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72
need to be raised and allocated for National Health purposes and
how they may be deployed is a policy matter for Central
Government. Out of a total of £2,255 millions estimated to be
expended on the National Health Service for the year ending
March 1972, local authority health departments are expected to
be responsible for £121 millions, a figure some £63 millions less
than that for the year 1969/70. Much of this reduction is undoubtedly
due to the transfer of former health and child care duties
to the Social Services. Nevertheless, taking into account increases
in salaries and wages together with the general rise in inflation,
the present allocation seems somewhat meagre for such an important
preventive function, particularly in the light of the fact that
the average weekly cost of maintaining a patient in hospital continues
to rise, e.g. from £66.70 in 1970/71 to £78.58 in 1971/72.
An authority's first contact with disease usually arises via the
practitioner service and it is encouraging to learn that, during
1971, the number of principals in England giving full general
medical services rose by 1.4% to a total of 19,374, thereby continuing
a trend evident since 1966. (Doctors born overseas, however,
still form a considerable proportion of the total). Correspondingly,
average patients per doctor fell by 18 to 2,460, this
being the second consecutive year of such an occurrence.
An essential ingredient in the control of disease is health
education. Although based upon the results of epidemiological
investigations and knowledge gained empirically in the actual
treatment of the sick, it is not the mere accumulation of information.
For example, how often do we meet people who, despite
being well-informed of the inherent dangers, continue to smoke
to the detriment of their health. Rather is health education
the sum total of all experience and knowledge wisely used to
influence behaviour towards healthier practices. Our own health
education section is organised for the furtherance of just such
objectives and its impact on the public is becoming progressively
more marked. The W.H.O's definition of health is a condition
of "complete physical, mental and social well-being" but this can
hardly be considered realistic for there would be few, if any,
who could lay claim to being healthy in accordance with such
criteria. It has been suggested that a more practical exposition
would be that a healthy person is one who, though on occasions
suffering from some disability or discomfort, could remain
socially and economically active. Effective health education would
support such a suggestion in that it would inculcate a more
personal responsibility for individual good health, discourage
unnecessary treatment, prevent an over-loading of the general
practitioner and hospital services and thereby offer enhanced