General Purposes Committee

109

P U B L I C H E A L T H , March, 1951 The Association had instituted a Sub-Committee to consider desirable amendments to the National Health Service Act and the Committee stated that they would be glad to receive any suggestions that the Society may care to make. It was resolved that no special recommendations be made and that the question be left in the hands of the Society's representatives on the Association. 110. Public Health Engineers.--A letter dated February 2nd was received from Dr. O. L. Peterson, of the Rockefeller Foundation, as follows: " As you know, the Rockefeller Foundation has sponsored the new department at the Imperial College of Science for the training of public health engineers. A similar course has been started at the University of Durham, in Newcastle, by Mr. Isaacs, a member of the Engineering Department. Since the training of public health engineers has begun it would appear to be very important that the Medical Officers of Health understand the nature of this training and consider the future employment of public health engineers. " I have already taken the initiative to bring public health engineering to the attention of the Metropolitan and Home Counties branches of the Society of Medical Officers of Health in the form of a panel discussion programme which was later repeated before the Scottish Medical Officers of Health. As Dr. Metcalfe Brown suggested, it would probably be a good idea if the Council of the Society of Medical Officers of Health considered whether it could recommend such meetings to present the case for and to discuss the training and utilisation of public health engineers. If the Council feels that these discussions are of some value and wishes to commend them to branches of the Society, Mr. F. E. Bruce, who is in charge of the training of engineers at the Imperial College of Science, Dr. R. F. Guymer, who is responsible for the part of the course given at the London School of Hygiene, and Dr. R. P. Burden, an engineer member of the Rockefeller Foundation, would be very happy to visit the various Branches to present a panel discussion covering the field. " I am enclosing a prospectus of the course for public health engineers at Imperial College but do not feel that it is necessary to include any information about that field since most of the members of the Council are quite well versed in the development. Sir Allen Datey, I believe, was consulted at the time that the course at Imperial College and the London School of Hygiene was instituted, and probably other members of the Council have had some contact with it. " The development of a corps of public health engineers would, I feel, be of very valuable aid to the Medical Officers of Health, particularly in executing such environmental health projects as are being sought by the Clean Food Campaign. In so much as my own organisation has participated in the initiation of this project, I would like to do everything possible to see its introduction accompanied with the minimum of friction and for this reason would be most grateful if the Council could recommend a thorough discussion of the problems among the Branches of the Society of Medical Officers of Health." It was resolved that the letter be received and published in the minutes of the meeting. 111. British Medical Guilfl.--It was reported that at a meeting of the Public Health Service Defence Trust on February 2rid it had been reported that only 615 Public Health Service Medical Officers (out of an estimated total of 2,243) had contributed to the Trust F u n d - - t h e total amount received being £681 0s. ld. It was resolved that the Executive Secretary of the Society send a communication to Branch and Group Secretarias asking them to do everything that they could to encourage their members to send contributions to the Trust and that an article on the Trust be inserted in the next convenient issue of PUBLIC HEALTH. 112. Public Health Ass0ciati0n.--Prof. Parry had given notice of his intention to move : " That the time is now opportune for all public health workers to join together to form a Public Health Association, and that the Society of M.O.Hs. should take the iriitiative and approach the following bodies with that in mind, viz. : Women Public Health Officers Association, Sanitary Inspectors' Association, and other bodies." The proposition was seconded by Dr. Atcock. Members were of opinion that there was already in existence an organisation very similar to that proposed by Prof. Parry and, on the resolution being put to the meeting, it was lost by a large majority. 113. Virus Infection during Pregnan0y.--It was reported that the General Register Officer had now stated that, since the last report showing the receipt of cards from six County Councils and 22 County Boroughs, registration cards had been received from a further 25 County Councils and 26 County Boroughs.

