Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others.
- Date:
- 1870
Licence: Public Domain Mark
Credit: Report of the sub-committee appointed to consider the means by which the abuses of the Out-Patient Department of General Hospitals may best be remedied / [A. Meadows and others. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
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![on payment, it is obvious that the workman will avail himself of the privilege when and as he pleases, even though suffer- ing under slight complaints. In this case, regarded from a professional ])oint of view, the business of the general prac- titioner, who is willing and competent to attend these classes on terms suitable to their means, is practically transferred to the consultee, and every farthing paid to the hospital managers will be regarded by the latter as an abstraction from his legitimate source of income. Moreover, if the prin- ciple of admission by payment be once admitted, it follows, as a logical consecjuence, that the members of the staff are entitled to a share of what is ])aid, in which case they enter into personal competition with the general practitioner, with the special advantage of having the subscriptions of the bene- volent to back them up. Reformed as we propose, the out- patient staff will, howevei', be strictly legitimate. The assistant physicians and surgeons will aid the general prac- titioners in all suitable cases, and instead of the general prac- titioner regarding the assistant staff with suspicion, because they lure away his patients, he will look to them as friends. The Sub-committee are of opinion that the reform of the out-patient department, as proposed, will render the work of the staff less onerous and more interesting. The improve- ment in the position of the assistant staff in respect to clinical teaching, together with the improved relationship between the consultees and the general practitioner, which would certainly lead to more frequent consultations between them, would generally prove to be more profitable sources of income than any which the managers of hospitals could generally afford to give. At the same time, the Sub-committee think that a moderate remuneration of the out-patient staff, rather by way of honorarium than of pay representing the work actually done, would be a proper and most desirable thing. It would often enable, or at least assist, men of high professional attain- ments but small means to take hospital appointments, and enter upon’ consulting practice in London, to the great advan- tage of the profession and the public. In conclusion, the Sub-committee are quite aware of the great difficulties and obstacles which are likely to obstruct reform. Much objection will doubtless be raised against the great restrictions which these proposals will involve. But it is obvious that no reform ean be effected worth the name, unless by perfecting the Poor Law system of medical relief we take away every excuse for unlimited gratuitous assistance to the poor, and put such a moral pressure upon the artizan and labouring classes, as will make it incumbent upon them to](https://iiif.wellcomecollection.org/image/b22472460_0017.jp2/full/800%2C/0/default.jpg)
