The Emergence of Priorities in Psychiatry
DAVID H. CLARK M.A., M.D., F.R.C.P.E., D.P.M.1
1 Physician superintendent, Fulbourn Hospital, Cambridge, England
The premises upon which the National Health Service was established have influenced the development of priorities in British psychiatry since 1948. Thus the egalitarian concept of a certain acceptable standard of service for everyone meant that initial postwar emphasis was largely upon raising the low standards of the poorest hospitals. In response to growing public and Parliamentary pressures, the emphasis has now shifted toward community services. Because the psychiatrist receives most of his income as a fixed salary from the NHS, he tends to allocate most of his time to those he feels are sickest rather than to those who can best afford his services.
