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FRIENDLY SOCIETIES AND THE MEDICAL PROFESSION.
THE HEALTH OF LONDON IN 1898.
976 to be avoided.
We may be, it is true, groping feebly dark along very pathway, but there are, we think, indications of the light to come already visible. means
a
THE Bill for the reform and re-arrangement of Local Government areas in London, now under the consideration of Parliament, gives additional interest to the RegistrarGeneral’s annual summary which deals with the vital and
mortality statistics of London and of other large towns in England and Wales during 1898. The statistics for London, while comparing favourably with those for the larger provincial towns and with those for most of the Continental cities, afford abundant evidence, if closely analysed, that the sanitary condition of some of the more crowded portions of our large metropolis leaves much to be desired and to be expected from more energetic local government. The recorded death-rate in the whole of London last year was 18’7 per 1000, which was one per 1000 below the average rate in the preceding 10 years 1888-97, during which the rate ranged from 21-5 in 1891 to 17’8in 1894. After correction for differences of age and sex constitution, the same population which gave 1000 deaths in England and Wales in 1898 gave 1133 deaths in London. Among the 33 towns dealt with in the Registrar-General’s annual summary the comparative mortality figure in 1898 was below 1000 in Croydon, Cardiff, West Ham, Portsmouth, and Brighton, ranging from 824 in Croydon to 973 in Brighton ; in each of these five towns the rate of mortality last year was, after correction for age and sex differences, below the mean
England and Wales. comparative mortality figure
rate of the whole of
In five of these
exceeded 1300 ; 33 towns this it was 1327 in Newcastle, 1351 in Sunderland, 1411 in Manchester, 1452 in Salford, and 1498 in Liverpool. These figures show that among the 33 towns last year in equal
living, equally constituted as to age and sex, 150 deaths occurred in Liverpool and only 82 in Croydon. This startling contrast between the social and sanitary condition of these two urban populations is a matter of most serious import, and the mortality statistics for the different districts within the metropolitan area show contrasts equally startling. Registration or Inner London is at present divided into 43 separate sanitary areas. After the distribution of the deaths recorded in public institutions numbers
to the localities from which the inmates
were
admitted,
the death-rates last year in the various sanitary areas ranged from 11-7 per 1000 in Hampstead, 13-2 in St. George Hanover-square, and 13’7 in Fulham, to 23’8 in Limehouse, 24-4 in St. George-the-Martyr Southwark, 24 8 in St. George-in-the-East, 24-9 in Holborn, and 25-7 in St. Luke. It should not be overlooked that the rates in Hampstead, St. George Hanover-square, and Fulham are understated through the abnormal proportion of domestic servants included in those populations; but after due allowance for this disturbing factor these widely divergent rates undoubtedly indicate a disastrous loss of health and life in many of the more crowded central districts of London. If the health condition of these sanitary areas be tested by the proportions of infant mortality measured by the number of deaths under one year of age to 1000 births, very similar conclusions must be accepted. This proportion of infant
mortality, which was 108 in Stoke Newington, St. George Hanover-square, and 125 in Hampstead, the other sanitary areas to 208 in Limehouse,
120 in rose
in
211 in. St. Saviour Southwark, and 221 in Holborn. Thus the infant born in Holborn has less than half the chance of living through its first year of life than has the infant born in Stoke Newington. This waste of infant life has undoubtedly close relation to overcrowding in more or less insanitary tenements and can only be reduced by strict and constant enforcement of the provisions of the Public Health Acts by medical officers of health and by efficient sanitary inspectors. The apathy of many of the present London sanitary authorities in health matters is proverbial and we confidently look forward to the new Local Government Bill for London as a means of initiating a marked acceleration and increase of interest in sanitary progress within the county of London.
Annotations. "Ne
quid nimis."
FRIENDLY SOCIETIES AND THE MEDICAL PROFESSION. ON April 3rd the twentieth annual conference of the Friendly Societies Medical Alliance was held in the Assembly Rooms at Leamington. Alderman T. S. Harvey of Leamington presided and in his inaugural address is reported (we quote from the Times) as saying that it was a matter for regret that in certain towns there still existed hostility to the objects and aims of friendly societies medical associations on the part of the medical profession. Meetings had been held between representatives of the General Medical Council and the leading friendly societies of the country with a view to bringing about mutual settlements of disputes. They must be careful to limit their attendance to bonâ fide members of friendly societies, for medical men had every right to object to their medical associations going about touting for patients outside the ranks of friendly societies. But the medical profession would have to concede the right-not the privilege but the right-of the principal friendly societies to make combined provision for all their members altogether apart from their social position. They would strenuously resist any claim put forward by the medical profession to impose any wage limit to membership. If these are the views of the medical associations in general It is we cannot congratulate them on their wisdom. all a part of the modern craze for cheapness which is ruining everything. Just as goods made by sweaters, whether clothing, furniture, or anything else, are shoddy and rotten, so sweated medical attendance will naturally be careless and inferior. Good workmen nowadays, whether they work with their heads or with their hands, must be paid well if they are to be kept and sensible employers are finding this out. The friendly societies will have to learn this lesson and the Battle of the Clubs is by no means over yet. Respectable and conscientious medical men are getting more and more unwilling to attend friendly societies and this state of matters will continue until some steps are taken to limit the membership of such societies to those who are
really needy.
-
THE SALE OF HOSPITAL CASE BOOKS. A STATEMEKT appears in Tr1lth of March 30th which if gravely upon the management of the for Women, Soho-square. It is to the effect that
Hospital
correct reflects very
976 to be avoided.