114. Sanitary Officers lqegulati0ns.--A letter dated February 7th was received from the Ministry of Health enclosing copies of the new Sanitary Officers' Regulations which the Minister was proposing to make, together with copies of a circular and explanatory note which it was intended to issue with them to Local Authorities. The proposals arose out of a report of the Local Government Manpower Committee which had recommended the simplification of the procedure in the appointment of M.O.H. and Sanitary Inspector. The alternations in the Regulations were only those necessary to implement this recommendation so that, in future, it would not be necessary for Local Authorities to obtain the Minister's prior approval for the appointment of an M.O.H., except in the case of the appointment of an M.O.H. of (1)'a Metropolitan Borough (for the time being) or (2) of a Borough outside London, or of an Urban or Rural District, the Council of which propose in making the appointment not to comply with arrangements made by County Councils under Section 3 of the Local Government Act or which is in a county for which arrangements under Section 3 have not yet been made. The Regulations would also remove the necessity for the Minister's approval to be obtained for individual salaries which would now be governed by central negotiating machinery. T h e Regulations provide a right of appeal to the Minister for an officer who objects to a proposed variation in the terms of his appointment. The Regulations would also restrict the power of Local Authorities to suspend an M.O.H. or Sanitary Inspector to cases where the officer's fitness to continue in his office is under investigation. The Council considered very carefully the proposals of the Minister, and it was resolved that no objection be made to any of the proposed provisions. 115. Representation el the Society.--(a) National Smoke .4batement Society.--The question of representation on the Council o f t h e N , S . A . S , was referred to the General Purposes Committee. (b) Central Council for Health Education.--Two representatives. Drs. E. K. Macdonald and H. C. Maurice Williams were reelected. 116. Recommendations for Full Paid Life Membership.--The following recommendations for Life Membership, from the Branch indicated, were confirmed for election at the next ordinary meeting of the Society : Welsh B r a n c h . - - Dr. N. T. K. Jordan (formerly Chest Physician, Welsh National Memorial Association), elected 1920. 3/Ietropolitan Branch.--Dr. T. S. McIntosh (formerly M.O., Ministry of Health), elected 1919 ; and Dr. A. B. Porteus (formerly Chest Physician, Paddington) elected 1920. Home Counties B r a n c h . - - D r . Edith Shannon (formerly A.M.O.H., Middlesex C.C.), elected 1916. North-IYestern Branch. Dr. F. Hall (formerly C.M.O.H., Lancashire), elected 1911; and Dr. J. E. Spence (formerly M.O.H., Eccles M.B.), elected 1911. The meeting was declared closed at 12.50 p.m.

GENERAL PURPOSES COMMITTEE A meeting of the General Purposes Committee was held in the Council Chamber of the Medical Defence Union on Friday, January 19th, at 10 a.m. Present.--Dr. J. M. Gibson (President), Sir Allen Daley (Chairman of Council), Drs. C. Fraser Brockington, George Buchan, H. D. Chalke, W. G. Clark, C. K. Cullen, James Fenton, Miriam Florentin, F. Hall, R. H. H. Jolly, J. Maddison, Maurice Mitman, A. A. E. Newth, Prof. R. H. Parry, Drs. Hugh Paul, J. A. Stirling, Mr. A. Gordon Taylor, L.D.S., Drs. H. C. Maurice Williams, and J. Yule. Apologies for absence were received from Drs. C. Metcalfe Brown and C. E. Herington. 60. Election of Chalrman.--It was unanimously resolved that Dr. H. C. Maurice Williams be elected Chairman of the Committee for the current session. 61. Minutes of the meeting held on October 20th (PuBLIC HEALTH, January, pages 57 to 59) were confirmed and signed. 62. Whitley Medical Functional Council (Min. 3).--In the absence, through illness, of Dr. C. Metcalfe Brown, Dr. ]. M. Gibson reported briefly on the re-action of the Staff Side el Committee C to the recent award in the Industrial Court and the consideration which was being given to the matters in the award which were referred for further negotiation in Committee C. 63. Dental Whitley Functional Council (Min. 4 ) . - Mr. A. Gordon Taylor, L.D.S., submitted a verbal report of the negotia tions on Dental Officers Salaries. 64. Amendments to Soh001 Building Regulations (Min. 6).-It was reported that the resolution of the Council regarding the health effects of the amendments to the School Building Regulations had been forwarded to the Ministry of Education. In reply the Ministry had stated that Regulations 6 (2) and 7 (1)

