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Mental deficiency act defects
~4
NOWMBRR,
PUBLIC H E A L T H .
Act, in connection with which it was undoubtedly a House of Commons decision that the medical work under the Board of Education should be absorbed by the Ministry of Health. It will .be remembered that the Society of Medical Officers of Health joined with the British Medical Association in a deputation to the Minister of Health on this subject, when arguments which ought to have been convincing were put forward in support of the inclusion of the school health service definitely into the Ministry of Health. P R E V E N T I O N OF V E N E R E A L DISEASE. W e understand that the Joint Committee composed of representatives of the National CouneiI for Combating Venereal Diseases and the Society for the Prevention of Venereal Disease has been appointed and that the first meeting has been fixed for October 30th, and we take this opportunity of again expressing the hope that these two Societies will agree to work on the common ground of the Trevethin Report. Both Societies have openly supported the Report, and, as a matter of factl both have claimed its issue as a great victory. It should, therefore, be entirely satisfactory to both and a combination of effort, with rapidly successful results, may be reasonably expected. A correspondent has called our attention to the fact that the quotation made in our last issue from Colonel Harrison's lecture published in the " Journal of State Medicine " i n :1919 may be misleading in view of the statements made by Colonel Harrison at a Conference held at Scarborougti this year when, according to our correspondent, Colonel Harrison " expressly referred to this opinion of his in 1919 and the known fact that his present opinion has quite altered, and categorically stated that careful Study of later statistics had caused him to reverse his former opinion." W e are not quite sure in what direction Colonel Harrison has altered his opinion as the quotation referred to is mainly a simple statement of scientific facts about which there is little or no dispute, but we gather that the main fact is that Colonel Harrison has changed his views with regard to the relative value of immediate disinfection, and we have much pleasure in publishing this addition to the quotation made from his lecture. Upon controversial subjects such as the relative v a l u e of imtfiediate self-disinfection, and birth ('ontrol, the Society of Medical Officers of Health has not yet expressed any official opinion and undoubtedly different Members of the Society hold entirely opposing views upon both these subjects.
W e hold no brief for either side, but we take the view that no public benefit is to be obtained by any attempted s u p p r e s s i o n of scientific facts. Opponents of certain policies are, unfortunately, not always content with registering their opposition and a r g u i n g the case, but there is occasionally a dangerous tendency on their part to try to suppress facts which if generally known may lead the public to adopt the views of the other side. " P'rohibition " of any kind is at present repulsive to the views of the great majority o f persons in this country, and the pages of this Journal continue to be open for the expression of all facts, views or opinions which claim to be likely to improve the public health. ,
i
T H E I N S U R A N C E ACT AND P R E V E N T I O N . Sir William Glyn Jones, in his presidential address to the National Association of Insurance Committees sitting in London, complained that the provisions in the Insurance Act for reducing sickness by removing the preventable causes had been practically a dead letter. Great promises w e r e held out by the Government of the improvements ia the health of the community which would result if the country accepted the Insurance Bill but, whatever might be said about the work of the scheme in the direction of insurance or treatlnent, the other promises had been unfulfilled. Parliament intended that insurance committees should be more than organisations for the administration of medical benefit, and each Committee owed a statutory duty to insured persons and to the approv.ed soc]etids to regard itself as a statutory health authority. M E N T A L D E F I C I E N C Y ACT D E F E C T S . The Annual Report of the Board of Control for 1.922 contains references to certain defects which
have been revealed in the Mental Deficiency Act. It is pointed out that though the Act undoubtedly aimed at creating machinery by means of which unity and continuity of control might be secured, yet, in practice, this is not the result. The chief difficulty arises from the lack of co-operation between the authorities responsible for mental defectives. The Board of Education is responsible for feeble-minded children from 7 to 16 years of age ; the Home Office is responsible for those dealt with under The ChiIdren Act, and also through the prison service for adult mentally defective criminals ; while the Ministry of Health, through the Poor Law, deals with very large numbers of all types and ages of the mentally defective.
