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London's new training centre for the diploma in public health
~78
PUBLIC HEALTH.
the Service have been inclined to. believe that in this matter the health organisation has been very backward; would have been inclined to agree that, compared with o t h e r s - - t h e Americans particularly--there was next to nothing done here in the way of postor production and propaganda, for example. T h e Central Council's guide reveals bow wrong is such a view : shows, too, a wonderful store of teaching material in the form of exhibits in the hands of a multitude of bodies concerned to help in education of the people wherever and whenever an opening appears. H ow readily available it: is for the use of those engaged in teaching the guide also reveals. Every medical officer of health should have it by him. It will surely help him, It will help others too - - e d u c a t i o n committees, and insurance committees, for instance--to know what there is, what is being" done, and what can be done. T h e Council itself the publication will help, and the Society that founded the Council, by revealing the anxiety and the desire of all associated with it, and who form the Society, to sho.ulder responsibilities and to aid in providing" education that is at the base of health, as it is the basis of so much else in the reahn of social progress.
London's New Training Centre for the Diploma in Public Health. H E foundation stone of the Lo,ndon School of H y g i e n e and Tropical Medicine was laid by the Minister of Health in July, 1926, and it is expected that the bui],ding will be opened by H . R . H . the Prince of Wales in July of this year. T h e first course of study for the Diploma in Public Health will commence in October, and information is no,w available regarding the instruction to be pro~ vided by the various divisions of the School. Everyone knows that, in accordance with the Regulations of the General Medical Council, a course of study for the Diploma in Public Health must extend over a period of twelve calendar months. This does not mean, however, that a student must necessarily devote the whole of his time td the work, although such a practice is obviously desirable. T h e School Council have recognised the difficulty some students may experience in giving whole-time attendance and have arranged the course in such a way that those prepared to attend five afternoons a week will meet all the re~luirements of the General Medical Council and will, in addition, get full
T
JUNE,
benefit from the interesting scheme of instruction devised. T h e course has been planned in such a ~ a y as to co-ordinate the teaching of the various divisions. N o longer will bacteriology, chemistry and medical zooJogy be regarded as special subjects to be studied merely for examination purposes; laboratory work will be taught rather as a means of assisting in the solution of the larger problems of public health. It would appear, in fact, that the course has been outlined in the first instance by persons possessing a knowledge of public health administrative requirements, and that those responsible for teaching- the laboratory side of the work have made a real endeavour to fit their teaching into the general scheme. This represents a great advance on a n y t h i n g previously attempted in this country, and indicates that the aim of the School Council is to give their students as sound and as practical a general training as possible without stressing one aspect of public health at the expense of another. In addition to the teaching given by the general school staff, a large number of visits to places of special p u b l i c health interest will be arranged and some forty Or more lectures will be delivered o n selected subjects by recognised experts. Most of these lectures will be given at 5 o'clock in the afternoon and any member of the public health service who cares to attend will be made welcome. A uniform date of entry is essential in a course of this nature; hence all students will be expected to enter the School at the beginning of the aut um n term. T h e School Council will be prepared to consider applications for admission from students who can attend only three afternoons a week. In their case, however, the course of stud), will have to extend over two years and much of the efforts of the staff to co-ordir}ate t h e teaching will be lost. T h e composition fee, which has been fixed at fifty guineas, will include payments~in respect of work in public health departments and of instruction in infectious disease and hospital: management. It will be news to many that L o n d o n University has decided to institute its own Diploma in Public Health. T h e course given at the L ondon School of H y g i e n e and Tropical Medicine will qualify students for admission to this examination. Finally, the School Council hope that the provision of set courses of instruction will constitute only a part, albeit a most important
1929.
PUBLIC HEALTH.
