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INSTITUTE OF MEDICAL PSYCHOLOGYA NEW BEGINNING

THIS institute, until recently known as the

Tavistock-square Clinic, formally opened its new

premises at 6, Torrington-place, London, W.C., onDec. 9th. Sir Henry and Lady Brackenbury receivedthe visitors, who inspected the building and heardaddresses by Sir Walter Fletcher and Dr. Bernard Harton the work and aims of the institute.The new building is an object lesson to organisations

which have to get much value for little money. Beingunable to afford to purchase land and erect an

adequate new building, the institute acquired a leaseof a building formerly used by Messrs. Shoolbredsas their packing department. It is solidly constructed I

The waiting-room.

of brick, and well supplied with windows, and has afrontage on Torrington-place of about 15 yards anda depth of 40 or 50. The whole interior has beenreconstructed to meet the needs of an out-patientclinic. The same style of internal decoration hasbeen followed throughout, the impression beinga restful combination of dark green and sunnyyellow. The children’s department on the ground-floor is very different from the old single room,where office work and consultations had to takeplace in the disturbing atmosphere of a crowdednursery. The children have a large airy playroom,fitted with attractive pictures and toys ; there isa roomy office for the registrar of the department,four consulting rooms for physicians treating childpatients, and two for social workers. The ground-floor also contains two refectories, one for adultpatients and the other for staff, with a kitchen

between, and most of the remainderof the space is occupied by anattractive L-shaped lecture-roomin which 250 people can sit com-fortably. The upper storey housesthe director’s room and those ofthe senior staff, 11 small consulting-rooms where patients are treated,and the laboratory.The furniture is mostly of bare

oak, the lighting and equipmentare in a modern style, and thecentral heating is thermostaticallycontrolled in every room. The main

waiting-room has a comfortableatmosphere, with its easy-chairs,thick carpet, and powerful electricradiator. The library is another .

good room, but its shelves are verybare, and sympathisers are askedto do what they can to supply thisneed. The laboratory is fullyequipped for routine work, andthe honorary pathologist is intouch with institutions which canundertake more elaborate investiga-tions.A second reception was held

on Saturday, the 10th, for thebenefit of visitors unable to come

during the week, and Prof.

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W. Langdon Brown and Prof. W. W. Jameson gaveaddresses.

Prof. LANGDON BROWN spoke from the point ofview of a physician who had seen the materialism ofthe nineteenth century, with its romantic veneer,give place to the twentieth with its awareness andconsequent loss of happiness. The present age, hesaid, was an extraordinarily unhappy one, but theinstitute believed that by applying knowledge itcould increase happiness. The institute arose fromthe realisation that many people were ill becausethey were unhappy, or unhappy because they wereill. Such people had hitherto been diagnosed as

"just nerves," and often had been forced to"cook" physical symptoms. Nowadays, thanksto education, patients were less ashamed. of havingillnesses in their association cells. The institutehad a system which ensured that, while nervoussymptoms were properly treated, organic diseaseshould not be overlooked. The work was uniqueand marked a change in the whole point of view ofmedicine.

Prof. JAMESON said that the psychological workof the School of Hygiene showed the need for theprofessional education which was an important partof the activities of the institute. The school foundit absolutely necessary to train future medicalofficers of health in industrial psychology. Theresearch work which the school was carrying outon large numbers of employed persons would be ofsubstantial assistance to the institute. So-called"nerves" were the greatest cause of industrialabsenteeism, other than common colds and influenza,and to neglect nervous symptoms was unfair to thepatient and extremely wasteful to the community.One of the greatest difficulties of the school’s systemof medical education was the lack of adequate instruc-tion in the things that mattered most to themedical practitioner. Knowledge of how to makea psychological approach to a medical question wasindispensable. He looked forward to the time whenthe school and the institute would cooperate actively.,and the institute would take its proper place amongthe teaching bodies of London University.

PANEL AND CONTRACT PRACTICE

The Pension and Insurance Scheme

MoST practitioners will now have received thebooklet issued by the Insurance Acts Committeeon the pension and insurance scheme which wasadopted by the last panel conference with practicallyno dissentient. With it comes a letter from Dr.Anderson urging practitioners to adopt the schemefor their own benefit and pointing out that at presentit is limited to those who have contracts with insurancecommittees. The scheme has already been set outin detail in these columns (Sept. 3rd, p. 537), butthe terms offered are so good that we make no apologyfor calling attention to them again. Especially asthe enclosing of one of the new business replyenvelopes, the postage of which " will be paid byaddressee," might suggest that the addressee has

something to gain on it. It has, indeed, seriouslybeen suggested by financial authority that it wouldpay most insurance doctors to scrap their existingpolicies, take their surrender value, and transferto this new scheme up to the full five units allowed.It will be remembered that by a special arrangementwith the Ministry of Health contributions may bededucted from the doctor’s panel income at its source,or alternatively the premium may be paid by abanker’s order. The source is of course the localinsurance committee. This committee will requireformal authorisation to be given by each practitionerto the committee to make the deduction and paysums as due to the Medical Insurance Agency, actingas agents for the three insurance offices. The sumsdeducted will be regular unfiuctuating quarterlyamounts, which the committee will hand over inbulk to the Agency after deducting one shilling permember. Proper arrangements are made for changesof residence and other relevant particulars. In thisway the Agency and therefore the three companiesconcerned-any one of which may be chosen-receive their money without the expense of muchclerical work, posting of notices, receipts, and thelike ; hence, the terms offered are much better thancould otherwise have been obtained. Practitionerswill be well advised to go into this scheme as far as

possible. Incidentally, it will be a tremendousassistance to the benevolent funds of the professionby making timely provision for the future against

contingencies which they are frequently asked,however inadequately, to meet.

Lost ChequesIt was reported at the last meeting of the London

panel committee that a practitioner in Londonalleged that his quarterly cheque had not arrived,and that on mentioning this to the London insurancecommittee he had been asked to sign the usualindemnity form, protecting the committee from lossof funds, before the committee would issue a substitu-tion cheque. In this case there was a definite state-ment that the doctor had never received the chequeand not, as is frequently the case, that the chequehad been mislaid in the doctor’s house after deliveryat the proper address. The regulations on the matterare interesting. The usual procedure is that all

eheques drawn on the committee’s bankers are validfor three months only ; if notice is received that a

cheque is lost or not received that cheque is stopped1t the committee’s bankers and another issued inthree months if the indemnity form is not signed.rhe insurance committee’s regulations require thatill payment by or on behalf of the committee shall? made by cheque or other order, except for amountsmder two pounds. In this practitioner’s case theMinistry of Health has supported his contention thatie should not be required to sign an indemnity form.apparently the legal position is that a practitionerworking under the N.H.I. Acts is entitled to his:emuneration in cash, in the absence of any agreementexpressed or implied to accept a cheque, and the’act that he has accepted a cheque in the past cannotn itself be construed as an agreement to acceptpayment by cheque in the future. Thus a cheque;ent by post by the committee is sent at the com-nittee’s risk unless there is an agreement that thepractitioner would accept payment by cheque ; ifihe cheque is lost, the committee is not absolvedrom payment. The Ministry’s view is that in spitetf insurance committee regulations mentioned aboveequiring the committees to make payment by cheque,t is very doubtful whether these regulations wouldeffect the practitioner’s ordinary rights under theaw unless there be special provision to the contraryn the term of service accepted by the practitioner.Fhe Post Office would be regarded as the committee’s