110 were inaccurate. The error had been remedied in later announcements and the effect was to raise the standard of sanitary accommodation in primary schools, and the Ministry hoped that the Society's concerns in this respect had been removed. With regard to the second part of the Council's resolution, the Ministry pointed out that in stating that provision of separate wash-basins and water closet accommodation near school kitchens was desirable, the Minister had in mind that in certain cases the main sanitary arrangements could be so organised that they would also serve the kitchen. In these circumstances, it would not be necessary to provide separate accommodation near the kitcher but in other circumstances such provision near the kitchen was essential. 65. Tuberculosis Regulations (Min. 7 ) . - - i t was reported that a letter had been addressed to Dr. Godber stating that the Society presumed that the draft new Tuberculosis Regulations would be the subject of consultation with Local Authority Associations as well az further consultation with the Society before they came into operation. Dr. Godber had replied that since nothing new had been introduced by these Regulations the Ministry would not, in the ordinary way, be consulting the Local Authority Associations. T h e Society was consulted as an expert body rather than as representing the point of view of the local authorities. Dr. Godber will attend a further meeting of the Committee to deal with the points raised at the previous meeting. 66. Purchase Tax on Water Heaters (Min. 8 ) . - - I t was reported that following the last meeting of the Committee a letter had been addressed to the Ministry of Health urging that consideration should he given to the reduction or abolition of purchase tax on gas and electric water heaters. The Ministry had informed the Society that following consultation with the Commissioners of Customs and Excise, it appeared that the Chancellor of the Exchequer had recently considered, on a number of occasions, the question of granting relief from tax on gas and electric water heating appliances and had been unable to grant such relief. T h e matter would, however, be considered when the tax was next under review. 67. International Public Health Association (Min. 16).--It was reported that a letter had been received from Dr. R. M. Atwater, Executive Secretary, American Public Health Association, asking the S9ciety's views on a number of points in the proposals for the formation of an International Public Health Association. Dr. Atwater had been informed that there was general support in the Society's Council for the formation of such an organisation and the reply had also covered the specific points raised by Dr. Atwater. 68. Relations between the Public Health Service and Other Parts of the National Health Service (Min. 17).--It was reported that the Society's memorandum of evidence had been agreed with the B.M.A. and forwarded to the Committee of the Central Health Services Council (P.H., Feb., p. 75). T h e question of the need for the existence in each local area of one co-ordinating administrator of all branches of medical work was referred for consideration by the Committee to the Council. It was resolved to defer consideration until the results and deliberations of the Committee of the Central Health Services Council were known. 69. Methylene Blue Test for Ice-Cream (Min. 25).--It was resolved that this matter be forwarded to the Standing SubCommittee for Food Matters for further consideration. 70. Financial Arrangements with V61untary Organlsations (Min. 30).--It was reported that the County and County Borough Groups of the Society had noted with interest the arrangements made in the London area covering the conditions for the payment of maintenance allowances in respect of patients undergoing treatment or recuperating in voluntary establishments. It was resolved that these arrangements be circulated to members of the Council (Appendix A). 71. Vaccination Committee (Min. 35).--It was reported that the Vaccination Committee had concluded its deliberations on the day previous to the meeting of the Committee and would report direct to Council. 7-°. Election of Council under Article 19 (f) (Min. 38).--It was reported that Prof. G. S. Wilson had indicated his pleasure in accepting membership of the Council of the Society. 73. Capitation Grants (Min. 4 1 ) . - - T h e request of the Scottish Branch for a special grant in aid was referred to the Chairman and Hen. Treasurer for decision. 74. Central Council for Rivers Protection (Min. 4 2 ) . - T h e Committee had before them the comments of Col. E. F. W. Mackenzie on the Rivers (Prevention of Pollution) Bill I t was resolved that CoL Mackenzie be thanked for his report and that he be informed that the Society supported him in the action that he was taking on the Central Council for Rivers Protection for certain amendments to the Bill. Dr. George Chesney, who had been appointed together with Col. Mackenzie, the Society's

