213
putting together into a small group patients whom he was already treating individually psychoanalytically. His observations were made independently of those of Schilder, Wolf, and others in the United States of America. Wartime service in the R.A.M.C. brought opportunities for applying these group techniques on a large scale. Northfield military Hospital became world-famous for experiments in applying psychodynamic understanding to the processes of becoming and being a patient and of giving up patienthood to return to active military or civilian life. Group processes were
applied throughout the hospital and the lessons learned there by a whole generation of Army psychiatrists have influenced hospital practice on a world-wide scale. Foulkes published his first book on group analytic psychotherapy in 1948, in which he detailed both his hospital experience and the work he had already done with small groups of neurotic patients. In 1950 this was followed by the famous Penguin, written together with James Anthony, which introduced generations of therapists to group analytical concepts. He continued to write and to teach, and his last book appeared only last year. He founded the Group Analytic Society (London) and gathered around him a group of colleagues who in their turn founded the Institute of Group Analysis, which has become an important centre for training in therapy of both stranger and family groups. After being on the staff of St. Bartholomew’s, Dr Foulkes became consultant psychotherapist at the Maudsley Hospital until his retirement, when he was appointed emeritus physician. After his retirement he took
ing
a new
on
journal, Group Analysis.
the arduous task of edit-
He
was
visiting professor
North Carolina University and travelled extensively abroad in the course of his teaching. He has undoubtedly left his mark on the world of modern psychotherapy through his constant effort to bring into being a social psychology adapted to therapy that took full account of man’s basically social nature and of the profound findings of individual psychoanalysis. His first wife died in 1950. He is survived by his second wife, Elizabeth, and three children of his first marriage. M. P. at
JOHN ALBERT HOPSON B.41.0xon., M.Sc.Lond., M.R.C.G.P., D.I.H. Dr John Hopson, who had been in general practice in Hastings since 1973, died on July 8 at the age of 46. He was educated at Manchester Grammar School, St. Catherine’s College, Oxford, and Oxford University Medical School, graduating B.M. in 1955. He joined the R.A.F. Medical Service in 1958, and spent three years at the Desert Air Base of El Adem. He was early marked out for promotion in the Service, and was selected to attend the R.A.F. Staff College at Bracknell, where he was placed third from among a hundred of the most able people from all branches of the Service. He then served on the staff of the Director-General of Medical Services at the Ministry of Defence. Amongst other duties he edited the R.A.F. Medical Branch News Letter. He then attended a course at the London School of Hygiene and emerged with the D.i.H. and an M.sc. in occupational health. His final posting in the R.A.F. was as second-in-command of an R.A.F. Hospital in Germany, Wegberg, with the rank of wing-commander. There he started a very successful hospital news letter. Eventually Dr Hopson felt the call to return to clinical medicine, and in 1973 he joined Dr W. N. Ingham in general practice in St. Leonards. He introduced many new ideas into the practice and he was appointed on a part-time basis to develop a most successful occupational health service for the Hastings health district. His excellence as a G.P., his training in administration, and his seniority in the Royal College of General Practitioners, made him the ideal person to develop a G.P. vocational training scheme in Hastings. Dr Hopson was always cheerful and concerned for other people. All the tasks he undertook made immense demands
upon his time and energy, but he made a great success of them all and never appeared ruffled or in a hurry. He will be much missed in the Hastings health district, but the G.P. vocational training scheme and the occupational health service will live as
his memorial. He is survived
by his wife. R. E. I.
