Læknablaðið - 01.06.1972, Page 58

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LÆKNABLAÐIÐ
I had been looking then for ways of promoting development of this
kind and the approach was timely and welcome. The Nuffield Pro-
vincial Hospitals Trust responded generously to the needs of these
two groups and went on to sponsor a small symposium of people who
should be concerned in future developments. That conference in 1961
was to stimulate the most important development in the British
National Health Service in the whole of its 23 years. A hand picked
group meeting at Oxford over a weekend reached unanimous con-
clusions about the need to provide both for ongoing education for
all doctors and organised vocational training for those entering any
field of clinical practice. The conference concluded that every district
hospital should have its own organised in-service training systems.
The Trust immediately announced its intention of contributing a
large sum of money to help with the establishment of centres where-
ever local people were prepared to develop them. The response to
this initiative was remarkable and the enthusiasm that had been
shown in Stoke and Exeter developed spontaneously in a large unmber
of other regional centres outside the immediate vicinities of the
medical schools. In a way this is reminiscent of the origins of many
local medical societies in Britain. Most of the earlies ones started
anything from 100 to 180 years ago as journal or book clubs which
provided access to a literature which then was sparse, and they
developed as a form of ongoing education in which it was customary
for distinguished speakers from the main centres to play a voluntary
part. But the present day requires far more than the goodwill of a
series of visiting lecturers. It needs the organised opportimity for ex-
change of information between the specialists and the general prac-
titioners who together provide medical care for the population of a
district, supplemented by the planned introduction of new material
from teachers with special knowledge; and it requires access to far
more reference material and to a very considerable range of journals.
The medical literature is now enormous and no one can be conversant
with it all, yet at any time there may be someone with a need for
access to even the most unusual journal. The National Reference
Library and a regional organisation backing the district medical
centres has made it possible for this general access to be available
to all.
In the last nine years the number of medical institutes at district
hospitals which serve populations of up to 250,000 has grown so
rapidly that there are now few such hospitals without an organised
centre and about 200 of them have special premises, purpose built or
adapted, with good lecture facilities and libraries, most of them open
to all the health professions in the area. Each has its own committee
and a clinical tutor appointed and paid by the regional university.
A substantial part of the cost was met by the profession itself, rather
than wait until the hospital rebuilding programme would eventually
have provided a centre from government funds. But some of the
new hospitals opened in recent years have incorporated centres pro-
vided as part of the hospital building and hospital authorities provide