PROFESSIONAL CRITICISM OF THE GENERAL MEDICAL COUNCIL.
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50 on the basis of some metabolic disturbance which was essentially protective in type, a disturbance most probably of the nature of a retention of a normal product of katabolism. The interest I felt in Dr. Spaeth’s original communication will be appreciated. How far this new communication of Dr. Spaeth bears on those opinions I do not ask for space to discuss here, for at the present time the essential points are that fatigue under certain conditions appears to raise the bodily resistance to infection, and that in an attack of influenza there are symptoms simulating fatigue which appear to be of good prognostic significance. This work may also throw new light on the infantile convulsion and the rigor of adult life. For many reasons it is to be hoped that the untimely end of Dr. Spaeth may not lead to an abandonment of investigations into the relationship of fatigue to infection. His work deserves all the prominence which has been given to it through your leading article. I am, Sir, yours faithfully, Halifax, Dec. 23rd, 1925. A. GARVIE. PROFESSIONAL CRITICISM OF THE GENERAL MEDICAL COUNCIL. To the Editor of THE LANCET. SIR,—In your issue of Dec. 26th Dr. Gordon Ward writes apparently with approval of an action on the part of medical men which would seem to me most reprehensible. I refer to his statement in regard to the signing of a " certificate which requires the doctor to certify that he has seen all the children of so-and-so alive on this date." I have long taught senior students and junior practitioners working under me that members of our profession are far too careless of the way in which they fill in certificates of all sorts, and warn them against signing their names in blank to any document or putting their signatures to any statement without first reading it carefully. The right to sign certain documents-such as applications for passports or for payment of pensions-is one which we share with justices of the peace and with members of a limited number of other professions. It is a right of which we should be proud, and carelessness in using our right should be avoided. This is, however, the first time that I have ever heard of a medical man openly stating that he is in the habit of signing such certificates knowing that he is making a false statement. Cer- tainly I should call such behaviour both " fraudu- lent " and " unethical " (these are his actual words). I am writing this because the layman who reads your paper should not be allowed to think that such a standpoint will go unchallenged. At any committee with disciplinary powers I, for one, should view with disfavour anyone who had made such a false statement by carelessness, and be prepared to recommend a severe penalty on anyone who was proved knowingly and intentionally to have done the same. I am, Sir, yours faithfully, T. B. LAYTON. V’elbeck-street, W., Dec. 26th, 1925. To the Editor of THE LANCET.. SIR,—Will you allow me a word of friendly criti- cism of the leading article in your issue of Dec. 19th ? In the course of that article you state that it is a British tradition that every trade and every profes- sion is to manage its own affairs. Supposing I were a member of the black squad and, being democratic, I insisted on working for the wage offered by the employers, and that the other members of the trade- union did not agree to my doing so and forthwith proceeded to maul me. Am I not to be allowed to apply to the ordinary judicature of the country for reparation ; is my case only to be considered by the trade-union ? I do not agree to any such attitude whatsoever. Now the General Medical Council as presently established is a law unto itself ; in fact, if I read matters aright, it is superior even to the law of the land. It has a power which has not been held by any tribunal so far as I know since the Court of High Commission in the reign of James II. of England, that Court which directed the Bloody Assize in the West country. In some cases it appears to be very slack in its proceedings, in others unnecessarily severe. Many years ago a contribution which I made on the subject of seamen’s eyesight, and which, with my consent, was published in the Liverpool Journal of Commerce, might even now get me into trouble. The General Medical Council may take it into its head even yet that such a contribution should not have been made to a lay journal. It was, however, an important contribution and stopped the adoption of certain regulations which would have put a very large number of competent men out of employment. Even at this moment I am anxious to make a com- munication on miners’ nystagmus to an audience which would be composed chiefly of coal-pit managers and of the officials of the various unions. If the General Medical Council took it into its head it might say that that is an infamous thing to do. Naturally I believe that my communication will be of some value in helping to solve an extremely intricate economic problem. The General Medical