London's Pulse: Medical Officer of Health reports 1848-1972

View report page

Greenwich 1969

[Report of the Medical Officer of Health for Greenwich Borough]

This page requires JavaScript

131
family life but, in these days of new-found "freedoms", such an
achievement would be little short of miraculous.
Apart from this fundamental alteration in the pattern of life,
i.e. from one of close personal family relationships to that predominantly
of mercenary acquisition, other disadvantages flow
from the modern concept of both parents being "bread
winners". Economically, the family with two "wage-earning"
parents contributes to the maintenance of high prices, much to the
detriment of the "one wage-packet" household. Moreover, a
vicious circle is established in that, to perpetuate the rise in standards
of personal comfort, the "temporary" married female
employee is constrained to become "permanent" and the family
with only one bread winner becomes correspondingly and relatively
poorer and in greater need of support. Family life disintegrates
and enlargement of service departments and their staffs, all of
whom rightly seek suitable career structures, is thereby stimulated
and professionalism in the social field is increased. Inevitably this
leads to a greater proportion of available finances going to those
who provide the services rather than to those who need them and,
with limited resources, quality begins to conflict with quantity.
In the financial climate of recent times, understandably, much
has been made of the "business" approach to local government
services and, in particular, their "cost effectiveness". Whilst it
cannot be denied that there are aspects which could perhaps benefit
from such analyses, their value in the health, welfare and social
fields is questionable. There has always been an under-estimation
of services whose worth to the community has never really been
determined, simply because it is indeterminable. How does one
cost disability, whether physical or mental, or the human misery
bound up with incurable disease and in environmental conditions
which we know are not capable of solution for a generation or
more? Who is to say that training schemes for the educationally
subnormal or bathing and incontinent laundry facilities for infirm
elderly people are effective, costwise—and effective for whom?
Persistent ill-health, in whatever form, is costly both individually
and collectively but results from efforts taken for its prevention or
alleviation cannot, with justice, be measured by a financial yardstick.
Indeed, once schemes introduced for cogent health or compelling
social reasons have been successfully launched, they cannot
be expected to function efficiently if, subsequently, they become
parsimoniously circumscribed. Profligacy, in whatever guise, must
be ruthlessly eliminated but our drive for improvement,