Notes and News N.H.S. EXPENDITURE The proportion of the gross national product spent on the National Health Service in the United Kingdom in 1975 was about 5.4%, which is higher than in 1974 (5.3%) and 1973 (4-8%), but still less than the proportion spent on health services in most comparable countries, and, according to present projections, the proportion of G.N.P. spent on the N.H.S. may well fall by the end of the decade. These figures, presented in a new information sheet from the Office of Health Economics,’1 show that N.H.S. expenditure has risen over 35% more than G.N.P. since 1960, although the percentage of total public expenditure going to the N.H.S. has remained pretty constant over the past decade at 10%. The total cost of the N.H.S. in 1974 was 3922 million (of which 103 million came from payments for items such as prescriptions, dental treatment, and spectacles), the estimated figure for 1975 being just over 5000 million. The hospital service absorbed 67% of total expenditure in 1974, compared with 66.2% in 1973, and an estimated 69% for 1975-76. Correspondingly smaller shares of N.H.S. expenditure were spent on the family-practitioner pharmaceutical service (9% in 1974 as opposed to 9.4% in 1973) and on general medical services (6-5% as against 7.4%). Treasury projections of expenditure on health and personal social services show that there will be a gradual growth in spending up to the end of the decade (amounting to about 6% at 1974 prices in the N.H.S. and 2% in the social services), but this will be confined to current expenditure. Total capital expenditure on hospital and community services will fall by an estimated 21% (although some programmes, such as those for health centres and mental-health care, will be protected), and on the personal social services by 53%. Even allowing for transfer of capital money from the N.H.S. under joint financing arrangements, social services will at the end of the decade have only about 60% of the capital funds available to them in 1975-76. HEALTH-CARE PLANNING IN SCOTLAND AFTER 2 years’ existence the Scottish Health Service Planning Council is, to judge by its second annual report,’ now getting into its stride in setting up the network of multidisciplinary advisory bodies and planning groups which are to help it in its task of developing long-term strategies for health care in Scotland, and it has also responded to demands for action on
immediate practical issues. During the year 4programme planning groups were set up to explore specific health-care needs across the boundaries of professional and administrative divisions. The 4 groups will be considering the care of the elderly, mental disorders, child health, and cardiac surgery, and a fifth group, on cancer, is now to be set up. The report also describes the work of 5 advisory groups which met during the year. The Scottish Home and Health Department has now accepted the recommendation of the advisory group on information and computer services that 5 health board computer consortia committees should be set up for information-processing purposes, each with standard-sized computers, and that the Common Services Agency should have its own computer, com1. The Cost of the N.H.S. Information Sheet no. 29. Office of Health Economics, 162 Regent Street, London W1R 6DD.
214 FLOATING ALLEGORY
patible with those serving the boards. The other advisory groups are for scientific services, blood-transfusion, epidemioligical and other aspects of infections, and new developments in health care (this group considers applications for funds for services which it is accepted should be provided by one or perhaps two boards for the whole of Scotland, such as the phenylketonuria screening programme in Glasgow, and also for experimental pilot schemes to assess proposed new service developments, such as the breast-cancer screening project in Edinburgh). The new health priorities working-party had its first meeting in September, and the Council has now agreed to
IN the television series M.A.S.H. surgeons, with humour and
humanity, patch up the injured of the Korean war. Postoperatively the martinis flow and the food is hot; they are not expected to kill or be killed. Reality is often harsher, but doctors who make statements about war do well to recognise that their position may be seen as privileged as well as special. There is this nagging doubt about an allegorical first novel from Dr Martin Bax, secretary of the Medical Association for the Prevention of War.’ His hospital ship is doing its best to repair the ravages, mental and physical, of some unspecified global catastrophe. Atom-powered, well-succoured, blessed with an erratic communications system, and unmolested, it wanders from tragedy to horror and back again, but always cocooned and always on the move. This is all the narrative that Bax provides. The catastrophe is unspecified, but hints may lie in the factual accounts, of Vietnam for example, with which Bax (awkwardly, it must be said) litters his book. A Vietnamese prostitute and an American businessman are the clinical focus for cure by love-in, a therapy in which the medical staff happily join in their own way. "All you need is love", says Bax as his ship sails off into a sunset honeymoon. Behind the cowed survivors and those crucified at the quayside have come too close to horror. This privileged professional immunity may be one of the points Bax is trying to make, but allegories can be too mysterious.
the setting-up of a working party on general-practice pharmacy ; it has also approved a proposal to introduce training courses in health-planning, and it has accepted and recommended to the Secretary of State a report on preventive dentistry which urges fluoridation of the water supply in Scotland. The Council now has under its wing what seems like a profusion of working-parties and groups of various kinds, but the report makes it clear that great importance is attached to close working relationships both with the national consultative committees (whose representatives attend all Planning Council meetings), and with the Common Services Agency and the professional and administrative officers of the Scottish Home and Health Department.
