. R. SHERIDAN (Middlesex) suggested that there Dr. GRAY (G.M.S. Committee) suggested that the was a shortage of prospective trainees, though the motion was unfortunately worded. No medical certifi- number of trainers had not fallen to the same extent. cate was required for a dentist, but it was necessary The quality of the trainees applying for appointments that the patient's number should be recorded on the had fallen very greatly. There were a number of foreign form which the dentist sent to the Dental Estimates graduates in this country who were not finding employ- Board. The Conference would not wish to interfere ment in the hospital service and who applied to be with the arrangements of a sister profession, and could trainees. Dr. WHITAKER (Surrey) said that the trainee not " deplore " the numbers being required. scheme was not started to find occupations for men A motion to pass to the next business was carried. who had nothing to do. It was one of the biggest votes of confidence in general practice in this country ever to REFRESHER COURSES be announced in Parliament. Dr. DAVIES moved that the part of the report under Dr. F. E. GOULD (G.M.S. Committee) said that the "Refresher Courses " be approved. conception of the trainee scheme had altered very Dr. G. S. R. LITTLE (London) moved the following considerably since it was first suggested by the Spens amendment: " That this Conference urges that the Committee. Its idea was that elderly doctors might in allowance for a locumtenent engaged during the this way have a grant to help them in their later years, absence of a principal on a refresher course be increased and that the scheme might be more on apprenticeship from 22 to 30 guineas per week to cover the increased lines than it was at present. Dr. Gould said that he cost incurred in the employment of a locumtenent and had never known a trainee assistant who had not been further that the amount of this allowance be constantly abused in his position as a trainee by being used as an under review." assistant rather than as a trainee. The trainee scheme He said that no one would get a locum for 22 guineas was not necessary. per week. 30 guineas was a reasonable amount. Dr. W. F. HUDSON (Oxford) recalled that when the Dr. DAVIES said if Dr. Little would accept the words scheme was started Dr. Gould had made a precisely "be substantially increased," he would take the matter similar speech in which he said more or less the same up. Dr. LITLE agreed, and the amendment, as things that he had just said, except he prefaced them modified, was carried. with the words: " This is what we will find." Dr. J. S. An amendment moved on behalf of Lothians and HAPPEL (Hampshire) said he had been a trainee and Peebles by Dr. G. M. DEWAR to the effect that the he had not been abused. He had also been a trainer special course for recent entrants to general practice and hoped that he had not abused his trainees. should include record-keeping within the subjects was The motion by Derbyshire was lost. carried. REMAINDER OF REPORT TRAINEE SCHEME Dr. DAVIES moved that the remainder of the report Dr. DAVIES moved that the part of the report dealing be approved. with the trainee scheme be approved. Dr. I. R. D. PROCrOR (Derbyshire) moved: "That Maximum Size of List this Conference calls for the abolition of the Trainee Dr. R. S. RUSSELL SMITH (Southampton) moved by General Practitioner Scheme." way of amendment: "That this Conference cannot He said that with the greater ease of acquiring accept that reduction of the maximum size of lists is practices the number of potential trainees would be wholly impracticable and that in view of the continually further diminished. Furthermore, more men would be increasing content of service means should be found to drawn into the armed Forces because of the revised reduce the maximum size of lists without loss of scale of pay. So far as trainers were concerned, there incomes." seemed to be difficulty in finding a common yardstick. The amendment was carried. Dr. H. S. HOWIE WOOD (G.M.S. Committee) suggested that a local medical committee that found it Service Commttee Procedur impossible to work the trainee scheme should be critical Dr. WYNNE THOMAS (Berkshire) moved: " That in the of itself. Dr. R. A. A. R. LAWRENCE (Derbyshire) said opinion of this Conference it should be the responsibility that in his view the trainee practitioner scheme was of the full medical service committee to refer a inherently good, and if there were difficulties the fault complaint for hearing under the service committee lay with the trainer selection panel of the local medical regulations and not that of the chairman alone." JUNE 1962 SUPPLEMENT TO THE 303 23, LOCAL MEDICAL COMMITTEES BRITISH MEDICAL JOURNAL It should be necessary for the chairman to consult near-unanimous hostility of the doctors providing such his committe9 on all cases before deciding