Housing

Housing

P U B L I C H E A L T H , October, t944 culosis officer a n d t h e dispensary staff c o u l d c o n c e n t r a t e o n t h o s e cases in n e e d o ...

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P U B L I C H E A L T H , October, t944 culosis officer a n d t h e dispensary staff c o u l d c o n c e n t r a t e o n t h o s e cases in n e e d o f h e l p and advice. 2. T h e general p r a c t i t i o n e r s c o u l d really m a k e t h e w i d e s t possible use of c h e s t x - r a y examination. At p r e s e n t even t h e m o s t conscientious doctors are s o m e w h g t r e l u c t a n t to s e n d every p a t i e n t w i t h any little s y m p t o m to t h e d i s p e n s a r y for two r e a s o n s : (a) I n o r d e r not to o v e r b u r d e n t h e d i s p e n s a r y staff w i t h trivial c a s e s ; (b) because m a n y a p a t i e n t r e s e n t s going to a place stigmatised as a tuberculosis centre, h o w e v e r camouflaged. But n o b o d y w o u l d refuse to be x - r a y e d at a neutral e x a m i n a t i o n centre. 3. T h e periodical x - r a y e x a m i n a t i o n of all the contacts b y m a s s - r a d i o g r a p h y is m u c h s i m p l e r and m o r e economical t h a n b y routine e x a m i n a t i o n at t h e dispensary. 4. T h e exposure of n o n - t u b e r c u l o u s people to t u b e r culosis infection in o v e r c r o w d e d d i s p e n s a r y w a i t i n g r o o m s w o u l d b e avoided. M a s s - r a d i o g r a p h y u n i t s u s e d in this w a y w o u l d p r o m o t e cooperation b e t w e e n the general practitioners a n d medical officers c o n c e r n e d , and make available m u c h clinical a n d scientific material for research. T o examine a cross-section o f t h e general p o p u l a t i o n is n o t t h e best way to detect early cases o f tuberculosis. T h e p r e s e n t application of routine m a s s - r a d i o g r a p h y is u n e c o n o m i c , and t h e results so far o b t a i n e d are out o f p r o p o r t i o n to t h e expense, material, time, and expert labour s p e n t o n it. I t is t h e general p r a c t i t i o n e r w h o is the first clearing station for tuberculosis. T o secure early diagnosis on a wide f r o n t w e s h o u l d start w i t h i m m e d i a t e mass r a d i o g r a p h y - - a t a neutral diagnostic centre r a t h e r t h a n at the tuberculosis d i s p e n s a r y - - o f all patients seeking advice for a n y suggestive s y m p t o m . T h i s d e m a n d s full c o , o p e r a t i o n w i t h t h e general practitioners, and for p o s t - g r a d u a t e tuberculosis courses to make t h e m stilt m o r e t u b e r c u l o s i s - m i n d e d t h a n is the case a t present. " Early diagnosis " o f p u l m o n a r y tuberculosis, h o w e v e r , is not an e n d in itself. T h e e n d is to treat t u b e r c u l o u s patients at an early and responsive stage o f t h e disease. T h e r e m u s t t h e r e f o r e b e adequate institutional facilities. " It is useless to insist o n t h e n e e d for early diagnosis, i f t r e a t m e n t is delayed once the diagnosis has b e e n m a d e . . . . Clearly the value of diagnosis at an early stage of t h e disease will be stultified if i m m e d i a t e t r e a t m e n t is n o t available. Special provision for s u c h p r o m p t t r e a t m e n t is therefore essential. ''3 M y thanks are due to Dr. J; F. Galloway f o r p e r m i s s i o n to p u b l i s h this paper.

