1427

THE

ORGANISATION OF THE PROFESSION.

(FROM OUR SPECIAL COMMISSIONER.)(Continued from p. 1356.)

The Difficulty with Old-established Medical Aid Assoocia-tions rvhich offer Advantageous Terms.-The Struggle atAshington and at Broomhill.THE amicable and practical arrangement by which the

active cooperation of the consultants has been secured

naturally increases the influence of the Northumberland andNewcastle Medical Union. It numbers now 185 members

and the question of the 9d., which was the first point raised,had been carried trough triumphantly in almost everycase. Throughout the county it is now generally recognisedthat the pay for collier families must be 9d. per fortnightinstead of 6d. as formerly. Still, there are efforts made hereand there to prevent the medical practitioners obtaining thewhole of this 9d. and there is some difficulty in reformingold and well-established institutions. A case in point hasoccurred at Ashington and it is instructive, for it shows whatdifficulties may arise even when the medical practitionerswho are personally concerned behave loyally throughout totheir union. Long before the medical union was formedthere existed at Ashington a medical aid associationformed by colliers. The colliers collected 6d per fortnightfrom every family belonging to their association and withthis sum they were able to pay a fixed salary ofmore than £200 a year to their medical officer andto provide him with a house, drugs, and instruments aswell. It was a good p)st. Still, the medical officerof this association, Dr M. Bruce, -eems to have recognisedfrom the very first that the system was wrong. In anycase, when, now more than two year-; ago, a general meetingof medical practitioners was convoked at Newcastle for thepurpose of forming a medical union Dr. Bruce attended.As the medical practitioners present at this meeting con-stituted themselves into a me iical union Dr. Bruce becameone of the founders and original members of the union Buteven if he had joined later and consequently had had tobe elected there would have been no reason for votingagainst him. The medical union was not then attacking oldinstitutions, the mot it strove to do was to prevent thecreation of new ones. Then assurances were given that theAshington medical aid association did not canvass-in fact,there was then no reason to take action against it.

In the course of time, however, when the question of

raising the 6d. to 9d. began to spread throughout the

county, some action had to be taken. Mr. J. RutherfordMorison, as President of the Northumberland and NewcastleMedical Union, went down three times to interview and tonegotiate with the committee of the Ashington medicalaid association. Mr. Morison explained to the committeethe position and the princip’es of the medical union and theobjections it had to such medical aid associations as thatformed by the colliers of Ashington But at the same timehe confessed that there was a differencen in attacking old,well-established institutions and the prevention of the crea-tion of new abuses. The medical union would prevent theformation of new medical aid a-sociations, but he understoodthat the one which already existed at Ashington was behavinghonourably, that it did not canvass, that it did not advertise,that it did not strive to decoy other medical practitioners’patients, that its medical officer, Dr. Bruce, was wellconsidered by his fellow practitioners established in the

neighb Jurhood, and certainly he was likewise respected bythe medical union of which he was a member. In allthese circumstances Mr. Morison did not think that themedical union would take any action against the Ashingtonmedical aid association if it raised the subscriptionof its members from 6d. to 9d. per fortnight. Thecolliers, however, absolutely refused to raise the subscrip-tion to 9d., saying that they were not going to submit to thedictation of the medical men. This attitude rendered it diffi-cult for the three or four other colliery surgeons practisingin the district to obtain the 9d. which they were claiming.In their case there was no intermediary. The collierssimply notified to the paying clerk at the pit brow that hewas to deduct so much per fortnight from their pay and totransmit the amount to the medical practitioner whom the

colliers had of their own free will selected. The paying clerkreceives from the colliery surgeon a commission for histrouble in collecting the money. This is by far the best andsimplest arrangement that can be made ; but if medicalattendance could be obtained from the medical officer of theassociation for 6d., why should the colliers pay 9d. to privatepractitioners ? ‘!

Here, then, was the parting of the ways, and the questionarose whether Dr. Bruce would act in keeping with theprinciples of the medical union to which he belonged or inthe interest of his employers, the medical aid association. Heselected to stand by the union and his fellow members of theprofession. First of all, he supported the demand for the 9d.by insisting on an increase of pay. The association rather thanyield in respect to the 9d. per fortnight organised a systemof special levies which, in the long run, ended by amountingto as much as the extra 3d. demanded. But this was notall. Fearing that men might be attracted by the apparentlycheaper terms of the association Dr. Bruce explained to hiscommittee that it must not increase the membership andthat he could not do justice to his patients if it were toaugment their number. By these means he prevented hisassociation from competing against the colliery surgeonswho in the neighbourhood were raising their terms from 6d.to 9d. A short time ago another occasion arose for bringingfurther pressure to bear. According to his agreement Dr.Bruce had the right to a holiday of 14 days, during whichtime the association paid for his locum-tenent. But hefelt ill and then a.ain a locum tenent had to be

engaged. On this occasion the association refused to payand if I understand correctly, argued that. as the holidaywas limited to 14 days, its financial responsibility in

regard to illness should al-o be limited to 14 days Ittherefore refused to pay for the locum-tenent and Dr. Bruce

brought an action against it. Just before goint intocourt the medical aid association, however, paid the wholesum claimed ; but at the same time served Dr. Bruce with

. a notice of dismissal.