whether services became fully known to our leaders and the Ministry. there was a prima facie case or not, he said. While G.P.s were still grappling with that monstrous new Dr. GRAY (G.M.S. Committee) said that the motion, form and dutifully recording their five post-natal visits, etc., if passed, would mean delay for all doctors. Further, the Royal Air Force advertisement for medical officers if the chairman did as was suggested in every case the (Journal, May 26, advertisement p. 1) had this telling phrase: " You will have full clinical freedom and your practice will committee would be giving a preliminary hearing in the normally include the families of serving members. absence of the doctor and would be very liable to be (my italics). This invites the question: How many Service prejudiced when it came to hearing the parties. M.O.s subject to Service discipline have ever had to conform The motion was lost. to anything like the ministerial direction their colleagues in general practice have hitherto had to when engaged in the obstetric care of "families" ? OTHER MAIlERS The contention that the consultant's contract with the Dr. J. J. HAYWARD (Wiltshire) moved: " That this regional hospital board is a contract " of service," that he Conference considers that the principle that a general is an employee, and "is engaged to obey his employer's practitioner be entitled to six weeks' vacation a year, and orders from time to time "-to quote Dr. Gorsky's inter- that the responsibility for paying and providing locum pretation-made Dr. Wrathall Rowe conclude (Supplement, tenens be that of the particular executive council, September 2, 1961, p. 133): "The truth is, I think . . . should be accepted by the Minister." we now have two entirely new legal animals. On the one hand, we have the consultant employed under a contract of Dr. A. BEAucHAMP (G.M.S. Committee) pointed out service who is not controlled by his masters, and, on the that executive councils had no money out of which the other hand, we have the G.P. subjected to a mass of regula- grant could be paid. Furthermore, if the motion were tions imposed by the Minister...." The picture of our passed, the Conference was on the way towards changing consultant brethren groaning under the yokes of the regional the status of general practitioners from that of indepen- hospital boards, tied by their "contracts of service," and dent contractors to the Minister to servants of the hauling a band-wagon of " merit awardees "-in purdah Minister. of course-complete with nursing and ancillary staff, the The motion was lost. whole pushed by a bevy of holiday and sick locums (if available) must be viewed in a light other than Gilbertian or purely comic. But if that is the nadir of whole- or part- Nurses' Pay time " salaried serfdom" in the National Health Service The Conference supported in principle a resolution of then no G.P., like your correspondent Dr. J. F. O'Neill the Council declaring support for the nurses "in their (May 19, p. 237), need fear the bogy-man. struggle against the unjust application of the Govern- Two things surely must be made plain. The G.P.'s status ment's pay restraint policy to their claims " (Supplement, as an apparent " independent contractor" in the N.H.S. May 12, p. 217). must be exposed for the fiction which it is. It has been nullified in practice by ministerial direction and statutory On the motion of Dr. G. BARWELL (Middlesex), a vote instrument. No must he work slave to illusions was longer (a of thanks to the Chairman, Dr. C. J. SWANSON, of independence if nothing else) in a crypto-salaried service carried by acclamation, and the Conference terminated carrying the economic burdens of which 99% belong rightly at 6 p.m. on June 7. to the State. The second fiction which must be exposed is that the G.P. would, somehow, be providing a " different" sort of service were his contract one " of service" and not " for services." Different, presumably, in quality. Since Correspondence the Government are anxious to foist merit awards on G.P.s the gap between these two forms of contract becomes Because of heavy pressure on our space, correspondents are smaller still (were the contracts similar, perhaps the ratio asked to keep their letters short. of the awards would be too ?). In the plainest of language, if the provision of adequate premises, of ancillary staff, and Doctors and the State so on makes the consultant if'anything less and not more subservient to State interference than his G.P. colleague has SIR,-The tenor of the correspondence in your columns been shown to be in the immediate past, then the sooner during the past six months, and more recently especially, our leaders seek a similar type of contract for us the better. renews my astonishment that the important letter from Dr. If full clinical freedom is now assured in cold print to J. B. Wrathall Rowe (September 2, 1961, p. 133) produced