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APPEAL FROM GREAT ORMOND STREET
863
another Fabian tract 13 Prof. R. M. TiTMUSs has stern; but at a time when the Younghusband report has reiterated his view that the better-off third of the set us thinking about the organisation of the social population enjoy fiscal and occupational benefits at the services, her plea for a reconsideration of their purpose expense of the welfare services which could offer real and deployment should not be neglected. support to those who are " living precariously close to the margin of poverty ". Mrs. HARVEY agrees with this: Annotations indeed in her view it is chiefly the middle classes who have benefited from some recent developments of the social services, notably the National Health Service. APPEAL FROM GREAT ORMOND STREET In unfair contrast, the poor carry a burden of indirect THE Institute of Child Health, which was formed in taxation which for them is relatively heavier than for the 1946 and is associated with the world-famous Hospital better-off. Though widows, old people, and the sick are for Sick Children in Great Ormond Street, London, has eligible for benefits, these are modest and the regulations established itself not only as a national but also as an hedging extra earnings and National Assistance are, international centre. Most would agree that such a Mecca within each specialty is a necessity-for teaching postin Mrs. HARVEY’S view, irksome and often harsh. The most urgent basic need of the poor, she thinks, graduates at all levels, for coordinating the study of is cheap housing. Yet local-authority building fell from special problems, and, above all, for research. And in 200,000 dwellings in 1954 to 113,000 in 1958 (though the 1960s even Mecca must be up to date and look to the
the future.
private building expanded). The The Institute has now reached the point where its need" "general housing subsidy, abolished in 1956, resources are exhausted and it can neither accommodate has never been restored, and she says that we spend a all its would-be students nor properly fulfil its research lower proportion of our income on housing than all projects. Those who study there can see all types of but three of fifteen other European countries. It is a disease, and, for comparison, the relatively healthy commonplace that the home is the centre of family life, children who attend the Province of Natal Welfare Centre. and for a family of wavering stability it may make all But the amenities for students are meagre, and the the difference between independence and reluctant laboratory facilities are badly overcrowded. Such a
over
reliance
same
years
the social services. Each of the three examples we cited above had failed to find reasonable accommodation, and a section of Mrs. HARVEY’S tract describes in detail the misfortunes of a family which almost disintegrated, largely from lack of a home of their own. Though they were given a great deal of expensive help from various social services, no authority seemed able to provide them with the house or flat which at much less cost would have set them on their feet again. "It is one of the salient anomalies of the Welfare " State ", she writes, that despite its insistence on ’the importance of the family’, far more services are provided for efficiently sweeping under the carpet the remains of a family after it has disintegrated than for preventing this disaster. Nor is it generally recognised that what is needed to prevent this is far less often solemn amateur psychiatry than helpful information and advice and, sometimes-in an emergency-just plain cash as a loan ". This last sentence expresses Mrs. HARVEY’s dissatisfaction with the manners as well as the matter of the Welfare State. In her work at a citizens’ advice bureau in a poor district, she has perhaps tended to meet an undue proportion of those who have found its administration bewildering and its help grudging. Standing outside the official specialist services as she does, she has come to regard the professional social worker with some reserve. Though she recognises many notable exceptions, she finds among them a "terrifying tendency to blame unfortunate people for their misfortunes " and to expect of them standards of conformity and virtue " stern beyond belief ". To those who see the work of the social services as a whole such criticism may itself seem unduly 13. The
on
Irresponsible Society. 1960. Pp. 20. (2s. 8d., post free, from the
Fabian Society.)
situation must obviously be remedied quickly at a time when progress in medicine lies so largely in the laboratory. This is perhaps particularly true of pxdiatrics, and of advances in the treatment of the sick newborn baby. Because of the Institute’s insufficient buildings and the growing demands made on it as a Commonwealth centre, a new and larger building has become a matter of urgency. A site is available, and plans are already drawn up; but though these include only provisions for the foreseeable future the estimated cost will be t400,000. As part of the British Postgraduate Medical Federation, the Institute would normally look to the University of London for funds from the allocation made by the University Grants Committee. But at present the universities are giving priority to expansion in technology. and pure science, and the necessary money is unlikely to be given to the Institute quickly. Accordingly it has launched its own building appeal, in the hope that those who have benefited from the work of " Great Ormond Street ", either directly or indirectly, and who believe that its future should match its past, will give all the support they can. Donations may be sent to Sir Hugh Beaver at the Appeal Office, Institute of Child Health, Great Ormond Street, London, W.C.1. PREVENTION OF SERUM HEPATITIS
SERUM hepatitis is potentially fatal, and every effort must be made to screen donor blood for the hepatitis virus. In the absence of specific means of identifying the agent or its antibodies, present screening methods are necessarily crude. Donors with a previous history of jaundice are unacceptable, but this does not exclude the significant number carrying the virus from a latent or anicteric form of the disease. In order to detect this group of hepatitis carriers, donor blood has been subjected to a battery of liver-function tests, but none has proved effective.l2 1. 2.
