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6
protection of that much smaller additional proportion who need to be
treated, to remove any real risk. But to attempt to see that every
child was protected would call for an effort of much greater size and
one which would be unwarrantable as it could be carried out only
at the expense of effort on other lines. It might well be that
standards are continually being pushed up to an unprofitable height.
It must be very tempting for the orthodontist to aim to get the
very best results, but perhaps he achieves the final improvement in some
children only at the expense of other children who need his help. Notices
under the Housing Acts can be served to call on the owner to do work
which, were it not done, it could not be said that the health of the occupants
of the house would necessarily suffer. It is times of financial stress
that lead to the consideration of such matters as these calling for a
reassessment to decide whether the right step is not a lowering of the
standard of service provided, retaining what is necessary but eliminating
what can be achieved only by the expenditure of disproportionate amounts
of money or labour which in present circumstances can be done only at
the expense of some other service or help. Whether what is being considered
is the physical health of the population, or its mental health, which
so often has its repercussions on the physical side of the body, there are
certain fundamental standards. Of these, perhaps the most essential
is a sufficiency of a sound dietary. Close in importance to this is housing,
the securing for each family its own home in a house of sound hygienic
standards. Even overcrowding may not matter if the one family is
occupying the house. Overcrowding, though, is so often caused by the
occupation of a house by more than one family. It is then possibly
more damaging in its effects than low hygienic standards. It can only
be with satisfactory housing standards that the family unit can again
become the real important factor ; one which is necessary to bring
about an improvement in to-day's lowered standards of morality or of
living. Bad housing must be the cause of so very much of to-day's
troubles in the country.
It is now going on for four years since the National Health Service
Act came into operation—a short enough time, particularly having
regard to national and international difficulties and disturbances, for
the full benefit of the change to have been achieved, but long enough for
there to be a definite indication of whether these benefits really are to
be brought about. In regard to Part III Services, especially those which
were previously locally provided but are now the responsibility of the
County Council, it does not seem that any progress has been made. There
are still no signs that the County Council is likely to grant that measure
of autonomy to the local Area Committee which alone can ensure that
full benefit can be obtained from local knowledge and interest, and to
that extent the services provided are likely to be less efficient than they
would have been had they continued to be the responsibility of the Local
Authority. This is not a fault of the general scheme, but probably it is
merely a weakness of the working of the arrangements. It is natural
that districts such as this which previously supplied what they were
satisfied were adequate services, should have a different standard from
those in some other areas where the standard of service just could not