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The health congress, 1948
PUBLIC
HEALTH
SOCIETY OF MEDICAL OFFICERS OF HEALTH No. 10. Vol. LXI.
JULY, 1948 CONTENTS
EDITORIAL Superannuation, Transfer and Compensation ,. . . . . . . . . . . T h e Health Congress, 1948 . . . . . . . . . . . . . . . . . . . . . T h e President-Elect Work of the London Schoo'I, 194"6-47 ' " ;i; ii~ ~ "" iii Child Health Services in the Oxford Region .,. iii ... . . . . . . Personal Health Services in Westminster . . . . . . . . . . . . . . . SPECIAL ARTICLES T h e HandicaPped Child as a Social and Educational Problem, By J, D. Kershaw. M.D., D.p.tt . . . . . . . . . . . . . . . . . Some Common. Skirl Affections in the"School"Child~" By Brian Russell, M.D.. M.R.C.P.. D.P.rI . . . . . . . . . . . . . . . . . . . . . . . . . Child Guidance. By W. Lindesay Neustatter, M.D., B.SC.. M.E.C.P, T h e Quest for Standards of Physical Proportion and Performance in Scho'oi Children. By Dr. J. E. Cheesman . . . . . . . . . . . . . . . . . . T h e S t a f f i n g of Chest Clinics in the New Health Service. M e m o r a n d u m agreed by the Tubercuic~sis G r o u p and P l a n n i n g Committee of the Society of M.O.H . . . . . . . . ;. . . . . . . . . . . . . . . . . . . OBITUARY Sir George Newman, O.B.E., K.C.B., I~I.D,EDIN., D.SC., LL.D,, P.R.C.P., F.E.C.S., P,D.H .
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PAGE 183 183 184 184 185 185
186 187 191 193 195
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Superalmuation, Transfer and Compeasation Many letters h a v e been reaching the Society's office posing the problems of individual members which arise f r o m the new conditions after the appointed day. Regarding superannuation, the most authoritative advice can be obtained, from the Ministry's H e a l t h Services Superannuation Division, 28, Princes Gate, London, S.W.7, but there are certain general points on which an opinion given in these columns m a y help members of the Society. First, the Minister had power under Section 67 of the National H e a l t h Service Act to m a k e superannuation regulations only for officers of local authorities coming within the National H e a l t h Service. T h e Act does not cover local sanitary authorities and new legislation will be required to m a k e the new superannuation scheme open to officers of L.SIA.s. T h e only circumstances in which an officer who divides his time between t h e service of an L.S.A. and that of an L . H . A . could enter the new scheme would seem to be those mentioned in Superannuation Regulation 89 (3); for instance, if Dr. A. is employed directly b y a borough or district as M.O.H. for 30% of his time and also ,directly b y a county as divisional or assistant medical officer for the remaining 70% of his time he would appear to b e eligible for inclusion in the new scheme as being " mainly engaged " in L . H . A . services. If, however, he is retained as Borough or District M.O.H. and his services are merely lent to the county council on a r e p a y m e n t basis, he is not eligible for the new scheme and remains under the Local G o v e r n m e n t Superannuation Act of 1937 or a n y existing local Act. I n the latter case, his position is perhaps better in regard to security of tenure ~nd general independence but he cannot enter the new superannuation scheme, and since he is not a " transferred officer " his authority cannot pass a resolution (under Regulations 15 and 40a) that his non-contributory service shall be reckonable as contributory service. Secondly, members who are automatically transferred on the appointed day can get the benefit of Regulations 15 and 40a (regarding and reckoning of non-contributory service) if their former employing authority passes the necessary resolution either before J u l y 5th or within three mouths thereafter. Representations should be m a d e if possible to the authority, as such resolutions must specifically refer b y name to the officer concerned. Thirdly, members ask whether it is to their a d v a n t a g e to enter the new scheme or to use their option to remain in the old scheme.* This decision must really be an individual T h e actual financial pros and cons of the new and old s c ~ : ~ * Superannuation Scheme for those engaged in the N~'f~nal Health Set,ice. An Explanation. H.M. Stationery Office. Prt~$BO.
