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Election of Medical Officers to Public InstitutionsAuthor(s): MedicusSource: Provincial Medical Journal and Retrospect of the Medical Sciences, Vol. 6, No. 133(Apr. 15, 1843), pp. 57-58Published by: BMJStable URL: http://www.jstor.org/stable/25491976 .

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ELECTIONS AT PUBLIC INSTITUTIONS.5

stranger to the merits and standing of the medical men residing in the locality, and who must necessarily be greatly influenced, if not altogether guided in his

choice, by the recommendation of the sub-inspector of the district, often a medical man himself, and hence not a proper person to judge of the merits or qualifica tions of his professional brethren, or to act impartially and free from bias in his recommendations. Moreover, it is an anomaly in the principle of the new bill to

delegate this power to irresponsible inspectors, whilst in other appointments the magistrates have the con trol-a control more likely to be used advantageously as regards certifying surgeons and the public generally, and free from less objection, than other appointments under the new bill, now causing such discussion.

It would be invidious to make comparisons in

Leeds; but I will venture to assert that any appoint ments that have been made by the millowners, almost, I may say, in defiance of the inspectors (as they have all along been anxious to arrogate to themselves the sole power of appointment, though the present fac tory bill gives no such authority), are appointments that will bear comparison with any of those made by the inspectors themselves, or through the influence of the sub-inspector. With regard to what has been stated as to the desirability of limiting the number of certifying surgeons in order to produce greater uni formity, I see no such necessity, unless it is to lessen the trouble of the inspectors, who are not so ill paid as to render a little trouble an object; and surely one properly educated medical practitioner is as well qualified as another to certify as to the simple matter of the age of a child and its general fitness for factory labor. Errors may doubtless be committed in the most judicious hands, and there are cases on record where the inspectors and sub-inspectors have been as much deceived as the simplest and least experienced. At any rate, if the duty of certifying surgeon is not properly performed, the inspector has the power to interfere. In order to show that those most experi enced in the office do not consider the duties cannot be equally well performed by others, I may state that when the oldest certifying surgeon 'in the town was applied to by the inspector to sanction the principle of limiting the number, he declined to do so, much to his credit, as he considered it would be establishing a monopoly injurious to the bulk of his professional brethren.

I cannot imagine, then, that either the medical pro fession or the millowners will tamely submit to allow such increased powers and patronage to be given to

any class of paid public officers. What claims have

they to it?-what jobbing may it not lead to?-what

guarantee have the public or the profession that the

appointment will be impartially and satisfactorily made? None whatever. But place the controlling power in the hands of a bench of magistrates, and the

poor man's child would be protected, the millowner

satisfied, the rights of the medical profession preserved, and jobbing and intrigue guarded against.

In conclusion, I propose that a memorial be pre sented to the Home-office, as numerously signed as

possible by my professional brethren and others in terested in the matter, stating the grounds on which

we oppose the insertion of the clauses alluded to. Such a memorial I intend to have prepared without

delay; for if the present opportunity escape it will be

too late to interfere; and respectfully requesting your active co-operation and that of my medical friends,

I have the honor to be, Gentlemen, Your obedient Servant,

J. INGHAMD IKIN.

Cookridgc-street, Leeds, April 3, 1843.

ELECTION OF MEDICAL OFFICERS TO PUBLIC INSTITUTIONS.

TO THE EDITORS OF TIIE PROVINCIAL MEDICAL JOURNAL.

GENTLEMEN,-The history of our profession, as connected with the election of medical officers to

public hospitals, infirmaries, and dispensaries, has

long exhibited much that is unsatisfactory and un

pleasant to the profession at large, and much that is

very degrading and, in many cases, very onerous to

those members who are from time to time desirous to be

appointed to such honorary situations in these institu tions. It is natural and highly laudable for medical

men to aspire to such offices; for, quite irrespective of any pecuniary advantage they may remotely derive from holding these situations (and, I believe, they are rated in this respect far above their ascer tained value), they afford not only a field for the im

provement of medical and surgical talents, which is a

virtuous and praiseworthy ambition, but they also

place the benevolently-minded man in a position for

administering to and relieving the ailments of his

poorer brethren, which is a noble and heaven-born

gratification, but which otherwise could not be per formed nor enjoyed by him.

It is, however, well known, that to obtain such

honorary situations for the improvement of medical skill and the exercise of benevolence, neither the

extent of education, the amount of talent, nor the

standing in the profession will of themselves avail;

nay, the preferable certificates and testimonials of teachers and of seniors il the profession will even

profit but little. The candidate has to obtain the far

more important requisites of the hotly-canvassed votes

of trustees, governors, or subscribers-of men pro fessedly ignorant of the science or art of medicine and

surgery, and incapable of deciding upon the qualifica tion of the lowest member of the profession. To

these the candidate must pay his court, and some

times in the most beseeching and humble manner, not

to advocate his professional claims, for that would be

misplaced, but to bear upon the mind of the suffragan with the more prevailing pleas of political, religious, commercial, or social connection, goodwill, and interest. To puzzle the mind of the aspirant for office, he or his friends will hear the highest respect paid to his character and talents, which may even be

acknowledged to be superior to any of the other com

petitors, but this politeness is soon neutralised by-" I

am sorry I have promised my vote long since, or must

reserve it for the son of my old friend, or, may be, of

a near connection of my wife, or for Mr. - , who

is strongly recommended by our minister, and much

pressed upon me by our attorney." To recount the numerous scenes of manoeuvring

and professional degradation that occur on these oc

casions would be little creditable to our dignity and

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58 ELECTIONS AT PUBLIC INSTITUTIONS.

self-respect; besides, they often entail a pecuniary expense which, even to the successful candidate, is anything but comfortable to his pocket, and forestalls

many " an angel visit" of his future fees. It may be

said, what there is of evil or degradation in all this is owing to the profession themselves. The public naturally concludes there must be in these contests something more valuable in the victory than they are simply led to suppose, else all this obsequious solici tation, all this canvassing of offices, counting-houses, shops, and drawing-rooms, these showers of circulars and cards, and all these coaches, cabs, and carriages at their command, would never take place.

