SUPPLEEM1E\ NT TO THE BRITISH MEDICAL JOURNAL. LONDON: SATURDAY, MAY 28TH, 1904. CONTENTS. Page. Page Lancashire and Cheshire Brancll: Altrincham Division I MEDICAL ACTS AMENDMENT BILL: '34 ,, ,,9Blackburn Division '35I Vlr-n A vT A XnnorMkff%nD A M T%TTs.r IJtLPAl.NAUTORY lVlZ0lANUMdsy............................ 125. = Leinster Branch ... ... '35I REVISED DRAFT OF BITr L ... 27 Metropolitan Counties Branch: Chelsea Division ... '35I SCHEDULE I ... ... ... 131 City Division ... 136 PROCEEDINGS OF STANDING COMMITTEES: St. Pancras Division ... 136 Walthamstow Division I36 MEDICO-POLITICAL COmmixrEE.-National Deposit Friendly Society 132 Wandsworth Division 136 REPORTS OF BRANCH MEETINGS: Midland Branch: Leicester Division ... ... I40 Birmingham Branch: Coventry Division .,. ... ... r33 Oxford and Reading Branch ... 340 ... Dorset and West Hants Branch ... ... ... ... 133 South-Eastern Branch: Eastbourne Division 140 Edinburgh Branch: South Edinburgh Division ... *-* 133 it ,, Reigate Division ... ... 140 Glasgow and West of Scotland Branch: Glasgow Southern Division 134 Southern Branch: Isle of Wight Division 140 Gloucestershire Branch ... ... ... ... ... 134 LUNACY ACTS AMENDMENT BILL ... 140 measure should be laid before Parliament by the British Medical Association until time has been allowed for all the %nttsbgettrat Sso"at*m consideration necessary not only to perfect every detail of the proposals made, but also to secure the greatest attainable agreement in the profession. MEDICO-POLIT[CAL COMMITTEE. 6. The Committee therefore recommends to the Representa- tive Meeting that after matters of principle have been deter- REVISED DRAFT OF mined by the approaching meeting at Oxford, the Bill should be referred back to the Committee for further consideration of details and points of drafting, and submitted again to the MEDICAL ACTS AMENDMENT BILL Divisions with a view to final consideration, rand adoption WITH if approved, by the Annual Representative Meeting of I905. 7. If the Divisions approve the foregoing recommendation EXPLANATORY MEMORANDUM. they may find it sufficient at the present stage to give such consideration to the Bill as will prepare the way for a de- MEMORANDUM. cision of the principles thereof. 8. The Committee, for the assistance of Divisions in con- THE Medico-Political Committee in again submitting the sidering the Bill, has authorized the preparation of the Medical Acts Amendment Bill for the consideration of the Memoranda presented herewith, (I) to explain the principles Divisions, preparatory to an expression of opinion thereon by on which the Bill is based, (II) to explain the principal points the Annual Representative Meeting at Oxford, begs to report of difference between the Bill as submitted to the Divisions as follows: in August last and as now submitted. i. As the result of the preliminary discussion of the original draft Bill by the Divisions, consequent upon the circulation THE BILL. of the Bill by order of the Council in August, 1903, expressions I.-PRINCIPLES OF of opinion were received by the Committee from iog Divisions, A.-GENERAL REMARKS. prior to April I3th, when the Committee commenced the I. Purpose and Form ofthe Bill.-The Bill being framed for work of revision. the amendment of the Medical Acts, is drafted in such form 2. The Committee has given the most careful attention to as to be construed with those Acts. From this principle of the replies of the Divisions, and in revising the Bill has construction it follows: adopted (a) those changes in the draft previously submitted (a) That it is not proposed to repeal any of the Medical which have appeared to the Committee to be generally de- Acts except so far as may be necessary to bring these Acts sired; (b) many valuable suggestions made by individual into agreement with the Bill. Divisions on points of detail. (b) That provisions which are contained in the Acts are not 3. The Committee has also taken into consideration, and in repeated in the Bill except when needful for clearness, as, for many instances adopted, amendments in the Bill which have example, certain provisions as to nomination of members of been put forward by the British Dental Association. The the General Council by the Crown. circumstances in which such amendments received considera- (c) That terms, such as "the General Council," which are tion from the Committee are stated in the proceedings of defined in the Acts, are used in the same sense in the Bill, the Committee, published in the SUPPLEMENT of the BRITISH without further definition. MEDICAL JOURNAL of May 7th, 1904 (PP. io8 and Io9). 2. Provisions as to Dentists.