THE FINANCES OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND AND THEIR RELATION TO THE REFORM OF THE...
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492 movement for early closing. Finally, we may be tempted to consider what further remedial measures naturally suggesb themselves. THE FINANCES OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND AND THEIR RELATION TO THE REFORM OF THE COLLEGE. IN the struggles and debates at the Royal College 01 Surgeons of England neither the Fellows nor the Members have made sufficient use of the materials for argument which may be derived from the tables of income and ex- penditure published annually in the Calendar of the College. Beyond casual references to the large sums expended in bricks and mortar, the handsome emoluments of examiners elected out of the body which distributes the revenue of the institution, the injustice of excluding altogether from power or influence the very persons to whom the College is indebted for its existence and pros- perity, and a stray resolution to the tffect that the Fellows and Members ought to be consulted in regard to any extraordinary expenditure, wecannob recall anything approaching to effective criticism. And yet we believe that a close examination into the present condition of the income and expenditure of the College-which it is the business and duty of the Fellows and Members to watch, and, if possible, to control-will furnish one of the most effectual weapons ever placed in the hands of the friends of reform and of a liberal constitution, and, if properly utilised, will effectually prevent the continuance and augmentation of the power at present wielded by the Council of the College. As we cannot pretend to deal exhaustively with this subject within the limits of a single article, we shall direct attention to the salient features of the financial position and show how they support the principles of con- stitutional reform which have again and again been urged upon the attention of the Council of the ColJfgf. 1. It must impress itself strongly on all who inspect he balance-sheets how large a revenue is annually administered by the Council, large both absolutely in itself and relatively to that at the command of similar institutions where a far more liberal constitution prevails. In 1890-91 the total income of the College amounted to no less a sum than £27,174. We have not the material before us for making any close comparison between thecullege of Surgeons of England and the other profes- sional Colleges, as the balance sheets of the latter are not readily accessible ; but, judging by returns furnished a few years ago, it may be concluded, we believe with a fair approach to accuracy, that the income of the Royal College of Surgeons of England varies from about nine times to two and a half times as much as that of the other Colleges. 2. On comparing the income of the College for 1890-91 with that of preceding years, a considerable increase will be observed. Ten ears previously-viz., in 1881-82-the income was £18,578, or £8596 less than in 1890-91, Part of the increase is due to the larger receipts from the Membership examinations, for in 1881-82 the receipts from this source were £13,191, and in 1890-91 £17,122 In the intervening years the receipts fluctuated considerably, owing chiefly to the introduction and working of the Conjoint Examinirg Scheme. The most fruitful year of the decade was 1886-87, when the receipts from the Members’ examinations rose as high as £20,977. The whole of this large sum was derived from the strictly pro fessional examinations, for the Preliminary examination conducted by the College, which used to yield about £700 per annum, was discontinued in 1881-82. The rest of the increase of income has been due to the Erasmus Wilson bequest. The stock dividends from this source accrued in 1887-88, and in 1890-91 amounted to £5438. 3. It is a very striking fact, and one of the utmost importance for the reformer to note, that not far short of .j620 000 out of the £27,174 of the income of the College in 1890-91 were derived from the professional examina- tions. The exact sum was £19,393 17s 6d., comprised of £17,122 17s. 6d. from the Members’ examinations, £1830 from the Fellow!)’ examinations, and £441 from the Dental examinations. Thus the receipts from the Members" examinations were more than nine times as great as those fro m the Fellows’ examinations. For a strict and fair com. parison, however, between the receipts from the Members and the receipts from the Fellows, it would be necessary to deduct from the £17,000 received from the Members’ examinations the sums paid by those who subsequently obtain the Fellowship, and to add this to the receipts from the Fellows’ examinations. This adjustment would lessen the disproportion between the two sources of income, but would scarcely make the receipts from the Fellows amount to more than one. fifth or one. sixth of the receipts from the Members of the College. 