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The Health Congress, Hastings, 1953
78
PUBLIC HEALTH, February, 1953
h a n d m a i d e n s and general material collectors for all and s u n d r y . M a n y reports have b e e n p r o d u c e d f r o m material w h i c h has b e e n collected chiefly b y ourselves or our staff. A n o t h e r way in w h i c h our Society could help the individual m e m b e r s w o u l d be by h o l d i n g a pool for information that could be d i s s e m i n a t e d on request and the h o l d i n g of a central register o f information on certain public health topics. M u c h i n f o r m a t i o n suitable for inclusion in such a m a n u s c r i p t library w o u l d b e readily available b y correlation of the replies to the m a n y questionnaires w h i c h we complete. It w o u l d be easy for the tabulated results of all questionnaires to be sent to the central point. Use of such a centralised information d e p o t would give u p - t o - d a t e i n f o r m a t i o n and f r e q u e n t l y obviate duplication in making enquiries, some system o f arranging for answers to queries f r o m m e m b e r s or sources w i t h special knowledge would at times be especially helpful. I n the recent smallpox outbreak certain papers in journals w e r e f o u n d to be of great practical value and at the time great difficulty and waste of time was entailed in obtaining copies. W h i l s t on this topic, could some approach be m a d e to the Ministries of H e a l t h and E d u c a t i o n to see if t h e y could pass on some of the m o s t valuable information t h a t at times they obtain ? It has b e e n said before, the direction in w h i c h the future of public health may go will d e p e n d u p o n a host of influences and factors. N o single influence will alone shape w h a t will develop, but a m o n g s t the influences what we do a n d say as medical officers of health m a y add a little of the salt of experience and reason to the final shape. W e w o u l d express our views, first, as to w h a t w o u l d be the best authority to a d m i n i s t e r the public health services and, secondly, as to what are our appropriate duties and s p h e r e of action. T h e r e can and p r o b a b l y will be advocates for m a n y suggested possibilities of public health administration, b u t we o f the Local Authorities are satisfied that the Local A u t h o r i t y is the best way to carry out the work. W e m u s t see that this is p r o v e d in practice. O n e of our duties is constantly to put before o u r authorities their responsibilities and see that in the future t h e y are given their full share in the changes and advances that may come. O n our o w n b e h a l f as medical officers o f health we m u s t continually p u t forward our claims for p r e v e n t i o n and see that our local authorities realise what should be done. T h e Medical Officer of H e a l t h ' s p r e s e n t position is briefly declared by Sir J o h n A. Charles in the R e p o r t of the M i n i s t r y of Health, in a m a n n e r w h i c h s u m s u p for the p r e s e n t and augurs well for the future. H e says : " T h e Medical Officer of H e a l t h to-day, in short, is c o n c e r n e d with m a n ' s total e n v i r o n m e n t a l welfare, a n d to this e n d he should enlarge his training and knowledge to include all aspects of m a n ' s physical and m e n t a l well b e i n g . " S h o u l d these things be done, the future is ensured.
THE HEALTH CONGRESS, HASTINGS, I953 The Royal Sanitary Institute has sent out the preliminary programme of the Health Congress to be held at Hastings from April 28th to May 1st next, with Lord Eustace Percy, p.c., as President. In the Section of Preventive Medicine, Mr. Fred Messer, C.B.E., M.P., will preside, and the speakers on " The Tasks Ahead in Preventive Medicine " will be Drs. J. F. Warin (M.O.H., Oxford C.B.) and R. Scott (Lecturer, Edinburgh University). The Conference of M.O.H.s will have Dr. Andrew Topping, President of the Society, in the chair, and speakers will b e Dr. C. Banning (C.M.O., The Netherlands) on '~ Housing Conditions and Health of the People in Holland," and Dr. J. V. Walker (M.O.H., Darlington C.B.) on ',Aspects of Social Medicine particularly illustrated by Housing." In the Section of Maternal and Child Health, President, Dr. B. E. Schlesinger, there will be discussions on " The Future of the Maternity and Child Welfare Service," opened by Drs. F. J. W. Miller (Newcastle-on-Tyne), M. R. Woods (G.P.), Dorothy F. Egan (Senior M.O., L.C.C.) and Miss V. R. Shand (Supervisor of Midwives, Lancashire), and on " The Place of the Social Worker in the M. & C.W. Service," opened by Dr. Mary Hellier (G.P.), Miss M. Noble (Almoner) and Miss F. E. Lillywhite (Chairman, W.P.H.O.A.).
