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13
conditions for which at the moment curative medicine can offer
only expensive palliatives and at best a long or short period of
comfortable semi-invalidism.
I am appalled at the increasing amount of apparent ill-health
which is reflected in the national statistics which are available to
me. The surgeries of General Practitioners have never been so
full; there are waiting lists for most out-patient departments.
On occasions it takes three weeks to have an X-ray and when the
patient finally does arrive in hospital, he is subjected to a barrage
of investigation ever more elaborate and comprehensive, and so
we go on, requiring more hospitals, more doctors, more nurses and
auxiliary technic j,ns to cope with the bewildering complexities
of an infinite expansion of the therapeutic services, which has the
elements of self-destruction of the scientific method within it, as
well as pre-disposing to national bankruptey.
The Exchequer has now called a financial halt to rising expenditure
on hospital services, but this action solves nothing. Under
our present system of health priorities, hospital expenditure inevitably
must and will continue to rise. The yardstick of progress
must be increased expenditure on the treatment of disease and there
is little which can be done about it except, perhaps, by the hospitals
shedding a few superfluous passengers. However, this is a drop in
the bucket. While medical science continues to discover more
about the treatment of disease and neglects, and at times scorns,
investigation into social pathology where disease is bred and
nurtured, this state of affairs will continue.
As a Nation can we afford to spend increasing sums on the
treatment of disease? Perhaps, with expanding production of
wealth, expenditure on treatment and the care of the sick can
keep pace on a pro rata basis, but this is flagrant profligacy and is
the economics of an ill-regulated community. It is clear to me that
prevention or amelioration before real sickness develops is the one
salvation from our present dilemma.
These remarks are occasioned by my reflections throughout
the course of this year. My observations have no particular
reference to the Metropolitan area or to the place which Metropolitan
Borough Councils have been allocated in the Public Health set-up.
This has been decided by Act of Parliament and by mutual arrangement
between Borough and County and we must try with a genuine
good-will to make the scheme work, but I cannot help feeling how
much preventive medicine in general might give to the community
in other circumstances. Who knows what we can accomplish until
we are given a real chance?