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77
The ultimate costliness of the policy of permitting preventable
disease to continue in order to avoid a present small
expenditure is becoming more and more appreciated. Maternity
and Child Welfare work is preventive; it prevents the development
of the host of ailments that so greatly diminish industrial
efficiency and cost the community vast sums in curative services.
Prevention is not only better; it is cheaper than cure. It is
fortunate that this view is spreading, although any extension of the
preventive medical services always meets with the opposition that
arose on the grounds of economy to their establishment in the
first instance, and that still endeavours to hinder their successful
performance. Many early resolutions recorded in this direction
make interesting reading, for instance, a reference to the Public
Health Committee in Hackney at the outset of an epidemic of
small-pox, objecting to the coach hire of the Medical Officer,
this particular London epidemic costing approximately half a
million of money in hospital treatment alone. Also resolutions
reflecting unfavourably on the temerity of officials who (have
•condemned a water supply as compared with resolutions adopted
after an epidemic of water-bourne disease has directed the attention
of the country to the locality. Small-pox and Typhoid
Fever are, of course, spectacular diseases as compared with
Measles and other non-notifiable infectious diseases, but the cost
to the country nevertheless of these latter is incalculable.
It should be remembered that deficiency in any one respect
interacts on other parts of a preventive scheme. Too few clerks
results in Health Visitors doing clerical work. Too few Centres
results in overcrowded Centres and three or four Health Visitors
being required at each Clinic, and in the doctor being unable to see
all those cases he should see. Too few Health Visitors results
in no "following up," and attention only to curative instead of
preventive work. Greenwich, for instance, where Measles,
Whooping Cough and Zymotic Enteritis are notifiable is particularly
well cared for as regards nursing, there being three