Scot.

moo J 1975, 20:, 201

THE SCOTTISH SOCIETY OF PHYSICIANS * H Conway Royal Alexandria Infirmary, Paisley

year we enter new territory by meeting T in Oban. It is appropriate that this dis-

the Beaton family, we have and always have had, the royal physicians in Scotland in our tinguished Society should come to Oban, for membership. Our roll contains international just across these waters in the Hebridean authorities on many subjects and not a few islands mainly Islay, Mull, Skye and the world-wide travellers of great medical repute. Uists, there dwelt for centuries successive Carlyle recorded that in the second half of generations of the most outstanding medical the eighteenth century a club met once a week family in Scottish history:-the Beatons or in London in a coffee-house in the Strand. MacBeaths. Through these physicians, for The members were Scottish physicians of the four hundred years from the beginning of the city and court and William Hunter was fourteenth century the Lords of the Isles and credited with the toast 'May Scottish medicine associated nobles subsidised what was in retain its honoured place in the sphere of effecta Highlands and Islands medical service. scientific progress through the ages, and In return for grants of land and other perquis- throughout the world'. I believe that at this ites, at least one son had to be trained in the time our physicians are not failing him. What of the events of the recent past? medical arts, and from 1512 their names appear on the roll of the University of They can be summarised in two words, Glasgow. Their renown was remarkable, and reorganisation and demoralisation. There their success with herbs as extraordinary as may be conflicting views whether these their therapy courageous. They observed occurrences are connected. As for reorganisaLewis Carroll's precept : 'You've no idea tion, some may agree with the sentiment what a difference it makes mixing it with other expressed in a misquotation of the well known things such as gun-powder and sealing wax'. rhyming couplet: But they were not just quacks. They were 'Across the wires the electric message came, abreast of the science of their time and have It is no better, it is much the same.' left a legacy of Gaelic manuscripts including But a correspondent in the Financial Times a translation of the aphorisms of Hippocrates.' last July was more forthright. I quote: 'This Over the centuries, they compiled a medical reorganisation will probably go down in vade-mecum comprising translations of foreign history as a classic example of how to shake work and personal comments and observa- morale to its very foundations in an organisations. Prevention of illness is stressed, and tion in which morale is the greatest single there are dictates such as 'have a cheerful asset, in pursuit of dubious and possibly unmind and moderate diet and take exercise'. attainable objectives'. Caius Pretonius So prominent was this family of physicians Arbiter, a Roman Governor at the time of that at least one representative was in Nero, said 'we trained hard, but it seemed attendance during the illnesses of all the every time we were beginning to form teams sovereigns of Scotland from the time of we were reorganised. I was to learn later in Robert the Bruce until James VI went to the life that we tend to meet every situation by English throne. Indeed, it is recorded that reorganising and a wonderful method it can James took with him to London one James be for creating the illusion of progress while Beaton because he was s 'skilled empiricist'. producing confusion, inefficiency, and deJust as the Beatons strove for excellency in moralisation'. So spoke Caius Petronius their time, so does this Society believe in the Arbiter. quality of excellence in medical practice. Like For some considerable time our political "Toast of the Society at the Annual Meeting, Oban masters have had no confidence in the ability of consultants to supervise the hospitals and 1974. HIS

The Scottish Society of Physicians

one of the purposes of the new system is to do this more efficiently and at less cost. But we have heard such idealistic statements before. We must wait and see. At the time of the last reorganisation in 1948 we were told that the National Health Service would reduce sickness and therefore pay for itself. But these halcyon days soon passed and the economic exercise of financing the service has now become like the labour of Sisyphus. Dr Peter Taylor, Chief Medical officer of the Post Office, recently concluded that the more money is provided for the health service the more sickness results and at the present time the cost of sickness absence to the British economy is similar to the entire expenditure on the National Health Service. The decline of morale in hospitals is very serious. I think it dates from 1966 when the general practitioners had their grievances recognised. This altered in a subtle way the traditional relationship between consultants and general practitioners. Then we watched with interest the conception and gestation of the community physician and wondered how he would develop. Now even the Glasgow

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Herald recently referred to the administrative doctors as the top doctors. We all recognise the importance of the physician who studies health needs in the community, but I hope that community medicine does not become too closely identified with administration. Surely, community medicine and administration are not synonymous. The malaise which affects hospitals, compounded by many factors, not least the Salmon structure of nursing, has resulted in falling standards which worries greatly the members of this society-a society dedicated to the maintenance of high standards. We must stand up and fight to restore the level of practice which we accepted as normal in the past and we anticipate the time when young doctors will once again be proud to become consultants. Longfellow, plagiarising Euripides, said: 'Whom the gods would destroy they first make mad'. If he had been alive today he might have said whom the gods would destroy they first reorganise. A C K NOW LED GEM E N T. For information about the Beaton family, I am much indebted to Dr Martin Whittet of Inverness.

The Scottish society of physicians.

Scot. moo J 1975, 20:, 201 THE SCOTTISH SOCIETY OF PHYSICIANS * H Conway Royal Alexandria Infirmary, Paisley year we enter new territory by meeting...
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