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Health Services in Israel
BOOK REVIEWS
253
have been re-arranged and some of the ideas brought up-to-date. It is hearlening to see that the chapter on Drugs, Alcohol and Tobacco has been re-written to corresp~nd with the needs o f today particularly in the field of health education. The stated purpose of this handbook is to help young men and women studying to become teachers to equip themselves for this arduous role. It is written with the needs of busy practising teachers in mind and as a reminder of the broad scope of the work in health education and of the careful planning and team work required if it is to be effective. Afler a brief but interesting account of the history and development of medicine in the world and in the U,K. and of the evolution of preventive medicine in this country, the rest of the book is divided into four sections under the headings of Major Health Topics, The School's Role, Community Health and Further Education. The section on Major Health Topics deals with ordinary hygiene, such as cleanliness, movement and rest, etc. The section on the School's Role considers the biological basis of health education and the child at home and at school, and gives some sound and practical ideas on how health education in school should be carried out. Under Community Health are discussed the prevention of communicable diseases, mental health, drugs, alcohol and tobacco and accidents. Further Education deals with health education and youtl~, health education and the adult, and the training of teachers. On the whole the re-grouping of chapters seems to be an improvement on the previous edition as it follows the normal requirements of the growing child, and teachers may find this arrangement easier and more logical. Useful additions to the previous edition are the three appendices: lhe first is a reproduction of Chapter Ill of the Report of the Commission on Maladjusted Childten, I955 and deals with normal development; the second is Recommendation N~. 63 ofithe International Conference on Public Education; and the third is a useful but, unfortunately, far from complete bibliography. There i; ~ doubt that this handbook is the foundation stone of Health Education ;~:~ tree would ideally like to see it carried out throughout the country. Ideally, too, ~t i~ a book ~hat no teacher or student of Health Education should omit to possess.
Health Visithlg Practice. By Mary Saunders. Oxford, 1968: Pergamon Press. pp. 112: 25s. (hard cover); !.2s. 6d. (flexi-cover). MANY A HEALTH visiToR--either recently qualified or returning to practice alter some years~will be grateful to Mary Saunders tbr this very pleasing-little book. For either of these~bemused by the welter of conflicting theories and facts poured out by wellmeaning lecturers and tutors, field work instructors and others~it must be very difficult to see the wood for the trees. Mary Saunders has picked her wood with great care; the result is lifts pocketsized book providing practical guidance for the Health Visitor in her day-to-day practice. One can forgive her calling the Principal School Medical Officer the Chief School Medical Officer! One can even almost forgive the complete absence of the word "prevention"! Health Services h, Israel. Edited by T. Grushka, M.D. The Ministry of Health i9.68: Jerusalem, pp. 455. FRaNCtS BACON wrote: "Travel, in the younger sort, is a part of education; in the elder, a part of experience". As not e')eryone can have the opportunity to travel, and even those who do travel cannot see everything, a book, such as this, can be a partial
254
PUBLIC HEALTH VOL, 83 NO. 5
substitute for the stay-at-home and a supplement t\~r the traveller. This book is not an annual report; it is an extensive review of the last 20 years. The contents, written by over 100 named contributors, are surprisingly readable and must reflcct the efforts of the editor, the late Thomas Grushka, who was at one time the professor of social medicine at the Hebrew University.~ The subjects covered include the ministry and regional health services administration, environmental sanitation, communicable diseases control, maternal and'Vhild health, mental health services, chronic diseases and rehabilitation, occupational [lealth services, public health nursing service, hospital services, municipal health servicds, health insurance, voluntary agencies, social welfare and social insurance, and the c,~tucalion and training of the health professions. The book concludes with eight interesting background review essays. Throughout there are many helpful graphs and tables. There is a wealth of information in the book that obviously cannot be summarized in a review. During the 20 years, the health services and the health problems have shifted from those associated with a developing country to those of a developed country. The population is now over 2-~. million, the birth rate was 25.7 in 1964, the infant mortality rate was 28-2 and the crude death rate 6.3. Tuberculosis has been curbed, malaria almost eradicated and o{her communicaNe diseases are under control; todays health problems are increasingly those of the chronic diseases. Special rehabilitation programmes are being developed, but l)roblems of co-ordinating all the requisite services remain. Cancer registration has been introduced. An extensive hospital service has been created, which by our standards seems remarkably efficient. There were in I966, 3-31 "'general beds"/1000 inhabitants, 2.36 beds for patients with mental diseases. 