ABSTRACT

Even before the National Health Service, specialized medicine with its growing array of machinery, facilities, and staff was encouraging consultants to conduct most of their practice from within the hospital. The introduction of a salaried service formalized this trend by making it possible for consult­ ants in all specialties to be paid for the time they spent in hospital. Regional hospital boards, in their advertisements for consultant posts, encouraged specialists to accept a relatively large number of NHS sessions. As early as 1949 almost a fourth of consultants employed in the NHS were on wholetime contracts, and the average number of half-day sessions of whole-time and part-time consultants combined was well over seven per week.1