part, of the S c h o o l ' s activities: T h e aim of those too.st eager for the welfare of the School is to make tile Building a real centre of all public health interests. M e m b e r s of the health services will be welcomed at all times. A c o m m o n room wilt be p r o v i d e d for them where t h e y can meet one a n o t h e r a n d come in contact w i t h . m e m b e r s of the School staff. T h e r e they will learn what lectures are b e i n g given and will be e n c o u r a g e d to attend. T h e L i b r a r y a n d the M u s e u m will be at their disposal. T h e staff will always be glad to give what help they can to a n y medical officer seeking their assistance. T h e ultimate success of the School will d e p e n d largely o.n tile use m a d e of it and the co-operation afforded it: by the health workers of the c o u n t r y :
Mental De/iciencg. H E l o n g delay in the presentation of the report of the Mental Deficiency Committee of the B o a r d of E d u c a t i o n , ~ which was appo.inted in June, 1924, and the air of m y s t e r y which preceded its even now incomplete publication, has raised the expectation of tile public. T h e time was ripe for a reconsideration of the whole p r o b l e m in the light of recent knowledge, a n d early in its existence the committee f o u n d itself u n d e r the necessity of e x t e n d i n g its consideration of the mentally deficient child so. a s to include within its purview the mentally deficient adult, and to add to its n u m b e r representatives of the B o a r d ,of Control. T h i s fact has added very materially to the interest of the report, which may, i n fact, be co.nsidered as an a d d e n d u m to the report of the R o y a l C o m m i s s i o n on the Care and Co.ntrol of the Feeble-minded, which was p u b l i s h e d in 1908. T h e subject has so m a n y facets and can be viewed from so. m a n y a n g l e s that wide divergefices.of:i~ie~vs a r e possible, and it is all the more grBtifying that the report is a u n a n i m o u s one. T h i s ~unanimity gives added weight to: the c0nck~sio:'ns of-the::cGinmittee~.. ~ Afte~ a p r e l i m i n a r y chapter on the nature of the problem at issue, the r e p o r t proceeds to a review of the legislatio n with r e g a r d to. the mentally defective, and is at great pa'ins to discover what have been tlne m e a n i n g and intention of the l~gistato.rs b y whose wisdom these various legal e n a c t m e n t s were framed. It m a y be
T
* REPORT OF THE MENTAL DEFICIENCY COMMITTEE, being a Joint C o m m i t t e e of ,the Board of Education and Board of Control. P a r t s I, 1I and IV. H.M. Stationery Office, 1999. pp. 239. Price 5~. 0d, net,
~79
admitted at once that these estimable people had no clear cut ideas as to the true nature of the p r o b l e m with which they were called upon to. deal, with the result that tile legislation has been confused and even contradictory. In E n g l a n d tile a p p r o a c h to the subject has been p r i m a r i l y from the educational point of view, but with the growth of our k n o w l e d g e of tlle p s y c h o l o g i c a l factors involved in education, this viewpoint has been f o u n d to be u n s o u n d in that it stresses too much the defects in educational capacity, rather than those of a d a p t a t i o n to. tlle social e n v i r o n m e n t . T h e confusion between the educational and tile social points of view has been the main difficulty in the past and if the C o m m i t t e e had p e r f o r m e d no other function t h a n to draw attention to the power of social adaptability as tile true criterion, it would have e a r n e d our gratitude. " W e have taken the view that, whatever m a y be the correct legal interpretation of these definitions, t h e real criterion of mental deficiency is a social o n e , a n d that a mentally defective individual, w h e t h e r child or adtdt, is one who by reason of inco.mplete mental d e v e l o p m e n t is incapable of independent social a d a p a t i o n . " It has been this confusion that has been the root cause, above all o.thers, of tile opposition of parents to the education o.f their child~-en at special schools u n d e r the l~;lementary Education (Defective a n d Epileptic Children) Acts, for these Acts have compelled children, who exhibit various defects in the specific educational capacities, to be e a r m a r k e d and c o m p u l s o r i l y associated with children who, by reason of mental defect, are manifestly incapable of complete social adjustment. It must be r e m e m b e r e d that m u c h of tile r o u g h work of the world, upon which the c o m p l e x structure of our civilisation depends, m u s t of necessity be p e r f o r m e d by those w h o s e educational capac!ties are not of a high order, and that the " h'ewers o.f wood and drawers of w a t e r , " if t h e y ba,ve the c a p a c i t y o.f c o n f o r m i n g to. the dictates and intf'ibitlo'ng of~tt:e ~ so cihty of which the), are members, have their own share in the rights a n d duties of citizenship. T h e E l e m e n t a r y E d u c a t i o n (Defective and Epileptic Children) Act, 1899, f o r m e d a valuable scaffold for the s u b s e q u e n t structure built on the f o u n d a t i o n of the R e p o r t of the R o y a l Commission---the Mental Deficency Acts. T h e r e is, however, no n,eed to retain that scSff01d a n y longer, and the r e c o m m e n d a t i o n of the committee that cert.ification should "be abolished is a most
PUBLIC HEALTH.