-In the Bill the precedents of 4. The Bill as amended by the Committee has been sub- the Medical Acts of 1858 and I886, which included provisions mitted to an expert Parliamentary draftsman and by him affecting both the medical and dental professions, have been recast into its present form. followed, in preference to that of the Dentists' Act, 1878, 5. The Committee is of opinion that in a matter of such which affected one profession only. If this principle receives consequence to the medical profession as an extensive amend- the approval of the British Medical Association, as it has ment of the Medical Acts it is highly desirable that no that of the British Dental Association, and if it is sanctioned by (20) 126 s u_zcALoux=] MEMORANDUM ON DRAFT MEDICAL ACTS AMENDMENT BILL. IMAY 28, I194. a Parliament, the legislation affecting the constitution, duties, The necessity for this proposal is shown by the following and powers of the General Medical Council will be brought considerations: into more convenient form for practical purposes. (i) The present income of the General Medical Council is 3. Arrangement of the Bill.-ihe Bill is divided, for con- insufficient for its present expenditure, and even venience of reference, into Parts, each of which relates to a under the existing law the work of the Council is definite group of reforms. In each of the following Sections crippled by want of funds. of this Memorandum one Part of the Bill is dealt with. (ii) The provisions of the Bill as to the increase of B.-CONSTITUTION OF THE GENERAL COUNCIL (PART I). direct representation, as to the conduct of final exa- The principles underlying thig Part of the Bill are: minations by the Council (the " one-portal system "), i. That the representation of the Crown on the Council and as to the prohibition of unqualified practice, should remain unaltered. making it the duty of the Council to protect the pro- 2. That those existing universities which have medical fession and the public by enforcing the penal clauses faculties should be represented on the Council, and that, as (Part V), will entail considerable increase of expend- such representatives sit on the Council primarily as educa- iture. Such expenditure will be in the interest of tional experts to advise the Council in its duty of controlling the profession as well as of the public, and the only medical education and examinations, each university should funds out of which it can be defrayed are those derived be permitted to appoint its representative in such manner from medical and dental registration fees. as it may deem most expedient. (c) The privileges conferred by registration upon medical 3. That inasmuch as the medical corporations, with one and dental practitioners in respect of their practice are clearly eXception, are not educational bodies, and no longer discharge defined, the anomalies and injustice of the existing law being those functions on behalf of the medical profession for which removed. Among the privileges of medical registration it is their charters were originally conferred, they should not be proposed to include the right to use the style of " doctor" as represented on the Council on an equality with the uni- a prefix to the name, thus recognizing by statute the customary versities, but that their historic position should be recognized usage of the public in reference to medical practitioners, and by representation in a reduced degree. doing away with distinctions which the great differences in 4. That the direct representation of the medical profession status of nominally equal qualifying examinations have should equal that of all the bodies above named, and that, rendered arbitrary and unjust. to secure adequate representation of every part of the United Kingdom, a topographical method of election should be adopted. E. EXAMINATIONS (PART IV). 5. That the principle of direct representation on the The principal ehanges in this Part of the Bill are: Council should be extended to the dental profession. I. The institution of the " one-portal " system for admis- Other amendments have been included in this part which sion to both the medical and dentists' registers, by means of are consequential on the foregoing or will simplify the pro- final (State) examinations under the absolute control and cedure of election. sole management of the Council. Statutory provision is proposed for the election of a Vice- 2. Definite statutory provision for complete control by the President of the Council. Council of the medical curriculum, beginning with the pre- liminary examination, and for the effective supervision and 0.-BRANCH COUNCILS AND FINANCE (PART II). control of the intermediate examination, subject only to a The objects of this Part of the Bill are: possible appeal by examining bodies to the Privy Council. i. To simplify the administration of the Council, andreduce expenditure by doing away with the cumbrous machinery consequent upon the Branch Council system provided by the F.-OFFENCE5 (PART V). Act of I858. Experience has shown (a) that no advantage The provisions of this Part fall under the heads of (i) those results from the division of the work of registration; (b) that affecting registered persons, whether students or practitioners, apart from registration no duties devolve upon Branch Coun- (2) those affecting unregistered persons. cils which could not be performed equally well by the Com- (i) As regards offences by registered persons: mittees proposed under the Bill.