Appointments

1152

He built up an excellent eye department in the SouthernGeneral Hospital, which attracted staff from this country andoverseas. He was a popular teacher, but he will be rememberedprincipally for his research in ophthalmology, particularly hiswork on the effects of vascular disease on the eye, for whichhe was awarded the Treacher Collins prize in 1954. Althoughhis name was a byword among his colleagues he rarelyattended meetings and was amazed by the trend he saw in hislater years toward national, international and world cori-

gresses, believing, as so many do, that more is achieved in theintimacy of consultation, or in quiet reading and research,than by those modern phenomena. He is survived by his wifeand their son.

J. S. C.

JULIA BELLM.A., F.R.C.P.

Dr Julia Bell, who made important contributions tothe early study of human genetics, died on April 26,three months after her 100th birthday.

She read mathematics at Girton College, Cambridge, from1898 to 1901. On the basis of her postgraduate work at Cam-bridge she was awarded an M.A. by Trinity College, Dublin,since at that time women were not admitted to the CambridgeM.A. degree. After a period of postgraduate research on solarparallax at Cambridge University from 1902 to 1908, sheworked as statistical assistant at University College Londonfrom 1908 to 1914. In 1914-20 she assisted the late Prof. KarlPearson in his research; during this period she also studiedmedicine at the London School of Medicine for Women at theRoyal Free Hospital, graduating in 1920. In 1926 she wasmade Galton research fellow and was elected F.R.C.P. in 1938.In 1941 she was awarded the Weldon medal and prize byOxford University for her contribution to biometric science.Dr Bell’s early research work at the Galton Laboratory was

carried out under the direction of Professor Pearson until hisretirement in 1933, and was supported by personal researchgrants from the Medical Research Council. From 1933 untilher retirement in 1944, she was a member of the M.R.C.’sexternal scientific staff attached to the Galton Laboratory,then under the direction of Professor (later Sir) Roland Fisher.For one year following her retirement she was made an honor-ary research associate of University College London, and wasa member of the staff of the late Prof. J. B. S. Haldane. Theassociateship was subsequently extended and finally came toan end in 1965 when she was over 86 years of age. Herresearch in human genetics was concerned with statistical in-vestigations of the inheritance of anomalies and diseases of theeye; and with similar work on nervous diseases, muscular dys-trophies, and on digital anomalies.

I.A.

Appointments

North Western Regional Health Authority:

ANDREWS, K., M.R.C.P.: consultant in geriatrics, Manchester Area.GOWLAND, M. R., F.R.C.R.: consultant in radiology, Manchester Area.HALL, P. J., F.F.A. R.c.s.: consultant in anaesthesiology, Manchester Area.HYDE, C. E., M.R.C.PSYCH. : consultant in psychiatry, Manchester Area.NAQVI, N., M.R.C.P.: consultant in medicine, Wigan Area.RESTON, P., F.R.C.R.: consultant in radiology, Lancashire Area, Ormskirk Dis-

trict.SALEM, R. J., F.R.C.S.: consultant in surgery, Bolton Area.

Wessex Regional Health Authority:LODGE, G. J., M.R.C.PSYCH. : consultant in adult psychiatry, Wiltshire Area, Bath

District.

NEWSON-SMITH, J. G. B., M.R.C.PSYCH.: consultant m psychiatry, HampshireArea (Teaching).

VEAL, R. M., M.R.C.P., M.R.C.PSYCH. : consultant in mental handicap, HampshireArea (Teaching).

Notes and News

MANPOWER AGAIN

LAST week saw the publication of two more reports on medi-cal manpower and staffing requirements in the NationalHealth Service. The British Medical Association working-party’ was principally concerned with the training require-ments in the hospital service while the Institute of ManpowerStudies2 has been looking at the factors doctors take intoaccount when they choose a specialty career. Hospital trainingis not a good advertisement for planning and forecasting.Everyone agrees on what is needed, but the consultant gradehas expanded at a rate slower than that of the senior registrarand registrar grades (when the reverse was required); there isno central control of senior house-officer posts; and D.H.S.S.estimates that the numbers of overseas doctors in trainingposts would have fallen by a third in the decade 1968-77 hasbeen proved badly wrong, for the numbers rose by around50%. The B.M.A. solution is a set of more rigorous con-trols-a probationary year at registrar level accompanied bya link between numbers in post and the senior-registrar estab-lishment, restraints on the s.H.o. training grade so thatnumbers are kept within manpower targets, defined pro-grammes of training with limited tenure for overseas doctors,and urgent expansion, properly funded, of the consultant

grade, the whole package to be overseen by a central body withwide-ranging responsibilities for medical staffing. Discussionsabout manpower have been going on so long that new featureshave emerged that have to be taken account of in the calcula-tions. To be added to the potentially vicious spiral of juniorhospital doctors wanting more consultant posts so that they donot have too long to wait to attain their objective and, whenthey do, demanding plenty of junior assistance so that theirhard-won skills are not "wasted", must now be added the un-predictable impact of mandatory vocational training for

general practice on s.H.o. establishments and the risk (foreseenby wise heads) that posts are expanded in number but withrationing of the extra sessions available under the new consul-tant contract. The I.M.S. is more concerned with providingbackground to help improve the lot of the so-called shortagespecialties. Their questionnaires and interviews have thrownup a lot of material but the story told looks familiar: some

problems are curable (e.g., by exposure of medical students toa wider range of clinical and diagnostic specialties and bygreater clinical contact in diagnostic specialties) but it is not

easy to see what can be done about "low status in the profes-sion" and "less than average extra duty payments" both

thought to be contributing to lack of recruitment in most ofthe problems specialties. Comparisons with the situationbefore 1974 are not possible for community medicine, but thishas rapidly become a true shortage specialty. The I.M.S. find-ings are not encouraging: of those doctors who changed spe-cialty to community medicine only 4% did so because a newinterest developed, the more common reasons for change beingbetter career prospects, family commitments, lack of job satis-faction, and hours of work. The reasons given for poor recruit-ment may be predictable in many instances but the detail (300pages of text and tables based on over 200 interviews and a

questionnaire survey, of thousands of doctors, with a response-rate of 63%) makes the I.M.S. study a most useful basis forconstructive thought on the unpopular medical specialties.

1. Br. med. J. May 19, 1979, suppl. p. 1365.2. The Determinants of Doctors’ Career Decisions. Obtainable from the Insti-

tute of Manpower Studies, University of Sussex, Mantell Building.Falmer, Brighton BN1 9RF.