§ Every assignment of or charge on, and every agreement to assign or charge, any remuneration payable to a medical practitioner in respect of the administration of medical benefit shall be void, and, on the bankruptcy of any medical practitioner entitled to such remuneration, the remuneration shall not pass to any trustee or other person acting on behalf of his creditors.—[Mr. Rhys Davies.]
§ Brought up, and read the First time.
§ 7.57 p.m.
§ Mr. RHYS DAVIESI beg to move, "That the Clause be read a Second time."
108 On this occasion I am on rather delicate ground, and am also treading rather a new path. I will do so with good humour as far as I can. The purpose of the Clause is to bring to the notice of Parliament some anomalies that have crept into the panel practices of this country, in some parts of the country more than in others. The position, so far as I understand it, is briefly this: A medical student who has passed all his examinations in a university must, of course, get a practice as a doctor, and he may, when starting his career, be poor. To buy a practice he must have money. He may buy a private practice, or a panel practice, or perhaps both, from an older 109 doctor, but I am given to understand rather authoritatively that the position is not always quite as simple as that, for I believe that in some cases the young doctor gets so involved in the hands of moneylenders that that fact leads to his practice suffering. I believe that within the medical profession arrangements exist whereby young doctors are helped in starting their careers, but I am not referring to that angle of the case at all. A good deal of evidence has been supplied to me, but I need only refer to the report of the annual conference of the Association of Insurance Committees, where the position is stated in a definite and official form.
I am not going to criticise the young doctor who borrows money. It is quite possible that most young men might be in that position in entering any business or profession. But we want to say definitely that, where a person lends money to a young doctor, he shall not lay down such conditions for the repayment of that money as would affect the practice of the doctor himself in his work as a panel doctor. I cannot believe that a young man can perform his duties as a panel doctor efficiently and effectively if he is unduly harassed by an unscrupulous moneylender into whose hands he has fallen.
We desire to ask the right hon. Gentleman whether he knows of any way to get over this difficulty. He knows that the problem has been raised with him on more than one occasion, but I believe the reply of the Ministry of Health is always to this effect: "Unless you can show us that the doctor's work is adversely affected by these commercialised transactions, the Ministry of Health will take no notice of them." I think, however, that the mere fact that these cases have been brought before the Ministry ought to be enough to move them, not only to keep panel practice in its proper status, but also to save the young doctor from getting into financial difficulties with unscrupulous people who lend him money.
It must not be supposed, because we raise this problem to-day, that every panel doctor is in that position. Such cases are few and far between, and probably, on a percentage basis, the number is smaller than it would be in many of the other professions. Nevertheless, as this is the Parliament of the country, and as this is 110 a debating Chamber where all anomalies ought to be explained and abuses exposed, we have thought it fitting to put this Clause down in order to see whether something can be done to remove some of the anomalies which I have indicated.
§ 8.0 p.m.
§ Mr. SHAKESPEAREI quite agree with the hon. Gentleman that, if the situation that he fears had arisen, whereby panel practitioners were borrowing money on harsh terms on the security of their practice, we should have to see that the matter was taken up. At present there is no evidence, except in an infinitesimal number of cases, that the efficiency of the panel practitioner is affected by the fact that he does what any other person in another profession might do—use the security of his practice in order to advance himself in his career. I think it would be putting too great a disability on a young panel practitioner to prevent him from borrowing money on the security of his practice. The real safeguard is that it is a matter for the British Medical Association to see that the panel practitioner is not made the prey of unscrupulous people. More and more reputable insurance societies are making provision to enable practitioners to borrow on reasonable terms. I quite appreciate the fear which actuates the hon. Gentleman, but it only applies in an infinitesimal number of cases. We will watch the position in consultation with the British Medical Association to see that the panel practitioner is not disadvantaged by mortgaging his security.
§ 8.2 p.m.
§ Mr. LOGANI have here a report of a meeting that took place about Easter in regard to young doctors, from which I should like to read a few lines:
The result was that a young doctor buying a practice was put under certain conditions which must reflect on his efforts in connection with the treatment of insured persons. He has to assign all his capitation fees to agents. He has also to sign a blank form of assignation, and a blank form to appoint a successor without the name of the successor. Something should be done to stop the practice.I certainly think some medical body ought to see to it that any practitioner, whether an old or a young man, taking over a practice, should not get into the hands of sharks, and should not be worried by people wanting to get money 111 from him when he ought to be attending his patients. Any young man starting out in life has a perfect right to get money, but it should be advanced at such a reasonable rate of interest as gives him an opportunity of carrying on, and he should not be worried by moneylenders, and wonder how he is going to find the money.
§ Motion and Clause, by leave, withdrawn.