The Ulster Medical Protective Association was founded in 1859 to protect the interests of the profession and was one of the 3 predecessors of the Ulster Medical Society.All unreferenced quotations are from the transcribed records of the Association in which will be found notes of the original sources.
INTRODUCTION
Although it is commonly said that two societies, the Belfast Medical Society and the Belfast Clinical and Pathological Society, were amalgamated in 1862 to form the Ulster Medical Society, there were in fact three, the third being the Ulster Medical Protective Association. The evidence for this lies in Professor J. C. Ferguson’s presidential address to the Ulster Medical Society on 1 November 1862 where he refers to ‘the amalgamation of the three previously existing societies, to form the Ulster Medical Society’, and in the newspaper report of that same meeting which more specifically records that ‘this important provincial association of medical practitioners—being an amalgamation of the parent “Belfast Medical Society” (founded in 1822), the “Belfast Clinical and Pathological Society”, and the “Ulster Medical Protective Association”—was inaugurated’.
BACKGROUND
The Ulster Medical Protective Association came into being in 1859. Unlike a modern body such as the Canadian Medical Protective Association, it did not offer indemnity to the individual practitioner but rather was set up with the objects ‘to protect the interests of the profession, in the admission of its members, to sustain the status of qualified Practitioners, and to watch over, and, if desirable, to promote such legislative measures as may seem generally beneficial.’ The Belfast Medical Society had taken an interest in wider professional matters and in the 7 sessions up to April 1859 had considered the reform of the profession, the Medical Charities Act, the standard of professional education for the medical officers of the Navy, and the activities of the Irish Medical Association. It had joined the Irish Medical Association in October 1855 and paid the annual subscription of one guinea for at least that year and the following. That it was the Society’s intention to continue in these activities is shown by Surgeon Browne’s remarks in his presidential address in June 1857 in which he said ‘Should the necessity again arise, as it likely will, this association will still take the lead in contending for our common interests, and in arousing the spirit of our brethren to the assertion of our inalienable rights.’ Despite this, only 2 years later Browne was taking the lead in setting up the Ulster Medical Protective Association and it is likely that he and his fellow-promoters could see that having a separate body with the potential for a wider membership would allow them greater freedom of action.
INITIAL STEPS
The original records of the Ulster Medical Protective Association are not available but the proceedings of many of the early meetings were recorded in the newspapers of the day. These have been transcribed and placed on the Ulster Medical Society’s website. Plans for the association must have been well advanced if not complete in June 1859 as a circular entitled ‘Address to the Medical Profession of Ulster’ issued by John C. Ferguson and Samuel Browne, Chairman and Secretary respectively of the Provisional Committee, was dated the 30th of that month. The ‘Address’ and the ‘Rules’ of the proposed Association were published in the Dublin Medical Press for 20 July 1859. On 26 July 1859, an interesting editorial, perhaps inspired or written by Surgeon Samuel Browne himself, appeared in the Belfast Daily Mercury condemning the ‘great number of unauthorised practitioners, who drive a profitable trade by butchering, and poisoning, and drugging to death the unfortunate people who are imposed upon by their pretensions.’ This allowed Browne to reply the following day ‘I am happy to inform you that a Medical Protection Association for Ulster has been organised, and will soon be in a position to deal with the gentry in question’. A public notice inserted by the Provisional Committee of the Ulster Medical Protective Association on 18 August 1859 begged ‘to remind practitioners who have received the “Address to the Medical Profession of Ulster” that they should send their names and subscriptions to the Acting Treasurer … before Thursday, the 1st of September on which day the first meeting of the Society will take place.’
INAUGURAL MEETING
Thirty-six medical practitioners attended that meeting and a total of 112 were said to have signed up and to have paid the subscription of 5 shillings. While the majority of the members were, as might be expected, from counties Antrim and Down (65 and 18 respectively, the greater number in county Antrim included those from Belfast), 8 were from counties Monaghan, Cavan and Donegal. Only one had joined from Fermanagh but this was probably because Fermanagh already had its own protective association. Dr. M’Gee, Surgeon Browne, and Dr. Patterson were appointed Chairman, Secretary, and Treasurer, respectively, with 12 members from Belfast and 3 from each of the participating counties being appointed to form the governing committee. Surgeon Browne pointed out that protective societies had existed for some years in Great Britain (the Medical Association of Great Britain) and Ireland (the Irish Medical Association). The latter was made up of a number of local organisations (including the one in Fermanagh) and he had found that its members were ‘most anxious that we in the North should fraternise more than we had hitherto done’.
