View report page

as their disinterested friend are they likely to accept and follow
advice. For such a one who takes an interest in them during sickness,
or in various other ways, they will put themselves out, but
with a paid official, even with all diplomas and certificates, and under
the official shield of the local authority, they are likely to have
superficial agreement, but nothing else. Hence it appears likely
that a nurse with her practical advice and experience of sickness
would be more likely to be listened to, and her advice far more likely
to be followed, than a health visitor well up in all the modern ideas
of sanitation, but who will perhaps be lacking in the human side in
which the nurse from her life is more likely to possess.
The mortality of children under one year has received even
greater attention than usual. In view of the loss of so many men
in the war, ante-natal care, maternity centres, and many other
schemes have all had their advocates. It might seem that, were
they to effect all the reduction that their advocates claim for them,
there would be a certain decline in the number of deaths among
infants. But if this reduction is to be accompanied by the still
greater one in the number of births, which now seems to be year
by year in greater evidence, the swamping of this nation by others
that are more fertile can only be a question of time. It is obvious
that there has been a greatly increased number of marriages, but
these have not been accompanied by more births, but by fewer. It
is possible, but exceedingly unlikely, that the potential fertility of
the race is declining, so, even if there were no other probable reason,
this could hardly be accepted as one. The superficial financial advantage
of a small family, and chances of an easy life, free from care
and responsibility, attracts many with whom it does not take long to
decide the question between limitation of fertility with its associated
relief and the carrying out of the duty to the State that is embodied
in rearing future citizens, even though the freedom so sought from
trouble is by no means always realised.
The fall in the birth-rate is a far more important and an infinitely
more difficult problem to deal with than to take steps which,
although loudly and continually acclaimed, are by no means certain
to bring down the infantile mortality rate, and certainly to hold
these up as being of sovereign importance only tends to cloud the
more important issue. As the limitation of families probably
depends as much on a desire to avoid expense as a wish to have a
"good time," a practical method would seem to be the minimising
of the advantages and increasing the disadvantages in the same
sense. Hence the money spent in efforts to diminish infantile mortality
might be better employed in allowing some financial benefit
for the rearing of healthy children, a benefit which might increase
according to the years the child lives, and the extra taxation of
childless persons, which although it might be a hardship in individual
instances, would bring some contribution towards this
expense, in addition to the discount it would put on the small
family.
The campaign in favour of health visitors goes on with un-