Medicine: The Nationalized Doctors

Prime Minister Harold Macmillan wrote a prescription last week for the general practitioners who keep Britain's socialized National Health Service running: a 5% increase in their pay. The doctors scoffed at it as merely soothing syrup, incapable of curing their deep-seated financial ills.

Ever since Britain nationalized its health services in 1948, doctors have been happy over the fact that they do not have to bother sending and collecting bills. But they have been sharply discontented about their own pay. Of the nation's 40,000 doctors, all but 700 signed up for the National Health Service; 18,000 work full time in hospitals, more than 21,000 as family doctors. The family doctors serve patients (up to 3,500 on a single doctor's panel) for a fixed per-capita fee, paid by the state, of $2.38 a year regardless of how much service the patients need. Since their one pay raise in 1951, the G.P.s have averaged only $6,221 a year from N.H.S. (for cruelly long hours, including night calls); most pick up a few hundred more in special fees or by working for industry. Last summer the powerful British Medical Association and its trade-union shadow, the British Medical Guild, decided that something must be done. They drummed up doctors' indignation, presented the government with a demand for a 24% across-the-board increase. Trying to check Britain's wage-price spiral, the government flatly refused.

The doctors' organizations began to threaten a strike. It would not be a real strike—physicians would keep on treating patients, but they would sabotage the N.H.S. by refusing to sign certificates enabling patients to draw sick pay, by pulling out of all N.H.S. committees, and by charging fees as in pre-N.H.S. times. The suggested five-shilling fee aroused some doctors' hopes (see cut). The government still said no and appointed a Royal Commission, which could spend months looking into the matter.

Last week's interim raise of 5% for G.P.s and dentists was designed to stave off mounting anger among doctors, but it settled nothing. The chairman of a doctors' negotiating committee who favored accepting the government's plan was forced by angry colleagues to resign. Britain's doctors carried on—overworked as usual—hopelessly divided among themselves as to the best tactics to pursue, but unanimous in feeling underpaid.