I9t 3,
PUBLIC HEALTH.
These central authorities have corresponding local authorities and, although the Mental Deficiency Act created an elaborate system whereby a defective could be transferred from one authority t o another, the Board of Control has found that, in practice, it is ~ost difficult to secure complete co-operation between the various local authorities. They feel that it is still to a large extent true that " mentally defective persons pass from one authority or institution to another, helped or detained a little in each, but permanently cared for by none." H E A L T H W E E K IN T H E W E S T R I D I N G . Health VVeek was celebrated in the West Riding of Yorkshire on an unusually large scale. The Education Committee of the County Council granted permission for addresses to be given to school children throughout the county area during Health Week, and these, as far as possible, were given by medical practitioners. No tess than 142 medical practitioners (of whom 138 are insurance doctors) consented to give these vohmtary addresses to the scholars. Where no such medical services were available the addresses were given by the head teachers, and the final arrangements showed the astonishing totals of 2z14 addresses give~ by medical practitioners and 588 addresses given by head teachers. Dr. K a y e , the County Medical Officer, prepared skeIetaI notes and suggestions for the addresses and these were Circularised to those concerned. At the conclusion of the addresses health cards were given to the children, one being a scholar's "Health Creed," and the other an acrostic on the motto for the year, "Self Help in Health." Some 214,000 of each of these cards were distributed to the scholars of the West Riding. S C H O O L M E D I C A L I N S P E C T I O N IN IRELAND. To the Council of the County Borough of Cork must be accorded the distinction of being the first public body in the Irish Free State to formulate, and put into operation, a scheme for t h e medical inspection of school children, tn a recent report by the M.S.O.H. (Dr. D. Donovan) the Council were advised to make provision in the yearly estimate for the c a r r y i n g out of the provisions of the Public Health (Medical Treatment of Children Ireland, Act, 1919. The City fathers were quick to see the advantages which nmst accrue to the rising generation by the adoption of the provisions of this Act, and as a result
~5
a comprehensive scheme for school medical inspection has been submitted to the Minister of Local Government for his approval. As a preliminary to the establishment of a permanent service the Council propose to appoint a wholetime School Medical Officer, at a salary of ~500 per annum, to be assisted by a whole-time school nurse. The function of these officials will be to make a health survey of the primary schoqls within the Borough and to report thereon to the Council, who will then be in a position to proceed with the appointment of the necessary officers, including a whole-time Dentist and additional nurses. It is confidently hoped that the good example set by Cork will be followed in the near future by other Urban and Rural Councils throughout the Free State. PRECAUTIONS
AGAINST SMALLPOX.
The Scottish Board of Health have issued Regulations making chickenpox compulsorily notifiable in Scotland. T h e Regulations came into force on July 23rd and will continue in force until the end of the year. It is understood that the spread of the serious epidemic of smallpox which is in progress in Gloucester has been due in some instances to its being mistaken for chickenpox. Cases of smallpox are occurring also in many other parts of England, and this step .of making chickenpox a notifiable disease ih Scotland is taken because of t h e p o s s i b i l i t y of the introduction of smallpox inio this country. E v e r y doctor who is attending a person suffering from chickenpox is required by the Regulations to notify the case to the Medical Officer of Health of the district. This should prevent cases of smallpox slipping through as chickenpox and so spreading the disease. Mild cases of smallpox are sometimes confused. also with infections other than chickenpox Several instances of this came to the notice of the Board o f Health during the epidemic of smallpox in Scotland in 1920-21. To prevent a repetition of this, the Board have suggested to the local authorities that they should ask the medical practitioners in their district to seek the co-operation of the Medical Officer of Health in dealing with any illness that has even a remote resemblance to smallpox. Every medical practitioner is being supplied through the local authorities with a copy o f t h e Regulations.