4. It may not be generally known that nearly all the fees derived from the candidates for the Fellowship examination are absorbed in expenses. On the first Fellowship examination there is a surplus, but the Una!) Fellowship examination entails no incoIlsiderable loss to the College, the balance being barely redressed when the surplus from the first examination is set off against the deficit on the final. The result is that the receipts from the- Fellowship examinations contribute little towards the main. tenance of the College establishment. How much the Members contribute was most forcibly shown a few years ago by Mr. Eichsen in a well. remembered speech at the College, afterwards published as a pamphlet, composed, curiously enough, to prove that the Members ought to be excluded from a share in the government of the College. Mr. Erichsen said that "the fees paid by the Members sufficed, not only to pay the Board and Court of Examiners, to buy the diploma stamps, to defray at least two thirds of the working expenses of the College, mainly due to the requirements of the examinations, and nearly the whole of the cost of maintaining the museum and library, but to* leave a balance of .E6000, out of which pensions and various other collegiate expenses were paid. Out of each diploma fee of 20 guineas 6 or 7 guineas went into the coffers of the College. " ’ The foregoing remarks concern the income of the College. We turn now to the expenditure. The most noteworthy points in regard to the expenditure are these :- 5. The whole of the income is absorbed by the p:x,- penditure There is no margin. Neither last year, 1890-9, nor for several years, has there been any fresh investment out of the income of the College. The expenditure, ordinary and extraordinary, has both diminished capital, IInd has more than swallowed up the interest on the Erasmus Wilson stocks. 6. The Examiners of the College received aboub one- third of the income for 1890-91. They divided between them as nearly as possible f9000. The percentage pro. portion of examiners’ fees to receipts works out to about* 42 in the case of the Members’ examinations, and to about 82 in the case of the Fellows’ examinations. For the benefit of the examiners there is a capitation fee on each candidate examined, whether accepted or rf jacked, so that a rfjected candidate may involve a loss to the College, bui! not to the examiners. ’ 7. The working expenses of the e:xarninatioI1s exclusive of exe miners may be reckoned as not less than 20 per cent. Hence there would be a balance of between 30 and 40 per cmt on Members’ fees available for the general expenses of the College, but on the Fellows’ fees little if any. 8. During the last few years three new sources of expense have been opened-the Examination Hall and the labora- tories on the Embankment, and the enlargement of the College by the addition of new museums &e. In ten years more than jE62 000 have been expended on bricks and mortar and buildings generally. In 1890 91 the proportion of expanses paid by the College for the Examination Hal was £4274 12s. 4d., and the laboratories cost £1434; but,. as £761 were expended on furniture and fittings, the annual cost for the future may be reckoned as less than 91COO. We have no means of estimating accurately the additional exa- penditure caused by the new buildings at the College itself but the whole cost of maintaining the three new establish- ments may be put down in round numbers at £6000 annually. 9. If the receipts from examinations and trust funds are set aside, and regard paid only to the fixed income and necessary expenditure, there is a considerable an:Ji1uaJ!deficit. The fixed income of the College from rents aad stock amounted in 189J-91 to f6807 7s. 3d, and the necessary expenditure-i.e., the expenditure for maintenance of the- establishment—was about f9500. In other words, there was
Transcript of THE FINANCES OF THE ROYAL COLLEGE OF SURGEONS OF ENGLAND AND THEIR RELATION TO THE REFORM OF THE...
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movement for early closing. Finally, we may be tempted toconsider what further remedial measures naturally suggesbthemselves.
THE FINANCES OF THE ROYAL COLLEGEOF SURGEONS OF ENGLAND AND THEIR
RELATION TO THE REFORM OFTHE COLLEGE.
IN the struggles and debates at the Royal College 01
Surgeons of England neither the Fellows nor the Membershave made sufficient use of the materials for argumentwhich may be derived from the tables of income and ex-
penditure published annually in the Calendar of the College.Beyond casual references to the large sums expended inbricks and mortar, the handsome emoluments of examinerselected out of the body which distributes the revenueof the institution, the injustice of excluding altogetherfrom power or influence the very persons to whomthe College is indebted for its existence and pros-perity, and a stray resolution to the tffect that theFellows and Members ought to be consulted in regardto any extraordinary expenditure, wecannob recall anythingapproaching to effective criticism. And yet we believe thata close examination into the present condition of the incomeand expenditure of the College-which it is the businessand duty of the Fellows and Members to watch, and, ifpossible, to control-will furnish one of the most effectualweapons ever placed in the hands of the friends of reformand of a liberal constitution, and, if properly utilised, willeffectually prevent the continuance and augmentation ofthe power at present wielded by the Council of theCollege. As we cannot pretend to deal exhaustively withthis subject within the limits of a single article, we shalldirect attention to the salient features of the financialposition and show how they support the principles of con-stitutional reform which have again and again been urgedupon the attention of the Council of the ColJfgf.