BOOK REVIEWS T h e Social Medicine of Old Age. (J, H. Sheldon) ... Q . . . . . . . . . Diseases of the Chest. (Robert Coope) . . . . . . . . . . . . . . . . M y Life in General Practice. (H. W. Pooler) ... ...... F a t t y L i v e r D i . . . . . in Infants in B.W.I. (J, C. Waterlow) ...... Bacterial and Vi'rus Diseases. (H. J. Parish) ,.. Registrar-General's Statistical Review England and Wales,"1943. " T a b l e s , Part I. Medical . . . . . . Air-borne Infections and Ai'r Sanitation." (Hm~ovia.'i~td.) .,. "'" ~i~ Young Workers at Meal Time. (London Council of Social Se~'ice) .., Matters of Life and Death. (General Register Office) ......... THE SOCIETY OF MEDICAL OFFICERS OF HEALTH T h e A n n u a l Dinner . . . . . . . . . . . . . . . . . . . . . . . . East NIidland Branch . . . . . . . . . . . . . . . . . . . . . . . . Northern Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . North-Western Branch . . . . . . . . . . . . . . . . . . . . . . . , Welsh Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . Yorkshire Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . County District G r o u p . . . . . . . . . . . . . . . . . . . . . . . . School Health Service G r o u p . . . . . . . . . . . . . . . . . . . . . Services Hygiene G r o u p . . . . . . . . . . . . . . . . . . . . . . . . Tuberculosis G r o u p . . . . . . . . . . . . . . . . . . . . . . . .
PAGE 199 199 200 200 200 200 201 201 201 202
202 202 202 204 204 205 205 206 206
can be reckoned quite easily with the aid~ of the simple guide to the National Health Service Superannuation Scheme which is to be issued to everyone entering the H e a l t h Service. One u n d o u b t e d advantage of the new scheme is that it provides for a widow's pension and death gratuity if the contributor dies at a n y time after completing ten years' service or within 12 months of leaving the service; another is that pensions and retiring allowances are calculated on the last three instead of the last five years average remuneration. T h e option to remain in the old scheme can be used up to October 4th next. T u r n i n g to the more obscure subjects of transfer and compensation, we refer our members to an explanatory article which will shortly be printed in ~the S u p p l e m e n ~ to the B r i t i s h M e d i c a l ] o u o ' n M , As the grounds for compensation will be loss of e m p l o y m e n t or diminution of emoluments and as in most cases of transfer in the public h e a l t h service the compensating authority will be the county council which takes o v e r responsibility for the transferred service, it would seem to be in the interests of the county councils themselves to give transferred officers " reasonably comparable office." On the whole, one would not advise any officer below the age of 45 or without a cast-iron case to claim compensation with a n y hope of success , in view of the provisos and qualifying phrases such as " the extent to which he has sought suitable alternative employme~at " or that if an officer " has unreasonably refused a suitable offer " he shall be deemed to h a v e entered the e m p l o y m e n t so offered. No doubt some test cases of claims and appeals will arise which will throw some light on this problematic field. Meantime i t is clear t h a t the Minister wishes to see every employable public health medical officer fitted, suitably into the new scheme of things.
The Health Congress, 1948 W i t h only 40 days and 40 nights to go before the appointed day (as pointed out by Dr. Walton in a paper to the M a t e r n i t y and Child H e a l t h Section), the medical sections of the Royal Sanitary Institute's Health Congress at Harrogate this year showed particular interest in some administrative p r o b l e m s o f the forthcoming transfer of services. L o r d I n m a n of Knaresb o r o u g h set the note in his presidential address, which c o m bined interesting retrospect of the past 100 years with his thoughts on the change in the hospital world u n d e r the new dispensation. His appeal for the retention of the voluntary spirit in State-owned hospitals was w a r m l y applauded. O u r resident, Dr. Frederick Hall, presiding o v e r the conof medical Officers of health on M a y 2 6 t h , took as_ I~s°,t~¢e " T e a m W o r k in P u b l i c H e a l t h , " and in his usual ~'t~out~ful way tried to foresee how the apparent gaps in the , g t ~ m i j t r a t i v e structure set up by the National H e a l t h Service
184 Act would in practice be bridged. He expressed an optimistic note in the amount of co-operation which would be achieved by personal contact and by common membership of local health authorities and Regional Boards, executive councils and Local Management Committees. Regarding premises, he hoped that some useful experience would accumulate by joint use of existing local authority clinics and centres by hospital specialists and public health medical officers. He placed the responsibility of administrators high in this formative period of the new social services and hoped that recruitment of medical admini0trators on the hospital side would continue to be from those who had acquired similar experience in the local government service. ~ T h e sessions of both the Preventive Medicine Section and of the Medical Officers of Health Conference were largely devoted to the place of the Public Health Laboratdry Service in co-operating with the medical officer of health in his fundamental duty of the control of communicable diseases and the prevention of their spread. T h e note expressed