0.83 for the mentally retarded and 0.34 for the care of th.ose with chrof~ic diseases. The average annual occupancy was almost 100%;; and the average length of stay of all patients only 9 days. For maternity patients the average length of stay was 4-9 days, -for general surgery 10'3 and general medicine tl.4 days. The main causes .of admission to hospital in 1965 were accidents, abortions, gastroenteritis "and pneumonia, coronary disease, cancer, hernias, benign neoplasms and hypertrophy of tonsils. "1here is a lot of information about the problems (health and others) of absorbing large numbers of immigrants. Israel has probably had more intensive experience of this than any other country. At first all immigrar~ts passed through transit camps iu Israel, but now there are various transit camps around tile world where the medical and social situation of the whole immigrant family can be assessed before acceptance for immigration. Many ideas which should be considered by other natierts are discussed both in the main body of the report and in the special concluding essays.
Sexual Discord #z Marriage. A FieM for Brie/'Psychotherapy. 13y Michael Courtcnay. London, 1968: Tavistock Publications. pp. I37: 35s. TOD,X~% people more often turn to medicine for the solution of those psychosocial problems which, by tradition, were the province of the Law and the Church. Yet doctors are still trained to deal with illness rather than with the more complex disturbance of personal relationships. A number o f doctors working in the Family Planning Association's Clinics, aware that they were called on to deal, not only with their client's gynaecological and contraceptive difficulties, but also their sexual and marital problems, established marital problem clinics. These interested doctors, who were general practitioners, or "medical gynaecologists", got together with psychoanalytic consultants to study the treatment of marital difficulties. Working as a
253
have been re-arranged and some of the ideas brought up-to-date. It is hearlening to see that the chapter on Drugs, Alcohol and Tobacco has been re-written to corresp~nd with the needs o f today particularly in the field of health education. The stated purpose of this handbook is to help young men and women studying to become teachers to equip themselves for this arduous role. It is written with the needs of busy practising teachers in mind and as a reminder of the broad scope of the work in health education and of the careful planning and team work required if it is to be effective. Afler a brief but interesting account of the history and development of medicine in the world and in the U,K. and of the evolution of preventive medicine in this country, the rest of the book is divided into four sections under the headings of Major Health Topics, The School's Role, Community Health and Further Education. The section on Major Health Topics deals with ordinary hygiene, such as cleanliness, movement and rest, etc. The section on the School's Role considers the biological basis of health education and the child at home and at school, and gives some sound and practical ideas on how health education in school should be carried out. Under Community Health are discussed the prevention of communicable diseases, mental health, drugs, alcohol and tobacco and accidents. Further Education deals with health education and youtl~, health education and the adult, and the training of teachers. On the whole the re-grouping of chapters seems to be an improvement on the previous edition as it follows the normal requirements of the growing child, and teachers may find this arrangement easier and more logical. Useful additions to the previous edition are the three appendices: lhe first is a reproduction of Chapter Ill of the Report of the Commission on Maladjusted Childten, I955 and deals with normal development; the second is Recommendation N~. 63 ofithe International Conference on Public Education; and the third is a useful but, unfortunately, far from complete bibliography. There i; ~ doubt that this handbook is the foundation stone of Health Education ;~:~ tree would ideally like to see it carried out throughout the country. Ideally, too, ~t i~ a book ~hat no teacher or student of Health Education should omit to possess.
