NEW UNDERGRADUATE COURSES IN MEDICINE
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756 assuming equality in list size, can be E700 a year in the unlikely event of the single-handed doctor being able to afford six weeks’ holiday. No doubt many will consider it an anachronism, com- parable perhaps to chimney-sweepers’ boys, that such doctors still exist, but exist we do and in many rural areas there is a standard of practice quite equal to that of most health centres allied to a friendly understanding of our patients. Is the alternative to our present existence to sacrifice our patients and friends, our families, our way of life and all that we have strived for, and move into health centres in towns or can we hope that here also it will be recognised there is a reverse of justice ? Townswell, Brailsford, Derby. P. W. BOWDEN. NEW UNDERGRADUATE COURSES IN MEDICINE Sir have observed in your journal, and in others, outlines of new medical undergraduate courses. I have also been subjected to such an " enlightened " course in my present undergraduate years. It seems to me that many of these excellent objective outlines miss one vital point: the subjective experience of the student. To me a course by any other name is only as good as the outcome of all the personal and individual interactions during the course. From my own experience the study of medicine is only worth while when I am enjoying it, such enjoyment depending on the personality and interest of the individual people one is working with, and not upon the theoretical superstructure of a syllabus and assessment system. If some medical educators are feeling satisfied with their new paper systems, then I suggest that their ideas and attitudes still fall short of the educational philosophy held by some of their contemporaries in other areas of education. I would also urge them to delve into the subjective experi- ence of students just to make sure that things are going as well as they imagine. Flat 1, 12 Cromwell Road, South Yarra, Victoria 3141, Australia. RICHARD N. WARD. Parliament Health Education Council The Health Education Council came up for discussion in the debate on the Consolidated Fund Bill on March 20 in the House of Commons. Mr. MICHAEL MCNAIR-WILSON said that this was the first time the work of the Council had been debated since its inception in January, 1968. The aims of the Council, which had a budget of E586,000 in 1971-72, were to plan and promote national programmes of health education, to assist in the development of local programmes, and to undertake research into health-educa- tion techniques. It was clear that the Council was con- strained by the size of its budget from tackling as it would wish the task it saw itself as having been allotted. For the year ending March 31, 1970, E107,550 had been spent on a campaign about smoking and health, E9463 on a dental- health campaign, E2846 on venereal disease, E2078 on food hygiene, E878 on cancer, E763 on sex education and contraception, E563 on accident prevention, and E475 on child health; nothing was spent on campaigns about immunisation and vaccination or prevention of drug abuse. There was a general feeling that the Council spent too much money on researching subjects in which it was interested and not enough on getting out leaflets and posters for public consumption; in fact, many of the leaflets and posters produced by the Council had had a mixed reception, and the question was whether the Council was really producing the material required by the local authorities and other groups. Mr. MICHAEL COCKS said that the Council could play an important role in informing the public of the real value of the various health-insurance schemes which were now being widely advertised, some- times misleadingly. Mr. MICHAEL ALISON, Under-Secretary of State for Health and Social Services, said that he could not reply on this last point as he had not been prepared for it. The raison d’etre of a body such as the Health Education Council was that it was wholly free to concentrate on health education, and freer to experiment and to try to break new ground than a Government Department. Within its resources the Council must necessarily plan its activities by allocating priorities on its own initiative and responsibility; the areas of health-education activity which were currently being given priority were smoking and health, family planning, and venereal disease. It had established itself during its short life as a source of advice and help on health education matters to local and central Government, to voluntary organisations, and to the mass media, and other activities included the training of medical and health- personnel in health education, health education in schools, and the publication of the quarterly Health Education Journal and the half-yearly Health Information Digest. E50.000 would be spent in 1972-73 on venereal-disease education; an experimental health-education and contact- tracing campaign was being held in the two London boroughs of Lambeth and Wandsworth. The Council accepted that serious consideration should be given to the problem of drug abuse, but care was needed both because there were still gaps in the knowledge of the precise size and nature of the drug problem in Britain, and because there was a very real risk that ill-chosen education methods might encourage an interest in drugs in people who had not previously felt it. Social Security In a statement in both Houses of Parliament on March 22, it was announced that the retirement pension would be increased from October by 75p for a single person and ill.20 for a married couple (85p and E1.30 for those with supplementary pensions). The Secretary of State for Social Services, Sir KEITH JOSEPH, said in the House of Commons that other National Insurance benefits and war pensions would be correspondingly improved. Increases in the main scale-rates for supplementary benefits would be the same as, and would operate from the same time, the increases to the main National Insurance benefits. The new constant attendance allowance would go up from E4.80 to E5.40, and the scheme would be widened to include those needing attention either by day or by night (rather than both day and night), who would receive S3.60 a week. The war and industrial disablement pen- sion for 100% assessment would go up to El 1.20, the nor- mal maximum of constant attendance allowance and the exceptionally severe disablement allowance from E4 to E4.50, standard war widow’s pension from S7.80 to E8.80, and industrial injuries pension from E6.55 to E7.30. The level of earnings a person was allowed from a subsidiary occupation before title to unemployment benefit was affected would be raised from 33!p to 75p a day, and corresponding changes made in earnings limits for sick- ness and invalidity benefits and unemployability supple- ments. The Supplementary Benefits Commission would increase the extra heating allowance by 20%, and there would also be increases in the allowances for special diets. The total cost of the proposals would be about E480 million in 1973-74, E395 million of which would fall on the National Insurance funds. The uprating would be financed mainly from increases in graduated contributions, and also from increases on the employer’s flat-rate contributions.
