1102 Mrs Barbara Castle, the Social Services Secretary, argued that because she had not used her power of authorisation to whittle away pay beds by administrative means, preferring instead to leave the decision to Parliament, so the medical profession in its turn must be ready to accept the will of Parliament. Mrs Castle sought to present herself in the guise of a moderate on the paybeds issue, caught between two opposing extremes. There was the medical profession totally opposed to the proposals; the nurses who, while not opposing the principle of phasing out, wanted agreement reached with all the parties ("a difficult remit", said Mrs Castle); and the T.U.C. and unions active in the N.H.S. who wanted the Government to go further and abolish private medicine altogether. Though firm in her resolve to implement what she reminded the House was an election promise, Mrs Castle appeared much more flexible when it came to the details of her legislation. She was anxious to continue consultations with the medical profession about the timing of the phasing-out of pay beds: this must be reasonable to ensure that those who wished to practise privately were able to continue to do so. "As a good trade-unionist, I recognise that all who serve the N.H.S. have the right to have their essential interests safeguarded", she declared. As a result, she was ready to discuss whether the method she was proposing for licensing private practice was the right one. The Government was convinced that real benefits would flow from the separation of private practice from the N.H.S. Resources of staff and facilities equivalent to those required for four district general hospitals would be released for the benefit of N.H.S. patients. Indeed, in a recent Parliamentary reply, Mrs Castle estimated the capital cost of providing a afresh between 2500 and 3000 beds at between 60 million and 70 million. "Separation not abolition" was the message which Mrs Castle once again attempted to put over. But she also admitted that some Labour M.p.s might disagree with her aim of helping to safeguard the right of private practice. Unfortunately, Labour M.p.s neither agreed nor disagreed, since they had chosen this debate to stage a boycott of the Commons in protest at the Government’s decision to send a Cabinet Minister to Franco’s funeral. The result was domination of the debate by Conservatives and they made no secret of their belief that Mrs Castle was the reason for much of the current strife and turmoil in the Health Service. "Calamity Castle" was what Mr Norman Fowler dubbed her. He believed the abolition of pay beds would further lower morale in the N.H.S., encourage emigration by doctors, and provoke fresh confrontation. It was nonsense to speak of extra beds being made available, since these were often in areas of the country, such as the south-east, where they were not needed and where at the moment several thousand N.H.S. beds were not being used because of staff shortages. He pledged the Conservatives not only to fight the policy in Parliament with every legitimate weapon at their disposal but also to repeal the proposals if they became Law, when the Tories were returned to power. Mr Fowler also voiced Opposition fears about Mrs Castle’s proposed licensing system, claiming that she wanted the private sector to remain a cottage industry. Would licensing be by quality as well as quantity? But his real doubt was whether Mrs Castle had the determination to resist demands for the total abolition of the private sec-
"Will she fight and fight again for the preservation of the private sector?" It was no surprise that the private sector should be the main theme of a debate which revolved around the Government’s legislative proposals this session. After all it was only a month since M.p.s last debated the affairs of the N.H.S. But it meant that precious little attention was paid to the less glamorous, less strife-torn areas of the Service. It was left to Dr David Owen, Minister of State, to touch on some of them and to hint at painful decisions now being made to cut back Health Service spending. One area being looked at for restrictions was the massive pharmaceutical budget which faces the N.H.S. each year. There was also the difficult exercise of switching resources from one region of the country to tor.
lately recommended by a departmental working-party.’ It would not be easy to switch revenue from the four London metropolitan regional authorities and Merseyside to other less well-off regions. No deanother,
as
cisions had been made and there would have to be ful consideration locally before any moves began. 1. See Lancet,
Oct. 18, 1975, p. 753; Br. med. J. Oct. 11, 1975, p
care-
66
Obituary THOMAS VIBERT PEARCE M.D. Lond., F.R.C.S. to the Hargroup, died on Nov. 12 at the age of 75. Before beginning his medical studies he served in the
Mr T. V.