1. It must impress itself strongly on all who inspecthe balance-sheets how large a revenue is annuallyadministered by the Council, large both absolutely initself and relatively to that at the command of similarinstitutions where a far more liberal constitution prevails.In 1890-91 the total income of the College amountedto no less a sum than £27,174. We have not thematerial before us for making any close comparison betweenthecullege of Surgeons of England and the other profes-sional Colleges, as the balance sheets of the latter are notreadily accessible ; but, judging by returns furnished a fewyears ago, it may be concluded, we believe with a fairapproach to accuracy, that the income of the Royal Collegeof Surgeons of England varies from about nine times to twoand a half times as much as that of the other Colleges.
2. On comparing the income of the College for1890-91 with that of preceding years, a considerableincrease will be observed. Ten ears previously-viz., in1881-82-the income was £18,578, or £8596 less than in1890-91, Part of the increase is due to the larger receiptsfrom the Membership examinations, for in 1881-82 thereceipts from this source were £13,191, and in 1890-91£17,122 In the intervening years the receipts fluctuatedconsiderably, owing chiefly to the introduction and workingof the Conjoint Examinirg Scheme. The most fruitfulyear of the decade was 1886-87, when the receipts fromthe Members’ examinations rose as high as £20,977. Thewhole of this large sum was derived from the strictly professional examinations, for the Preliminary examinationconducted by the College, which used to yield about £700per annum, was discontinued in 1881-82. The rest of theincrease of income has been due to the Erasmus Wilsonbequest. The stock dividends from this source accrued in1887-88, and in 1890-91 amounted to £5438.
3. It is a very striking fact, and one of the utmostimportance for the reformer to note, that not far shortof .j620 000 out of the £27,174 of the income of the Collegein 1890-91 were derived from the professional examina-tions. The exact sum was £19,393 17s 6d., comprisedof £17,122 17s. 6d. from the Members’ examinations,£1830 from the Fellow!)’ examinations, and £441 from the
Dental examinations. Thus the receipts from the Members"examinations were more than nine times as great as thosefro m the Fellows’ examinations. For a strict and fair com.
parison, however, between the receipts from the Membersand the receipts from the Fellows, it would be necessaryto deduct from the £17,000 received from the Members’examinations the sums paid by those who subsequentlyobtain the Fellowship, and to add this to the receipts fromthe Fellows’ examinations. This adjustment would lessenthe disproportion between the two sources of income, butwould scarcely make the receipts from the Fellows amountto more than one. fifth or one. sixth of the receipts from theMembers of the College.
4. It may not be generally known that nearly all thefees derived from the candidates for the Fellowshipexamination are absorbed in expenses. On the firstFellowship examination there is a surplus, but the Una!)Fellowship examination entails no incoIlsiderable loss to theCollege, the balance being barely redressed when thesurplus from the first examination is set off against thedeficit on the final. The result is that the receipts from the-Fellowship examinations contribute little towards the main.tenance of the College establishment. How much theMembers contribute was most forcibly shown a few yearsago by Mr. Eichsen in a well. remembered speech at theCollege, afterwards published as a pamphlet, composed,curiously enough, to prove that the Members ought tobe excluded from a share in the government of the College.Mr. Erichsen said that "the fees paid by the Memberssufficed, not only to pay the Board and Court of Examiners,to buy the diploma stamps, to defray at least two thirds ofthe working expenses of the College, mainly due to therequirements of the examinations, and nearly the whole ofthe cost of maintaining the museum and library, but to*leave a balance of .E6000, out of which pensions and variousother collegiate expenses were paid. Out of each diplomafee of 20 guineas 6 or 7 guineas went into the coffers of theCollege. "
’ The foregoing remarks concern the income of the College.We turn now to the expenditure. The most noteworthypoints in regard to the expenditure are these :-
5. The whole of the income is absorbed by the p:x,-
penditure There is no margin. Neither last year, 1890-9,nor for several years, has there been any fresh investmentout of the income of the College. The expenditure,ordinary and extraordinary, has both diminished capital,IInd has more than swallowed up the interest on the ErasmusWilson stocks.
6. The Examiners of the College received aboub one-
third of the income for 1890-91. They divided betweenthem as nearly as possible f9000. The percentage pro.portion of examiners’ fees to receipts works out to about*42 in the case of the Members’ examinations, and to about82 in the case of the Fellows’ examinations. For thebenefit of the examiners there is a capitation fee on eachcandidate examined, whether accepted or rf jacked, so thata rfjected candidate may involve a loss to the College, bui!not to the examiners.
