Battle in Britain

Parliament had passed the National Health Service Bill, promising free, womb-to-tomb medical care for every Briton (TIME, April 1).* Now it was up to the doctors. Last week their answer came in: by a 23,110-to-18,972 vote, the British Medical Association said No.

Health Minister Aneurin Bevan had worked hard to win the doctors over. On his side were the prestigious Royal College of Physicians, a majority of medical men in the military services, and most low-income medicos. To reassure opponents, the bill left open to negotiation the key questions of pay and terms of employment under the plan (the B.M.A. vote was on the question of whether to enter such negotiations). To sweeten a provision most obnoxious to doctors--a ban on the sale of practices--Bevan set up a $266,000,000 fund for payments to physicians at retirement or death.

Nonetheless, the B.M.A. decided that the plan smacked of "slavery." Reason: while the bill permitted private practice, and left physicians free to stay out of the plan if they chose, B.M.A. argued that most doctors would have no choice but to become virtual employes of the Government. Said Dr. Charles Hill, B.M.A.'s suave secretary: "It is not a question of money, for $266,000,000 was dangled before the profession. It is a question of the freedom of medicine."

"Inevitable Conflict." But money had something to do with it. Many a doctor hated the thought of haggling over fees with the Government. Under "Britain's 35-year-old National Health Insurance system, haggling has been chronic: British dentists are currently in a fee row with the Ministry of National Insurance (they demand -L-9 9s. for a set of false teeth v. the Ministry's offer of -L-7), and insurance physicians recently won a raise (to 15s. a patient) only after long dispute.

While the B.M.A. girded itself for "the inevitable conflict," most Britons put their money on Bevan. The B.M.A. was plainly divided (besides the 18,972 who had voted to dicker, 14,525 had not voted at all). Bevan promptly announced that he would proceed to negotiate with other medical societies (e.g., the Royal College of Physicians). If he could negotiate satisfactory terms, many a doctor would come into the plan, B.M.A. or no B.M.A. Said the London Times: "If it [ B.M.A. ] persists in refusing to attach as much importance to the general election of 1945 as it does to the doctors' ballot of 1946, it may well find that ... it will have deprived both itself and Parliament of any chance of reaching a compromise. In such a situation, though the conflict might be protracted, it cannot be doubted who would in the end be worsted."

* Main provisions: the Government would take over all hospitals, help set up local health centers, train more physicians, spend some $600,000,000 a year to see that every Briton got complete medical and dental care, including drugs, eyeglasses, false teeth.

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