rogate
Pearce, formerly senior surgeon
hospital
as a pilot. He graduated M.B. from St. Thomas’s Hospital Medical School in 1923 and M.D. in 1931; he became F.R.C.S. in 1928. After house-appointments at St. Thomas’ Hospital and St. Giles’ Hospital, and a period as resident surgical officer at the Royal Northern Hospital, he moved, in 1932, to Harrogate, where he became surgeon to the Harrogate and District General Hospital, and to the Royal Bath Hospital and Ripon Hospital. He was secretary of the Harrogate Medical Society for 5 years, being president in 1954, and chairman of the Harrogate division of the British Medical Association in 1949 and president of the Yorkshire branch in 1954. He was also president of the section of surgery when the annual meeting of the B.M.A. was held in Harrogate in 1949. Mr Pearce took pride in being a general surgeon. In his early years he undertook a good deal of orthopaedic and gynxcological surgery, and he collaborated with physicians at the Royal Bath Hospital in the treatment of rheumatic disorders. His versatility was of particular value during the 1939-45 war, when he successfully carried out specialised and emer-
R.N.A.S.
gency surgery with the minimum of assistance. After retiring he continued to work as a locum consultant surgeon, generally in the more remote parts of Scotland. Outside medicine his interests extended to mathematics, stamp-collecting, and literature.
He is survived by his wife, a son, and three of whom is medically qualified.
daughters,
one
T.G.R. writes: "The tall, slender, almost ascetic figure of Tom Pearce belied his capacity for prolonged physical effort and for sympathy with those in any sort of trouble, which was mvariably quickly translated into practical help. He operated with such
dexterity
that
nothing
ever
appeared difficult;
he
was
patient
1103 and methodical in consultation, and had need only of essential investigations. Occasionally he could be impishly perverse, usually to determine how firmly the opinions of others were held-a characteristic which made him delight in a vicious game of croquet. Although he retired 10 years ago his patients and colleagues in Harrogate and the surrounding villages continue to remember him with gratitude and affection." LUDWIK ANIGSTEIN M.D. Poznan, Ph.D.
Heidelberg Dr Ludwik Anigstein, emeritus professor of preventive medicine and community health at the University of Texas in Galveston, died on Oct. 31, at the age of 84. He was born in Warsaw, Poland, and studied zoology at the University of Heidelberg, where he obtained his PH.D. He then studied medicine at the University of Dorpat, and graduated M.D. at the University of Poznan (Poland). During the 1914-18 war he worked as surgeon and epidemiologist with the Russian Red Cross, and then in 1926 he was appointed lecturer in microbiology and parasitology at the State Institute of Hygiene in Warsaw. From 1924 to 1939 he was a member of the Malaria Commission of the League of Nations and travelled widely in Asia, Africa, and Europe. He was adviser in public health to the Government of Liberia. The 1939-45 war broke out when Anigstein was in the U.S.A., and he accepted the post of assistant professor of tropical medicine and public health at the University of Texas in Galveston. In 1946 he took over the chair of preventive medicine and public health at that university, and held it until his retirement. Anigstein was a strikingly handsome man with tremendous vitality and great personal charm. His research activity
covered many fields. Studies on rickettsial diseases occupy a major portion of his 150 published papers, but among his more recent interests were immunology and cancer. Together with his second wife (formerly Dorothy M. Whitney), he was a pioneer of the experimental study of antibodies to hormonal substances. His loss will be keenly felt by his many friends, especially in the U.S.A., in Germany, and in his native Poland.
L.J.B.-C.
Diary of the Week NOV.
30
6
TO DEC.
Monday, list CHARING CROSS HOSPITAL, Fulham Palace Road, London W6 8RF 12.15 P.M. Psychiatry. Dr Richard Farmer EpidemIOlogy of Attempted Stiicide.
Tuesday, 2nd
-
ROY,L ARMY Cot u’GF, Millbank, London SW1 5 P.M. Dr D. B. Grant: Current Concepts of Growth and Growth Failure
Wednesday, 3rd
Notes and News OFFPRINTS AND REPRINTS FROM the issue of Jan. 3 authors of signed articles in The Lancet will automatically be sent complimentary offprints of their papers. The lay-out of the journal means that these pagesize offprints will almost always contain the beginning and/or the end of other papers in the same issue. However, the number of copies will be increased to 100 and they will be despatched (by air to destinations outside Europe) within a week of the date of publication. We hope that this more generous and speedier service will more than compensate for the loss of the 50 free reprints to which contributors have been accustomed. Reprints can still be made, however, and requests for quotations (and all communications about offprints) should be addressed to the Reprint Deparment, The Lancet, 7 Adam Street, London WC2N 6AD.