APPROVED NAMES THE Medicines Commission has issued the mentary list of approved names: Other
Approved name Azatadine
Balipramine
following supple-
names
5,6-Dihydro-l l-(l-methyl-4-piperidylidene)benzo [h]cyclohepta[b]pyridine 3-Dibenz[b,azepin-5-ylpropyldimethylamine;
Bevantolol
depramine (I.N.N.); GP 31406 1-(3,4-Dimethoxyphenethylamino)-3-mtolyloxypropan-2-ol; C.I. 775 is the
Carbuterol
hydrochloride [5-(2-tert-Butylamino-1-hydroxycthyl)-240383-A is hydroxyphenyl]urea ; SK&F
Cefazedone
University of London Dr Andrew Herxheimer has been appointed senior lecturer in clinical pharmacology and therapeutics at Charing Cross Hospital Medical School.
the
hydrochloride 7-(3,5-Dichloro-4-oxo-l-pyridyl)acetamidol]-3(5-methyl-1,3,4-thiadiazol-2-ylthiomethyl)-3cephem-4-carboxylic acid; EMD 30 087 is the
Medical Defence Union First prize in the medical essay competition for students has been awarded to Mr Dominic Kwiatkowski (Guy’s Hospital, London) and second prizes have been awarded to Mr Stephen Brearley (Middlesex Hospital, London) and Mr T. H. Turner (St. Bartholomew’s Hospital, London); the essays were on the State and professional independence.
sodium salt
Mianserin
N-Butyl-2-methyl-N-(4-methyloxazol-2-yl) propionamide; LRCL 3950 1,2,3,4,10,14b-Hexahydro-2-methyldibenzo[cf,] pyrazinol[1,2-a]azepine; (Bolvidon) and Org GB 94 are the hydrochloride
Norgestomet
11&bgr;-Methyl-3,20-dioxo-19-norpregn-4-en17&phgr;-yl
Sulindac
(Z)-5-Fluoro-2-methyl-l-(4-methylsulphinyl benzylidene)indene-3-acetic acid [2,3-Dichloro-4-(2-thenoyl)phenoxy]acetic acid;
Isamoxole
acetate; SC-21009
Tienilic acid
SK&F
Research Award for Women Doctors
62698
Tolmesoxide
4,5-Dimethoxy-o-tolyl methyl sulphoxide;
Ubisindine
2-(2-Diethylaminoethyl)-3-phenylisoindolin-l-one (35,7R)-3,4,5,6, 7 ,8,9,10,11, 12-decahydro-7,14,16trthydroxy-3-methyl-1H-2-benzoxacyclo-
RX 71107 Zeranol
_
tetradecin-1-one; P 1496; 13-304
Cross-references for
Proprietary &c. 13-304 name
Bolvidon C.I. 775
proprietary
Approved
Proprietary
name
name
Zeranol Mianserin
Bevantolol
Depramine
Balipramine
EMD 30 087 GP 31406 LRCL 3950
Cefazedone
Balipramine
&c.
Org GB 94 P 1496 RX 71107
SC-21009 SK&F 40383-A SK&F 62698
follows:
Approved name
Mianserin Zeranol Tolmesoxide
Norgestomet Carbuterol Tienilic acid
Isamoxole
Planning Council. Report for 1975. Scottish Department, Edinburgh. H.M. Stationery Office. 45p.
1. Scottish Health Service
and Health
names are as
The Medical Women’s Federation invites applications for the Christine Murrell memorial fellowship award (value £1000) from women medical practitioners on the Medical Register. The award will be made for research, for the secretarial expenses of research work, or for buying equipment for research. Application forms, which should be returned, together with a plan of the proposed research project and the names of 3 referees, by Sept. 1, may be had from the Secretary, Medical Women’s Federation, Tavistock House North, Tavistock Square, London WC1H 9HX.
International Society for Clinical Enzymology This society was formally established at a meeting held in Vienna on April 7, when Prof. J. H. Wilkinson (U.K.) was elected president and Prof. A. Burlina (Italy) vice-president. Details of the society may be had from the secretary, Dr M. Roth, Laboratoire Central, Hopital Cantonal, 1211 Geneva 4, Switzerland.
