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might also be made of the activities sponsored by the Public Health
Committee in the very important held of food hygiene.
This very brief resume of the duties covered by the Public
Health Committee will surely make it obvious that the work of the
Borough Council in the field of preventive medicine is by no
means insignificant.
It is, of course, a fact that preventive medicine as opposed
to curative medicine is non-spectacular, and is apt to be taken for
granted or even forgotten. Preventive medicine seldom enters the
limelight unless things go wrong; at all other times it is relegated
to the shadowy hinterland of medicine, continuing from day to day,
from year to year, without publicity. No one seeks publicity,
yet one cannot help feeling that the very fact that this work is
carried on without fuss or blare of trumpets has, in part at least,
resulted in the emphasis on curative medicine which signalised
the National Health Service Act, 1946. This same principle
applies even more forcibly to the Public Health services undertaken
by the Borough Council.
The personal health services have at least the satisfaction of a
direct, positive approach. These personal services furnish the
means whereby mothers and children can attend clinics for advice
and even treatment; they can immunise, vaccinate, provide goods
and services which are very real and at all times visible to the
recipients. The Public Health services of the Borough Council are
not so fortunate. Our approach must of necessity be indirect and
circuitous in many instances. Our main concern is to ensure that
the conditions under which the community lives and works is such
as to encourage positive health. Need the fact that this problem
is gigantic be emphasised? We know only too well that conditions
exist which should not be tolerated; we know what we would
like to do, what we feel we ought to do. And yet, in so many
cases, the remedy is either inadequate, or is quite without our
reach. In this connection one need only specify the problems
presented by tuberculosis. So long as living conditions remain as
they are, this problem will continue to present itself. Vast sums
are being spent on treating cases of tuberculosis, either at home
of in sanatoria; those who are attempting to control the spread
by improving environmental conditions are prevented from exercising
the full measure of such control by lack of adequate means.
This is indeed an unhappy state of affairs, which must give one
cause for perturbation.
It is an unfortunate corollary of present-day conditions that
a Medical Officer of Health should feel it necessary to act as an
advocate for the Public Health services sponsored by his local
authority. I am quite aware, of course, that the Borough Council
is fully cognisant of the part which the Public Health Department
has to play, and appreciates its responsible obligations. The
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