IS YOUR POST APPROVED? THE Joint Committee on Higher Medical Training has issued, with its second report,’ a list of the first 386 posts
approved for the four specialist years of postgraduate training scheme-i.e., posts usually in the senior-registrar grade obtained after the M.R.c.P. and after the completion of three years of general professional training. Nineteen specialties are recognised, but there are fourteen others for which synopses of suitable training are also provided but which, for organisational purposes, will come under the advisory committees for the major specialties. In deciding whether or not a post is suitable for approval, visiting teams have been taking into account the number of consultants in the specialty (at least two), the presence of other approved posts in related specialties in the same hospital group, time allowed for study and teaching (with at least a third of the time spent on clinical work), patient turnover, and laboratory and library facilities. The reassurance on the recognition of time spent in research is repeated. Certificates of accreditation will be granted on satisfactory completion of training, but if, as might happen in a shortage specialty, a trainee gets a consultant post before his four years are up, accreditation will be granted. On the future role of the existing postgraduate structure, the J.C.H.M.T. merely says that it will give advice and support to regional postgraduate committees and joint advisory committees on senior registrars. Also unresolved is the question whether, m view of the shorter training periods allowed in other Common Market countries, accreditation by the J.C.H.M.T. and similar bodies can fairly be equated, via the General Medical Council, with specialist recognition for E.E.C. purposes. The first list of posts is in no way complete and trainees are advised to contact the J.C.H.M.T. direct for up-to-date information. Quite clearly some regions and some specialties have been quicker off the mark in seeking approval for posts than others. So far the
in the Todd
distribution of posts is
as
follows:
BRITISH POSTGRADUATE MFDICAL F[DFRATlON 1.15 P.M. (Channel 7, LL.E.A. Closed Circuit Television System.) Dr Jacob Schrager’ The Chemistry of Mucus-The Composmon of Glvcoproteins from Gastrointestinal Carcmomata. (Repeated on ’) bursday at 12.15 P.M. and Friday at 1.15 P.M..) hlTITlITF OF ORTHOPAEDICS, 234 Great Portland Street, London WIN 6AD. 6 P M Mr H. Jackson Burrows’ On Giving a Second Opinion. RoL FREF HosptTAi, Pond Street, Hampstead, London NW3 2QG 5 r M Prof. L A ’I’urnberg: Clinical Aspects of Intestinal Salt and Water
Transport. B1fDICO-CHIRURGICAL SOClFTY OF EOINBtlRGH 8 P.M. (Pfizer Foundation.) Dr R. V. Short,
F.R.s.’
The Evolution of Human
Reproduction.
Besides the coded posts the J.C.H.M.T.
Thursday, 4th Ro)Cot I fGI
OF
SURGHJNS
OF
p.M
Mr M. A Bedford. Current Views
Ocular Tumours.
of approved
ENGI AND, Lincoln’s Inn Fields, London BX’C2A
3PN 530
geographical classification provides a specialty list.
(Otolaryngology
the Management of Lid and lecture.) on
1. The Joint Committee on Higher Medical Training Second Report 1975 Obtainable from the J.C.H.M.T., Royal College of Physicians, 11 Si Andrew’s Place, London NW1 4LE. £1 50.
"Will she fight and fight again for the preservation of the private sector?" It was no surprise that the private sector should be the main theme of a debate which revolved around the Government’s legislative proposals this session. After all it was only a month since M.p.s last debated the affairs of the N.H.S. But it meant that precious little attention was paid to the less glamorous, less strife-torn areas of the Service. It was left to Dr David Owen, Minister of State, to touch on some of them and to hint at painful decisions now being made to cut back Health Service spending. One area being looked at for restrictions was the massive pharmaceutical budget which faces the N.H.S. each year. There was also the difficult exercise of switching resources from one region of the country to tor.