our Service colleagues it should not be beyond the scope no response. Close readers of the Supplement will recall of our leaders to negotiate similar safeguards in fresh that for two years Dr. Wrathall Rowe has been trying to contracts with the executive councils and the Minister. If secure a high authoritative legal answer to the very we stagnate in the status quo, as Dr. Rowe has been at fundamental question which he asked (Supplement, August pains to point out, the story might be different next time, 5, 1961, p. 115): "Are we so very sure that the general when another "package" labelled "For increased content practitioner is not already a whole-time salaried medical of service" is laid on our doorstep. It is time the position servant of the State ?" of the G.P. vis-a-vis the State employer was clarified beyond For two years at the A.R.M. Dr. Wrathall Rowe and the dispute. From his anomalous status stems, I believe, much rest of us have had to remain content with the official reply of the discontent, misunderstanding, and-who knows ?- that the Association's solicitor considered that the general headlong flight from general practice from these shores. practitioner's contract in the N.H.S. was " for services " and Let us hope that at the next A.R.M. sufficient courage not a contract " of service" and therefore he remains an and support will be forthcoming to exact from our leaders " independent contractor." Your readers may also recall the an undertaking to secure the highest possible legal inter- late Dr. J. A. Gorsky's interpretation (Supplement, August pretation of the present standing of the G.P. with his 19, 1961, p. 127) of this legal casuistry which made him monopoly employer. Whence, one hopes, one may then conclude: "The independent contractor, in other words, is proceed in stages to a full revaluation of the G.P.'s worth bound by the contract and not by the orders." (The italics to the community to-day, not forgetting-which the Royal are his.) " Not by the orders " indeed ! We have just seen Commission certainly did-the subsidized help of the G.P.'s the successful withdrawal of some very high-handed wife.-I am, etc., " orders " in respect of the maternity regulations when the Royston, Yorks. M. E. TAPiSSIER. SUPPLEMENT TO THE 3(4 JUNE 23, 1962 ASSOCIATION NOTICES BMsrISH MEDICAL JOURNAL difficulties arise if he is to await the result of the laboratory Selection for Practice Vacancies examination of body fluids. (1) Is the accused to be SIR,-Probably not many of your readers have attended detained by the police until the result of the analysis is an oral hearing of appeals regarding practice vacancies. I known; or (2) is the accused to be permitted to return to have attended such hearings as an unsuccessful appellant on his car and drive it if the doctor is unwilling to say, " This two occasions, and I would certainly do so again if I felt that man is unfit to drive" ? my claims to selection had not been accorded fair and just Dr. Hirsh gave no reply to these questions.-I am, etc., consideration and the Minister saw fit to arrange an oral CHARLES H. JOHNSON, hearing after receiving a notice of appeal. Both the selec- Honorary Secretary, tion committees and the Medical Practices Committee are London N.19. Association of Police Surgeons of . doubtless fair and impartial, and they would gain nothing by being otherwise, but there is just a remote possibility that the former committee- may be swayed by personal Association Notices considerations, especially if some of its members are acquainted with some of the applicants. The M.P.C. Diary of Central Meetings consists mostly of doctors, and usually accepts the choice JUNE of the selection committee. 25 Mon. Joint Consultants Committee, 10.30 a.m. In order to prevent doctors from building "Chinese 27 Wed. Council, 10 a.m. walls" around themselves, as the late Aneurin Bevan put it, 28 Thurs. Committee on the Increase of V.D. particularly amongst Young People, 10.30 a.m. there must exist an impartial lay authority, which cannot be 29 Pri. Tuberculosis- and Diseases of the Chest Group outvoted at a meeting, to ensure that justice is always done. (at Common Room, St. John's College, Rare occasions may arise when the Minister, often accused Oxford), 5 p.m. by us of being a dictator and/or an interloper, would have JULY to rescue a doctor from his colleagues, as the High Court 4 Wed. Staff Side Committee C, Medical Whitley Council, has had to rescue doctors and at least one dentist from the 11 am. verdicts of their disciplinary committees. Furthermore, the 4 Wed. Full Committee C, Medical Whitley Council (at 14 Russell Square, London W.C.), 2 p.m. Minister must have the last word in the matter, as he is 5 Thurs. Rural Practices Subcommittee (General Medical responsible to Parliament and may have to answer questions Services Committee), 2 p.m. there about any practice vacancy.