National Health Insurance Notes

As I promised in my last notes to discuss the question of over-prescribing, I must now briefly consider this difficult problem-for problem it is to every insurance practitioner who endeavours to satisfy patients and at the same time spend his drug allowance economically. The chief cause of the high cost on the Drug Fund is to be found in the Belfast inhabitants' love for a bottle of medicine. If the doctor does not prescribe a mixture, no matter what advice is given, the complaint, imaginary or otherwise, cannot be relieved. Another strange belief of the Belfast inhabitant is the magic virtue of three bottles in succession. I suppose this belief was created in days of old by doctors in industrial areas, who, on account of their small fees, encouraged their patients to attend at least three times, and as the doctor usually charged the same fee for examination and medicine as for medicine alone, the patient came to the conclusion that medicine was much more important than the examination and advice. The doctor is now faced with the delicate and difficult task of re-educating his patients, without loss of their confidence, to the fact that customs of yesterday are not always applicable to present-day conditions, and that many ills can be cured without resort to the fetish of the medicine bottle. I believe this re-education is merely a matter of time, and at no distant date the Drug Fund will be able to bear any cost imposed upon it, in this necessary, and even at times expensive, treatment of certain diseases. Dr. J. S. Jowett Lee has been appointed secretary to the Belfast Medical Guild in place of Dr. S. Rodgers, resigned. Dr. Lee should make an efficient secretary. It is to be regretted that the meetings of the Guild are but poorly attended. Yet insurance practitioners could make this a very helpful organisation to themselves if they took sufficient interest in it. The Medical Club had an enjoyable supper at their rooms in the Grand Central Hotel last December. But I fear the high cost of running a social club in a central position makes it unattractive to most practitioners. The most economical way of making a social club successful would be for all insurance practitioners to join the Ulster Mledical Society, and they could use the Institute for clubrooms. I am sure the Ulster Medical Council would welcome such a scheme. The North Belfast Branch of the Medical Guild continues to have well-attended meetings every month in the Institute. These meetings, under the chairmanship of Dr. Cahill, are all for the welfare of the practitioners of the district, as the harmonious working of a service is a great advantage. Dr. Boyd, R.M.O., who was a guest at the last meeting, expressed the hope that other districts would follow North Belfast's lead. He said such guilds were a great benefit to all concerned, and made for the smooth working of the National Health Insurance. S. MCCOMB. Albertville, Crumlin Road, Belfast.