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Notes and News

ANALYSIS OF MEDICAL-ASSISTANT GRADE

IN view of criticism about the development of the assistantgrade the professions and the Health Departments agreed inJuly that there should be a moratorium for a period on thecreation of full-time posts in the assistant grade and that a jointinvestigation should be undertaken into the development ofthe grade since its creation in 1964. This investigation hasnow been completed.

England and Wales, up to June, 1968, had 1642 approvedassistant posts, of which only 180 were new posts. The greatmajority (1199) of the 1642 posts are conversions from theS.H.M.O. and J.H.M.o. grades, and many of the holders retainthese gradings. The total numbers in the non-consultantcareer grades fell from 1884 in 1964 to 1112 in 1967, while thenumber of consultant posts rose from 6201 to 7380. There isno evidence for the suggestion that increases in the number ofconsultant posts have been avoided by deliberate enlargementof the assistant grade. Detailed figures show that the assistantgrade has not been allowed to develop in an uncontrolled orhaphazard way, and the criticisms that have been made arebased on misunderstandings which the publication of thesefigures should remove. Similar tables for Scotland lead to thesame general conclusions. The investigation also showed thatin England and Wales, of 17 doctors leaving the assistant gradewhose subsequent employment was known, 7 had becomeconsultants; and in Scotland of 13 leaving the grade, 9 hadbecome consultants.

DISTRICT NURSING CARE

A PLEA for the recognition of the district nurse’s rightfulplace in progressive patient care has come from the Queen’sInstitute of District Nursing. A study 1 by Lisbeth Hockeyclaims that district nurses could take a more active part in

caring for discharged inpatients and current outpatients, andso advance continuity of care between hospital and community.The inquiry was limited to the general medical and surgicalpatients of six hospitals with 300-700 beds, including teachingand non-teaching hospitals. The findings showed that manyattended for aftercare or for outpatient treatment when theycould have been looked after in their own homes if the skillof district nurses had been fully utilised. A recognised aftercareservice, such as a team of nursing, medicosocial, and ancillarystaff attached to a general medical group practice, is stronglyrecommended. Every effort should be made to encouragehospital and district nursing staff to meet and to foster a teamapproach to patient care. The district nurse should be used asa desirable alternative to hospital care and not as a last resort.

WHITAKER

FROM the gold crisis to details of the two-tier postal system,Whitaker 1969 1 has it all. The latest issue includes informa-tion on heart transplant operations, the foot-and-mouth

epidemic, the brain drain, and the first report of the Com-mittee on Public Schools. In the diary of events a specialsection has been given to Czechoslovakia, and reference hasbeen made to the war in Vietnam and the French politicalcrisis. This up-to-date and well-indexed Almanack is sure toprove as invaluable as ever.

University of CambridgeDr. B. A. Young has been appointed lecturer in anatomy.

University of LondonProf. Leslie Brent has been appointed to the Pfizer chair of

immunology tenable at St. Mary’s Hospital Medical School.1. Care in the Balance: a study of collaboration between hospital and

community services. By LISBETH HOCKEY. Obtainable from the

Queen’s Institute of District Nursing, 57 Lower Belgrave Street,London S.W.1, price 10s.

1. Whitaker’s Almanack 1969. London: J. Whitaker. Pp. 1222. 27s. 6d.

University of DundeeProf. D. M. Douglas has been elected dean of the faculty

of medicine in succession to Prof. J. L. Henderson.

Royal College of Obstetricians and GynaecologistsAt a meeting of council on Nov. 30, the Edgar Gentilli

prize was awarded to Dr. Eng Soon Teoh (Singapore).Dhanwantri Eustace Gunatilleke was admitted to the fellow-ship.

Royal College of Physicians of EdinburghAt a meeting on Dec. 5 the following office bearers were

elected:

President, Dr. Christopher Clayson; vice-president, Dr. J. G. M.Hamilton; members of council, Dr. R. H. Girdwood, Dr. J. Laurie, Dr. R. F.Robertson, Dr. R. M. Marquis, Dr. J. W. Crofton.

Royal College of Physicians and Surgeons of GlasgowAt a meeting of the college on Dec. 2, the following were

elected to the fellowship qua physician:J. O’D. Alexander, M. D. Black, Hugh Brebner, W. W. Buchanan,

A. T. Elder, W. Hamilton, J. H. Haldane, Robert Hume, J. W. Kerr,N. McE. Lamont, Z. A. Leitner, A. L. Linton, C. P. Lowther,Abdul Latif Minhas, Francis Moran, H. G. Morgan, W. M. McCrae,J. B. McGuinness, I. M. Macgregor, Alexander Pringle, A. W. Purdie,W. N. Rogers, David Ross, Leo Schamroth, John Stevenson, J. A. Thomson,James Walker, R. R. Wilson, Hock Boon Wong.

Faculty of RadiologistsOn Nov. 17 the following candidates were admitted

fellows:J. N. Brown, J. M. Dawson, G. W. Dodd, M. J. Gibson, Patricia M.

Hewlett, J. B. Hourihane, G. R. Jankharia, A. B. C. Johnson, U Ko Ko,P. P. Leddy, C. L. Louisy, W. H. A. MacMahon, A. V. Mitchell, J. H. W.Pexman, A. L. M. Piotrowicz, A. J. Porter, M. Rahman, C. W. Rutherford,T. Sherwood, J. Smith, S. E. W. Smith, R. J. Stabler, J. R. Young (radio-diagnosis) ; G. G. Ahmed, E. Mary Catterall, C. L. Harmer, G. Kitchen,M. M. Qasim, D. G. Seay, E. R. Smith, Margaret F. Spittle (radiotherapy).

Ministry of DefenceBrigadier J. M. Matheson has been appointed commandant

and director of studies at the Royal Army Medical College,with the rank of major-general in succession to Major-GeneralN. G. G. Talbot. Colonel N. C. Rogers has been appointeddirector of army surgery and consulting surgeon to the Army,with the rank of major-general in succession to Major-GeneralP. R. Wheatley.

Postgraduate MedicineA repeat of the programme on congenital heart-disease in

infants will be shown on Tyne Tees Television on Sunday,Dec. 15, at 10.20 A.M. A programme on vascular complica-tions of diabetes will be shown on Tyne Tees Television onWednesday, Dec. 18, at 1 P.M., and on Scottish Televisionon Monday, Dec. 16, at 11.20 P.M., with a repeat on Wednes-day, Dec. 18, at 1.10 P.M.

CORRIGENDUM: Vesicoureteric Reflux in Patients with Bacteriuria inPregnancy.-In this article by Mr. G. L. Williams and his colleagueslast week (p. 1202) the first sentence in Patients and Methods shouldhave read "... bacteriuria was determined in 2820 [not 4720]women...".

Pamphlets and Reports

Blood Coagulation, Thrombosis, and Female Hormones.The second James F. Mitchell Foundation symposium held inWashington, D.C., in May, 1967, included eight papers describingoriginal work directed at elucidating the effects of hormone treat-ment (including oral contraception) and pregnancy on fibrinolysis,coagulation, and thrombosis. (Obtainable from the Foundation,5401 Western Avenue, N.W., Washington, D.C. 20015.$2.75.)

Current Research on Group A Streptococcus. The proceed-ings of a symposium held in Paris in July, 1966. (Amsterdam:Excerpta Medica. D. fl. 90; 10 95;$25.)Thyroid Neoplasia. Proceedings of the Second Imperial Cancer

Research Fund symposium held in London in April, 1967. (Londonand New York: Academic Press. E6 6s.;$19.50.)