by Prof. G. S. Wilson in his presidential address to the Section of Preventive Medicine on May 25th, and by Dr. W. H. Bradley, speaking to the medical officers of health on the 26th, was to suggest that more infections might be prevented at their source. T h e many members of the public health service who spoke in these sessions were obviously appreciative of the expert aid and advice so freely given by the staff of the Public Health Laboratory Service, and Dr. Greenwood Wilson, of Cardiff, suggested certain reciprocal help which local authorities could give to the service. T h e Section of Maternal and Child Health heard an interesting discussion on the administrative implications of the Ministry of Health's Circular 118/47, which Dr. Walton of Newcastle-upon-Tyne praised as an attempt to fuse t h e tripartite structure of the Act. He gave some useful illustrations of the co-operation possible between a Local Health Authority mad a University Department of Child Health, while Dr. Catherine Morris-Jones, of Gloucestershire, the other opener, suggested answers to some of the problems of*rural midwifery and maternity and child welfare. She particularly hoped that the introduction of the new general practitioner/obstetrician service would not remove the professional interest from the work of the midwife. She also put very clearly the responsibility of local health authorities in obtaining admission of maternity eases to hospital on " social " grounds. One other speaker, Dr. E. D. Irvine, of Dewsbury, struck a warning note when he said that unless public health work was better remunerated in future public health staffs would be lacking. T h e second session of this Section on May 28th dealt with the relation between parent and child and the effects on the latter's health and well-being. Dr. J. D. Kershaw, of Colchester, gave an eloquent opening address, and Dr. Mary Fisher, of Oxford, followed up with some interesting findings from the investigation carried out in conjunction with the Oxford Institute of Social Medicine on the level of maternal efficiency and its effect on the health of children. I n the Conference of Health Visitors, Prof. Andrew Topping, of Manchhster, paid tribute to the ubiquity of the health visitor and suggested how the proper use of her services could relieve the strain on those of the doctors and the hospitals. He forecast a still more ubiquitous type of health visitor under the social demands of the new health service. His address led to an interesting discussion on the question whether the health visitor's training now called for revision and broadening o n the sociological side so that she would be p a r excellence the home visitor and social worker for all preventive services. Dr. Brockington, of the West Riding, made some specific suggestions to this end and an unofficial resolution was eventually adopted urging early consideration of a change in the health visitor's training and examination on the assumption that the new nursing training proposed by the Working Party's Report might be coming into operation. Space does not allow of adequate reference to the other sections and conferences. T h e sanitary inspectors discussed standards of fitness in housing, smoke abatement, ice-cream and food adulteration; the engineers and architects, homes for the aged, and the possibilities of prefabrication for-health
PUBLIC HEALTH, July, 1948 service buildings; and in the Housing and T o w n Planning Section, Prof. W. G. Holford gave an interesting address on the new responsibilities of local authorities as property owners under the T o w n and Country Planning Act. T h e social side of the week in Harrogate was well looked after. T h e actual attendance at the Congress was a new high record of more than 2,400 members and delegates, of whom about 350 attended the dinner presided over by the Chairman of Council of the Royal Sanitary Institute, Mr. George Laws, M.B.E., t~.8.I.A. Congratulations are due to the Institute, especially to the Congress Committee and its Chairman, Sir Weldon Dalrymple-Champneys, and to the Secretariat, on the organisation of yet another successful Congress.
The Presldent-Elect This is the first opportunity which, we have had of congratulating Prof. R. H. Parry of Bristol on his election by the meetings of May 21st as President of the Society for the session 1948-49. It will be a responsible period, the first full year in the era of the National Health Service, and no more representative medical officer of health could be found than Prof. Parry, who personifies the desirable liaison between local authorities and the academic and teaching world, by combinin,g the post of M.O.H. and S.M.O. of a great city and port with that of professor of preventive medicine in the University of Bristol. He also shows the contact between clinical and, preventive medicine by his Fellowship of the Royal College of Physicians. Moreover, he has played a leading part in the counsels of the Society and latterly has taken on two onerous chairmanships, those of the special committee on Health Centres and of the Planning Committee which is dealing with matters arising from the National Health Service Act, 1946. Other reasons for gratification at this election are that Prof. Parry was nominated by the West of England Branch, which last provided a President in 1936-37 (the late Dr. Ernest Ward), and that h e is a son of Wales, whose last representative as a President was Dr. J. Howard-Jones in 1928-29. We wish Prof. Parry a happy a n d successful year of office.