NOWMBRR,
PUBLIC H E A L T H .
Act, in connection with which it was undoubtedly a House of Commons decision that the medical work under the Board of Education should be absorbed by the Ministry of Health. It will .be remembered that the Society of Medical Officers of Health joined with the British Medical Association in a deputation to the Minister of Health on this subject, when arguments which ought to have been convincing were put forward in support of the inclusion of the school health service definitely into the Ministry of Health. P R E V E N T I O N OF V E N E R E A L DISEASE. W e understand that the Joint Committee composed of representatives of the National CouneiI for Combating Venereal Diseases and the Society for the Prevention of Venereal Disease has been appointed and that the first meeting has been fixed for October 30th, and we take this opportunity of again expressing the hope that these two Societies will agree to work on the common ground of the Trevethin Report. Both Societies have openly supported the Report, and, as a matter of factl both have claimed its issue as a great victory. It should, therefore, be entirely satisfactory to both and a combination of effort, with rapidly successful results, may be reasonably expected. A correspondent has called our attention to the fact that the quotation made in our last issue from Colonel Harrison's lecture published in the " Journal of State Medicine " i n :1919 may be misleading in view of the statements made by Colonel Harrison at a Conference held at Scarborougti this year when, according to our correspondent, Colonel Harrison " expressly referred to this opinion of his in 1919 and the known fact that his present opinion has quite altered, and categorically stated that careful Study of later statistics had caused him to reverse his former opinion." W e are not quite sure in what direction Colonel Harrison has altered his opinion as the quotation referred to is mainly a simple statement of scientific facts about which there is little or no dispute, but we gather that the main fact is that Colonel Harrison has changed his views with regard to the relative value of immediate disinfection, and we have much pleasure in publishing this addition to the quotation made from his lecture. Upon controversial subjects such as the relative v a l u e of imtfiediate self-disinfection, and birth ('ontrol, the Society of Medical Officers of Health has not yet expressed any official opinion and undoubtedly different Members of the Society hold entirely opposing views upon both these subjects.
W e hold no brief for either side, but we take the view that no public benefit is to be obtained by any attempted s u p p r e s s i o n of scientific facts. Opponents of certain policies are, unfortunately, not always content with registering their opposition and a r g u i n g the case, but there is occasionally a dangerous tendency on their part to try to suppress facts which if generally known may lead the public to adopt the views of the other side. " P'rohibition " of any kind is at present repulsive to the views of the great majority o f persons in this country, and the pages of this Journal continue to be open for the expression of all facts, views or opinions which claim to be likely to improve the public health. ,
i
T H E I N S U R A N C E ACT AND P R E V E N T I O N . Sir William Glyn Jones, in his presidential address to the National Association of Insurance Committees sitting in London, complained that the provisions in the Insurance Act for reducing sickness by removing the preventable causes had been practically a dead letter. Great promises w e r e held out by the Government of the improvements ia the health of the community which would result if the country accepted the Insurance Bill but, whatever might be said about the work of the scheme in the direction of insurance or treatlnent, the other promises had been unfulfilled. Parliament intended that insurance committees should be more than organisations for the administration of medical benefit, and each Committee owed a statutory duty to insured persons and to the approv.ed soc]etids to regard itself as a statutory health authority. M E N T A L D E F I C I E N C Y ACT D E F E C T S . The Annual Report of the Board of Control for 1.922 contains references to certain defects which
have been revealed in the Mental Deficiency Act. It is pointed out that though the Act undoubtedly aimed at creating machinery by means of which unity and continuity of control might be secured, yet, in practice, this is not the result. The chief difficulty arises from the lack of co-operation between the authorities responsible for mental defectives. The Board of Education is responsible for feeble-minded children from 7 to 16 years of age ; the Home Office is responsible for those dealt with under The ChiIdren Act, and also through the prison service for adult mentally defective criminals ; while the Ministry of Health, through the Poor Law, deals with very large numbers of all types and ages of the mentally defective.