the Service have been inclined to. believe that in this matter the health organisation has been very backward; would have been inclined to agree that, compared with o t h e r s - - t h e Americans particularly--there was next to nothing done here in the way of postor production and propaganda, for example. T h e Central Council's guide reveals bow wrong is such a view : shows, too, a wonderful store of teaching material in the form of exhibits in the hands of a multitude of bodies concerned to help in education of the people wherever and whenever an opening appears. H ow readily available it: is for the use of those engaged in teaching the guide also reveals. Every medical officer of health should have it by him. It will surely help him, It will help others too - - e d u c a t i o n committees, and insurance committees, for instance--to know what there is, what is being" done, and what can be done. T h e Council itself the publication will help, and the Society that founded the Council, by revealing the anxiety and the desire of all associated with it, and who form the Society, to sho.ulder responsibilities and to aid in providing" education that is at the base of health, as it is the basis of so much else in the reahn of social progress.
London's New Training Centre for the Diploma in Public Health. H E foundation stone of the Lo,ndon School of H y g i e n e and Tropical Medicine was laid by the Minister of Health in July, 1926, and it is expected that the bui],ding will be opened by H . R . H . the Prince of Wales in July of this year. T h e first course of study for the Diploma in Public Health will commence in October, and information is no,w available regarding the instruction to be pro~ vided by the various divisions of the School. Everyone knows that, in accordance with the Regulations of the General Medical Council, a course of study for the Diploma in Public Health must extend over a period of twelve calendar months. This does not mean, however, that a student must necessarily devote the whole of his time td the work, although such a practice is obviously desirable. T h e School Council have recognised the difficulty some students may experience in giving whole-time attendance and have arranged the course in such a way that those prepared to attend five afternoons a week will meet all the re~luirements of the General Medical Council and will, in addition, get full
T
JUNE,
benefit from the interesting scheme of instruction devised. T h e course has been planned in such a ~ a y as to co-ordinate the teaching of the various divisions. N o longer will bacteriology, chemistry and medical zooJogy be regarded as special subjects to be studied merely for examination purposes; laboratory work will be taught rather as a means of assisting in the solution of the larger problems of public health. It would appear, in fact, that the course has been outlined in the first instance by persons possessing a knowledge of public health administrative requirements, and that those responsible for teaching- the laboratory side of the work have made a real endeavour to fit their teaching into the general scheme. This represents a great advance on a n y t h i n g previously attempted in this country, and indicates that the aim of the School Council is to give their students as sound and as practical a general training as possible without stressing one aspect of public health at the expense of another. In addition to the teaching given by the general school staff, a large number of visits to places of special p u b l i c health interest will be arranged and some forty Or more lectures will be delivered o n selected subjects by recognised experts. Most of these lectures will be given at 5 o'clock in the afternoon and any member of the public health service who cares to attend will be made welcome. A uniform date of entry is essential in a course of this nature; hence all students will be expected to enter the School at the beginning of the aut um n term. T h e School Council will be prepared to consider applications for admission from students who can attend only three afternoons a week. In their case, however, the course of stud), will have to extend over two years and much of the efforts of the staff to co-ordir}ate t h e teaching will be lost. T h e composition fee, which has been fixed at fifty guineas, will include payments~in respect of work in public health departments and of instruction in infectious disease and hospital: management. It will be news to many that L o n d o n University has decided to institute its own Diploma in Public Health. T h e course given at the L ondon School of H y g i e n e and Tropical Medicine will qualify students for admission to this examination. Finally, the School Council hope that the provision of set courses of instruction will constitute only a part, albeit a most important
1929.
PUBLIC HEALTH.