lately recommended by a departmental working-party.’ It would not be easy to switch revenue from the four London metropolitan regional authorities and Merseyside to other less well-off regions. No deanother,
as
cisions had been made and there would have to be ful consideration locally before any moves began. 1. See Lancet,
Oct. 18, 1975, p. 753; Br. med. J. Oct. 11, 1975, p
care-
66
Obituary THOMAS VIBERT PEARCE M.D. Lond., F.R.C.S. to the Hargroup, died on Nov. 12 at the age of 75. Before beginning his medical studies he served in the
Mr T. V.
rogate
Pearce, formerly senior surgeon
hospital
as a pilot. He graduated M.B. from St. Thomas’s Hospital Medical School in 1923 and M.D. in 1931; he became F.R.C.S. in 1928. After house-appointments at St. Thomas’ Hospital and St. Giles’ Hospital, and a period as resident surgical officer at the Royal Northern Hospital, he moved, in 1932, to Harrogate, where he became surgeon to the Harrogate and District General Hospital, and to the Royal Bath Hospital and Ripon Hospital. He was secretary of the Harrogate Medical Society for 5 years, being president in 1954, and chairman of the Harrogate division of the British Medical Association in 1949 and president of the Yorkshire branch in 1954. He was also president of the section of surgery when the annual meeting of the B.M.A. was held in Harrogate in 1949. Mr Pearce took pride in being a general surgeon. In his early years he undertook a good deal of orthopaedic and gynxcological surgery, and he collaborated with physicians at the Royal Bath Hospital in the treatment of rheumatic disorders. His versatility was of particular value during the 1939-45 war, when he successfully carried out specialised and emer-
R.N.A.S.
gency surgery with the minimum of assistance. After retiring he continued to work as a locum consultant surgeon, generally in the more remote parts of Scotland. Outside medicine his interests extended to mathematics, stamp-collecting, and literature.
He is survived by his wife, a son, and three of whom is medically qualified.
daughters,
one
T.G.R. writes: "The tall, slender, almost ascetic figure of Tom Pearce belied his capacity for prolonged physical effort and for sympathy with those in any sort of trouble, which was mvariably quickly translated into practical help. He operated with such
dexterity
that
nothing
ever
appeared difficult;
he
was
patient
1103 and methodical in consultation, and had need only of essential investigations. Occasionally he could be impishly perverse, usually to determine how firmly the opinions of others were held-a characteristic which made him delight in a vicious game of croquet. Although he retired 10 years ago his patients and colleagues in Harrogate and the surrounding villages continue to remember him with gratitude and affection." LUDWIK ANIGSTEIN M.D. Poznan, Ph.D.
Heidelberg Dr Ludwik Anigstein, emeritus professor of preventive medicine and community health at the University of Texas in Galveston, died on Oct. 31, at the age of 84. He was born in Warsaw, Poland, and studied zoology at the University of Heidelberg, where he obtained his PH.D. He then studied medicine at the University of Dorpat, and graduated M.D. at the University of Poznan (Poland). During the 1914-18 war he worked as surgeon and epidemiologist with the Russian Red Cross, and then in 1926 he was appointed lecturer in microbiology and parasitology at the State Institute of Hygiene in Warsaw. From 1924 to 1939 he was a member of the Malaria Commission of the League of Nations and travelled widely in Asia, Africa, and Europe. He was adviser in public health to the Government of Liberia. The 1939-45 war broke out when Anigstein was in the U.S.A., and he accepted the post of assistant professor of tropical medicine and public health at the University of Texas in Galveston. In 1946 he took over the chair of preventive medicine and public health at that university, and held it until his retirement. Anigstein was a strikingly handsome man with tremendous vitality and great personal charm. His research activity
covered many fields. Studies on rickettsial diseases occupy a major portion of his 150 published papers, but among his more recent interests were immunology and cancer. Together with his second wife (formerly Dorothy M. Whitney), he was a pioneer of the experimental study of antibodies to hormonal substances. His loss will be keenly felt by his many friends, especially in the U.S.A., in Germany, and in his native Poland.
L.J.B.-C.
Diary of the Week NOV.
30
6
TO DEC.
Monday, list CHARING CROSS HOSPITAL, Fulham Palace Road, London W6 8RF 12.15 P.M. Psychiatry. Dr Richard Farmer EpidemIOlogy of Attempted Stiicide.