Home 1. The
Hospital Ship. By
MARTIN BAX. London:
Cape. 1976. Pp. 223. £3.95
putting together into a small group patients whom he was already treating individually psychoanalytically. His observations were made independently of those of Schilder, Wolf, and others in the United States of America. Wartime service in the R.A.M.C. brought opportunities for applying these group techniques on a large scale. Northfield military Hospital became world-famous for experiments in applying psychodynamic understanding to the processes of becoming and being a patient and of giving up patienthood to return to active military or civilian life. Group processes were
applied throughout the hospital and the lessons learned there by a whole generation of Army psychiatrists have influenced hospital practice on a world-wide scale. Foulkes published his first book on group analytic psychotherapy in 1948, in which he detailed both his hospital experience and the work he had already done with small groups of neurotic patients. In 1950 this was followed by the famous Penguin, written together with James Anthony, which introduced generations of therapists to group analytical concepts. He continued to write and to teach, and his last book appeared only last year. He founded the Group Analytic Society (London) and gathered around him a group of colleagues who in their turn founded the Institute of Group Analysis, which has become an important centre for training in therapy of both stranger and family groups. After being on the staff of St. Bartholomew’s, Dr Foulkes became consultant psychotherapist at the Maudsley Hospital until his retirement, when he was appointed emeritus physician. After his retirement he took
ing
a new
on
journal, Group Analysis.
the arduous task of edit-
He
was
visiting professor
North Carolina University and travelled extensively abroad in the course of his teaching. He has undoubtedly left his mark on the world of modern psychotherapy through his constant effort to bring into being a social psychology adapted to therapy that took full account of man’s basically social nature and of the profound findings of individual psychoanalysis. His first wife died in 1950. He is survived by his second wife, Elizabeth, and three children of his first marriage. M. P. at
JOHN ALBERT HOPSON B.41.0xon., M.Sc.Lond., M.R.C.G.P., D.I.H. Dr John Hopson, who had been in general practice in Hastings since 1973, died on July 8 at the age of 46. He was educated at Manchester Grammar School, St. Catherine’s College, Oxford, and Oxford University Medical School, graduating B.M. in 1955. He joined the R.A.F. Medical Service in 1958, and spent three years at the Desert Air Base of El Adem. He was early marked out for promotion in the Service, and was selected to attend the R.A.F. Staff College at Bracknell, where he was placed third from among a hundred of the most able people from all branches of the Service. He then served on the staff of the Director-General of Medical Services at the Ministry of Defence. Amongst other duties he edited the R.A.F. Medical Branch News Letter. He then attended a course at the London School of Hygiene and emerged with the D.i.H. and an M.sc. in occupational health. His final posting in the R.A.F. was as second-in-command of an R.A.F. Hospital in Germany, Wegberg, with the rank of wing-commander. There he started a very successful hospital news letter. Eventually Dr Hopson felt the call to return to clinical medicine, and in 1973 he joined Dr W. N. Ingham in general practice in St. Leonards. He introduced many new ideas into the practice and he was appointed on a part-time basis to develop a most successful occupational health service for the Hastings health district. His excellence as a G.P., his training in administration, and his seniority in the Royal College of General Practitioners, made him the ideal person to develop a G.P. vocational training scheme in Hastings. Dr Hopson was always cheerful and concerned for other people. All the tasks he undertook made immense demands
upon his time and energy, but he made a great success of them all and never appeared ruffled or in a hurry. He will be much missed in the Hastings health district, but the G.P. vocational training scheme and the occupational health service will live as
his memorial. He is survived
by his wife. R. E. I.
