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The Budget and the MedicalProfession.

THE BUDGET AND THE MEDICAL PROFESSION.

THE LANCET.

LONDON: SATURDAY MA Y 9, 1914.

THE Chancellor of the Exchequer made his

Budget statement in the House of Commons on

Monday last and revealed a financial condition ofthe country that has been realised with mixed

feelings, the enormous value of the national

resources being counterbalanced by the unprece-dented demand upon those resources. We do not

attempt to analyse his statement from the stand-point of the financier or the statistician, but proposeonly to call attention to the features of it whichmust have particular interest for our readers in themedical profession. How far Mr. LLOYD GEORGE’Sintentions are instinct with wide-eyed patriotismand how far they are the offspring of deliberateattempts to win the support of the many by theexploitation of the few can be learned from thecolumns of the daily press. But if we read the

press of one party we learn one thing, and if weread the press of another party we learn anotherthing, and the net result of such clarification ofMr. LLOYD GEORGE’S alleged obscurity is not

informing.There are designs in the Budget statement which

are sure of the approval of the medical professionwhatever the party politicians may say of them.The proposal that further and substantial aid

should come from the Exchequer to mitigate theburdens put upon local authorities, in their attemptsto meet the obligations incurred under legislationto carry on local government, will be regarded byfair-minded people as a move in the right direc-tion, and will receive the endorsement of sanitaryauthorities. They will be in no trouble to criticisethe methods introduced for raising the sums of

money required in the indicated direction; it is acase of non olet pec2arcia. The finding of sub-

stantial sums, amounting in all to £1,250,000, inaid of the work of the National Insurance Act, willbe approved as a whole. The establishment of localclinics to assist panel practitioners, the organisa-tion of health lectures, and the control of malinger-ing (which will require very discreet management),are legitimate outcomes of the working of the Act.That expenditure in suppressing cattle diseaseshould be borne by the Exchequer will seem just,knowing with what difficulty this expenditure hassometimes been met by some localities; and it is

good to learn that certain laggard or impoverishedcounties will be assisted to discharge their dutiesunder the Mental Deficiency Act. The additional

contribution from the State towards the main-

tenance of proper machinery for the promotion ofnational health and the well-being of the com-

munity will be welcomed. The intention will be

applauded to provide local authorities with assist-ance in their endeavours to clear slums and pro-vide better housing accommodation, to deal withthe tuberculosis problem, to train an adequatesupply of nurses, and to set up labora-

tories in which can be reinforced the efforts of

medical men desirous of fighting disease in a

scientific manner. These things are an adjunct to,or an elaboration of, the plans advocated by all oursanitarians ; and however the money is raised, solong as the mere raising of it does not paralyseefforts of equal or greater value to the community,we must welcome such projects.But members of the medical profession have to

regard the Budget from the business point of view.As citizens they will take a substantial share in theburden of finding the money whose destination isso worthy. The new graduation of the income-tax ineach of its forms cannot be other than irksome to the

medical profession. Earned incomes up to £1000

are not interfered with, but from that point thefigures are: £1000 to £1500, 10½d. ; JE1500 to JE2000,Is. ; C2000 to .t2500, Is. 2d. ; E2500 to £3000, Is. 4d. ;above £3000 and on all unearned incomes, Is. 4d.Thriving medical men in every branch of the pro-fession will be affected by the imposition of thehigher rate, anyhow between £1000 and JE2000;while the raising of the tax on unearned incomesfrom Is. 2d. to Is. 4d. will fall particularly hardupon them as investors, because the investments ofmedical men almost invariably represent their earn-ings and not their inheritance. The lowering of theline at which super-tax has to be paid, from C5000to £3000, may only catch the very successful classamong us, but hitherto most of these have escaped.The fact, however, that the first .t2500 of these

large incomes will be exempt from the charge willmitigate the circumstances to the majority of thoseaffected. The medical profession is as ready to

pay a high price for a proud citizenship as anysection of the community, but it would not be

difficult to show that this country is steadilybecoming a very expensive one for the professionalman. His burdens grow.

The Narrow Way to MedicalResearch.

THE reports of the Royal Commission on Uni-versity Education in London, Mr. ABRAHAM

FLEXNER’S Report on Medical Education in Europe,Sir WILLIAM OSLER’S pronouncements on severaloccasions, and articles in our own columns have oflate in different ways brought the academic ideal inmedical education to the forefront, and the con-

sideration of it has brought forth many weightydocuments. An outstanding principle, that the

teaching of a subject such as medicine in all itsbranches is inextricably bound up with continued