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60
one tenth of their 1900 rates and an increased expectation of life
at birth by 60% in the case of males to almost 69 years and in
females by 66% to nearly 75 are further examples, if needed, of the
results of successful policies largely implemented by the preventive
health services. Although when reviewed on an annual basis such
advances would not appear to be startling, nevertheless, a long-term
appraisal reveals that dramatic benefits have been conferred on the
community not only in terms of prolonging life and improving its
quality but also in a financial saving to the nation, the magnitude
of which is inestimable.
Success in the preventive field has never been easy. Indeed,
in the face of ignorance, apathy and deep-rooted prejudice, it has
been achieved through dedication, education, persistence and sheer
endurance on the part of the public health officers and enlightened
citizens, more often than not, with a minimum of resources.
Undoubtedly an identical spirit will be needed to meet and overcome
the present health problems of lung cancer, alcoholism, drug
addiction, mental illness, venereal disease and the many other
chronic, degenerative and inherited disabilities now becoming
prominent.
However, it would be naive to assume that any massive additional
finances will be made available within the forseeable future in
favour of preventive medicine for, at a time when the situation
really calls for integration of preventive health and its ancillary
services, the local authority is charged with the duty of launching
a new "social services" department to undertake many of the
responsibilities hitherto regarded as falling within the sphere of
"public health". This partition, whilst posing a number of "demarkation"
problems, will demand for the new discipline all the
resources which can be mustered, financial and professional with
the future degree of success becoming dependent upon the measure
of co-operation established between two separate departments. It
is unfortunate that such a dichotomy comes at a time when amalgamation
of hospital, general practitioner and local authority health
services is being actively pursued by the government. It could well
be that, as a result, a vital opportunity for substantial improvements
in health services to the community may be missed.
Alcoholism
In alcoholism we have a practical example of the need for
integration of the health and social services because, as a medicosocial
problem, it manifests itself throughout all social classes
and no country is free from its addicts.
That it is of major public health importance is shown by the
fact that, although documentation is far from being complete,