Moreover, not only is it
impossible for the private practitioner to possess the knowledge
required to treat his patients adequately: he cannot possess the
scientific mechanical equipment nowadays required alike for diagnosis
and treatment, and every day becoming more elaborate, more expensive,
more difficult to manipulate. It is installed in our great hospitals
for the benefit of the poorest patient; it could, perhaps, be set up
in a millionaire's palace, but it is hopelessly beyond the private
practitioner, though without it his work must remain unsatisfactory and
inadequate.[1] In the second place, the whole direction of modern
medicine is being changed and to an end away from private practice; our
thoughts are not now mainly bent on the cure of disease but on its
prevention. Medicine is becoming more and more transformed into hygiene,
and in this transformation, though the tasks presented are larger and
more systematic, they are also easier and more economical. These two
fundamental tendencies of modern medicine--greater complexity of its
methods and the predominantly preventive character of its aims--alone
suffice to render the position of the private practitioner untenable. He
cannot cope with the complexity of modern medicine; he has no authority
to enforce its hygiene.
The medical system of the future must be a national system co-ordinating
all the conditions of health. At the centre we should expect to find a
Minister of Health, and every doctor of the State would give his whole
time to his work and be paid by salary which in the case of the higher
posts would be equal to that now fixed for the higher legal offices, for
the chief doctor in the State ought to be at least as important an
official as the Lord Chancellor.
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