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cause the statute, in erecting that college, had in express terms reserved the privileges of the universities. And we think they may with propriety be referred to as authoritative in this case, as there is no reason to hold that the law of Scotland differs from that of England with regard to the privileges of universities, at least as to the effect of degrees. When this court, therefore, in the case of Steel just mentioned, found that persons who had graduated at the university in physic were entitled to practise physic in Glasgow without a license from the defenders [i.e. the Glasgow Faculty], we apprendend the judgment proceeded, not on the ground that the diploma [i e. the university degree] per se conferred that privilege to the exclusion of all corporate rights, but, on the contrary, that it proceeded on the ground that the charter of the defenders contained an exception to that effect,-an exception, as already observed, confined to medicine, and not extending to surgery."
It seems quite undeniable, therefore, that university degrees are regarded in the same light both by the law of England and by that of Scotland - viz. as “ testimonials," conferring an honourable distinction, “ but no right ;” and, with respect to certain expressions in the speech of Lord Chancellor (Cottenham), in affirming the judgment of the Court of Session in the last Glasgow case, which have been supposed to countenance the idea that university degrees do constitute, per se, licences to practise medicine, it is only necessary to peruse attentively the whole speech, and to observe the distinction drawn in the concluding part of the above excerpt, to perceive clearly the limited sense in which these passages in the speech are to be understood. The matter under consideration being the nature and effect of the Glasgow Faculty's Charter (an obscurely expressed document of the sixteenth century-more than a century before medicine was taught in the University of Glasgow, and nearly as long before it was taught in Edinburgh), his Lordship is there reciting the terms of that charter, commenting upon the extent of the exclusive privilege thereby conferred, and distinguishing what was reserved or excepted therefrom, within the district of country embraced in the charter, and in another passage is rehearsing the terms of the decision of the Court of Session in the unreported case of Steel referred to by the consulted Judges and is not pronouncing any indgment or opinion on the abstract nature and value of university degrees. No exception being taken to the law on that subject, so anxiously laid down in the learned opinion above quoted, his Lordship must of course be understood to have acquiesced in that opinion to the fullest extent.
Again, with regard to the act of last session, so far from repudiating the principle that the nature and purpose of universities is to confer honours, not rights of practice, the act is in reality a confirmation of that principle. The object of that act was to place the graduates in medicine of the University of London upon the same footing in regard to the right of practice as those of the Universities of Oxford and Cambridge. What that footing may be, it is not for the Council precisely to determine ; but an act of Parliament having been required for the purpose, it is obvious that the powers which it conferred could not have been inherent in the “ nature" of a university. It is most important also to observe that the act, which was sought for in redemption of a pledge given by the Government at the institution of the London University, was carefully limited to that particular university, and was still further limited by a clause to exclude surgery, midwifery, and pharmacy, from the departments of medical practice to which, in the case of that university, its provisions were to extend.
It appears, therefore, to the Council, that the framers of this bill have made out no case to show that the Universities of Scotland can confer rights of practice in any department, while it is clear that the legislature has, in August last, solemnly refused to sanction the claim then made by the London University in relation to three important departments, constituting the greatest part of the business of the general practitioner, by the insertion in its bill of the clause above noticed.
The Council would now invite the attention of the College to the probable effects of the concession of the claim of the universities to be constituted, for the first time, licensing bodies in all departments of medical practice.
And the Council must remark in the outset, that as university degrees have the advantage over ordinary medical qualifications, of conveying a certain rank and an honorary title, objects naturally desired by medical men, it follows, that if universities were permitted, in addition to these, to confer that legal right of engaging in general practice which was so recently refused by the legislature, the possessors of those degrees would have no inotive to seek any additional qualifications, and the entitled qualifications conferred by a variety of Boards in this country would be gradually extinguished. It is true that, in page 4 of the prefatory “ statement," the authors of the bill have asserted that " no existing institution will suffer unless it ceases to enjoy the public confidence." In opposition to the opinion thus hazarded by the framers of this draft bill, the council think it quite certain that, in the very unequal competition which the bill would introduce between universities conferring both the honour and the license, and medical and surgical incorporations conferring the license only, the latter would suffer seriously; and they see no good reason why the universities, which have their own separate emoluments, should be permitted to absorb those derived from the exercise of the licensing power, which, both in this and other colleges, constitute the principal support of museums and other expensive establishments, and are absolutely necessary to the maintenance and improvement of their examinations. How small is the value of the protection alleged to arise from enjoying “ the public confidence," is manifest from the known fact that worthless degrees have been disposed of largely, both in this country and in those foreign universities which the framers of the draft bill seem to regard as models for imitation ; and that the institutions which now carry on, or have carried on, this traffic in times not long gone by, have conferred many such degrees on medical men now living in this country
As one of those public bodies of professional men to which the legislature has intrusted certain definite powers of conferring rights of practice, this College may indeed be called upon to relinquish its privileges for the public good ; but is bound to defend them against all encroachments which are not founded on this high consideration, and as it is obvious that the legislature ought to be guided by this principle in granting, or recalling all delegated powers and privileges, the Council invite the particular attention of the College to the comparative advantages, in a public point of view, of conferring rights of practice by means of universities, or by means of the incorporated bodies of the profession itself.