, S" far it will be seen that the course of events was quitesatisfactory. Dr Bmce, by his loyalty, had prevented

. the medical aid association from competing againstthe other colliery surgeons who were obtaining 9d.

, N’jw he had been dismissed and there was a fairt chance that the medical aid association would die a

natural death. Such was the position when, a short[ time ago, it was announced that Dr. Bnd, who was in; practice at Newcastle, had accepted an offer to take Dr.; Bruce’s place. This seemed all the more extraordinary as

Dr. Bond was a member of the medical union and it wasincredible that he should thus suddenly betray the caue.

F The general secretary of the medical union, Mr. Garthorn; Drury, at one wrote to him saying that Mr. Morisont could not believe that he would accept such an appointment

and thus set himself in opposition to the prineples of the) medical union and to Dr. Bruce who throughout had

acted most loyally. Dr. Bond at once replied that hes had been deceived and had no desire to act against

the principles of the medical union to which he hadsubscribed. Then Dr. Bond explained that he had been

3 told of the vacancy by some dispensing chemists in the

, town who had acted as intermediaries in the matter andwho it was not to be supposed would act against the

a interests of the medical profession He theretore went

i down to Ashington and the committee of the medicalaid association explained that Mr. Morison had said

, it was an honourable association and that it was now pre-

,’ pared to pay 9d. per fortnight. The solicitor employedby the medical aid association was also said to have

e declared that there was no dispute pending. In thesey circumstances Dr. Bond had almost concluded negotiationsI for the sale of his practice and had signed an agreemente accepting the post of medical officer of the Ashingtona medical aid association. Finding that he had been mis-n led, and though in a somewhat precarious position, hee nevertheless placed his agreement with the medical aid

association in the hands of the solicitors of the medicale union, and he would seek to withdraw the proposal he hadi- made for the sale of his practice. In a word, he was readyg in every way to do whatever the medical union thought, r most advisable in the circumstances.s It so happened that while I was in Newcastle a meetinge of the Northumberland and Newcastle Medical Union waso held in the library of the infirmary, and I was invited toe assist at this gathering and was thus able to see how this

1428

.matter was finally decided. Dr. Bond, it was explainedduring the course of this meeting, might give notice to quitat once and he would then have to serve for a month at

Ashington, or else he might break his agreement on the

.ground that he had been led to sign it by misreprenta-tions. There would then be some chance of his being prose-.cuted for breach of contract. On the other hand, thecommittee of the Asbington medical aid association had

perhaps acted in a somewhat irregular manner. A memberof the medical union related that it had dismissed Dr.Bruce without consulting its members. Then when

complaints were made about this it hastily called a

- meeting, but selected an especially inconvenient hour anddid not send out notices to everyone entitled to receive them.Indeed, the whole proceedings seem to have been so irregularthat there is some question of applying to the Regibtrar ofFriendly Societies for the summoning of a proper meeting.Mr. Morison related that he had warned the committeethat it would be very difficult to replace Dr. Bruceand that it would not be opposed if it gave him the 9d.The committee of the Ashington medical aid associationrefused to do this. It would persist in paying a fixed

salary which it would raise to E300 ; it also paid for thedrugs and provided a house rent free and it argued thatin response to such an offer it would receive hundreds of .applications. Mr. Morison replied that doubtless it would i

receive applications for such a well-paid post, but from what sort of persons. In this respect an amusing incident was re- lated concerning another district where a somewhat similar- dispute had arisen. Here the colliers had succeeded in t

importing a medical officer. When he arrived he was so drunk that he had to be conveyed to his house in a cart. :

For the first three days he was too ill to see any patients. After he had recovered he again took to drink and by the end of a fortnight the colliers were glad to pay him o that (

they might get rid of him. The position here is further

complicated by the presence of a nurse whom the colliers c

also employ and if she does not approve of their medical officer his life is apt to become burdensome. Having fully i.discussed the situation’at Ashington and its legal aspects a motion was unanimously carried to the effect that the c

.Northumberland and Newcastle Medical Union advises Dr. tBond not to go to Ashington and that the medical union n

will undertake to support Dr. Bond in any consequences that gmay accrue or action that may be brought against him. n

At Broomhill there is much the same difficulty as at c

Ashington. Here also the colliers have an old-established vmedical aid association, but their medical officer, Mr. Foster, was not a member of the medical union. The la’ter organisation followed the same policy as at Ashington and n

said that the Broomhill medical aid association would not be n

opposed if its members paid the 9d to its medical officer. t]