Notes and News N.H.S. EXPENDITURE The proportion of the gross national product spent on the National Health Service in the United Kingdom in 1975 was about 5.4%, which is higher than in 1974 (5.3%) and 1973 (4-8%), but still less than the proportion spent on health services in most comparable countries, and, according to present projections, the proportion of G.N.P. spent on the N.H.S. may well fall by the end of the decade. These figures, presented in a new information sheet from the Office of Health Economics,’1 show that N.H.S. expenditure has risen over 35% more than G.N.P. since 1960, although the percentage of total public expenditure going to the N.H.S. has remained pretty constant over the past decade at 10%. The total cost of the N.H.S. in 1974 was 3922 million (of which 103 million came from payments for items such as prescriptions, dental treatment, and spectacles), the estimated figure for 1975 being just over 5000 million. The hospital service absorbed 67% of total expenditure in 1974, compared with 66.2% in 1973, and an estimated 69% for 1975-76. Correspondingly smaller shares of N.H.S. expenditure were spent on the family-practitioner pharmaceutical service (9% in 1974 as opposed to 9.4% in 1973) and on general medical services (6-5% as against 7.4%). Treasury projections of expenditure on health and personal social services show that there will be a gradual growth in spending up to the end of the decade (amounting to about 6% at 1974 prices in the N.H.S. and 2% in the social services), but this will be confined to current expenditure. Total capital expenditure on hospital and community services will fall by an estimated 21% (although some programmes, such as those for health centres and mental-health care, will be protected), and on the personal social services by 53%. Even allowing for transfer of capital money from the N.H.S. under joint financing arrangements, social services will at the end of the decade have only about 60% of the capital funds available to them in 1975-76. HEALTH-CARE PLANNING IN SCOTLAND AFTER 2 years’ existence the Scottish Health Service Planning Council is, to judge by its second annual report,’ now getting into its stride in setting up the network of multidisciplinary advisory bodies and planning groups which are to help it in its task of developing long-term strategies for health care in Scotland, and it has also responded to demands for action on
immediate practical issues. During the year 4programme planning groups were set up to explore specific health-care needs across the boundaries of professional and administrative divisions. The 4 groups will be considering the care of the elderly, mental disorders, child health, and cardiac surgery, and a fifth group, on cancer, is now to be set up. The report also describes the work of 5 advisory groups which met during the year. The Scottish Home and Health Department has now accepted the recommendation of the advisory group on information and computer services that 5 health board computer consortia committees should be set up for information-processing purposes, each with standard-sized computers, and that the Common Services Agency should have its own computer, com1. The Cost of the N.H.S. Information Sheet no. 29. Office of Health Economics, 162 Regent Street, London W1R 6DD.
214 FLOATING ALLEGORY
patible with those serving the boards. The other advisory groups are for scientific services, blood-transfusion, epidemioligical and other aspects of infections, and new developments in health care (this group considers applications for funds for services which it is accepted should be provided by one or perhaps two boards for the whole of Scotland, such as the phenylketonuria screening programme in Glasgow, and also for experimental pilot schemes to assess proposed new service developments, such as the breast-cancer screening project in Edinburgh). The new health priorities working-party had its first meeting in September, and the Council has now agreed to
IN the television series M.A.S.H. surgeons, with humour and
humanity, patch up the injured of the Korean war. Postoperatively the martinis flow and the food is hot; they are not expected to kill or be killed. Reality is often harsher, but doctors who make statements about war do well to recognise that their position may be seen as privileged as well as special. There is this nagging doubt about an allegorical first novel from Dr Martin Bax, secretary of the Medical Association for the Prevention of War.’ His hospital ship is doing its best to repair the ravages, mental and physical, of some unspecified global catastrophe. Atom-powered, well-succoured, blessed with an erratic communications system, and unmolested, it wanders from tragedy to horror and back again, but always cocooned and always on the move. This is all the narrative that Bax provides. The catastrophe is unspecified, but hints may lie in the factual accounts, of Vietnam for example, with which Bax (awkwardly, it must be said) litters his book. A Vietnamese prostitute and an American businessman are the clinical focus for cure by love-in, a therapy in which the medical staff happily join in their own way. "All you need is love", says Bax as his ship sails off into a sunset honeymoon. Behind the cowed survivors and those crucified at the quayside have come too close to horror. This privileged professional immunity may be one of the points Bax is trying to make, but allegories can be too mysterious.
the setting-up of a working party on general-practice pharmacy ; it has also approved a proposal to introduce training courses in health-planning, and it has accepted and recommended to the Secretary of State a report on preventive dentistry which urges fluoridation of the water supply in Scotland. The Council now has under its wing what seems like a profusion of working-parties and groups of various kinds, but the report makes it clear that great importance is attached to close working relationships both with the national consultative committees (whose representatives attend all Planning Council meetings), and with the Common Services Agency and the professional and administrative officers of the Scottish Home and Health Department.