CORRESPONDENCE THF
ScHool. D E N T A L SERViCe':
To the Editor of PUBLIC HEALTH. Sir,mYour l)ecember editorial, reviewing two recent memoranda oi1 dental care of children, recommends as prerequisite to any new approach a rebuilding of the School Dental Service. Anyone who has watched from the vantage point of a dental hospital the progressive breakdown of that Service since 1948 will agree that there is little evidence that the (;eneral Dental Service then introduced can replace it either on the remedial side, where the (i.D.S. lacks follow-up facilities, or on the health education and preventive side, where only an environmental service can combat ignorance, apathy and neglect at their most vulnerable points--in the home and in the school. The major problem of the School I)ental Service is, and always has been, one of manpower. Nowadays most young men who do not enter general practice take higher qualifications with a view rather to becoming surgeons than to filling and extracting chihlren's teeth. Those who do enter this despised field seek, as you say, to become " full blown paedodontists " and to develop their craftsmanship to the utmost rather than to content themselves with securing a maxinmm of healthy mouths in a minimum of time by the simplest and most economical means. There is obvious need for the " full blown paedodontist" in the Service but it cannot be expected that his output, qualitatively admirable, will quantitatively much exceed that of a New Zealand dental nurse or that his enthusiasm for oral hygiene instruction and dental health propaganda will compare with that of the old-time P.D.O., who at least knew one cause of caries and was not afraid to say so. The solution would seem to be to btfild up the school service (at any rate experimentally in certain areas) to permit of two branches being formed: one mainly therapeutic and the other mainly preventive. --The former would hope to attract the men keen on paedodontic and orthodontic specialisation: the latter would be staffed either by newly qualified grant-aided dentists conscripted to the Service for a term of years or by auxiliaries (hygienists and New Zealand dental nurses), both of them serving under dental officers specially interested in public health. C. H. RVB~A. " Foxglove Cottage," Copthorne, Sussex. December 17th, 1952. TRAI~ING VOR PUmAC HEALTH
7"0 the Editor of PUBLIC HEALTH. Sir,--In his interesting article (" Controversial Thoughts on l,ocal Government and the Future of the Public Health Service") in your December issue, Dr. J. V. Walker complains that the I).P.H. course, " although it has been changed of late in the promotion of time given to various subjects, dates from an epoch when it was necessary for a Medical Officer of Health to have technical skill in chemistry and bacteriology and when environmental hygiene presented a simpler and cruder problem than it does to-day." The fact that it dates from such an epoch is no more a justifiable criticism that: would be an attack on the M.B. because it dates from a time when technical skill in leeching, cupping and letting were prerequisites of all practitioners. As one who has recently undergone the new D.P.H. course, I feel that I must defend it against this attack, especially the implication that it is merely the old pre-1946 D.P.H. with its constituent subjects reshuffled. Probably the most important part of the D.P.H. is now the dissertation, which serves to give the trainee in public health exercise in research and in original thought, both of which are surely desirable attributes in any budding M.O.H. The rest of the course including, as it does, consideration of the history and administration of public health; social security; international matters; statistics; bacteriology; genetics ; health education; nutrition; occupational health and many other subjects gives, in my opinion, a far wider outlook on medicine and on humanity than does any other degree or diploma in medicine to-day. These subjects well taught (by which I mean taught in such a way as to stimulate thought) and coupled with numerous visits to pnblic offices of all kinds, industrial establishments, slmns, hospital almoners' departments, ships, coal mines, and divers other places, taught me something which many months in hospital wards failed to do--that medicine is only a very small facet of life, and that failure to appreciate that fact is a grave danger to which clinicians are constantly exposed.