’ 7. The working expenses of the e:xarninatioI1s exclusiveof exe miners may be reckoned as not less than 20 per cent.Hence there would be a balance of between 30 and 40 percmt on Members’ fees available for the general expenses ofthe College, but on the Fellows’ fees little if any.
8. During the last few years three new sources of expensehave been opened-the Examination Hall and the labora-tories on the Embankment, and the enlargement of theCollege by the addition of new museums &e. In ten yearsmore than jE62 000 have been expended on bricks andmortar and buildings generally. In 1890 91 the proportionof expanses paid by the College for the Examination Halwas £4274 12s. 4d., and the laboratories cost £1434; but,.as £761 were expended on furniture and fittings, the annualcost for the future may be reckoned as less than 91COO. Wehave no means of estimating accurately the additional exa-penditure caused by the new buildings at the College itselfbut the whole cost of maintaining the three new establish-ments may be put down in round numbers at £6000annually.
9. If the receipts from examinations and trust funds areset aside, and regard paid only to the fixed income andnecessary expenditure, there is a considerable an:Ji1uaJ!deficit.The fixed income of the College from rents aad stockamounted in 189J-91 to f6807 7s. 3d, and the necessaryexpenditure-i.e., the expenditure for maintenance of the-establishment—was about f9500. In other words, there was
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a deficit under the present administration of the College of)1early f2700. The deficit is likely to be greater this year,for there is a debt of .Ell,000 under existing contracts, andthis must be met by a fresh sale of stock, which will stillfurther diminish the fixed income Tho receipts fromhouse property have been recently reduced by more thanone half—viz., from j61503 to £700—in consequence ofthe demolition of houses to admiv of the enlargement ofthe College; but it is only fair to state that No. 41,Lincoln’s-inn-fields had been purchased five years pre-viously, and this brought £500 a year into the Collegeooffers. It has now gone, however, with a great deal moreof the capital, and at the present rate of expenditure thewhnle of the capital will disappear in a few years.
10. Of the £9000 devoted to the payment of examiners,about f5500 are distributed among the ten fortunatemembers of the Court of Examiners, and of this E5500seven-tenths, or £3850, replenish the pockets of seven
members.The conclusions which we draw from the foregoing facts
are these :-1. ;1;27,000 a year and upwards is a very large sum for a
corporation to receive and expend, and for a Council oftwenty-four persons only out of 16,000 to claim and exercisethe right of expending it, as well as of disposing of the capitalbelonging to the corporation, without submitting theirstewardship to the Fellows and Members who constitutethe corporation for unfettered and open criticism is ananachronism at the end of the nineteenth century.
2. The enormous preponderance of the confiributions ofthe Members of the College over those of the Fellows, andthe fact that from Members’ fees alone is derived moneyfor defraying the working expenses of the institution, showthe absolute injustice of excluding the Members from anyshare in the government and in the election of the Council.Let it be noted that the cost of maintenance of the Exami-nation Hall and labaratories—new sources of expenditure-equals the new source of income, the dividends from theErasmus Wilson stocks, so that without the Members’ feesthe College itself could not be maintained.
3. To have expended .673,000 on buildings in a few years Iwithout the sanction of the Fellows and Members is morallyat least an abuse of power, whether the money has beenrightly and judiciously expended or not. It is true thatthere is nothing in the Charters to prevent this, and theCouncil have acted strictly within tne letter of the law.The Charters, however, on which the present constitutionis based are from nearly a hundred to fifty years old, andfrom recent experience it appears that the Privy Councilwill not act in opposition to the governing body of a acorporation in amending Charters, whatever may be theweight of evidence and argument adduced in favour of thedesired amendments. And yet if a Charter had now to begranted for the first time, it would scarcely be framed in so)[liberal aspirit. All the circumstances have changed. TheCollege has grown into a rich curporation, and has attainedan importance which it did not possess a hundred or even fiftyyears ago. If all the facts could be laid before Parliamentand thoroughly investigated and mastered by the members,there can be little doubt that large concessions would bemade to the Fellows and Members, and some check be im-posed upon the autocracy of the Council.
