White Drug Cultures and Regulation in London, 1916–1960 by Christopher Hallam

Author:Christopher Hallam
Language: eng
Format: epub
ISBN: 9783319947709
Publisher: Springer International Publishing

The degree to which these opinions were shared is, once again, difficult to gauge.

In addition to providing them with a letter to act as warrant of their authority to carry out these inspections, the Ministry of Health produced detailed instructions for its RMOs when their new inspection duties commenced in 1923. These were organised under two headings, ‘routine’ and ‘special’ inspections. The former referred only to doctors who dispensed their own medicines, as those who did not were at this stage not obliged by the legislation to keep records. This meant that most doctors were not subject to routine visits by RMOs. Any suspicions were not acted upon by the RMO but reported to the Home Office which took the decision as to what, if any, action should be taken. Routine inspections were, moreover, carried out only in England and Wales; the Scottish Board of Health restricted RMOs to visits in exceptional circumstances. Special inspections took place when the Home Office requested the RMO to visit a practitioner, with instructions issued to the officer on a case-by-case basis. These were usually examples in which the Home Office suspected the possibility of addiction, either of the practitioner or a patient, which was being supplied with drugs in contravention to the law.

It is important to recognise that in this context much of the regulatory pressure was exerted by one part of the regulatory system on another. As we have seen, doctors were permitted to provide supplies of drugs for addicts in certain cases; this was itself a regulatory measure, securing the addict within a medical system of observation and record-keeping and theoretically maintaining doses at low levels. RMOs were called in by the Home Office to investigate in those circumstances where it appeared that doctors were not following the regulations governing such supplies. It was felt that ‘medical men’ were more suited to discussion of the complexities arising from cases of treatment than the Drugs Branch’s inspectors, and the Ministry of Health was assured that no medical professional would be placed in the invidious position of having to give evidence against a colleague in a court of law.98 Nevertheless, within a few years of the establishment of this arrangement, Dr Dill Russell , an RMO who regularly worked in cases of transgressive prescribing, was called as a witness for the prosecution in the case against Dr George Kingsbury , who had refused to supply the Home Office with the name of an addict patient. Dr Kingsbury was motivated, he protested, by a concern for his patient’s confidentiality and was fined.99

The main object of Drugs Branch attentions was the script doctor , who was viewed as the primary source of addiction when his prescribing or administration of dangerous drugs went beyond the informal limits that were supposed to be guaranteed by the system. Where it felt it necessary, the Home Office made use of the testimony of RMOs to obtain legal or professional restrictions on the prescribing of the transgressive practitioner.

The Regional Medical

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