Health Visithlg Practice. By Mary Saunders. Oxford, 1968: Pergamon Press. pp. 112: 25s. (hard cover); !.2s. 6d. (flexi-cover). MANY A HEALTH visiToR--either recently qualified or returning to practice alter some years~will be grateful to Mary Saunders tbr this very pleasing-little book. For either of these~bemused by the welter of conflicting theories and facts poured out by wellmeaning lecturers and tutors, field work instructors and others~it must be very difficult to see the wood for the trees. Mary Saunders has picked her wood with great care; the result is lifts pocketsized book providing practical guidance for the Health Visitor in her day-to-day practice. One can forgive her calling the Principal School Medical Officer the Chief School Medical Officer! One can even almost forgive the complete absence of the word "prevention"! Health Services h, Israel. Edited by T. Grushka, M.D. The Ministry of Health i9.68: Jerusalem, pp. 455. FRaNCtS BACON wrote: "Travel, in the younger sort, is a part of education; in the elder, a part of experience". As not e')eryone can have the opportunity to travel, and even those who do travel cannot see everything, a book, such as this, can be a partial
254
PUBLIC HEALTH VOL, 83 NO. 5
substitute for the stay-at-home and a supplement t\~r the traveller. This book is not an annual report; it is an extensive review of the last 20 years. The contents, written by over 100 named contributors, are surprisingly readable and must reflcct the efforts of the editor, the late Thomas Grushka, who was at one time the professor of social medicine at the Hebrew University.~ The subjects covered include the ministry and regional health services administration, environmental sanitation, communicable diseases control, maternal and'Vhild health, mental health services, chronic diseases and rehabilitation, occupational [lealth services, public health nursing service, hospital services, municipal health servicds, health insurance, voluntary agencies, social welfare and social insurance, and the c,~tucalion and training of the health professions. The book concludes with eight interesting background review essays. Throughout there are many helpful graphs and tables. There is a wealth of information in the book that obviously cannot be summarized in a review. During the 20 years, the health services and the health problems have shifted from those associated with a developing country to those of a developed country. The population is now over 2-~. million, the birth rate was 25.7 in 1964, the infant mortality rate was 28-2 and the crude death rate 6.3. Tuberculosis has been curbed, malaria almost eradicated and o{her communicaNe diseases are under control; todays health problems are increasingly those of the chronic diseases. Special rehabilitation programmes are being developed, but l)roblems of co-ordinating all the requisite services remain. Cancer registration has been introduced. An extensive hospital service has been created, which by our standards seems remarkably efficient. There were in I966, 3-31 "'general beds"/1000 inhabitants, 2.36 beds for patients with mental diseases. 0.83 for the mentally retarded and 0.34 for the care of th.ose with chrof~ic diseases. The average annual occupancy was almost 100%;; and the average length of stay of all patients only 9 days. For maternity patients the average length of stay was 4-9 days, -for general surgery 10'3 and general medicine tl.4 days. The main causes .of admission to hospital in 1965 were accidents, abortions, gastroenteritis "and pneumonia, coronary disease, cancer, hernias, benign neoplasms and hypertrophy of tonsils. "1here is a lot of information about the problems (health and others) of absorbing large numbers of immigrants. Israel has probably had more intensive experience of this than any other country. At first all immigrar~ts passed through transit camps iu Israel, but now there are various transit camps around tile world where the medical and social situation of the whole immigrant family can be assessed before acceptance for immigration. Many ideas which should be considered by other natierts are discussed both in the main body of the report and in the special concluding essays.
Sexual Discord #z Marriage. A FieM for Brie/'Psychotherapy. 13y Michael Courtcnay. London, 1968: Tavistock Publications. pp. I37: 35s. TOD,X~% people more often turn to medicine for the solution of those psychosocial problems which, by tradition, were the province of the Law and the Church. Yet doctors are still trained to deal with illness rather than with the more complex disturbance of personal relationships. A number o f doctors working in the Family Planning Association's Clinics, aware that they were called on to deal, not only with their client's gynaecological and contraceptive difficulties, but also their sexual and marital problems, established marital problem clinics. These interested doctors, who were general practitioners, or "medical gynaecologists", got together with psychoanalytic consultants to study the treatment of marital difficulties. Working as a