APPROVED NAMES THE Medicines Commission has issued the mentary list of approved names: Other
Approved name Azatadine
Balipramine
following supple-
names
5,6-Dihydro-l l-(l-methyl-4-piperidylidene)benzo [h]cyclohepta[b]pyridine 3-Dibenz[b,azepin-5-ylpropyldimethylamine;
Bevantolol
depramine (I.N.N.); GP 31406 1-(3,4-Dimethoxyphenethylamino)-3-mtolyloxypropan-2-ol; C.I. 775 is the
Carbuterol
hydrochloride [5-(2-tert-Butylamino-1-hydroxycthyl)-240383-A is hydroxyphenyl]urea ; SK&F
Cefazedone
University of London Dr Andrew Herxheimer has been appointed senior lecturer in clinical pharmacology and therapeutics at Charing Cross Hospital Medical School.
the
hydrochloride 7-(3,5-Dichloro-4-oxo-l-pyridyl)acetamidol]-3(5-methyl-1,3,4-thiadiazol-2-ylthiomethyl)-3cephem-4-carboxylic acid; EMD 30 087 is the
Medical Defence Union First prize in the medical essay competition for students has been awarded to Mr Dominic Kwiatkowski (Guy’s Hospital, London) and second prizes have been awarded to Mr Stephen Brearley (Middlesex Hospital, London) and Mr T. H. Turner (St. Bartholomew’s Hospital, London); the essays were on the State and professional independence.
sodium salt
Mianserin
N-Butyl-2-methyl-N-(4-methyloxazol-2-yl) propionamide; LRCL 3950 1,2,3,4,10,14b-Hexahydro-2-methyldibenzo[cf,] pyrazinol[1,2-a]azepine; (Bolvidon) and Org GB 94 are the hydrochloride
Norgestomet
11&bgr;-Methyl-3,20-dioxo-19-norpregn-4-en17&phgr;-yl
Sulindac
(Z)-5-Fluoro-2-methyl-l-(4-methylsulphinyl benzylidene)indene-3-acetic acid [2,3-Dichloro-4-(2-thenoyl)phenoxy]acetic acid;
Isamoxole
acetate; SC-21009
Tienilic acid
SK&F
Research Award for Women Doctors
62698
Tolmesoxide
4,5-Dimethoxy-o-tolyl methyl sulphoxide;
Ubisindine
2-(2-Diethylaminoethyl)-3-phenylisoindolin-l-one (35,7R)-3,4,5,6, 7 ,8,9,10,11, 12-decahydro-7,14,16trthydroxy-3-methyl-1H-2-benzoxacyclo-
RX 71107 Zeranol
_
tetradecin-1-one; P 1496; 13-304
Cross-references for
Proprietary &c. 13-304 name
Bolvidon C.I. 775
proprietary
Approved
Proprietary
name
name
Zeranol Mianserin
Bevantolol
Depramine
Balipramine
EMD 30 087 GP 31406 LRCL 3950
Cefazedone
Balipramine
&c.
Org GB 94 P 1496 RX 71107
SC-21009 SK&F 40383-A SK&F 62698
follows:
Approved name
Mianserin Zeranol Tolmesoxide
Norgestomet Carbuterol Tienilic acid
Isamoxole
Planning Council. Report for 1975. Scottish Department, Edinburgh. H.M. Stationery Office. 45p.
1. Scottish Health Service
and Health
names are as
The Medical Women’s Federation invites applications for the Christine Murrell memorial fellowship award (value £1000) from women medical practitioners on the Medical Register. The award will be made for research, for the secretarial expenses of research work, or for buying equipment for research. Application forms, which should be returned, together with a plan of the proposed research project and the names of 3 referees, by Sept. 1, may be had from the Secretary, Medical Women’s Federation, Tavistock House North, Tavistock Square, London WC1H 9HX.
International Society for Clinical Enzymology This society was formally established at a meeting held in Vienna on April 7, when Prof. J. H. Wilkinson (U.K.) was elected president and Prof. A. Burlina (Italy) vice-president. Details of the society may be had from the secretary, Dr M. Roth, Laboratoire Central, Hopital Cantonal, 1211 Geneva 4, Switzerland.
Home 1. The
Hospital Ship. By
MARTIN BAX. London:
Cape. 1976. Pp. 223. £3.95