The Work o,f the London School, 1946-47 The Report of the London School of Hygiene and Tropical Medicine for the year 1946-47, recently issued, is prefaced by a fascinating " Cavalcade of Public Health," the sto W of the 100 years from the Public Health Act, 1848, in the form of an enlightened commei~tary on the landmarks of the period, i.e., .the original Act of 1848, the consolidating Act of 1875, the Ministry of Health Act, 1919, the Local Government Act, 1929, and the National Health Service Act, 1946. • The ~nonymous writer (may we suspect Prof. Mackintosh?) has brilliantly picked out the contemporary opinions of the respective times to give a fascinating account of the historical background and the progress of the century. The regular sections of the School's report show that the School has got back into its stride after the war period: I n the Department of Public Health, Prof. Mackintosh has devised a seminar group system of special studies for his D.P.H. students which obviously stimulates their imagination and creative efforts and is a.n interesting example of the fostering of self-education b y enlightened leadership. I n the year under review one group of students made a study of contemporary literature on sanitary administration of the period 184048; another group demonstrated the work of a present-day welfare authority dealing with M. & C.W. questions; and a third group studied~ slum problems and devised an exhibition laying emphasis on the housing standards. The work of the 1947-48 groups was recently demonstrated following the an. nual Court meeting to a large audience and this time produced excellent visual and spoken demonstrations of the public health history of the late 1800's in which students provided the voices of Armstrong of Newcastle, Tatham of Manchester, and so on; investigations into home accidents (presented in the form of a diverting play); and of educational setbacks to children undergoing hospital treatment. The method obviously has great possibilities with a keen class of students.
HEALTH
SOCIETY OF MEDICAL OFFICERS OF HEALTH No. 10. Vol. LXI.
JULY, 1948 CONTENTS
EDITORIAL Superannuation, Transfer and Compensation ,. . . . . . . . . . . T h e Health Congress, 1948 . . . . . . . . . . . . . . . . . . . . . T h e President-Elect Work of the London Schoo'I, 194"6-47 ' " ;i; ii~ ~ "" iii Child Health Services in the Oxford Region .,. iii ... . . . . . . Personal Health Services in Westminster . . . . . . . . . . . . . . . SPECIAL ARTICLES T h e HandicaPped Child as a Social and Educational Problem, By J, D. Kershaw. M.D., D.p.tt . . . . . . . . . . . . . . . . . Some Common. Skirl Affections in the"School"Child~" By Brian Russell, M.D.. M.R.C.P.. D.P.rI . . . . . . . . . . . . . . . . . . . . . . . . . Child Guidance. By W. Lindesay Neustatter, M.D., B.SC.. M.E.C.P, T h e Quest for Standards of Physical Proportion and Performance in Scho'oi Children. By Dr. J. E. Cheesman . . . . . . . . . . . . . . . . . . T h e S t a f f i n g of Chest Clinics in the New Health Service. M e m o r a n d u m agreed by the Tubercuic~sis G r o u p and P l a n n i n g Committee of the Society of M.O.H . . . . . . . . ;. . . . . . . . . . . . . . . . . . . OBITUARY Sir George Newman, O.B.E., K.C.B., I~I.D,EDIN., D.SC., LL.D,, P.R.C.P., F.E.C.S., P,D.H .