part, of the S c h o o l ' s activities: T h e aim of those too.st eager for the welfare of the School is to make tile Building a real centre of all public health interests. M e m b e r s of the health services will be welcomed at all times. A c o m m o n room wilt be p r o v i d e d for them where t h e y can meet one a n o t h e r a n d come in contact w i t h . m e m b e r s of the School staff. T h e r e they will learn what lectures are b e i n g given and will be e n c o u r a g e d to attend. T h e L i b r a r y a n d the M u s e u m will be at their disposal. T h e staff will always be glad to give what help they can to a n y medical officer seeking their assistance. T h e ultimate success of the School will d e p e n d largely o.n tile use m a d e of it and the co-operation afforded it: by the health workers of the c o u n t r y :
Mental De/iciencg. H E l o n g delay in the presentation of the report of the Mental Deficiency Committee of the B o a r d of E d u c a t i o n , ~ which was appo.inted in June, 1924, and the air of m y s t e r y which preceded its even now incomplete publication, has raised the expectation of tile public. T h e time was ripe for a reconsideration of the whole p r o b l e m in the light of recent knowledge, a n d early in its existence the committee f o u n d itself u n d e r the necessity of e x t e n d i n g its consideration of the mentally deficient child so. a s to include within its purview the mentally deficient adult, and to add to its n u m b e r representatives of the B o a r d ,of Control. T h i s fact has added very materially to the interest of the report, which may, i n fact, be co.nsidered as an a d d e n d u m to the report of the R o y a l C o m m i s s i o n on the Care and Co.ntrol of the Feeble-minded, which was p u b l i s h e d in 1908. T h e subject has so m a n y facets and can be viewed from so. m a n y a n g l e s that wide divergefices.of:i~ie~vs a r e possible, and it is all the more grBtifying that the report is a u n a n i m o u s one. T h i s ~unanimity gives added weight to: the c0nck~sio:'ns of-the::cGinmittee~.. ~ Afte~ a p r e l i m i n a r y chapter on the nature of the problem at issue, the r e p o r t proceeds to a review of the legislatio n with r e g a r d to. the mentally defective, and is at great pa'ins to discover what have been tlne m e a n i n g and intention of the l~gistato.rs b y whose wisdom these various legal e n a c t m e n t s were framed. It m a y be
T
* REPORT OF THE MENTAL DEFICIENCY COMMITTEE, being a Joint C o m m i t t e e of ,the Board of Education and Board of Control. P a r t s I, 1I and IV. H.M. Stationery Office, 1999. pp. 239. Price 5~. 0d, net,
~79
admitted at once that these estimable people had no clear cut ideas as to the true nature of the p r o b l e m with which they were called upon to. deal, with the result that tile legislation has been confused and even contradictory. In E n g l a n d tile a p p r o a c h to the subject has been p r i m a r i l y from the educational point of view, but with the growth of our k n o w l e d g e of tlle p s y c h o l o g i c a l factors involved in education, this viewpoint has been f o u n d to be u n s o u n d in that it stresses too much the defects in educational capacity, rather than those of a d a p t a t i o n to. tlle social e n v i r o n m e n t . T h e confusion between the educational and tile social points of view has been the main difficulty in the past and if the C o m m i t t e e had p e r f o r m e d no other function t h a n to draw attention to the power of social adaptability as tile true criterion, it would have e a r n e d our gratitude. " W e have taken the view that, whatever m a y be the correct legal interpretation of these definitions, t h e real criterion of mental deficiency is a social o n e , a n d that a mentally defective individual, w h e t h e r child or adtdt, is one who by reason of inco.mplete mental d e v e l o p m e n t is incapable of independent social a d a p a t i o n . " It has been this confusion that has been the root cause, above all o.thers, of tile opposition of parents to the education o.f their child~-en at special schools u n d e r the l~;lementary Education (Defective a n d Epileptic Children) Acts, for these Acts have compelled children, who exhibit various defects in the specific educational capacities, to be e a r m a r k e d and c o m p u l s o r i l y associated with children who, by reason of mental defect, are manifestly incapable of complete social adjustment. It must be r e m e m b e r e d that m u c h of tile r o u g h work of the world, upon which the c o m p l e x structure of our civilisation depends, m u s t of necessity be p e r f o r m e d by those w h o s e educational capac!ties are not of a high order, and that the " h'ewers o.f wood and drawers of w a t e r , " if t h e y ba,ve the c a p a c i t y o.f c o n f o r m i n g to. the dictates and intf'ibitlo'ng of~tt:e ~ so cihty of which the), are members, have their own share in the rights a n d duties of citizenship. T h e E l e m e n t a r y E d u c a t i o n (Defective and Epileptic Children) Act, 1899, f o r m e d a valuable scaffold for the s u b s e q u e n t structure built on the f o u n d a t i o n of the R e p o r t of the R o y a l Commission---the Mental Deficency Acts. T h e r e is, however, no n,eed to retain that scSff01d a n y longer, and the r e c o m m e n d a t i o n of the committee that cert.ification should "be abolished is a most