RELATIONS WITH OTHERS
The promoters were keen not to upset the 2 main local societies nor the public. With regard to the former the ‘Address’ stated ‘And here it may be necessary to explain, that, while this association is quite independent of the Belfast Medical and Pathological Societies, it cannot in any measure, be antagonistic to them’; while with regard to the latter, Surgeon Browne said ‘I believe that this is not only protective of ourselves, but protective of the community, because it is quite clear if we prevent a large number of men from going on through the various districts around us practising in our profession, who have no right to assume the name of medical men, and who have no education for the claim, that we are not only protecting ourselves, but doing a vast amount of good to the community, who are suffering from the interference of these uneducated persons who assume to themselves the name and dignity of doctors.’ The suggestion that what was good for the medical profession was good for the community was one which was repeated regularly at the Association’s meetings but it was not altogether accepted as on 1 February 1861, the Belfast Daily Mercury said ‘We have in Belfast a Society that is called the “Ulster Medical Protective Association.” Such a body, we admit, is greatly needed, and if it only discharged its duties independently and fearlessly, it would confer vast benefits on the Profession, and also on the public. But we observe that while every exertion is made to serve the Profession, no attention whatever appears to be bestowed on the interests of the public…. But what we object to is, that this Association appears to think the poor were made for its profit—that there is no interest to be consulted but the Medical. We could point to many cases not unworthy of the Association’s attention, assuming that in their “Protective” character they desire to maintain the honour and dignity of the Profession.’
UNQUALIFIED PRACTITIONERS
The business of the committee fell into 3 main groups; dealing with unqualified practitioners, communicating with various bodies, and co-operating with the Irish Medical Association. By the time of the first committee meeting in October 1859 the services of a counsel, J. M. Thompson, Esq., Barrister- at-Law, had been retained. Members of the Association were asked to send in the names of those who were falsely setting themselves up as qualified practitioners but the publicity in the newspapers must have worried some of the latter as it was reported in November 1859 that ‘a good many of them had taken to flight from Belfast, and others were trying through subterfuge to escape the observation of the society.’ Those who continued to practice were sent a letter requesting that copies of their medical qualifications be forwarded to the Association and threatening action if satisfactory replies were not received. This lead some to apply for registration but others resisted. Three men were summonsed by Surgeon Browne (on behalf of the Ulster Medical Protective Association) to appear before the Petty Sessions Court in May 1860, ‘for having on the 3rd May inst. at Belfast, wilfully and falsely pretended to be practitioners in medicine and physicians, and that they did supply and prescribe medicine contrary to the 21st and 22nd Vic., cap. 90.’ The cases were postponed on a legal point until early June by which time one had left town. The first to appear in the witness stand was found to be un-registered but when after some argument he produced a diploma from the Apothecaries’ Hall, Dublin, judgement was postponed for a month to give him time to register properly (which he did). The cases against the other two were then withdrawn but the following year one of them was summonsed again after attending a woman who died. Owing to some difficulty in proving that he had attended ‘as a medical man’ judgement was postponed for three months. The final outcome is unknown.The reluctance with which the diploma was produced is reminiscent of a story told by Dr. Axel Munthe of a time when the police in Paris were taking steps to suppress unqualified practitioners. One man proved that he was qualified but begged that this be kept secret as he owed his enormous practice to the circumstance that he was considered by everybody to be a quack. Dr. John M. McCloy referred to a similar instance in his presidential address to the Ulster Medical Society in November 1938 saying ‘A young man [in Hungary] practising as a quack … was really a qualified doctor who had failed to attract patients, so he had moved to another address and, while continuing to use his medical knowledge quite properly, had built up a successful practice on the prestige that comes from being non-academic and non-scientific.’