PUBLIC HEALTH, February, 1953
h a n d m a i d e n s and general material collectors for all and s u n d r y . M a n y reports have b e e n p r o d u c e d f r o m material w h i c h has b e e n collected chiefly b y ourselves or our staff. A n o t h e r way in w h i c h our Society could help the individual m e m b e r s w o u l d be by h o l d i n g a pool for information that could be d i s s e m i n a t e d on request and the h o l d i n g of a central register o f information on certain public health topics. M u c h i n f o r m a t i o n suitable for inclusion in such a m a n u s c r i p t library w o u l d b e readily available b y correlation of the replies to the m a n y questionnaires w h i c h we complete. It w o u l d be easy for the tabulated results of all questionnaires to be sent to the central point. Use of such a centralised information d e p o t would give u p - t o - d a t e i n f o r m a t i o n and f r e q u e n t l y obviate duplication in making enquiries, some system o f arranging for answers to queries f r o m m e m b e r s or sources w i t h special knowledge would at times be especially helpful. I n the recent smallpox outbreak certain papers in journals w e r e f o u n d to be of great practical value and at the time great difficulty and waste of time was entailed in obtaining copies. W h i l s t on this topic, could some approach be m a d e to the Ministries of H e a l t h and E d u c a t i o n to see if t h e y could pass on some of the m o s t valuable information t h a t at times they obtain ? It has b e e n said before, the direction in w h i c h the future of public health may go will d e p e n d u p o n a host of influences and factors. N o single influence will alone shape w h a t will develop, but a m o n g s t the influences what we do a n d say as medical officers of health m a y add a little of the salt of experience and reason to the final shape. W e w o u l d express our views, first, as to w h a t w o u l d be the best authority to a d m i n i s t e r the public health services and, secondly, as to what are our appropriate duties and s p h e r e of action. T h e r e can and p r o b a b l y will be advocates for m a n y suggested possibilities of public health administration, b u t we o f the Local Authorities are satisfied that the Local A u t h o r i t y is the best way to carry out the work. W e m u s t see that this is p r o v e d in practice. O n e of our duties is constantly to put before o u r authorities their responsibilities and see that in the future t h e y are given their full share in the changes and advances that may come. O n our o w n b e h a l f as medical officers o f health we m u s t continually p u t forward our claims for p r e v e n t i o n and see that our local authorities realise what should be done. T h e Medical Officer of H e a l t h ' s p r e s e n t position is briefly declared by Sir J o h n A. Charles in the R e p o r t of the M i n i s t r y of Health, in a m a n n e r w h i c h s u m s u p for the p r e s e n t and augurs well for the future. H e says : " T h e Medical Officer of H e a l t h to-day, in short, is c o n c e r n e d with m a n ' s total e n v i r o n m e n t a l welfare, a n d to this e n d he should enlarge his training and knowledge to include all aspects of m a n ' s physical and m e n t a l well b e i n g . " S h o u l d these things be done, the future is ensured.
THE HEALTH CONGRESS, HASTINGS, I953 The Royal Sanitary Institute has sent out the preliminary programme of the Health Congress to be held at Hastings from April 28th to May 1st next, with Lord Eustace Percy, p.c., as President. In the Section of Preventive Medicine, Mr. Fred Messer, C.B.E., M.P., will preside, and the speakers on " The Tasks Ahead in Preventive Medicine " will be Drs. J. F. Warin (M.O.H., Oxford C.B.) and R. Scott (Lecturer, Edinburgh University). The Conference of M.O.H.s will have Dr. Andrew Topping, President of the Society, in the chair, and speakers will b e Dr. C. Banning (C.M.O., The Netherlands) on '~ Housing Conditions and Health of the People in Holland," and Dr. J. V. Walker (M.O.H., Darlington C.B.) on ',Aspects of Social Medicine particularly illustrated by Housing." In the Section of Maternal and Child Health, President, Dr. B. E. Schlesinger, there will be discussions on " The Future of the Maternity and Child Welfare Service," opened by Drs. F. J. W. Miller (Newcastle-on-Tyne), M. R. Woods (G.P.), Dorothy F. Egan (Senior M.O., L.C.C.) and Miss V. R. Shand (Supervisor of Midwives, Lancashire), and on " The Place of the Social Worker in the M. & C.W. Service," opened by Dr. Mary Hellier (G.P.), Miss M. Noble (Almoner) and Miss F. E. Lillywhite (Chairman, W.P.H.O.A.).
