This book contains the third series of Winter Lectures organised by the Office of Health Economics, and the first to be given after the publication of the 'Sainsbury Report'. Mr Freeman in his foreword to the volume containing the second series wrote: 'Not unnaturally some of the papers are concerned to justify the policies and practices of the principal firms in the industry.'
The total expenditure on medicines in the United Kingdom in 1966 was £267 million. Of this £188 million was for medicines prescribed on the National Health Service. The other £79 million was spent by the public mainly for medicines bought without a doctor's prescription. Thus self-treatment still forms an important aspect of medical care, although in terms of cost it accounts for less than half per cent of total consumer expenditure.
Iron deficiency anaemia is a very common condition in the United Kingdom. Prevalence is greatest amongst women of child-bearing age and elderly men and women. Detection is easy, accurate and fairly cheap by means of a simple battery operated haemoglobin meter. Anaemia is not a disease entity in itself, but a result of various causes. Thus, its morbidity rate and mortality rate are the collective ones for all the many underlying causes.
Chronic bronchitis and emphysema account for 7 per cent of all deaths in men and 3 per cent in women between the ages of 45-64. Simple bronchitis can be diagnosed by asking about persistent expectoration, or more specifically by measuring the volume of sputum a specimen of which, if purulent, will also permit the diagnosis of mucopurulent bronchitis. Obstructive bronchitis can be diagnosed by spirometry or by measuring peak flow and forced expiry time. These cheap, accurate and simple tests can be carried out by the General Practitioner.
Deaths from ischaemic heart disease are increasing amongst the early middle-aged in many countries. Over one quarter of all deaths amongst British males under the age of 45 are caused by arteriosclerotic heart disease and there is ample social and economic justification for attempting to detect asymptomatic and early disease — but only if effective preventive treatment is available.
In 1966, in England and Wales, there were about six million persons aged 65 and over, more than 12 per cent of the total population. In 1901, the figures were one and a half million accounting for 5 percent of the population. The rise in the number of the aged, a four-fold increase, has been much faster than the rise among other age groups The number of children aged 0-14 is, today, almost exactly the same as the number in 1911.
WITH the inception of the National Health Service in 1948 the scope of general practice was enlarged to provide free medical care for each and every member of the community. It was envisaged at the same time that the general practitioner would become a 'family doctor', establishing a personal relationship with each of his patients similar to that previously enjoyed by only a small proportion of the population. In the event, a number of factors have made this difficult to achieve.