Patient Improves

When Britain's Labor government began its vast tax-supported National Health Service in July 1948, doctors in the U.S. as well as many in Britain were quick to predict a rapid decline in British medical standards, and worse yet, the end of the traditional relationship between a patient and the doctor of his choice. In its bloated, red-tape-swaddled infancy, N.H.S. seemed set to fulfill the prediction.

A program encouraging 42 million Britons to seek cheap medical advice and free prescriptions for everything from sore feet to falling hair all but swamped Britain's 20,000 general practitioners, strained the bedside manner, quickened the leisurely house call. The drain on the hard-pressed Exchequer zoomed up to $1.2 billion a year. After 29 months of N.H.S., the British Medical Association sternly warned: "The public has run riot in the chemist's shop . . . The shocking waste of public money . . . has left little over for what is more urgently needed."

Equally concerned was the Ministry of Health. It appointed a committee of some of Britain's best physicians, led by Sir Henry Cohen, a bustling Liverpool physician and onetime head of the British Medical Association, and set it to diagnosing N.H.S.'s ailments. Last week, six years after N.H.S. was born. Sir Henry & Co. published a 67-page report. The committee's conclusion: thanks to changes made since 1950, N.H.S. is doing much better. One big reason for the improvement: after the Tories returned to power in 1951, they tightened up N.H.S., required Britons to pay nominal fees for extras, e.g., prescriptions, abdominal belts, orthopedic shoes (TIME. May 12, 1952).

The report's biggest surprise: the relationship between doctors and patients is as good as ever, and in many ways has improved. Patients are no longer reluctant to accept doctors' orders to undertake further treatment for fear of running up heavy medical bills. Doctors, with assigned lists of patients, are cooperating with each other instead of competing for patients. Most patients still regard their doctor as "their own," prefer to have one doctor for the entire family. If a patient is dissatisfied with his doctor, he may switch after giving 14 days' notice.

The report's other highlights:

P:Under socialized medicine, few doctors are loafing. A general practitioner with 3,500 patients on his list (the legal maximum) sees 2.300 of them a year, averages 4.8 consultations a patient, sends 800 patients on to hospitals or specialists.

P:Paid by the government at the basic rate of 17 shillings ($2.38) a year for each patient on his list--whether he visits the patient or not--plus bonuses, the G.P. rarely suffers financially from N.H.S.

P:N.H.S. suffers from overcrowded hospitals, inadequate waiting rooms in doctors' offices, inequalities in doctors' payments (in "overdoctored" areas). Despite much streamlining, doctors must still waste valuable time on paper work (e.g., sickness certificates) not connected with treatment of their patients.

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