Health > Quarterly bulletin of the Health Organisation > Volume 3

DEVELOPMENT OF GENERAL HOSPITALS IN ENGLAND 235
factorily in the Metropolitan area that the proposal to extend it to
the provinces is under consideration. Consultant lists would be
formed in the different provincial districts, but only if the consul¬
tants in each area concerned agreed to the establishment of such
a list. In the case of the Metropolitan area, the consultants are
available for :
(a) Persons entitled to medical benefit under the National
Health Insurance Act ;
(b) Members of approved hospital contributory schemes ;
(c) Members of approved medical services.
Any patient in these groups is now able to have a consultation for
one guinea. There is a class of persons who previously only had
the opportunity of a consultation at high fees, which they could
ill afford, or else got advice free through hospitals, voluntary or
municipal, and the arrangement for less expensive consultations,
therefore, prevents patients from having to overcrowd the hospitals,
and maintains a close relationship between patient and doctor.
Conditions under which a name should be added to the list of
consultants when these have been created in each district have
been laid down by the British Medical Association. A candidate
for the list would have to show :
(1) That he was holding, or had held, hospital or other
appointments affording special opportunity of acquiring special
skill and experience of the kind required for the performance
of the service to be rendered, and that he had had recent expe¬
rience in performing such service ; or
(2) lhat he had made special academic or post-graduate
study of the subject comprising the service to be rendered and
had had actual recent experience in performing such service; or
(3) That he was generally recognised by other practitioners
in the area as having special proficiency and experience in the
subject comprising the service to be rendered.
The large number of appointments made to the new Council
hospitals, both of medical and surgical specialists, has led to consi¬
derable discussion as to the terms and conditions of service of such
consultants. The question of whether consultants should be
appointed on a whole-time or a part-time basis has not yet been
agreed upon, some authorities following the first practice, and others