Rosenberg, J. N.Y. St. J. Med. 1957, 57, 2522. Capps, R. B., Stokes, J., Jr. J. Amer. med. Ass. 1952, 149,
557.
another Fabian tract 13 Prof. R. M. TiTMUSs has stern; but at a time when the Younghusband report has reiterated his view that the better-off third of the set us thinking about the organisation of the social population enjoy fiscal and occupational benefits at the services, her plea for a reconsideration of their purpose expense of the welfare services which could offer real and deployment should not be neglected. support to those who are " living precariously close to the margin of poverty ". Mrs. HARVEY agrees with this: Annotations indeed in her view it is chiefly the middle classes who have benefited from some recent developments of the social services, notably the National Health Service. APPEAL FROM GREAT ORMOND STREET In unfair contrast, the poor carry a burden of indirect THE Institute of Child Health, which was formed in taxation which for them is relatively heavier than for the 1946 and is associated with the world-famous Hospital better-off. Though widows, old people, and the sick are for Sick Children in Great Ormond Street, London, has eligible for benefits, these are modest and the regulations established itself not only as a national but also as an hedging extra earnings and National Assistance are, international centre. Most would agree that such a Mecca within each specialty is a necessity-for teaching postin Mrs. HARVEY’S view, irksome and often harsh. The most urgent basic need of the poor, she thinks, graduates at all levels, for coordinating the study of is cheap housing. Yet local-authority building fell from special problems, and, above all, for research. And in 200,000 dwellings in 1954 to 113,000 in 1958 (though the 1960s even Mecca must be up to date and look to the
the future.
private building expanded). The The Institute has now reached the point where its need" "general housing subsidy, abolished in 1956, resources are exhausted and it can neither accommodate has never been restored, and she says that we spend a all its would-be students nor properly fulfil its research lower proportion of our income on housing than all projects. Those who study there can see all types of but three of fifteen other European countries. It is a disease, and, for comparison, the relatively healthy commonplace that the home is the centre of family life, children who attend the Province of Natal Welfare Centre. and for a family of wavering stability it may make all But the amenities for students are meagre, and the the difference between independence and reluctant laboratory facilities are badly overcrowded. Such a
over
reliance
same
years
the social services. Each of the three examples we cited above had failed to find reasonable accommodation, and a section of Mrs. HARVEY’S tract describes in detail the misfortunes of a family which almost disintegrated, largely from lack of a home of their own. Though they were given a great deal of expensive help from various social services, no authority seemed able to provide them with the house or flat which at much less cost would have set them on their feet again. "It is one of the salient anomalies of the Welfare " State ", she writes, that despite its insistence on ’the importance of the family’, far more services are provided for efficiently sweeping under the carpet the remains of a family after it has disintegrated than for preventing this disaster. Nor is it generally recognised that what is needed to prevent this is far less often solemn amateur psychiatry than helpful information and advice and, sometimes-in an emergency-just plain cash as a loan ". This last sentence expresses Mrs. HARVEY’s dissatisfaction with the manners as well as the matter of the Welfare State. In her work at a citizens’ advice bureau in a poor district, she has perhaps tended to meet an undue proportion of those who have found its administration bewildering and its help grudging. Standing outside the official specialist services as she does, she has come to regard the professional social worker with some reserve. Though she recognises many notable exceptions, she finds among them a "terrifying tendency to blame unfortunate people for their misfortunes " and to expect of them standards of conformity and virtue " stern beyond belief ". To those who see the work of the social services as a whole such criticism may itself seem unduly 13. The
on
Irresponsible Society. 1960. Pp. 20. (2s. 8d., post free, from the
Fabian Society.)
situation must obviously be remedied quickly at a time when progress in medicine lies so largely in the laboratory. This is perhaps particularly true of pxdiatrics, and of advances in the treatment of the sick newborn baby. Because of the Institute’s insufficient buildings and the growing demands made on it as a Commonwealth centre, a new and larger building has become a matter of urgency. A site is available, and plans are already drawn up; but though these include only provisions for the foreseeable future the estimated cost will be t400,000. As part of the British Postgraduate Medical Federation, the Institute would normally look to the University of London for funds from the allocation made by the University Grants Committee. But at present the universities are giving priority to expansion in technology. and pure science, and the necessary money is unlikely to be given to the Institute quickly. Accordingly it has launched its own building appeal, in the hope that those who have benefited from the work of " Great Ormond Street ", either directly or indirectly, and who believe that its future should match its past, will give all the support they can. Donations may be sent to Sir Hugh Beaver at the Appeal Office, Institute of Child Health, Great Ormond Street, London, W.C.1. PREVENTION OF SERUM HEPATITIS
SERUM hepatitis is potentially fatal, and every effort must be made to screen donor blood for the hepatitis virus. In the absence of specific means of identifying the agent or its antibodies, present screening methods are necessarily crude. Donors with a previous history of jaundice are unacceptable, but this does not exclude the significant number carrying the virus from a latent or anicteric form of the disease. In order to detect this group of hepatitis carriers, donor blood has been subjected to a battery of liver-function tests, but none has proved effective.l2 1. 2.
Rosenberg, J. N.Y. St. J. Med. 1957, 57, 2522. Capps, R. B., Stokes, J., Jr. J. Amer. med. Ass. 1952, 149,
557.