P U B L I C H E A L T H . March. 1951 representatives on the Central Council for Rivers Protection, had stated that owing to pressure of other work he was unable to continue as one of the Society's representatives. It was resolved that Dr. Alcoek be asked to serve in his stead. 75. Use of Swimming Baths by Members of the Infantile Paralysis Fellowship (Min. 45).--It was resolved that the comments of Col. E. F. W. Mackenzie and Prof. G. S. Wilson (Appendix B) on this question be forwarded to the Medical Advisory Committee of the Metropolitan Boroughs Standing Committee, and that they be informed that it was the Society's considered opinion that under the circumstances it was inadvisable to allow exclusive use of swimming baths by the Infantile Paralysis Fellowship. 76. Statistics of Midwifery Work by Queen's Nurses (Min. 47).--It was reported that the Ministry of Health had been informed that the statistics collected by the Queen's Institute of District Nurses were no longer appropriate and that the information about domiciliary midwifery should be collected by the Ministry of Health over the whole country. T h e Ministry is giving consideration to the question. 77. School Ophthalmic Service (Min. 48).--Dr. Newth asked the Committee to allow the School Health Service Group to give further consideration to the question of sight-testing in schools, before a communication was addressed to the Ministry. It was resolved that consideration of the question be referred to the Council in order to give time for this to be done. 78. Research into Poliomyelitis (Min. 55).--It was reported that representatives of the Society had met Prof. G. S. Wilson and two other representatives of the Public Health Laboratory Service to discuss the proposed investigation by the M.R.C. of Poliomyelitis in England and Wales. Agreement had been reached concerning the part that should be played by M.O.H.s and a letter had been agreed for transmission to M.O.H.s throughout the country under the signatures of the C.M.O., Ministry of Health, the Secretary M.R.C., and the President of the Society. 79. Proposed Research Committee (Min. 56).--The recommendation from the joint meeting of the County and County Borough M.O.H. Groups that the Society should endeavour to be co-sponsors in national inquiries involving the use of public health staffs and information from public health departments and that the Council should set up a sub-committee to deal with matters such as surveys and research was considered. It was resolved that a circular be addressed to members of the Council and to all Branches and Groups asking for suggestions of matters which the Society could consider as subjects for research. T h e Committee agreed whole-heartedly with the opinion of the two Groups that the Society should take the lead in conducting research into matters which were affecting community health and that immediate action should be taken to carry out this policy. It was, however, considered that it was not necessary to set up a further standing committee but that when suggestions were received the line of research could be determined and an ad hoc committee formed to consider the matter fully. 80. Segregation of Children having B.C.G. Vaccination (Min. 57).--It was reported that the Ministry of Health had stated that there was no basic change in the policy that segregation of children before and after B.C.G. vacinnation was desirable. The Ministry felt, however, that where the introduction of B.C.G. vaccination was held up by difficulties of arranging segregation, vaccination rather than segregation should have priority. It was resolved that the Ministry of Health be asked to promulgate their advice by circular in view of the difficulties being experienced in many areas in arranging for segregation. 81. Programme,1950-51,-- It was resolved that an Ordinary Meeting of the Society be held on Thursday, February 15th, at 8 p.m., when Dr. W. Cockburn, of the Public Health Laboratory Service, would speak to members on the subject of whooping cough vaccine trials. The President informed the Committee that it was his intention to calla provincial meeting of the Council in Leeds on July 6th. 82. Staffing of the Central 0 f i l e e . - - T h e Committee had before them a report of the Executive Secretary on the future staffing of the Central Office. It was resolved : - (a) That the senior shorthand t~,pist, Miss Scotchford, be informed that the Society would make arrangements for the payment of a pension to her, to supplement any other pension she received on her ultimate retirement. (b) That the junior shorthand typist, Miss Paten, be granted an additional payment of 10s per week as from January 1st, 1951, and that she be paid a further increment of los. per week as from January 1st, 1952. (c) Further points in the Executive Secretary's J:eport regarding the secretaryship of the Society and the publication of PUBLIC HEALTH, were referred to a sub-committee for consideration and report to a special meeting of this committee before the next