Now, to undeceive the public in these respects, and to reinstate the profession in some of that dignity and independence which is due to a learned and scientific class of men, and which should ever be upheld, and

also to ensure, on the occasions above mentioned, the best interests of the community, both rich and poor, I venture to suggest how all this unsatisfactory system of canvassing, vexation, error, and unseemly turmoil, may be entirely superseded.

It must be granted that medical men are the best judges of the talents and fitness of any of their brethren, with whom they have lived in the same town or locality, for professional situations; and though individuals may have their unfair partialities for one

member in preference to another, I may venture to say, that as a body their decision would be the fairest

and the truest that could be obtained. No one

member would, moreover, say that his brethren, un biassed by fear or affection, would give an unjust estimate of his professional character, or thathe would dispute their verdict, on a simple appeal to their judgment and acquaintance. On this basis, which

may be considered the best that can be obtained in

this present condition of mind and matter, we would then ground the election of any candidate for a pub lic honorary situation in our medical institutions; and I can see no reason nor impediment why the election to all such offices may not be virtually and effectually retained in the hands of the profession itself, without

provoking any just cause of complaint or reclamation

on the part of the lay officers or supporters of these

institutions, however secretly opposed their interests and predilections may be. Let the profession only be

true to itself, and the work is done. In the first

place, let, in all cities, towns, and places, where there are public medical institutions, a register be kept, and yearly made up, of all resident qualified practi

tioners; and it is to be hoped the forthcoming Reform

Bill will enforce this regulation, and so legalise the

framework of our plan; the register to be kept by a

secretary appointed duly by the resident practitioners, and, for the purpose of working the plan of an election

when required, three or more scrutineers to be annually

appointed, who may also watch over the register and

any public interests of the members.

In the second place, when a medical office is

created, or a vacancy takes place in a public institu

tion, a notice of the same is to be sent by the secre

tary to each registered member, who, within an en.

closed printed letter, stamped with a registry seal or

mark, is to insert, without either his signature or

initials the name of the gentleman he thinks most

worthy or fitted for the situation in question at the

blank left. This letter to be sealed and returned to the secretary, according to its printed address. These

anonymous returns, on their delivery, are to be forth with put into the till of a box, which is to be publicly to the members, if they please to attend, unlocked by the scrutineers, and the name of the gentleman having the greatest number of nominations to be declared the

offering candidate for the situation. This the gentle man will do in his own name, and there being no

other candidate in the field, the governors or sub scribers will have no other alternative but to elect the chosen of the profession. If the name first on the

scrutiny declines, and in many instances this will be the case, the gentleman next named the greater num ber of times will offer, if he pleases, and so on.

A decision of this kind must not only carry the

highest recommendation to the governors and the

public, but must be of the most flattering and honor able character to the selected individual. It would be superfluous to enter into the minor details of this

plan; it is simple in itself, and is susceptible of every adaptation to all circumstances that may arise in the

appointment of, at least, honorary medical officers to

public institutions throughout the cities and towns of the provinces. The plan may, at first, be attended

with some difficulty, and require some preparatory trouble to adapt it to the numerous and intermingled institutions of the metropolis, but sectional registries

may be there also efficiently organised to make the scheme equally easy and serviceable.

The plan certainly requires the truthful adhesion of, at least, the majority of the respectable practi tioners in any one locality; but when it is considered that the free and unbiassed opinion of the profession

may thus be declared on the eligibility of any one of its members, and that without question, concussion, or solicitation, there appears to be no argument that would be avowed or supported to oppose its adoption. Political or sectarian favor, or the monopolising spirit of nepotism, may declare against the plan, when a

young or monied parvenu, or an ambitious favorite of some coterie is in the field of expectancy, yet as the counteraction of these unjust powers and influences

must be the abstract desire of every one in and out of

the profession, the plan proposed promises to effect this desirable correction in the best manner, without

any personal offence to such prejudices and power. The adoption, then, of such a registry and such a

quiet yet effectual concours would, in the opinion of

the writer, tend greatly to rescue the members of the

profession from that illegitimate and dependant posi tion in which they now stand in relation to these

affairs, and would save a host of degrading conde scensions and much trouble and anxiety of mind to

future candidates for medical offices, besides much

pecuniary expense to them in many instances. More

over, the plan would place not only the general body of the profession upon a more dignified footing in

society, but it would at all times ensure the most efficient of its members for the service of the public;

while at the same time this mode of election would

confer the highest possible honor and gratification on the individual member so preferred and elected.

Yours respectfully, MEDICUS.

March 23, 1843.

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