-I am, etc., 5 Thurs. Subcommittee on Spa Booklet (Physical Medicine Group Committee), 3 p.m. London E.l0. BRIAN HILL 6 Fri. Welsh Committee (at Board Room, Royal Salop Infirmary, Shrewsbury), 2.15 p.m. Fee for Attending Road Accidents 10 Tues. Film Subcommittee (Committee on Medical Science, Education, and Research), 1 p.m. SIR,-I recently attended an accident in which a lorry 12 Thurs. G.M.S. Committee, 10.30 a.m. driver was trapped in his overturned cab. With great 12 Thurs. Joint Formulary Committee, 11 a.m. difficulty I managed to reach him and give him an injection 19 Thurs. Annual Representative Meeting (at Belfast), 10 a.m. of morphine. After two hours he was released and I 20 Fri. Annual Representative Meeting (at Belfast), examined him and sent him to hospital. I eventually received 9.30 a.m. the magnificent sum of 12s. 6d. Is it not time that this fee 21 Sat. Annual Representative Meeting (at Belfast), was increased ? It has remained at 12s. 6d. since 1934.-I 9.30 a.m. am, etc., Branch and to be Hodnet, Salop. K. J. HARVEY. Division Meetings Held Honorary Secretaries of Branches and Divisions are asked Merit Awards for G.P.s to send notices of meetings to the Editor at least 14 days before they are to be held. SIR,-Why not merit awards by examination ? Why not CAMBERWELL DIvIsIoN.-At St. Giles's Hospital, Tuesday, let all doctors sit a shortened form of M.B., Ch.B. " finals " June 26, 8.30 p.m., discussion to be opened by Dr. H. B. Wright: examination every 10 years ? Those who pass to carry on "Periodic Medical Examinations." practising ; those who fail to go back to school, even if only DUDLEY DIVISION.-At Nurses' Lecture Theatre, The Guest Hospital, Dudley, Tuesday, June 26, 9 p.m., Dr. H. W. part time; those who pass with honours to get a merit Chadfield: " Corticosteroids in Dermatological Practice." award, whether in general practice or in other work.-I am, FINCHLEY DIVISION.-At Bull and Butcher Hostelry, Whet- etc., stone, Tuesday, June 26, 8.30 p.m., annual general meeting. H. M. DENHOLM-YOUNG. HARROW DIVISION.-At Fellows' Restaurant, Zoological Dartford, Kent. Society of London, Regent's Park, London N.W., Saturday, June 30, 7.15 for 8 p.m., annual dinner. Guest speakers: Mr. Certificates in Drunken Driving Cases A. Lawrence Abel and Dr. D. P. Stevenson (Secretary, B.M.A.). MID-HERTs DIVISION.-At Medical Staff Centre, St. Albans SIR,-The correspondence columns of the Supplement City Hospital (Normandy.Road), Friday, June 29, 8.45 p.m.. are not the place to instruct medical practitioners, especially annual general meeting. appointed police surgeons, in their proper function in the SOUTH BEDFORDSHIRE DIVISION.-At Chandos, Crescent Rise, examination of persons arrested for driving under the Luton, Saturday, June 30, 8 p.m., summer party. SOUTH-EAST Essex DIVISION.-At Lindisfarne School, Satur- influence of alcohol, but I must correct two false statements day, June 30, 3 p.m., annual B.M.A. children's party. in Dr. B. Hirsh's letter (June 16, p. 281). SUFFOLK BRANCH.-At White Lion Hotel, Aldeburgh, Wednes- The president of this association, Dr. Robert Hunt Cooke, day, June 27, 1 for 1.30 p.m., lunch, followed by annual meeting. TOwER HAMLETS DIvIsIoN.-At St. Andrew's Hospital, Devons gave Dr. Hirsh a generous hearing at our annual general Road, Bow, E., Friday, June 29, 3 p.m., Mr. A. J. Walton: meeting last month. The motion found no supporters and "Some Aspects of Surgery of Interest to the Family Doctor." was lost by a unanimous vote. Our members have always WEMBLEY DvIVSION.-At Wembley Hospital, Fairview Avenue, fully concurred with the B.M.A. report Relation of Alcohol Wembley, Tuesday, June 26, 8.30 p.m., clinical meeting. All medical practitioners in the area. of the Division are invited. to Road Accidents and continue to do so, including the WEST MIDDLeSEX DIvIsIoN.-At 3 Ascott Avenue, Ealng, desirability of having tests of the alcohol content of-blood Iondon W., Saturday, June 30, 6.30 p.m., cocktail party. Guests or urine carried out by properly trained and e'xperlenced are invited. forensic chemists. We do not support the view that an WEST SUSSEX DIvIsION.-At 2 LongfeUow Road, Worthing, Sunday, July 1, 3 p.m., general meeting. opinion formed as the result of a clinical examination, even WILLESDEN DIVISIoN.-At Willesden General Hospital, Tues- in a police station, should be withheld until the report of day, June 26, 9 p.m., Dr. Horace Joules, Dr. A. N. Mathias, and the forensic chemist is available. This is moral cowardice others: " The Effect of the Hospital Plan on Willesden and its on the part of the examining doctor. Hospitals." Guests are invited. YORKSHIRE BRANCH.-At the Guildhall, York, Thursday, June Should the examining doctor be unable to give an opinion 28, 2.15 p.m., annual general meeting. Presidential. address by resulting from his clinical examination alone two practical Dr. D. A. Geddes-Brown: " A Decorum of Doctors-1862."