P U B L I C H E A L T H , March, 1951 meeting of Council. The sub-committee to consist of the President (Dr. J. M. Gibson), the Chairman of Council (Sir Allen Daley), the Hen. Treasurer (Dr. James Fenton), the Chairman of the General Purposes Committee (Dr. H. C. Maurice Williams), Drs. C. Fraser Brockington, George Buehan and Prof. R. H. Parry. 83. Maladjusted Chlldren.--It was reported that the Minister of Education had appointed a committee to report upon the medical, educational and social problems relating to maladjusted children with reference to their treatment within the educational system. It was resolved that the Minister be informed that the Society would like to present a memorandum of evidence and that the question of the preparation of such evidence should be referred to the School Health Service Group. 84. General Practice under the National Health Servlce.--It was reported that the Central Health Services Council had appointed a committee to consider and make a report on " whether existing arrangements for engaging in general practice under the N.H.S. are such as to enable general medical practitioners to provide the best possible standard of service." One of the headings under which the committee Was to be asked particularly to give advice was liaison with local authority services. It was resolved that the British Medical Association be asked under the terms of the reciprocal agreement with the Society to give the Society an opportunity of commenting on its memorandum of evidence before it was forwarded to the committee. 85. Joint M0oting with N.A.P.T.--A letter was received from the Council of the N.A.P.T. asking the Society to give conmderation to the question of holding a joint meeting with the N.A.P.T. in the autumn of 1951 on the subject of " Housing of Tuberculous Families." t t was resolved that consideration of this matter be deferred until the May meeting when the name of the President-elect would be known. 86. National Registration of Plumbers. - - A letter dated December, 1950, was received from the Ministry of Works referring to the report of the Building Industry Working Party. In paragraph 92 of the report it was stated that it was probably desirable on grounds of public health and safety to continue some forms of registration in the plumbing and electrical trades. T h e National Consultative Council referred this matter to an acl hoe meeting of employers and operatives and, subsequently, proposals for the statutory registration and licensing of plumbers had been submitted to the National Joint Industrial Council. T h e Society's comments on the proposals, which were before the meeting, were requested. It was resolved that no comment be made on the proposals and that the Ministry be informed that, if invited, the Society would appoint a representative to serve on the Registration Council. 87. Proscription of Tuberculosis as an Industrial Dlseaso.--It was reported that the Minister of National Insurance had announced that she was accepting recommendations made to the Industrial Injuries Advisory Council that tuberculosis shunld be prescribed an industrial disease for certain nurses and health workers. 88. Amending Acts Committee.--A letter dated December 4th, 1950, has been received from the B.M.A. requesting the Society to make suggestions regarding items which should be included in the programme for the amendment of the National Health Service Acts, and Regulations and Orders made under those Acts. T h e question had been referred to all Branches and Groups for consideration and suggestions were still coming in from them. It was resolved that the committee which had previously been set up to deal with the functions of an M.O.H. be appointed, the committee to consider and to correlate these suggestions when received. 89. Revision of Ministry of Education Form 8 / M . - - A letter dated January 9th was received from the Ministry of Education enclosing a copy of a memorandum and revise of a form of return by local education authorities on medical inspection and treatment which it was proposed to issue for the year t951. T h e comments of the Society were invited on the proposals. It was resolved that the question be referred to the School Health Service Group for consideration and report and that with regard to a further invitation contained in the letter, that representatives of the Society attend the Ministry and discuss the wider question of routine medical inspection, the School Health Service Group be asked to appoint representatives who would attend at the Ministry, together with Sir Allen Daley, when a meeting could be arranged. 90. Maternal Deaths (Min. 149).--Dr. G. E. Godber, of the Ministry of Health, attended the meeting to enlarge upon a letter he had addressed to the Society regarding the future collections of confidential reports on maternal deaths which had been the subject of previous consultation he had had with the committee. The Ministry had considered the opinion expressed at that consultation and, as a result, had decided to continue the collec-

