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July 17, 1967

Doctors and State Medicine: A Study of the British Health Service

JAMA. 1967;201(3):212. doi:10.1001/jama.1967.03130030082036

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Dr. Forsyth, an authority on the problems of state medicine in England, concisely presents the complexities and politics surrounding the historical development and effectiveness of the British Health Service.

He stresses, that the British Medical Association's leadership has not been representative of the main body of medical practitioners. "To exert weight in medical politics, one must have money, and above all, time. Representative medical bodies are, therefore, inevitably weighed in favor of age, affluence, private practice, and the suburb." He points out that "the workload of medical administrators, newly-qualified doctors, and those working in urban working-class areas does not allow them time to participate in medical politics at the local level, and it is usually only through participation at this level, that influence can be exerted nationally." By emphasizing the conflict between specialist and general practitioners in England, he demonstrates that the physicians' drive for personal gain adversely affects the