We may be, it is true, groping feebly dark along very pathway, but there are, we think, indications of the light to come already visible. means
a
THE Bill for the reform and re-arrangement of Local Government areas in London, now under the consideration of Parliament, gives additional interest to the RegistrarGeneral’s annual summary which deals with the vital and
mortality statistics of London and of other large towns in England and Wales during 1898. The statistics for London, while comparing favourably with those for the larger provincial towns and with those for most of the Continental cities, afford abundant evidence, if closely analysed, that the sanitary condition of some of the more crowded portions of our large metropolis leaves much to be desired and to be expected from more energetic local government. The recorded death-rate in the whole of London last year was 18’7 per 1000, which was one per 1000 below the average rate in the preceding 10 years 1888-97, during which the rate ranged from 21-5 in 1891 to 17’8in 1894. After correction for differences of age and sex constitution, the same population which gave 1000 deaths in England and Wales in 1898 gave 1133 deaths in London. Among the 33 towns dealt with in the Registrar-General’s annual summary the comparative mortality figure in 1898 was below 1000 in Croydon, Cardiff, West Ham, Portsmouth, and Brighton, ranging from 824 in Croydon to 973 in Brighton ; in each of these five towns the rate of mortality last year was, after correction for age and sex differences, below the mean
England and Wales. comparative mortality figure
rate of the whole of
In five of these
exceeded 1300 ; 33 towns this it was 1327 in Newcastle, 1351 in Sunderland, 1411 in Manchester, 1452 in Salford, and 1498 in Liverpool. These figures show that among the 33 towns last year in equal
living, equally constituted as to age and sex, 150 deaths occurred in Liverpool and only 82 in Croydon. This startling contrast between the social and sanitary condition of these two urban populations is a matter of most serious import, and the mortality statistics for the different districts within the metropolitan area show contrasts equally startling. Registration or Inner London is at present divided into 43 separate sanitary areas. After the distribution of the deaths recorded in public institutions numbers
to the localities from which the inmates
were
admitted,
the death-rates last year in the various sanitary areas ranged from 11-7 per 1000 in Hampstead, 13-2 in St. George Hanover-square, and 13’7 in Fulham, to 23’8 in Limehouse, 24-4 in St. George-the-Martyr Southwark, 24 8 in St. George-in-the-East, 24-9 in Holborn, and 25-7 in St. Luke. It should not be overlooked that the rates in Hampstead, St. George Hanover-square, and Fulham are understated through the abnormal proportion of domestic servants included in those populations; but after due allowance for this disturbing factor these widely divergent rates undoubtedly indicate a disastrous loss of health and life in many of the more crowded central districts of London. If the health condition of these sanitary areas be tested by the proportions of infant mortality measured by the number of deaths under one year of age to 1000 births, very similar conclusions must be accepted. This proportion of infant
mortality, which was 108 in Stoke Newington, St. George Hanover-square, and 125 in Hampstead, the other sanitary areas to 208 in Limehouse,
120 in rose
in
211 in. St. Saviour Southwark, and 221 in Holborn. Thus the infant born in Holborn has less than half the chance of living through its first year of life than has the infant born in Stoke Newington. This waste of infant life has undoubtedly close relation to overcrowding in more or less insanitary tenements and can only be reduced by strict and constant enforcement of the provisions of the Public Health Acts by medical officers of health and by efficient sanitary inspectors. The apathy of many of the present London sanitary authorities in health matters is proverbial and we confidently look forward to the new Local Government Bill for London as a means of initiating a marked acceleration and increase of interest in sanitary progress within the county of London.
Annotations. "Ne
quid nimis."
FRIENDLY SOCIETIES AND THE MEDICAL PROFESSION. ON April 3rd the twentieth annual conference of the Friendly Societies Medical Alliance was held in the Assembly Rooms at Leamington. Alderman T. S. Harvey of Leamington presided and in his inaugural address is reported (we quote from the Times) as saying that it was a matter for regret that in certain towns there still existed hostility to the objects and aims of friendly societies medical associations on the part of the medical profession. Meetings had been held between representatives of the General Medical Council and the leading friendly societies of the country with a view to bringing about mutual settlements of disputes. They must be careful to limit their attendance to bonâ fide members of friendly societies, for medical men had every right to object to their medical associations going about touting for patients outside the ranks of friendly societies. But the medical profession would have to concede the right-not the privilege but the right-of the principal friendly societies to make combined provision for all their members altogether apart from their social position. They would strenuously resist any claim put forward by the medical profession to impose any wage limit to membership. If these are the views of the medical associations in general It is we cannot congratulate them on their wisdom. all a part of the modern craze for cheapness which is ruining everything. Just as goods made by sweaters, whether clothing, furniture, or anything else, are shoddy and rotten, so sweated medical attendance will naturally be careless and inferior. Good workmen nowadays, whether they work with their heads or with their hands, must be paid well if they are to be kept and sensible employers are finding this out. The friendly societies will have to learn this lesson and the Battle of the Clubs is by no means over yet. Respectable and conscientious medical men are getting more and more unwilling to attend friendly societies and this state of matters will continue until some steps are taken to limit the membership of such societies to those who are
really needy.
-
THE SALE OF HOSPITAL CASE BOOKS. A STATEMEKT appears in Tr1lth of March 30th which if gravely upon the management of the for Women, Soho-square. It is to the effect that
Hospital
correct reflects very