Council is absolutely unconditioned ; it may do what it likes, and nobody has any right to interfere with it. If THE LANCET thinks that that is a healthy state-of matters I do not. I cannot go on with the publica- tion meantime because one never knows what the General Medical Council will do. It is all very well to say that a name can be reponed. So it can be, but meantime it has been struck off and the person involved has no doubt lost any appointments he may have held under the Crown, such as an appointment of certifying surgeon. He will likely also have lost any hospital appointment he may hold. As a rule, hospital appointments can only be held by persons who are on the Medical Register. When his name is reponed by the General Medical Council, will he also get back any medical appointments which he may have lost ? P Will they not meantime have been filled up so that it is impos- sible for him to regain his appointments ? Unques- tionably there should be an appeal to a competent legal tribunal before anyone is involved in perhaps financial ruin by amateur lawyers. I have no wish whatever to disparage the General Medical Council. I think to some extent its consti- tution should be changed. But, given a right propor- tion of men who are of eminence in modern surgery and modern medicine, it is the proper body to deter- mine the medical curriculum. To my mind it has recently made a mess of the curriculum. That, however, is a matter on which opinions may legiti- mately differ. But, given a sound working Council, whose members are for the most part in the prime of life and actively engaged in the higher parts of medical work, then it would be an admirable body for arranging the curriculum. The refusal to have an investigation rather conveys to my mind the idea that the cause of the General Medical Council is not a particularly strong one. Were it otherwise the Council would welcome a proper investigation. My fear is that the discontent with the present organisation and powers of that body will cause its whole functions to be taken over by the Ministry of Health, and that is an event which I do not wish to occur. I think it can only be prevented by the General Medical Council insisting on an investigation and thereafter setting its house in order. I am, Sir, yours faithfully, Glasgow, Dec. 24th, 1925. FREELAND FERGUS. ** The passage in our leading article, on which Dr. Fergus bases his argument, is not quoted quite correctly. The sentence ran : " Nor let it be forgotten that it is the British tradition to rely upon each trade or calling or service to maintain its own standards."-ED. L.
Transcript of PROFESSIONAL CRITICISM OF THE GENERAL MEDICAL COUNCIL.
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on the basis of some metabolic disturbance which wasessentially protective in type, a disturbance mostprobably of the nature of a retention of a normalproduct of katabolism. The interest I felt in Dr.Spaeth’s original communication will be appreciated.How far this new communication of Dr. Spaethbears on those opinions I do not ask for space todiscuss here, for at the present time the essentialpoints are that fatigue under certain conditionsappears to raise the bodily resistance to infection,and that in an attack of influenza there are symptomssimulating fatigue which appear to be of goodprognostic significance.
This work may also throw new light on the infantileconvulsion and the rigor of adult life. For manyreasons it is to be hoped that the untimely end ofDr. Spaeth may not lead to an abandonment ofinvestigations into the relationship of fatigue toinfection. His work deserves all the prominencewhich has been given to it through your leadingarticle. I am, Sir, yours faithfully,
Halifax, Dec. 23rd, 1925. A. GARVIE.
PROFESSIONAL CRITICISM OF THEGENERAL MEDICAL COUNCIL.
To the Editor of THE LANCET.SIR,—In your issue of Dec. 26th Dr. Gordon
Ward writes apparently with approval of an actionon the part of medical men which would seem tome most reprehensible. I refer to his statement inregard to the signing of a " certificate which requiresthe doctor to certify that he has seen all the childrenof so-and-so alive on this date." I have long taughtsenior students and junior practitioners workingunder me that members of our profession are far toocareless of the way in which they fill in certificatesof all sorts, and warn them against signing theirnames in blank to any document or putting theirsignatures to any statement without first reading itcarefully. The right to sign certain documents-suchas applications for passports or for payment ofpensions-is one which we share with justices of thepeace and with members of a limited number ofother professions. It is a right of which we shouldbe proud, and carelessness in using our right shouldbe avoided. This is, however, the first time that Ihave ever heard of a medical man openly statingthat he is in the habit of signing such certificatesknowing that he is making a false statement. Cer-tainly I should call such behaviour both " fraudu-lent " and " unethical " (these are his actual words).
