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suffering from such infections in wards so close to patients suffering
from other diseases? It happened that at the time of the change of
administrative arrangements, the prevailing type of most of the infectious
diseases was of a mild clinical standard. It is to be hoped that those
into whose hands the responsibility of looking after them while they
are ill has passed, will not be too sanguine and will not adopt an outlook
that an infectious patient is merely a patient suffering from an illness
which, because it is communicable, has to be nursed under special conditions.
Those who have to be admitted to hospital are merely some of
those who are part, outside the hospital, of a greater or smaller epidemic
and while, to-day, most people are admitted to an isolation hospital
because of the need for them as individuals to receive treatment for
their illness, which is one of the infective variety, the position still remains
that some, at least, of the sufferers need to be admitted to hospital
because that step is necessary to avoid the spread of infection to others;
and if that accommodation should not be there, there might be the
spread with yet further need for accommodation.
The rush by the general public to take advantage of services now
available for the first time without charge, has had its repercussions on
the treatment services provided by the local authorities. The most
striking instance is the effect on the school dental services, where already
so much harm has been done, that if staffing could be restored even to
the early 1948 position, it would be many years before the school dental
service could be restored to what it was. Not only have the teeth of
the school children not been treated up to the standard of the pre-war
arrangements so that, in general, the mouths of these children are less
fit dentally and therefore, on an average, much more work is necessary
on each individual child, but there is the risk that all the efforts of years
towards educating the public to the state that there was a high
acceptance rate, is being lost. There were many in the public health
services who were apprehensive that the provisions of an Act designed
to deal with those needing treatment, would lessen the desirable emphasis
on the preventive aspects of disease. There were probably few enough
who could claim to have been sufficiently far-sighted as to have anticipated
that the operation of the Act would have such an unfortunate effect on
one of the preventive services. As yet, the solution to the problem
cannot be seen and, in the meantime, the priority dental service for
school children and for expectant and for nursing mothers, and for
children under five, is crumbling. This district is particularly fortunate
in that the strength of the dental staff has not been weakened, although
it is most disappointing, after the long wait to obtain premises that, at
the time when they are now available, there should be this further
obstacle to progress and to the development of a really satisfactory
dental service for the priority sections of the population. The delays in
supplying spectacles for school children, which was another effect of
the operation of the Act, were very long; but already seem to be
shortening and it looks as though this difficulty ought soon to pass.
When glasses are provided soon after prescription, it should be possible
for more satisfactory arrangements for the following-up of children
to be made than can be when the delay is long. Midwives were