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PAGE 183 183 184 184 185 185
186 187 191 193 195
199
Superalmuation, Transfer and Compeasation Many letters h a v e been reaching the Society's office posing the problems of individual members which arise f r o m the new conditions after the appointed day. Regarding superannuation, the most authoritative advice can be obtained, from the Ministry's H e a l t h Services Superannuation Division, 28, Princes Gate, London, S.W.7, but there are certain general points on which an opinion given in these columns m a y help members of the Society. First, the Minister had power under Section 67 of the National H e a l t h Service Act to m a k e superannuation regulations only for officers of local authorities coming within the National H e a l t h Service. T h e Act does not cover local sanitary authorities and new legislation will be required to m a k e the new superannuation scheme open to officers of L.SIA.s. T h e only circumstances in which an officer who divides his time between t h e service of an L.S.A. and that of an L . H . A . could enter the new scheme would seem to be those mentioned in Superannuation Regulation 89 (3); for instance, if Dr. A. is employed directly b y a borough or district as M.O.H. for 30% of his time and also ,directly b y a county as divisional or assistant medical officer for the remaining 70% of his time he would appear to b e eligible for inclusion in the new scheme as being " mainly engaged " in L . H . A . services. If, however, he is retained as Borough or District M.O.H. and his services are merely lent to the county council on a r e p a y m e n t basis, he is not eligible for the new scheme and remains under the Local G o v e r n m e n t Superannuation Act of 1937 or a n y existing local Act. I n the latter case, his position is perhaps better in regard to security of tenure ~nd general independence but he cannot enter the new superannuation scheme, and since he is not a " transferred officer " his authority cannot pass a resolution (under Regulations 15 and 40a) that his non-contributory service shall be reckonable as contributory service. Secondly, members who are automatically transferred on the appointed day can get the benefit of Regulations 15 and 40a (regarding and reckoning of non-contributory service) if their former employing authority passes the necessary resolution either before J u l y 5th or within three mouths thereafter. Representations should be m a d e if possible to the authority, as such resolutions must specifically refer b y name to the officer concerned. Thirdly, members ask whether it is to their a d v a n t a g e to enter the new scheme or to use their option to remain in the old scheme.* This decision must really be an individual T h e actual financial pros and cons of the new and old s c ~ : ~ * Superannuation Scheme for those engaged in the N~'f~nal Health Set,ice. An Explanation. H.M. Stationery Office. Prt~$BO.
BOOK REVIEWS T h e Social Medicine of Old Age. (J, H. Sheldon) ... Q . . . . . . . . . Diseases of the Chest. (Robert Coope) . . . . . . . . . . . . . . . . M y Life in General Practice. (H. W. Pooler) ... ...... F a t t y L i v e r D i . . . . . in Infants in B.W.I. (J, C. Waterlow) ...... Bacterial and Vi'rus Diseases. (H. J. Parish) ,.. Registrar-General's Statistical Review England and Wales,"1943. " T a b l e s , Part I. Medical . . . . . . Air-borne Infections and Ai'r Sanitation." (Hm~ovia.'i~td.) .,. "'" ~i~ Young Workers at Meal Time. (London Council of Social Se~'ice) .., Matters of Life and Death. (General Register Office) ......... THE SOCIETY OF MEDICAL OFFICERS OF HEALTH T h e A n n u a l Dinner . . . . . . . . . . . . . . . . . . . . . . . . East NIidland Branch . . . . . . . . . . . . . . . . . . . . . . . . Northern Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . North-Western Branch . . . . . . . . . . . . . . . . . . . . . . . , Welsh Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . Yorkshire Branch . . . . . . . . . . . . . . . . . . . . . . . . . . . County District G r o u p . . . . . . . . . . . . . . . . . . . . . . . . School Health Service G r o u p . . . . . . . . . . . . . . . . . . . . . Services Hygiene G r o u p . . . . . . . . . . . . . . . . . . . . . . . . Tuberculosis G r o u p . . . . . . . . . . . . . . . . . . . . . . . .
PAGE 199 199 200 200 200 200 201 201 201 202
202 202 202 204 204 205 205 206 206
can be reckoned quite easily with the aid~ of the simple guide to the National Health Service Superannuation Scheme which is to be issued to everyone entering the H e a l t h Service. One u n d o u b t e d advantage of the new scheme is that it provides for a widow's pension and death gratuity if the contributor dies at a n y time after completing ten years' service or within 12 months of leaving the service; another is that pensions and retiring allowances are calculated on the last three instead of the last five years average remuneration. T h e option to remain in the old scheme can be used up to October 4th next. T u r n i n g to the more obscure subjects of transfer and compensation, we refer our members to an explanatory article which will shortly be printed in ~the S u p p l e m e n ~ to the B r i t i s h M e d i c a l ] o u o ' n M , As the grounds for compensation will be loss of e m p l o y m e n t or diminution of emoluments and as in most cases of transfer in the public h e a l t h service the compensating authority will be the county council which takes o v e r responsibility for the transferred service, it would seem to be in the interests of the county councils themselves to give transferred officers " reasonably comparable office." On the whole, one would not advise any officer below the age of 45 or without a cast-iron case to claim compensation with a n y hope of success , in view of the provisos and qualifying phrases such as " the extent to which he has sought suitable alternative employme~at " or that if an officer " has unreasonably refused a suitable offer " he shall be deemed to h a v e entered the e m p l o y m e n t so offered. No doubt some test cases of claims and appeals will arise which will throw some light on this problematic field. Meantime i t is clear t h a t the Minister wishes to see every employable public health medical officer fitted, suitably into the new scheme of things.