In making this comparison, the Council will assume, not merely that the amount of control over the course of study proposed by clause 7, and the visitations of the examining boards proposed by clause 11 (supposing that these could be rendered practically effective), would be willingly acceded to both by the universities and by the medical incorporations, but that the latter, which now confer the license to practise, would be willing, as this College always has been, to defer to each other's just claims, and to consent to such changes as the legislature in its wisdom may suggest, in order to make them the instruments of the profession for self-government, and more effectually to identify their aggregate interests with those of the profession and of the public, under any bill of medical reform.
Now, the first remark which occurs to the Council is, that the medical profession, like the other learned professions, ought to be permitted, through the medium of some organization accessible to its members, to govern itself, and determine the conditions of admission to its ranks; and that other parties, having interests separate from the profession, ought not to be permitted to interfere in this matter, however respectable they may be, inasmuch as their interference would necessarily be subversive of this just and reasonable claim
of the members of the medical profession. This objection applies to all the universities in the kingdom, though there are important distinctions among them in the degree in which they possess the medical element; some having as many as eight or nine practitioners of medicine and surgery in their ranks, while others have only one; and one university, that of Durham, has not even one, and is believed to be almost purely an ecclesiastical institution. A proposal to confer professional qualifications on lawyers or divines, by means of universities and their degrees, and especially by means of such universities as do not include one single member of those professions respectively, would be justly derided by them ; and the Council do not see that the medical profession, so well fitted by its intelligence for self-government, ought to be asked to submit to this.
But there are other grave objections to the constitution of the senates of the universities, regarded as Boards for licensing medical practitioners, for which the bill does provide, and can provide, no remedy. There are universities in which a senate, to a certain extent under the influence of the Crown, but at the same time self-elected, and totally irresponsible to the medical profession, selects examiners for medical degrees. In these universities it is at least possible that improper examiners may be excluded. But in those universities in which the power of examining is claimed, in right of their professorships, by the meinbers of the medical Faculty of each, there can be no effectual remedy against incapacity from age, or infirmity of body or mind, nor against capricious lenity or harshness, nor against the wildest extravagances of conduct on the part of individual members of the Faculty, even if they should think fit to lend the sanction of a professor's name to undisguised charlatanism, in defiance of their colleagues. Those who are acquainted with the history of the universities must admit that these evils are far from theoretical. They have in fact been loudly complained of by most efficient and capable university professors, and there is not one of them which could exist for a single season in any Board deriving its powers from a college or other incorporated body of members of the medical profession.
There is a third class of universities, of which Durham and St Andrews are examples, in which there are either no medical professors, or only one, and in which the examiners of medical graduates are selected by the professors of law, literature, theology, and general science, and brought from distant places because they cannot be had at the sites of those universities. Boards thus constituted are anomalies even in conferring mere honorary degrees; but when it is gravely proposed to convert them into boards for conferring licences to practise, the profession has a good title to be listened to when it remonstrates against such a humiliation.
From all these objections to the exercise of the licensing power by universities, its exercise by the profession itself, or by boards chosen by such portion of the profession as is now incorporated or may in future be incoporated for that purpose under the provisions of a reform act, is altogether free. Such boards possess in their very constitution the principle of self-improvement. The examiners, selected annually by bodies accessible on easy terms to all respectable medical men, and consisting of capable judges, could not retain their position if they became liable to any serious objections.
There is yet one important point in this bill on which it is necessary to offer some remarks, viz., the constitution of the council (clause 3d), which is to be chosen by Her Majesty with advice of the Privy Council, and is to consist of a cabinet minister, with 12 members of the medical profession; 6 being from England, 3 from Scotland, and 3 from Ireland. With the exception of the relative numbers, which would perhaps give too great a preponderance to the southern division of Great Britain, there can be no objection to this arrangement, if it were coupled with a provision for securing that the choice of the medical councillors should be made from among a certain number of persons selected by the different bodies of medical men throughout the kingdom. But this seems to be necessary, to prevent the Crown from being misled in its choice 4 considerations of political farour, or by the advice of individuals, who howere estimable and even eminent, might not happen to enjoy the confidence of the profession, or might have become estranged from it by the pursuit of partia or even selfish views and interests, condemned by the sense of the profession i large, and subversive of its just rights and respectability.
On the other clauses of this bill there is little room for reinark. There are in its framework many things of which the college bas on former occasion expressed its approbation. A good bill of medical reform ought, in the opinio, of the President's Council, to secure uniformity of education, examination, and privilege, through the medium of those colleges and incorporated bodies a medical men which now exist in this country, and by means of examinine boards chosen by them. It should effect this under the superintendence of a general council such as has been indicated in the bill, with those important modifications of its constitution suggested in the preceding paragraph. Were this done, there ought to be no second examination in order to acquire the diploma conferred by this and similar bodies, which they ought to grant on the simple report of the examiners. The fellowships of colleges ought also to be open to all who hold diplomas, by a simple ballot without additional exam. ination. The fees for all those grades should be liable to be fixed by the general council under the reform act, with a due regard to the professional purposes to which these fees have been and may in future be applied ; and the courcil should have the power of controlling their application. The degrees of the universities may be superadded as they now are by those who desire them as titles of distinction.
