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Tuberculous patients and work
88
JANUARY,
PUBLIC HEALTH.
" With regard to the question of payment for the vaccine, an insurance practitioner who vaccinates one of his patients should himself provide the vaccine and claim payment from the Insurance COmmittee, on the basis of the Drug Tariff, under Part II. of the Committee's Distribution Scheme. "A supply of vaccine from the Government Lymph Establishment is made available for the use of the public vaccinator only and for medical officers of health for the vaccination of immediate contacts of persons suffering from smallpox. ~Fhis supply, therefore, does not affect the practitioner's right to receive payment from the Insurance Committee for vaccine provided by him for his insured patients." MI[,K AND T H E MINISTRY. Tile famous Circular--the Magna Charts of the fraudulent milk-dealer--has been referred to on several occasions in these columns, and we propose to deal further with the Subject m our next issue. Meanwhile we urge upon a!; medical officers of health the importance of making suitable reports on the subject, in accordance with the recommendations they have received from the Society of Medical Officers of Health. Every effort should be made by each member to secure the withdrawal of this scandalous circular. The Ministry is singularly unfortunate in its milk activities: everything~that is done appears to be undertaken largely with a view to the permanent endowment o f the trade at the expense of the public, a nd the enormous influence of the milk trader is apparent at every turn. A real Ministry o f Health would make a clean sweep of everything that has been done recently, as well as everything that is now being prepared, on the, subject, and would start fresh in an endeavouf to deal wit} the subject from the point of view of the consumer. In his annual report as County Medical Officer for Cheshire, Dr. Young declares that the policy of the Ministry in grading milk is radically wrong, and that milk labelled under licence is sold at prices too high for the poor, who, therefore, get the same quality as before, and derive no benefit under the new Act. These views are entirely in accord with those of most of the experienced members of the Public Health service. T he grading of milk has merely added a new terror to poverty.
T U B E R C U L O U S P A T I E N T S AND WORK. One of the many points of difficulty in connection with "sanitorium benefit" under the Insurance Act has been the opposition on the part of approved societies towards the partial employment of patients, even when such partial employment had been ordered by the doctor as a necessary part of the treatment. Insurance committees all over the country have passed resolutions urging" that sickness benefit be so amended that sickness or disablement benefit would be payable to insured persons suffering from tuberculosis who were able to engage in such open-air work .as might be prescribed by the medical practitioner as part of their treatment. Unfortunately, the opposition has up to the present been too strong, and no help seems to be forthcoming from the Ministry of Health on this important matter. The ordinary patient is barred from even doing a little work in his garden if it comes to the knowledge of his approved society, and similar restrictions are said to be in existence with regard to the performance of a small amount of domestic work by a female patient. Possibly official representations .on this subject through the Society of Medical Officers o f Health might obtain favourable consideration. BIRTH
CONTROL.
The practice of birth control is spreading amongst the lower middle classes and the upper part of the working classes, though it does not appear to. have yet reached the lower working classes, says Dr. Meredith Young, Cheshire County Medical Ot~cer of Health, in his report for I92I. "Indeed," he continues, " anyone who attempted to stem the tide of public opinion in this matter at present would be entering on a truly desperate task. T he case appears to me to have been carried beyond the stage of arguing for or against birth-control and t o have reached the point at which legitimate birthcontrol is accepted as being for the national good, and all that remains to be settled is the best means of control and the general education of the public on contraceptive methods. " T h a t is the position, whether we accept it and like it or not. Our task as medical officers of health is to accept what, after all, we have no power to alter and to concentrate more strongly still on reducing the mortality
JANUARY,
PUBLIC HEALTH.
" With regard to the question of payment for the vaccine, an insurance practitioner who vaccinates one of his patients should himself provide the vaccine and claim payment from the Insurance COmmittee, on the basis of the Drug Tariff, under Part II. of the Committee's Distribution Scheme. "A supply of vaccine from the Government Lymph Establishment is made available for the use of the public vaccinator only and for medical officers of health for the vaccination of immediate contacts of persons suffering from smallpox. ~Fhis supply, therefore, does not affect the practitioner's right to receive payment from the Insurance Committee for vaccine provided by him for his insured patients." MI[,K AND T H E MINISTRY. Tile famous Circular--the Magna Charts of the fraudulent milk-dealer--has been referred to on several occasions in these columns, and we propose to deal further with the Subject m our next issue. Meanwhile we urge upon a!; medical officers of health the importance of making suitable reports on the subject, in accordance with the recommendations they have received from the Society of Medical Officers of Health. Every effort should be made by each member to secure the withdrawal of this scandalous circular. The Ministry is singularly unfortunate in its milk activities: everything~that is done appears to be undertaken largely with a view to the permanent endowment o f the trade at the expense of the public, a nd the enormous influence of the milk trader is apparent at every turn. A real Ministry o f Health would make a clean sweep of everything that has been done recently, as well as everything that is now being prepared, on the, subject, and would start fresh in an endeavouf to deal wit} the subject from the point of view of the consumer. In his annual report as County Medical Officer for Cheshire, Dr. Young declares that the policy of the Ministry in grading milk is radically wrong, and that milk labelled under licence is sold at prices too high for the poor, who, therefore, get the same quality as before, and derive no benefit under the new Act. These views are entirely in accord with those of most of the experienced members of the Public Health service. T he grading of milk has merely added a new terror to poverty.
T U B E R C U L O U S P A T I E N T S AND WORK. One of the many points of difficulty in connection with "sanitorium benefit" under the Insurance Act has been the opposition on the part of approved societies towards the partial employment of patients, even when such partial employment had been ordered by the doctor as a necessary part of the treatment. Insurance committees all over the country have passed resolutions urging" that sickness benefit be so amended that sickness or disablement benefit would be payable to insured persons suffering from tuberculosis who were able to engage in such open-air work .as might be prescribed by the medical practitioner as part of their treatment. Unfortunately, the opposition has up to the present been too strong, and no help seems to be forthcoming from the Ministry of Health on this important matter. The ordinary patient is barred from even doing a little work in his garden if it comes to the knowledge of his approved society, and similar restrictions are said to be in existence with regard to the performance of a small amount of domestic work by a female patient. Possibly official representations .on this subject through the Society of Medical Officers o f Health might obtain favourable consideration. BIRTH
CONTROL.
The practice of birth control is spreading amongst the lower middle classes and the upper part of the working classes, though it does not appear to. have yet reached the lower working classes, says Dr. Meredith Young, Cheshire County Medical Ot~cer of Health, in his report for I92I. "Indeed," he continues, " anyone who attempted to stem the tide of public opinion in this matter at present would be entering on a truly desperate task. T he case appears to me to have been carried beyond the stage of arguing for or against birth-control and t o have reached the point at which legitimate birthcontrol is accepted as being for the national good, and all that remains to be settled is the best means of control and the general education of the public on contraceptive methods. " T h a t is the position, whether we accept it and like it or not. Our task as medical officers of health is to accept what, after all, we have no power to alter and to concentrate more strongly still on reducing the mortality