Tuesday, 2nd
-
ROY,L ARMY Cot u’GF, Millbank, London SW1 5 P.M. Dr D. B. Grant: Current Concepts of Growth and Growth Failure
Wednesday, 3rd
Notes and News OFFPRINTS AND REPRINTS FROM the issue of Jan. 3 authors of signed articles in The Lancet will automatically be sent complimentary offprints of their papers. The lay-out of the journal means that these pagesize offprints will almost always contain the beginning and/or the end of other papers in the same issue. However, the number of copies will be increased to 100 and they will be despatched (by air to destinations outside Europe) within a week of the date of publication. We hope that this more generous and speedier service will more than compensate for the loss of the 50 free reprints to which contributors have been accustomed. Reprints can still be made, however, and requests for quotations (and all communications about offprints) should be addressed to the Reprint Deparment, The Lancet, 7 Adam Street, London WC2N 6AD.
IS YOUR POST APPROVED? THE Joint Committee on Higher Medical Training has issued, with its second report,’ a list of the first 386 posts
approved for the four specialist years of postgraduate training scheme-i.e., posts usually in the senior-registrar grade obtained after the M.R.c.P. and after the completion of three years of general professional training. Nineteen specialties are recognised, but there are fourteen others for which synopses of suitable training are also provided but which, for organisational purposes, will come under the advisory committees for the major specialties. In deciding whether or not a post is suitable for approval, visiting teams have been taking into account the number of consultants in the specialty (at least two), the presence of other approved posts in related specialties in the same hospital group, time allowed for study and teaching (with at least a third of the time spent on clinical work), patient turnover, and laboratory and library facilities. The reassurance on the recognition of time spent in research is repeated. Certificates of accreditation will be granted on satisfactory completion of training, but if, as might happen in a shortage specialty, a trainee gets a consultant post before his four years are up, accreditation will be granted. On the future role of the existing postgraduate structure, the J.C.H.M.T. merely says that it will give advice and support to regional postgraduate committees and joint advisory committees on senior registrars. Also unresolved is the question whether, m view of the shorter training periods allowed in other Common Market countries, accreditation by the J.C.H.M.T. and similar bodies can fairly be equated, via the General Medical Council, with specialist recognition for E.E.C. purposes. The first list of posts is in no way complete and trainees are advised to contact the J.C.H.M.T. direct for up-to-date information. Quite clearly some regions and some specialties have been quicker off the mark in seeking approval for posts than others. So far the
in the Todd
distribution of posts is
as
follows:
BRITISH POSTGRADUATE MFDICAL F[DFRATlON 1.15 P.M. (Channel 7, LL.E.A. Closed Circuit Television System.) Dr Jacob Schrager’ The Chemistry of Mucus-The Composmon of Glvcoproteins from Gastrointestinal Carcmomata. (Repeated on ’) bursday at 12.15 P.M. and Friday at 1.15 P.M..) hlTITlITF OF ORTHOPAEDICS, 234 Great Portland Street, London WIN 6AD. 6 P M Mr H. Jackson Burrows’ On Giving a Second Opinion. RoL FREF HosptTAi, Pond Street, Hampstead, London NW3 2QG 5 r M Prof. L A ’I’urnberg: Clinical Aspects of Intestinal Salt and Water
Transport. B1fDICO-CHIRURGICAL SOClFTY OF EOINBtlRGH 8 P.M. (Pfizer Foundation.) Dr R. V. Short,
F.R.s.’
The Evolution of Human
Reproduction.
Besides the coded posts the J.C.H.M.T.
Thursday, 4th Ro)Cot I fGI
OF
SURGHJNS
OF
p.M
Mr M. A Bedford. Current Views
Ocular Tumours.
of approved
ENGI AND, Lincoln’s Inn Fields, London BX’C2A
3PN 530
geographical classification provides a specialty list.
(Otolaryngology
the Management of Lid and lecture.) on
1. The Joint Committee on Higher Medical Training Second Report 1975 Obtainable from the J.C.H.M.T., Royal College of Physicians, 11 Si Andrew’s Place, London NW1 4LE. £1 50.