Transcript of NEW UNDERGRADUATE COURSES IN MEDICINE
756
assuming equality in list size, can be E700 a year in theunlikely event of the single-handed doctor being able toafford six weeks’ holiday.No doubt many will consider it an anachronism, com-
parable perhaps to chimney-sweepers’ boys, that such doctorsstill exist, but exist we do and in many rural areas there is astandard of practice quite equal to that of most healthcentres allied to a friendly understanding of our patients.
Is the alternative to our present existence to sacrificeour patients and friends, our families, our way of life andall that we have strived for, and move into health centres intowns or can we hope that here also it will be recognisedthere is a reverse of justice ?
Townswell,Brailsford, Derby. P. W. BOWDEN.
NEW UNDERGRADUATE COURSES INMEDICINE
Sir have observed in your journal, and in others,outlines of new medical undergraduate courses. I havealso been subjected to such an " enlightened " course inmy present undergraduate years. It seems to me that manyof these excellent objective outlines miss one vital point:the subjective experience of the student. To me a course byany other name is only as good as the outcome of all thepersonal and individual interactions during the course.
From my own experience the study of medicine is onlyworth while when I am enjoying it, such enjoymentdepending on the personality and interest of the individualpeople one is working with, and not upon the theoreticalsuperstructure of a syllabus and assessment system.
If some medical educators are feeling satisfied with theirnew paper systems, then I suggest that their ideas andattitudes still fall short of the educational philosophy heldby some of their contemporaries in other areas of education.I would also urge them to delve into the subjective experi-ence of students just to make sure that things are goingas well as they imagine.
Flat 1, 12 Cromwell Road,South Yarra,
Victoria 3141, Australia. RICHARD N. WARD.
Parliament
Health Education CouncilThe Health Education Council came up for discussion in
the debate on the Consolidated Fund Bill on March 20 inthe House of Commons. Mr. MICHAEL MCNAIR-WILSONsaid that this was the first time the work of the Councilhad been debated since its inception in January, 1968.The aims of the Council, which had a budget of E586,000in 1971-72, were to plan and promote national programmesof health education, to assist in the development of localprogrammes, and to undertake research into health-educa-tion techniques. It was clear that the Council was con-strained by the size of its budget from tackling as it wouldwish the task it saw itself as having been allotted. For theyear ending March 31, 1970, E107,550 had been spent on acampaign about smoking and health, E9463 on a dental-health campaign, E2846 on venereal disease, E2078 onfood hygiene, E878 on cancer, E763 on sex education andcontraception, E563 on accident prevention, and E475 onchild health; nothing was spent on campaigns aboutimmunisation and vaccination or prevention of drug abuse.There was a general feeling that the Council spent too muchmoney on researching subjects in which it was interestedand not enough on getting out leaflets and posters forpublic consumption; in fact, many of the leaflets and
posters produced by the Council had had a mixed reception,and the question was whether the Council was really
producing the material required by the local authoritiesand other groups. Mr. MICHAEL COCKS said that theCouncil could play an important role in informing thepublic of the real value of the various health-insuranceschemes which were now being widely advertised, some-times misleadingly.Mr. MICHAEL ALISON, Under-Secretary of State for
Health and Social Services, said that he could not reply onthis last point as he had not been prepared for it. Theraison d’etre of a body such as the Health EducationCouncil was that it was wholly free to concentrate on healtheducation, and freer to experiment and to try to break newground than a Government Department. Within itsresources the Council must necessarily plan its activities byallocating priorities on its own initiative and responsibility;the areas of health-education activity which were currentlybeing given priority were smoking and health, familyplanning, and venereal disease. It had established itselfduring its short life as a source of advice and help on healtheducation matters to local and central Government, tovoluntary organisations, and to the mass media, and otheractivities included the training of medical and health-
personnel in health education, health education in schools,and the publication of the quarterly Health EducationJournal and the half-yearly Health Information Digest.E50.000 would be spent in 1972-73 on venereal-diseaseeducation; an experimental health-education and contact-tracing campaign was being held in the two Londonboroughs of Lambeth and Wandsworth. The Council
accepted that serious consideration should be given to theproblem of drug abuse, but care was needed both becausethere were still gaps in the knowledge of the precise sizeand nature of the drug problem in Britain, and becausethere was a very real risk that ill-chosen education methods
might encourage an interest in drugs in people who hadnot previously felt it.
Social SecurityIn a statement in both Houses of Parliament on March
22, it was announced that the retirement pension wouldbe increased from October by 75p for a single person andill.20 for a married couple (85p and E1.30 for those withsupplementary pensions). The Secretary of State for SocialServices, Sir KEITH JOSEPH, said in the House of Commonsthat other National Insurance benefits and war pensionswould be correspondingly improved. Increases in themain scale-rates for supplementary benefits would be thesame as, and would operate from the same time, theincreases to the main National Insurance benefits. Thenew constant attendance allowance would go up fromE4.80 to E5.40, and the scheme would be widened toinclude those needing attention either by day or by night(rather than both day and night), who would receiveS3.60 a week. The war and industrial disablement pen-sion for 100% assessment would go up to El 1.20, the nor-mal maximum of constant attendance allowance and the
exceptionally severe disablement allowance from E4 to
E4.50, standard war widow’s pension from S7.80 to E8.80,and industrial injuries pension from E6.55 to E7.30. Thelevel of earnings a person was allowed from a subsidiaryoccupation before title to unemployment benefit was
affected would be raised from 33!p to 75p a day, andcorresponding changes made in earnings limits for sick-ness and invalidity benefits and unemployability supple-ments. The Supplementary Benefits Commission wouldincrease the extra heating allowance by 20%, and therewould also be increases in the allowances for special diets.The total cost of the proposals would be about E480 millionin 1973-74, E395 million of which would fall on the NationalInsurance funds. The uprating would be financed mainlyfrom increases in graduated contributions, and also fromincreases on the employer’s flat-rate contributions.
