View report page

This is not a personal lament: there are scores of districts—large
districts, with highly efficient administration—whose position to-day
in Public Health is similar to that of Beckenham.
Looking back, one feels that the years were good, that the work
was well worth while, that the personal knowledge of and friendship
with so many of the people whom we served was a source of happiness.
Looking forward, it far too easy to be pessimistic—and there should
be no real need for pessimism: the future depends on the vision of those
who hold authority to-day. The Public Health Service has dealt very
successfully with most of the problems of environment: it must now be
re-oriented if it is to go on being of service in the improvement of Health,
and it must be an integral part of a real National Health Service.
The danger is that it may cease to attract medical men and women of
sufficiently high capacity and zeal. There is little inducement to enter a
service in which one's outlook is bounded by the walls of clinics in which,
although one may have the title of Medical Officer of Health, the
bulk of one's work is done under the direction of an officer in a remote
country town. There must be room for expansion, for originality and
initiative, for revolutionary ideas: the service which stands still is
already beginning to decay—and what is true of a service is true of a
man.
Is the Medical Officer of Health of the future to be an important
factor in developing Social Medicine, or is he to become fixed as a
subordinate officer in the clinics of Part III authorities?
I have enjoyed the twenty-odd years which I have spent in Beckenham:
they were full years; there was usually some new project or service
to be instituted or developed; there was plenty of scope for initiative,
and the mind was always occupied with ideas—many of them Utopian
and seemingly wildly impracticable: and yet, oddly enough, quite a
number of these came to fruition.
When I took up my duties in November 1927, the district was
suffering from one of those extensive outbreaks of diphtheria which
appeared every few years: it was a serious outbreak and a number
of children lost their lives. Of course, such incidents were quite common
in those days, but such an experience had not happened previously
to me. I felt that, come what may, this must not occur again. Diphtheria
Immunisation had by then passed the trial stage, but was not
in extensive use: the Council in 1928 agreed to its introduction into our
Health Services. It is with a feeling of gratitude that I can record now
that during my last two years of office, not one case of Diphtheria was
notified.
With one matter which concerned me very much I have less reason
for satisfaction. I refer to Housing. I have not failed to express my
views on this at fairly regular intervals. Remembering how willing
successive Councils have always been to approve and finance measures
proposed for the maintenance and improvement of the General Health
Services, I have always been puzzled by the obvious reluctance with which
5