4. The present expenditure at the -College ought to be(reduced so as to ensure a margin sufficient to admit of asubstantial annual investment, for the purpoe.e of bringing)Qip the fixed income to a level with necessary expenditure.instead of being paid out of capitation fees, fixed salariesshould be given to the examiners; and these should becalculated after due allowance had been made for meeting’1Jhe necessary expenditure and providing a surplus for invest-ment. Whilst cordially endorsing the view that examinersshould be well paid for their services, we think that thework could be well done for £300 a year, and there wouldbe no lack of thoroughly competent candidates for theappointments.
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SCOTTISH UNIVERSITIES’ COMMISSION.
A FEW days ago Ordinance No. 16 (Edinburgh, No. 1Regulations for Degrees in Medicine) was issued. Its
permanent form is more satisfactory than its draft formwas. Four degrees in medicine and surgery are to be con.ferred by the University—viz., Bachelor of Medicine
( VI. B.), Bachelor of Surgery (Ch.B.), Doctor of Medicine(M.D.), and Master of Surgery (Uh.M.). After dealingwith the preliminary examination, the general lines ofwhich are much the same as those at present in opera-tion, it proceeds to regulate professional education. Ofthe five years devoted to professional study, during atleast three of them hospital practice is compulsory,and duricg the fifth year candidates must be engaged inclinical study for nine months. Not less than nine months’attendance on clinical surgery and clinical medicine aremade compulsory, as against six months, which is thepresent arrangement. Practical pharmacy, to which suchprominence was given in the draft ordinance, and re-garding which there was almost unanimous disapprovalexpressed, save by those specially interested in the teachingof the subject, has been reduced to its proper place, twenty-five meetings of a practical pharmacy class or three months’dispensing in a hospital or dispensary, or in an establish-ment recognised by the Pharmaceutical Society, being nowall that is required. C andidates must have acted as clerk inthe medical house and dresser in the surgical ward3, andthey must have availed themselves, to such an extent asmay be required by the Senatus, with the approval of theUniversity Court, of opportunities of studying at a hospitalor dispensary, post mortem examinations, fevers, diseasesof children, ophthalmology, or such other special depart-ments as may from time to time be determined. Acourse of instruction in mental diseases has also beenmade compulsory. An important modification of thepresent system has been made possible by its beingmade the duty of the professors and lecturers tosubmit to the Senatus annually a scheme specify-ing whab proportion of the courses should be devotedto lectures, practical demonstrations, examinations, andtutorial work respectively, and the Senatus shall transmitsuch scheme, with such observations as it may think fit tomake thereon, to the University Court for its approval.At present the statutory regulation is that 100 lecturesmust be delivered to constitute a winter course.The professional examinations are to be four in num-
ber-viz. (1) botany, zoology, physics, and chemistry ;(2) anatomy, physiology, and materia medica and thera-peutics ; (3) pathology, and medical jurisprudence andpublic health; (4) surgery and clinical surgery, practiceof medicine and clinical medicine, and midwifery. Forthe first group candidates may present themselves atthe first examination held after they have attended a
complete course. The second examination comes off atthe end of the third winter session, the third at the end ofthe fourth winter session, and the final at the end of thefifth year of study. The result of the arrangement willprobably be that students will devote too much of theirenergy during the fourth year to these subjects. For thedegrees of Doctor of Medicine and Master in Surgery aspecial examination has been instituted in addition to thepresentation of a thesis.Ordinance No. 12 (General, No. 7, Regulations for Degrees
in Science) was issued at the same time. As regardsdegrees in pure science, it is ordained that there shall be afirst science examination in (1) mathematics or biology(i e., zoology and botany) ; (2) natural philosophy ;(3) chemistry ; and a second examination in any three ormore of the following :—Mathematics, natural philosophy,astronomy, chemistry, human anatomy (including anthro-pology), physiology, geology (including mineralogy), zoology(including comparative anatomy), botany (including vege-table physiology). Provision is also made for the establish.ment of degrees in applied science by the University Courtin each University.
UNIVERSITY RIOTS IN ITALY.
A MORAL cyclone has agitated the groves of the ItalianAcadema. Beginning at the University of Naples, where alaw professor inflicted personal chastisement on a contu-macious student, the disturbance has involved the wholeacademic life of Italy, till not a single sea.t of learning fromTurin to Palermo, from Padua to Cagliari, has escaped. Sowide has the chasm between professors and students becomethat in the maj )rity of the schools all work has beensuspended, and the time that should have been devoted totuition on the one hand and to classes on the other has beenfill -d by indignation meetings of the insubordinate youths