CORRESPONDENCE THF
ScHool. D E N T A L SERViCe':
To the Editor of PUBLIC HEALTH. Sir,mYour l)ecember editorial, reviewing two recent memoranda oi1 dental care of children, recommends as prerequisite to any new approach a rebuilding of the School Dental Service. Anyone who has watched from the vantage point of a dental hospital the progressive breakdown of that Service since 1948 will agree that there is little evidence that the (;eneral Dental Service then introduced can replace it either on the remedial side, where the (i.D.S. lacks follow-up facilities, or on the health education and preventive side, where only an environmental service can combat ignorance, apathy and neglect at their most vulnerable points--in the home and in the school. The major problem of the School I)ental Service is, and always has been, one of manpower. Nowadays most young men who do not enter general practice take higher qualifications with a view rather to becoming surgeons than to filling and extracting chihlren's teeth. Those who do enter this despised field seek, as you say, to become " full blown paedodontists " and to develop their craftsmanship to the utmost rather than to content themselves with securing a maxinmm of healthy mouths in a minimum of time by the simplest and most economical means. There is obvious need for the " full blown paedodontist" in the Service but it cannot be expected that his output, qualitatively admirable, will quantitatively much exceed that of a New Zealand dental nurse or that his enthusiasm for oral hygiene instruction and dental health propaganda will compare with that of the old-time P.D.O., who at least knew one cause of caries and was not afraid to say so. The solution would seem to be to btfild up the school service (at any rate experimentally in certain areas) to permit of two branches being formed: one mainly therapeutic and the other mainly preventive. --The former would hope to attract the men keen on paedodontic and orthodontic specialisation: the latter would be staffed either by newly qualified grant-aided dentists conscripted to the Service for a term of years or by auxiliaries (hygienists and New Zealand dental nurses), both of them serving under dental officers specially interested in public health. C. H. RVB~A. " Foxglove Cottage," Copthorne, Sussex. December 17th, 1952. TRAI~ING VOR PUmAC HEALTH
7"0 the Editor of PUBLIC HEALTH. Sir,--In his interesting article (" Controversial Thoughts on l,ocal Government and the Future of the Public Health Service") in your December issue, Dr. J. V. Walker complains that the I).P.H. course, " although it has been changed of late in the promotion of time given to various subjects, dates from an epoch when it was necessary for a Medical Officer of Health to have technical skill in chemistry and bacteriology and when environmental hygiene presented a simpler and cruder problem than it does to-day." The fact that it dates from such an epoch is no more a justifiable criticism that: would be an attack on the M.B. because it dates from a time when technical skill in leeching, cupping and letting were prerequisites of all practitioners. As one who has recently undergone the new D.P.H. course, I feel that I must defend it against this attack, especially the implication that it is merely the old pre-1946 D.P.H. with its constituent subjects reshuffled. Probably the most important part of the D.P.H. is now the dissertation, which serves to give the trainee in public health exercise in research and in original thought, both of which are surely desirable attributes in any budding M.O.H. The rest of the course including, as it does, consideration of the history and administration of public health; social security; international matters; statistics; bacteriology; genetics ; health education; nutrition; occupational health and many other subjects gives, in my opinion, a far wider outlook on medicine and on humanity than does any other degree or diploma in medicine to-day. These subjects well taught (by which I mean taught in such a way as to stimulate thought) and coupled with numerous visits to pnblic offices of all kinds, industrial establishments, slmns, hospital almoners' departments, ships, coal mines, and divers other places, taught me something which many months in hospital wards failed to do--that medicine is only a very small facet of life, and that failure to appreciate that fact is a grave danger to which clinicians are constantly exposed.