I am writing this because the layman who readsyour paper should not be allowed to think thatsuch a standpoint will go unchallenged. At anycommittee with disciplinary powers I, for one, shouldview with disfavour anyone who had made such afalse statement by carelessness, and be prepared torecommend a severe penalty on anyone who wasproved knowingly and intentionally to have done thesame. I am, Sir, yours faithfully,
T. B. LAYTON.V’elbeck-street, W., Dec. 26th, 1925.
To the Editor of THE LANCET..SIR,—Will you allow me a word of friendly criti-
cism of the leading article in your issue of Dec. 19th ?In the course of that article you state that it is aBritish tradition that every trade and every profes-sion is to manage its own affairs. Supposing I werea member of the black squad and, being democratic,I insisted on working for the wage offered by theemployers, and that the other members of the trade-union did not agree to my doing so and forthwithproceeded to maul me. Am I not to be allowed toapply to the ordinary judicature of the country forreparation ; is my case only to be considered by thetrade-union ? I do not agree to any such attitudewhatsoever.Now the General Medical Council as presently
established is a law unto itself ; in fact, if I read
matters aright, it is superior even to the law of theland. It has a power which has not been held byany tribunal so far as I know since the Court of HighCommission in the reign of James II. of England,that Court which directed the Bloody Assize in theWest country. In some cases it appears to be veryslack in its proceedings, in others unnecessarilysevere. Many years ago a contribution which I madeon the subject of seamen’s eyesight, and which, withmy consent, was published in the Liverpool Journalof Commerce, might even now get me into trouble.The General Medical Council may take it into itshead even yet that such a contribution should nothave been made to a lay journal. It was, however,an important contribution and stopped the adoptionof certain regulations which would have put a verylarge number of competent men out of employment.Even at this moment I am anxious to make a com-munication on miners’ nystagmus to an audiencewhich would be composed chiefly of coal-pit managersand of the officials of the various unions. If theGeneral Medical Council took it into its head it mightsay that that is an infamous thing to do. NaturallyI believe that my communication will be of somevalue in helping to solve an extremely intricateeconomic problem. The General Medical Council isabsolutely unconditioned ; it may do what it likes,and nobody has any right to interfere with it. IfTHE LANCET thinks that that is a healthy state-ofmatters I do not. I cannot go on with the publica-tion meantime because one never knows what theGeneral Medical Council will do.
It is all very well to say that a name can be reponed.So it can be, but meantime it has been struck offand the person involved has no doubt lost anyappointments he may have held under the Crown,such as an appointment of certifying surgeon. Hewill likely also have lost any hospital appointmenthe may hold. As a rule, hospital appointments canonly be held by persons who are on the MedicalRegister. When his name is reponed by the GeneralMedical Council, will he also get back any medicalappointments which he may have lost ? P Will theynot meantime have been filled up so that it is impos-sible for him to regain his appointments ? Unques-tionably there should be an appeal to a competentlegal tribunal before anyone is involved in perhapsfinancial ruin by amateur lawyers.
I have no wish whatever to disparage the GeneralMedical Council. I think to some extent its consti-tution should be changed. But, given a right propor-tion of men who are of eminence in modern surgeryand modern medicine, it is the proper body to deter-mine the medical curriculum. To my mind it hasrecently made a mess of the curriculum. That,however, is a matter on which opinions may legiti-mately differ. But, given a sound working Council,whose members are for the most part in the primeof life and actively engaged in the higher parts ofmedical work, then it would be an admirable bodyfor arranging the curriculum. The refusal to have aninvestigation rather conveys to my mind the ideathat the cause of the General Medical Council is nota particularly strong one. Were it otherwise theCouncil would welcome a proper investigation.My fear is that the discontent with the present
organisation and powers of that body will cause itswhole functions to be taken over by the Ministry ofHealth, and that is an event which I do not wish tooccur. I think it can only be prevented by the GeneralMedical Council insisting on an investigation andthereafter setting its house in order.
I am, Sir, yours faithfully,Glasgow, Dec. 24th, 1925. FREELAND FERGUS.
** The passage in our leading article, on whichDr. Fergus bases his argument, is not quoted quitecorrectly. The sentence ran : " Nor let it be forgottenthat it is the British tradition to rely upon eachtrade or calling or service to maintain its own
standards."-ED. L.