The members did pay 9d., but the committee deducted b

25 per cent. from this for the working expenses and to ’"

pay for the drugs. Mr. Foster was proposed as a member tl

of the medical union and was told that he would be elected e]if he obtained the 9d. and so arranged that when hisassociation published its balance-sheet it should not be

publicly circulated and made to serve as an advertise-ment. In a word, all touting must be abolished. Mr. Foster thereupon submitted these conditions and they were sa

refused, so he resigned his position as medical officer of the MBroomhill medical aid association. Mr. Morison related to ci

the meeting of the medical union at which I assisted that tba deputation from Broomhill had come to Newcastle and ofwaited upon him. The members of it indignantly asked plwhat the medical union meant by making Mr. Foster resign. ClMr. Morison replied that they must give the whole of the pt’9d. to Mr. Foster and he would provide the medicines. But inthe colliers objected, saying that if they did not themselves af

purcha-e the medicines they would only get water. During siithe course of the meeting it was explained that Mr. Foster afhad the right to private practice at Broomhill, but that. innevertheless, if a " blackleg " was introduced to replace him nc

as medical officer of the colliers’ medical aid association he buwould lose about half his income. Also, he had received Mnotice to quit the house he inhabited. In view of all these im.circumstances the Northumberland and Newcastle Medical EcUnion decided by a special vote that it would support Mr. a] Foster and, if necessary, give him financial compensation from the indemnity fund which the medical union

has th,

created, ofSuch are some of the difficulties that have arisen within foi

the last few months. Much has been said as to what the D[

id profession, if properly organised, could and ought to do.it But now mere theory is replaced by actual practice andit action. Here is a picture of what has been done, of theie obstacles that arii-e, and the manner in which they have been

overcome. The success will be complete if ’’ blacklegs "

!- can be kept out of such places as Ashir,gton and Broomhill.e It seems daily to be more and more difficult to find properlyd qualified practitioners willing to act against ’the generalr opinion of the profession. The more the Jacts are known the. greater will be this difficulty. The members of the Northum-n berland and Newcastle Medical Union have carried forwarda their campaign with skill and success and will continue tod increase in strength as their good work becomes better known. and appreciated.r - —*"**

MANCHESTER.(FROM OUR OWN CORRESPONDENT.)

n The New Board of the Manctester Infirmary.i GREAT interest was shown in the election on Nov. 14the of the new board of management of the Manchester,t Infirmary, although of 1240 voting papers-i.e., one tof each trustee-only 734 were returned duly filled up. Seven,moreover, were faulty. The interest was by no means con-t fined to the trustees. After the meeting at which it was- decided not to rebuild at Piccadilly a committee of trusteesr was formed who nominated 21 gentlemen and hoped thatthey would be accepted as the new board on theresignation of the old one, so that a contest might be. avoided. All do not, however, think alike, and some. considered that a contest would do no harm, and this

party nominated six more trustees. The Women’s Localt Government Association also nominated two lady trusteesr as candidates, and finally another lady and a memberof the old board were nominated independently. There1 were therefore 31 candidates for the 21 seats. Later

in the day the scrutineers announced the result of the count,which showed that 19 of the 21 nominated by the trustees’; committee were elected, also one of the six nominated by

those who declined to accept the list of the trustees’ com-mittee, and of the two nominated independently the

gentleman, not the lady, was chosen. Many will regret thatno ladies were elected, but it must be remembered that the

, chief responsibilities of the new board will be connectedwith the rebuilding of the infirmary, most probably on the

Staniey-grove site, as no better has hitherto been offered.. Eight members of the old board have been elected on thenew one, which will be complete when the four medicalmembers have been added. It is a great advantage to havethe experience of the eight who have already served on theboard, for the management of so large an institution with its’.arious off shoots is no sinecure. Since the above was writtenthe following representatives of the medical board have beenelected: Dr. Thomas Harris, Mr. J. Hardie, Mr. W. Thorburn,and Mr. G. A. Wright.

No Breakfast."Manchester will soon be considered the paradise of

cranks. " So an article in a Manchester weekly papersays, apropus of the first meeting of a new society-" I heManchester Physical Health Culture Society"-for "thecultivation of the highest degree of physical health andthe prevention and cure of disease by natural means." Oneof the chief agencies by which this result is to be accom-plished is the negative one of going without breakfast.Clubs are to be formed, by amateurs for amateurs for thepursuit of out-door games and sports, and weekly meet-

ings are to be held "for the discussion of subjectsaffecting health and physical development, "-i.e., in

simple language, to ask each other how they feelafter having had no breakfast for a week. This last stepin the evolution of advancing Manchester is, unhappily,not of home manufacture. nor was it "made in Germany,"but was brought over by an American philanthropist, a

Mr, Macfadden, some few months ago. The honour of its

inception must be given to ‘ an American medical man, Dr.Edward H. Dewey," who propounded this glorious scheme ina book on "The Rational Cure of Chronic Alcoholism. " amust not be supposed, however, that the large attendance atthe meeting " of young men and maidens and older personsof both sexes, "consisted of the victims of chronic alcoholism,for it seemed that the title of this book, which Mr. E. OliverDuerr, the honorary treasurer of the society, spoke of as his