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HOUSING Important recommendations on the part to be played by private enterprise in post-war housing are contained in a report submitted to the Minister of Health by his Central Housing Advisory Cornmitre. The Report ~ was prepared by a Sub-Committee on Private Enterprise Housing under the chairmanship of Sir Felix Pole. Evidence was taken from representatives of different sides of the building industry, from the National Federation of Housing Associations, the Building Societies Association, and other bodies. The sub-commlttee set up a special panel to consider how best to control the standard of construction of hodses built by private enterprise, and a report by this panel is appended to the main report. The Committee conclude that "given favourable Conditions, the housing needs of a large section of the people of this country can be met without assistance from public funds. The conditions .required include cheap money, a plentiful supply of labour and materials, building costs in close correspondence with the cost of living, and stability of values. Apart from war-tree shortages and restrictions, the chief obstacle to the resumption of building by private enterprise on a pre-war scale is the level of building costs, which a r e out of scale with the cost of living. Correlation of building costs with the cost of living is an essential condition of a high output by private enterprise. It will doubtless be a primary aim of housing policy in the immediate postwar period to secure that the cost of building is brought into accordance wth the cost of living and the general level of wage rates?' The Report recommends that "if private enterprise is to maintain its position in the post-war period, it must produce a considerably larger proportion of houses for letting. The participation of the building societies and similar bodies is essential if this is to be achieved." It assumes that in regulating the amount of building work, the highest priority compatible with other essential amenities will be allotted to house-building, and that no building of a luxury type Will be permitted until the most urgent housing needs have been met." Steps should be taken to ensure that an undue share of labour and materials is not absorbed in building very large houses, "and we should like to see priority accorded to houses intended for letting."

A conference on maternity and child welfare, which has been arranged by the National Association of Maternity and Child Welfare Centres and which was postponed in July last owing to the restriction of travel, will be held on November 23rd and 2.4th in the Big Hail, Friends' House, Euston Road, London, N.W.1. The Minister of Health has promised to be present on the morning of November 24th to give his Presidential Address, the subject of which will be the rebuilding of family life after the war. On the morning of November 23rd Miss Elizabeth Denby will speak on housing, Professor James Young on social and health services, Dr. Fraser Brockington on the viewpoint of the rural areas, Miss REFERENCES F . Hawtrey on nursery and nursery school provision, and Dr. Jean (l) Brit. reed. J., March 6th, 1943. (2) TOUSSAINT,C. H. C. and PmTCHAP~D,E.K. Proc. Ann. Con. N.A.P.T. (1943). Macintosh on education as it concerns the family. In the after(3) Report of the Committee on Tuberculosis in War-time. Publ. HZth., 1942~ noon Group Captain J. A. Cecil Wright will speak on population 56, 15. problems, Mrs. A. D. S. Large on the housewife and mother, Dr. Helen Standring on family life during the mother's confinement, and Dr. Innes Pearse on the family club. The following day, November 24th, the them~ will be " broken family life." Dr. A. B. Gardiner will discuss illegitimate children, Mrs. Rackham the malOBITUARY adjusted and delinquent child, Mr. C. E. Bridges substitute homes. ALLAN SEMPLE, M.B., CH.B., D.P.H. A bookstall wilt be open throughout the conference and there will We regret to record the recent death at the age Of t31 of Dr. Allan be various exhibits, including sections of the housing centre exhibition and of the travelling exhibition of the National Council for Semple, M.O.H. for Carlisle City. Owing to catering difficulties Allan Scruple was educated at Bea/'sden Academy, Dumbarton- Maternity and Child Welfare. shire, and at Allan Glen's Technical School, Glasgow. He studied people are advised to bring lunch with them. A limited number of medicine at Glasgow University, where in 1908 he qualified M.B., lunches and teas will be available at Friends' House and application Ch.B. with distinction. He e n t e r e d private practice in Bristol, for these, which should be made to Miss M. R. Lovelock, 117, PiccadiIIy, London, W.1, wilt be dealt with in rotation. Tickets where in 1915 he received the D.P.H. of the University. He t h e n obtained a commission in the R.A.M.C. and acted as Medical Officer for the. conference, 3s. for one day, 5s. for two days, are obtainable in hospital ships in the Mediterranean, and later as M.O. of an from the same address. artillery group in France. In 1.917 he was appointed Junior Assistant M.O.It. for Carlisle, and in 1921 Senior Tuberculosis Ot~cer. On the retirement of Dr. Beard in 1930, Dr. Semple was appointed Dr. R. C. Wofinden regrets that he omitted to add to his article M.O.H. and School M.O, for the City. He was aIso superintendent on " Problem Families " (PUBLIC H~ALTH, September, 1944, p: 136) of the City General Hospital and the infectious diseases and mater- a note of thanks to Miss J. Barraclough, Senior Health Visitor of nity hospitals. His untiring efforts to create an efficient first-aid Rotherham, for the collection of figures referring to the problem and ambulance service for the Civil Defence imposed a burden on families. his strength. Dr. Semple was a keen golfer and a Freemason. He'is survived *Private Enterprise Housing (H.M.S.O., York House, Kingsby his wife, a son (Capt. T. David Semple, R.A.M.C.) and a way, W.C.2), price ls., post free ls. 2d. daughter.