COMMUNICATIONS
Sir Hugh Cairns, M.P. for Belfast, presented at least 2 petitions from the Association to Parliament. The first, in March 1860, had been signed by over 200 Ulster practitioners, and may have related to the Poor Relief Amendment Bill, while the second, in June 1860, had related to the Birth, &c., Registration (Ireland) Bill. After the Limerick Junction meeting (see below) the Ulster Medical Protective Association wrote to the General Council for Medical Education urging the separate publication of a Medical Register for Ireland as it would be cheaper and more readily available; to the Chief Secretary for Ireland and the Poor-Law Commissioners opposing the proposed use of non-medical inspectors under the Medical Charities Act; to the Branch Medical Council for Ireland suggesting that the failings of the Vaccination Act could be remedied by passing an Act for the compulsory registration of births and deaths; and to the Apothecaries’ Hall, Dublin, regarding the preparation and sale by unqualified persons of medicines including opiates. The sense from the answers was that nothing was likely to change. No direct reply was received from the General Council but the Branch Medical Council for Ireland said that they had proposed the previous year that separate Registers should be published, and that they would forward the suggestion of compulsory birth and death registration to the General Council; the Chief Secretary said that the question of medical inspectors would receive full consideration; the Poor-law Commissioners only acknowledged receipt; and the Apothecaries’ Hall agreed that the problem existed but said that they lacked the legal power to intervene.
THE LIMERICK JUNCTION MEETING
Surgeon Browne had met with the Irish Medical Association previously while representing the Belfast Medical Society and continued to keep in touch with them in his new position. One matter over which they co-operated was that of the treatment of Dr Wall, a dispensary doctor in the Dunmanway Union who would have been appointed originally by the local District Dispensary Committee. Dr. Wall had attended a man who refused amputation after a severe leg fracture and who, with his friends, insisted against Dr. Wall’s advice on going to hospital in Cork where he died. The Poor-law Commissioners, based in Dublin, rebuked Dr. Wall for not having the leg amputated and for not stopping the transfer, and asked him to resign, which he did. The reason for the censure is unknown. The District Dispensary Committee must then have advertised the post as it is reported that Dr Wall put his name forward and was re-appointed unopposed. The Poor-law Commissioners did not accept this and asked him to resign for a second time. Again he complied, after which the Board of Guardians, the tier between the Poor-law Commissioners and the District Dispensary Committee, asked him to fill the post on a temporary basis until a permanent replacement could be found. (The Guardians seem to have been sympathetic to Dr. Wall as they wrote to the Commissioners in his support and organized a subscription for him.) The injustice in the case gave rise to much indignation and the Irish Medical Association arranged an ‘aggregate meeting of the medical profession in Ireland’ in the Limerick Junction Hotel on 15 December 1859. The Ulster Medical Protective Association sent as representatives Dr. M’Gee and Surgeon Browne and in his opening remarks the chairman drew particular attention to ‘the attendance at that meeting of a deputation from the Ulster Medical Protective Association, a society which was doing much to advance the position and maintain the high character of the medical profession’. Both Dr. M’Gee and Surgeon Browne spoke and were well received. A number of resolutions were passed in support of Dr. Wall and further action in the form of a petition to Parliament was planned. Before the meeting separated a ‘Dr Brown’ proposed and a ‘Dr Magee’ seconded that a committee should be set up to consider petitioning Parliament with regard to compulsory vaccination, compulsory birth and death registration, and reform of the sale of medicines. It is probable that the reporter meant ‘Surgeon Browne’ and ‘Dr. M’Gee’.
FINAL PHASE
At the Annual Meeting in May 1861 the Ulster Medical Protective Association seemed to have confidence in the future and had over 200 members but the newspaper reports of the proceedings stop at that point so that nothing is known now about the last eleven months of its existence. Despite the initial enthusiasm and activity, it cannot be said that the Association achieved great things but it did make a stand for the profession alongside the Irish Medical Association and others, and amalgamation into the Ulster Medical Society at least offered a dignified ending to the shortest-lived and least significant of the three founding societies.