111 tion of these reports but with an amended procedure. After considerable discussion the procedure suggested by the Ministry was agreed subject to certain minor modifications. T h e M.O.H. of the local health authority would be responsible for providing the report on each maternal death. He would obtain information, as he does now, through his own services about the circumstances of each particular case and he would consult the obstetrician if one had been concerned with the case. He would also obtain a report from any general practitioner concerned in the case. When the M.O. had obtained these local reports he would make his own comments in consultation, if necessary, with the regional assessor to be appointed by the Ministry and to whom the report would finally be sent for assessment and forwarding to the Chief M.O. of the Ministry. Post-abortion cases would be subject to report as well as cases following normal births. Dr. Godber agreed to consult the Chairman of Council on the form of report to be used. 91. Upholstery (Filling Materials) B I I I . - - A letter dated January l l t h was received from the Ministry o f Health enclosing a resum6 of the proposed Filling Materials Bill which would take the place of the Rag Flock Acts, 1911 and 1928. It was resolved that the Ministry be informed that the Society was sorry that the Ministry had not been able to accept the Society's recommendations in full but that the proposals were a step in the right direction. 92. Representation of the 8ooiety.--The following were appointed representatives of the Society on the organisarions indicated : - -

(a) British Council for Rehabilitation. Dr. J. A. Struthers.

(b) British Standards Institution. Technical Committee to undertake the revision of British Standard 795/1938 " ampoules." Dr. Maurice Mitman.

(c,) British Council for the Care of Spastics. Dr. Ann Mower White.

(d) Central Midwives Board. T h e President (Dr. J. M. Gibson).

(e) Suggestions for Central Health Services Council and Advisory Committees.--The Ministry had invited the Society to make suggestions for membership of the Council and certain advisory committees. T h e names to b e suggested to the committee were agreed as follows : - (i) Suggestions for Membership of Council. Drs. C. Metcalfe Brown, J. M. Gibson, Prof. R. H. Parry, Dr. H. C. Maurice Williams. (ii) Tuberculosis Advisory Committee. Drs. F. Hall and C. K. Cullan. (iii) Medical Advisory Committee. Drs. C. Metcalfe Brown and Wyndham Parker. (iv) Maternity and Midwifery Drs. J. M. Gibson and Jean Mackintosh. 93. Post-Graduate Course for Medical Officers of Health, Cardiff.--It was reported that Prof. Grundy had now been able to make tentative arrangements for a eburse for M.O.H.s to be heId in Cardiff. It was agreed that the course should be held from July 2rid to 6th and that Prof. Grundy be thanked for making the necessary arrangements and that he be asked to proceed with the programme suggested. 94. Application for Membership 0I the S0clety.--A letter was received from a non-member of the Society who had some time previously been informed that an application for membership would not be considered, asking if the Society would now consider his application. It was revolved that the writer be asked to state a case in writing before the matter was considered by the Council of the Society and that the two Branches immediately concerned should be asked to express their opinion as to whether or not he should be admitted. Owing to the lateness of the hour, consideration of several other matters which were on the agenda for the Committee were deferred for consideration by the Council at its meeting on February 18th. The meeting was declared closed at 1.20 p.m. APPENDIX A London County Council

Arrangements with voluntary organisations providing recuperative holiday home accommodation Services to be provided by recuperative holiday homes Payment for maintenance should be based on the assumption that the services to be provided would be in accordance with clearly defined conditions ; for example, those drawn up by the Society of Medical Officers of Health. The following conditions arc suggested : - -