THE PEDIATRICIAN AND THE PUBLIC

The British National Health Service is a highly original system. Its organization is as democratic as our public school system and free from political control. It is the most interesting and exciting social experiment of my life which means a great many years. It is time that we give up one-sided consideration and turn to study it fairly, for whatever direction medical care takes in this country it is possible to learn enormously from the experiences of the British system. I believe that it has some serious defects but that in spite of them it has been a prodigious success in supplying the needs of the people. I think that in assessing the value of the British National Health Service we Americans fall into two errors. In the first place we compare the best which we have in this country with what we happen to run across and in some instances with the selected worst in Great Britain. The second error, which is the more important, is that we think primarily in terms of the physicians, i.e., ourselves. We involuntarily put ourselves in the place of the British physician and ask how we would like to be restricted as they are. The primary aim of medical service is the patient and, in the aggregate, the preservation of the health and welfare of the nation. In developing any system of medical care, it is necessary to consider first the welfare of the people, but it is a fundamental mistake not to consider adequately the welfare of the physician. I think that the error in the organization of the National Health Service was in considering almost exclusively the needs of the people and giving very little attention to the needs of the physician, who have been moved about and their activities limited and defined too much as if they were chess men on the board. From this error, it is the people who will ultimately suffer.