The Health Congress, 1948 W i t h only 40 days and 40 nights to go before the appointed day (as pointed out by Dr. Walton in a paper to the M a t e r n i t y and Child H e a l t h Section), the medical sections of the Royal Sanitary Institute's Health Congress at Harrogate this year showed particular interest in some administrative p r o b l e m s o f the forthcoming transfer of services. L o r d I n m a n of Knaresb o r o u g h set the note in his presidential address, which c o m bined interesting retrospect of the past 100 years with his thoughts on the change in the hospital world u n d e r the new dispensation. His appeal for the retention of the voluntary spirit in State-owned hospitals was w a r m l y applauded. O u r resident, Dr. Frederick Hall, presiding o v e r the conof medical Officers of health on M a y 2 6 t h , took as_ I~s°,t~¢e " T e a m W o r k in P u b l i c H e a l t h , " and in his usual ~'t~out~ful way tried to foresee how the apparent gaps in the , g t ~ m i j t r a t i v e structure set up by the National H e a l t h Service
184 Act would in practice be bridged. He expressed an optimistic note in the amount of co-operation which would be achieved by personal contact and by common membership of local health authorities and Regional Boards, executive councils and Local Management Committees. Regarding premises, he hoped that some useful experience would accumulate by joint use of existing local authority clinics and centres by hospital specialists and public health medical officers. He placed the responsibility of administrators high in this formative period of the new social services and hoped that recruitment of medical admini0trators on the hospital side would continue to be from those who had acquired similar experience in the local government service. ~ T h e sessions of both the Preventive Medicine Section and of the Medical Officers of Health Conference were largely devoted to the place of the Public Health Laboratdry Service in co-operating with the medical officer of health in his fundamental duty of the control of communicable diseases and the prevention of their spread. T h e note expressed by Prof. G. S. Wilson in his presidential address to the Section of Preventive Medicine on May 25th, and by Dr. W. H. Bradley, speaking to the medical officers of health on the 26th, was to suggest that more infections might be prevented at their source. T h e many members of the public health service who spoke in these sessions were obviously appreciative of the expert aid and advice so freely given by the staff of the Public Health Laboratory Service, and Dr. Greenwood Wilson, of Cardiff, suggested certain reciprocal help which local authorities could give to the service. T h e Section of Maternal and Child Health heard an interesting discussion on the administrative implications of the Ministry of Health's Circular 118/47, which Dr. Walton of Newcastle-upon-Tyne praised as an attempt to fuse t h e tripartite structure of the Act. He gave some useful illustrations of the co-operation possible between a Local Health Authority mad a University Department of Child Health, while Dr. Catherine Morris-Jones, of Gloucestershire, the other opener, suggested answers to some of the problems of*rural midwifery and maternity and child welfare. She particularly hoped that the introduction of the new general practitioner/obstetrician service would not remove the professional interest from the work of the midwife. She also put very clearly the responsibility of local health authorities in obtaining admission of maternity eases to hospital on " social " grounds. One other speaker, Dr. E. D. Irvine, of Dewsbury, struck a warning note when he said that unless public health work was better remunerated in future public health staffs would be lacking. T h e second session of this Section on May 28th dealt with the relation between parent and child and the effects on the latter's health and well-being. Dr. J. D. Kershaw, of Colchester, gave an eloquent opening address, and Dr. Mary Fisher, of Oxford, followed up with some interesting findings from the investigation carried out in conjunction with the Oxford Institute of Social Medicine on the level of maternal efficiency and its effect on the health of children. I n the Conference of Health Visitors, Prof. Andrew Topping, of Manchhster, paid tribute to the ubiquity of the health visitor and suggested how the proper use of her services could relieve the strain on those of the doctors and the hospitals. He forecast a still more ubiquitous type of health visitor under the social demands of the new health service. His address led to an interesting discussion on the question whether the health visitor's training now called for revision and broadening o n the sociological side so that she would be p a r excellence the home visitor and social worker for all preventive services. Dr. Brockington, of the West Riding, made some specific suggestions to this end and an unofficial resolution was eventually adopted urging early consideration of a change in the health visitor's training and examination on the assumption that the new nursing training proposed by the Working Party's Report might be coming into operation. Space does not allow of adequate reference to the other sections and conferences. T h e sanitary inspectors discussed standards of fitness in housing, smoke abatement, ice-cream and food adulteration; the engineers and architects, homes for the aged, and the possibilities of prefabrication for-health