In conclusion, the President's Council regret to be obliged to express so unfavourable an opinion of this draft bill. Much as they would have preferred a good understanding with its framers on the subject of medical reform, they conceive that this college would ill discharge its duties to the medical profession if it did not offer the most determined resistance to a bill which, without being in any degree beneficial to the public, is full of provisions injurious to that profession, and in the opinion of the council, would make its condition worse instead of better.-By authority of the College,
ARCHD. INGLIS, President.
REPORT submitted by the Council to the Faculty of PHYSICIANs and SURGEON
of Glasgow, on a Draft Bill for Regulating and Improving the Medical Profession; presented on 22d March, and adopted by the Faculty on 6th of April 1855.
The president having learned that a “ Draft Bill for an Act for Regulating and Improving the Medical Profession," was under the consideration of Her Majesty's Government, lost no time in applying to the Home Secretary in the name of the Faculty for a copy, which with a prefixed explanatory statement was at once supplied. The Fellows of Faculty are thus afforded an opportunity of expressing their opinion on the provisions of this document.
The bill is understood to have emanated from certain professors of the University of Edinburgh, and before entering on its merits the council would take the liberty of remarking that it is neither likely to reconcile the differences which exist in the profession on the subject of medical reform, nor is it courteous to the various corporate bodies, who for centuries past have been invested with the legal right to grant licences for practice—that the members of any institution, having no such right, should frame in secret a measure for reforniing the profession, and use their influence to get such measure taken up and alopted by the Government.
The council having attentively considered the various provisions and proposals of this bill, and the effect which, in their opinion, it would have on the
profession, beg to submit the following report thereon, for the consideration of the Faculty.
The bill provides for the appointment of a medical council for the United Kingdom, which is to consist of one of the Secretaries of State, and twelve councillors. By an interlineation with the pen in the copy forwarded from the Home Office, only eight of these twelve must necessarily be members of the medical profession-six are to be resident in England-three in Scotland, and three in Ireland, and the whole are to be appointed by the Crown.
Your council are decidedly of opinion, that the principle of representation ought to be adopted in the election of a national medical council; but this is not the place to discuss either the extent or the best plan of carrying out such representative principle. They cannot recommend you to accede to the introduction of non-medical councillors, with the exception of a Secretary of State, as chairman. They can see no reason why the medical profession should not be allowed to regulate its own affairs, as is the custom with all other professions and callings. The members of the profession must, certainly, be better acquainted with its requirements and duties, than persons who have never devoted themselves to its studies, and who could have little community of feeling with the medical majority, on the important subjects which they would require to consider and regulate.
The interpretation clause of the bill proposes that the words “medical prac. tice, or medical profession, shall include and signify the practice of medicine, surgery, midwifery, and pharmacy,” and the 8th clause provides “ that the degrees, or diplomas, or licences, as physicians, or surgeons, or apothecaries, of all the Universities in Great Britain and Ireland, and other corporations within the kingdom, at present authorised to confer such, shall be recognised by the council as qualifications for registration, with a view to practice." These clauses, coupled with the paragraphs numbered 2 and 3 in page 2 of the explanatory statement, your council consider, would enact that any person holding any medical title whatever, from any university, or corporation authorised at present to grant the same, would be entitled to practise medicine and surgery, in the most comprehensive sense of these terms, in any part of Her Majesty's dominions.
Of the twenty institutions enuinerated at page 12 of this draft bill, and proposed to be recognised as licencing bodies, no fewer that eleven are universities, several of which have very incomplete schools for teaching medicine, and one of them has none at all. It is admitted that Oxford and Cambridge already possess the power to licence their graduates to practise in England ; which power they very rarely exercise. To the other nine universities it is now proposed to grant & new privilege, viz., that of licencing general practioners, under the appellation of doctors of medicine, on exactly the same terms as the chartered medical corporations, which have never assumed to grant a higher title than surgeon. Your council cannot for a moment believe that the universities, generally, could approve of such an enactment. It would place what has always been looked upon as the highest medical title (M.D.), which confers an honorary distinction, and implies a higher qualification, both as to general and professional education, on the same level as the licence of a surgeon or apothecary. Besides bestowing a new and most uncalled for privilege on the universities, such an enactment, with the semblance of liberality, would be most detrimental to the licencing corporations, in so far as very few candidates would apply to them for a surgical diploma, if they could obtain the degree of doctor of medicine conferring the same privileges, at the same age, and on the same curriculum of study.
An attempt is made in the explanatory statement to uphold the erroneous opinion, that a medical degree from a Scotch university confers the right to practice ; and the decision in the lawsuit which this Faculty had with the University of Glasgow is quoted in confirmation of this opinion. The fact is, that the privileges, if any, conferred by a Scotch degree in medicine were not comNEW SERIES.--NO. V. MAY 1855.