I9t 3,
PUBLIC HEALTH.
These central authorities have corresponding local authorities and, although the Mental Deficiency Act created an elaborate system whereby a defective could be transferred from one authority t o another, the Board of Control has found that, in practice, it is ~ost difficult to secure complete co-operation between the various local authorities. They feel that it is still to a large extent true that " mentally defective persons pass from one authority or institution to another, helped or detained a little in each, but permanently cared for by none." H E A L T H W E E K IN T H E W E S T R I D I N G . Health VVeek was celebrated in the West Riding of Yorkshire on an unusually large scale. The Education Committee of the County Council granted permission for addresses to be given to school children throughout the county area during Health Week, and these, as far as possible, were given by medical practitioners. No tess than 142 medical practitioners (of whom 138 are insurance doctors) consented to give these vohmtary addresses to the scholars. Where no such medical services were available the addresses were given by the head teachers, and the final arrangements showed the astonishing totals of 2z14 addresses give~ by medical practitioners and 588 addresses given by head teachers. Dr. K a y e , the County Medical Officer, prepared skeIetaI notes and suggestions for the addresses and these were Circularised to those concerned. At the conclusion of the addresses health cards were given to the children, one being a scholar's "Health Creed," and the other an acrostic on the motto for the year, "Self Help in Health." Some 214,000 of each of these cards were distributed to the scholars of the West Riding. S C H O O L M E D I C A L I N S P E C T I O N IN IRELAND. To the Council of the County Borough of Cork must be accorded the distinction of being the first public body in the Irish Free State to formulate, and put into operation, a scheme for t h e medical inspection of school children, tn a recent report by the M.S.O.H. (Dr. D. Donovan) the Council were advised to make provision in the yearly estimate for the c a r r y i n g out of the provisions of the Public Health (Medical Treatment of Children Ireland, Act, 1919. The City fathers were quick to see the advantages which nmst accrue to the rising generation by the adoption of the provisions of this Act, and as a result
~5
a comprehensive scheme for school medical inspection has been submitted to the Minister of Local Government for his approval. As a preliminary to the establishment of a permanent service the Council propose to appoint a wholetime School Medical Officer, at a salary of ~500 per annum, to be assisted by a whole-time school nurse. The function of these officials will be to make a health survey of the primary schoqls within the Borough and to report thereon to the Council, who will then be in a position to proceed with the appointment of the necessary officers, including a whole-time Dentist and additional nurses. It is confidently hoped that the good example set by Cork will be followed in the near future by other Urban and Rural Councils throughout the Free State. PRECAUTIONS
AGAINST SMALLPOX.
The Scottish Board of Health have issued Regulations making chickenpox compulsorily notifiable in Scotland. T h e Regulations came into force on July 23rd and will continue in force until the end of the year. It is understood that the spread of the serious epidemic of smallpox which is in progress in Gloucester has been due in some instances to its being mistaken for chickenpox. Cases of smallpox are occurring also in many other parts of England, and this step .of making chickenpox a notifiable disease ih Scotland is taken because of t h e p o s s i b i l i t y of the introduction of smallpox inio this country. E v e r y doctor who is attending a person suffering from chickenpox is required by the Regulations to notify the case to the Medical Officer of Health of the district. This should prevent cases of smallpox slipping through as chickenpox and so spreading the disease. Mild cases of smallpox are sometimes confused. also with infections other than chickenpox Several instances of this came to the notice of the Board o f Health during the epidemic of smallpox in Scotland in 1920-21. To prevent a repetition of this, the Board have suggested to the local authorities that they should ask the medical practitioners in their district to seek the co-operation of the Medical Officer of Health in dealing with any illness that has even a remote resemblance to smallpox. Every medical practitioner is being supplied through the local authorities with a copy o f t h e Regulations.