PUBLIC HEALTH, July, 1948 service buildings; and in the Housing and T o w n Planning Section, Prof. W. G. Holford gave an interesting address on the new responsibilities of local authorities as property owners under the T o w n and Country Planning Act. T h e social side of the week in Harrogate was well looked after. T h e actual attendance at the Congress was a new high record of more than 2,400 members and delegates, of whom about 350 attended the dinner presided over by the Chairman of Council of the Royal Sanitary Institute, Mr. George Laws, M.B.E., t~.8.I.A. Congratulations are due to the Institute, especially to the Congress Committee and its Chairman, Sir Weldon Dalrymple-Champneys, and to the Secretariat, on the organisation of yet another successful Congress.
The Presldent-Elect This is the first opportunity which, we have had of congratulating Prof. R. H. Parry of Bristol on his election by the meetings of May 21st as President of the Society for the session 1948-49. It will be a responsible period, the first full year in the era of the National Health Service, and no more representative medical officer of health could be found than Prof. Parry, who personifies the desirable liaison between local authorities and the academic and teaching world, by combinin,g the post of M.O.H. and S.M.O. of a great city and port with that of professor of preventive medicine in the University of Bristol. He also shows the contact between clinical and, preventive medicine by his Fellowship of the Royal College of Physicians. Moreover, he has played a leading part in the counsels of the Society and latterly has taken on two onerous chairmanships, those of the special committee on Health Centres and of the Planning Committee which is dealing with matters arising from the National Health Service Act, 1946. Other reasons for gratification at this election are that Prof. Parry was nominated by the West of England Branch, which last provided a President in 1936-37 (the late Dr. Ernest Ward), and that h e is a son of Wales, whose last representative as a President was Dr. J. Howard-Jones in 1928-29. We wish Prof. Parry a happy a n d successful year of office.
The Work o,f the London School, 1946-47 The Report of the London School of Hygiene and Tropical Medicine for the year 1946-47, recently issued, is prefaced by a fascinating " Cavalcade of Public Health," the sto W of the 100 years from the Public Health Act, 1848, in the form of an enlightened commei~tary on the landmarks of the period, i.e., .the original Act of 1848, the consolidating Act of 1875, the Ministry of Health Act, 1919, the Local Government Act, 1929, and the National Health Service Act, 1946. • The ~nonymous writer (may we suspect Prof. Mackintosh?) has brilliantly picked out the contemporary opinions of the respective times to give a fascinating account of the historical background and the progress of the century. The regular sections of the School's report show that the School has got back into its stride after the war period: I n the Department of Public Health, Prof. Mackintosh has devised a seminar group system of special studies for his D.P.H. students which obviously stimulates their imagination and creative efforts and is a.n interesting example of the fostering of self-education b y enlightened leadership. I n the year under review one group of students made a study of contemporary literature on sanitary administration of the period 184048; another group demonstrated the work of a present-day welfare authority dealing with M. & C.W. questions; and a third group studied~ slum problems and devised an exhibition laying emphasis on the housing standards. The work of the 1947-48 groups was recently demonstrated following the an. nual Court meeting to a large audience and this time produced excellent visual and spoken demonstrations of the public health history of the late 1800's in which students provided the voices of Armstrong of Newcastle, Tatham of Manchester, and so on; investigations into home accidents (presented in the form of a diverting play); and of educational setbacks to children undergoing hospital treatment. The method obviously has great possibilities with a keen class of students.