PRISONS

PRISONS

257 hospital-whether, in short, that particular hospital PUBLIC HEALTH shall survive. Any hospital which has to do with To the student contemplating ...

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257

hospital-whether, in short, that particular hospital PUBLIC HEALTH shall survive. Any hospital which has to do with To the student contemplating a career within the medical education is likely to be aided at once, but health services of this country, almost as many l public in the case of hospitals without educational or national of medical service are open as there are in the importance the question is sometimes difficult to decide. varieties 4 side of the profession. Originally concerned The fact that the decision rests with the Emergencyclinical Hospital Scheme of the Ministry of Health is somewith problems of sanitation and environmental hygiene, indication of the stature to which this infant giant1the British public health service led the world during has already grown and foreshadows the issues which1the nineteenth century in providing sanitary necessities will come within the scope of the medical service of theIand in removing some of the worst effects of the industrial ]revolution. About the beginning of this century its future. scope was extended to the more personal side of INDUSTRIAL MEDICAL SERVICES public health with the creation of the school medical, n and child welfare, tuberculosis and venereal Owing to the Factory (Medical and Welfare Services) maternity Order of the Ministry of Labour (1940) there has been a d disease services and all their ancillaries ; and later the I Government Act of 1929 enabled local authorities rapid increase in the number of industrial medical Local officers appointed to factories within the past year. t, take over and improve a vast system of public to The Minister of Labour now has power to compel b hospitals, so that at the outbreak of war the beds cont employers to make such appointments, being guided in trolled by public bodies were more than twice the this matter by the recommendations of the factory number of those in voluntary hospitals. To the man or n v inspectorate. Already most of larger firms in the woman seeking a hospital or laboratory appointment t differences between service under a local authority country (those employing 7500 persons or more) have the o the Emergency Medical Service and in a voluntary appointed whole-time medical officers. The greatest or increase, however, has been in the number of appoint- lJhospital are slight and diminishing. ments of general practitioners as part-time factory, These considerations, however, hardly apply to the medical officers. student contemplating public health as a specialist s It is estimated that there are approximately 120-150 c No medical officer of health may be appointed career. whole-time doctors employed in factories throughout thevunless he holds a registered diploma in public health or i country ; the number of these may increase before the its equivalent ; but once accepted he enjoys security end of this year but it is unlikely that they will exceed of tenure, in that his removal-like his appointmentc 200 because of the limited number of large industrial r must receive the sanction of the Minister of Health. E the war the number of institutions at which the organisations. This type of service must be expanded Since in the future to meet the requirements of smaller firms, c course of training required for the diploma in public either by the appointment of an increasing number of 1 health is available has been somewhat limited.** After c the D.P.H., an appointment as assistant part-time medical officers who will mainly be general obtaining practitioners, or by the institution of a special industrial Imedical officer of health and school medical officer can, medical service in which a doctor gives the whole of his under present conditions, be obtained without difficulty. 1 time to industry, but instead of working in one large duties at this stage are mainly clinical, in connexion r The firm supervises a number of smaller units. There is with the school medical service, maternity and child -N certainly a gap in the present health services of thewelfare and specialised clinics of various kinds, or in c of beds in isolation hospitals. In the counties, country which can be bridged best by appointing charge doctors whose sphere of work brings them within the t the post of assistant medical officer of health is often factory walls. The needs are three : medical supervision (combined with that of medical officer of health of a of the first treatment of cases of injury and sickness ( district, which provides an attractive mixture county occurring at work ; supervision of the final stages of cof administrative and public health work. The higher rehabilitation and of the return to work of sick and injured are in the main administrative and the medical 1 posts (officer of health of, say, a large county borough, is more persons; and a wider knowledge of working conditions on the part of the medical profession generally. Hitherto i the position of the managing director of an important in lack of such knowledge has made it difficult for anyoneifirm employing several hundreds of technicians than a to prevent ill health caused by industrial environment.
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