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optimistic timetable, apparently passed unnoticed. As a result 1948 will
be remembered by all concerned as a period of upheaval and uncertainty
resulting in hard work on reorganisation with but little hope that the health
of the public could be directly benefited thereby for years.
Certain beneficial results were, of course,, produced comparatively
rapidly, for example, the provision of spectacles and dentures for many
who needed them, although it is unfortunate that the priority classes
specified in the Act have been adversely affected by the rush to obtain
treatment. It is conceivable, however, that these benefits could have been
provided without at the same time attempting to re-organise so many
other branches of health work. It is much regretted, for instance, that
the transfer of the Maternity and Child Welfare responsibilities from a
District such as this should have been considered necessary, presumably
solely for reasons of tidiness in national administration. By this decision,
to a very large extent the local interest and control of one of the most
important, spectacular and successful of the Council's activities has been
removed. Divisionalisation, which is being tried with commendable
sincerity in Surrey, cannot retain the interest of the local Council, few of
whose members can know what is being recommended locally, and the
final outcome. The immediate effects appear to have been the creation
of a more cumbersome organisation, the complication of administration,
and a suspicion that the District Council has, in future, no important
contribution to make towards improving the public health. It is apt to
be forgotten that responsibility remains for the control of infectious
disease, for health education, and for dealing with the factors in our
environment which are liable to have a profound influence on health,
including the supervision of our food supply, the disposal of sewage and
refuse, control of pests, housing and general sanitation.
With the removal of the numerically stronger Child Welfare and
Ambulance Services, the service of the Sanitary Inspectors has tended
inevitably and rightly to monopolise local attention.
One of the purposes of an Annual Report such as this is to attempt
a survey of the whole field of public health activity in the District, and it
will be unfortunate if Medical Officers of Health who hold multiple
responsibilities are not encouraged to continue their attempt at a balanced
presentation, not only of the condition of the health of the area, but of
the attempts of the various branches of the health service to improve it.
Whatever its advantages or disadvantages, however, the new organisation
is in being, and all concerned must use, and where necessary adapt
it wisely. The general public must appreciate its limitations, which are,
at least temporarily, inevitable and not make unfair demands on its
limited resources. All involved m its working need, not only patience
and perseverance under irksome conditions, which must be allowed to
be only transitional, but to retain the humanitarian urge which has
inspired the medical and allied professions so successfully in the past.
We need to keep also a sense of perspective which recognises the part
others are attempting to play, and to give them helpful co-operation
rather than discouraging criticism. Undue concentration on the maintenance
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