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present form, because of technical faults in the wording.It was withdrawn. Amendments were then proposed toprovide that the Attendance Allowance Board should not becomposed entirely of doctors, but should contain peoplewith special experience of working with the disabled, and ifpossible disabled members as well. Many speakers rose tosupport these amendments. Mr. Dean, replying for theGovernment, pointed out that the Bill already provided foradditional members to the board, who might very well bedisabled, who could take part in any decision that was notmerely medical; and the medical members would nodoubt be chosen for their knowledge of disablement

problems. The amendment was defeated. At the close ofthe committee stage, the Bill was read a third time and

passed.

QUESTION TIMEDoctors’ Pay

Mr. JOHN FRASER asked the Secretary of State for

Employment and Productivity whether he would obtainfrom the National Board for Prices and Incomes and

publish its draft report on the reference to it of the ReviewBody’s recommendations on doctors’ pay. Mr. ROBERTCARR replied that the reference on doctors’ and dentists’pay was withdrawn on June 29 before the National Boardfor Prices and Incomes made its report. It would not be

appropriate to publish drafts or working papers.Mrs. BARBARA CASTLE asked whether it was not a fact

that this reference was withdrawn because the outline ofthe report was already clear and it was known that it wouldbe critical of the Kindersley report. How could the Secre-tary of State hope to persuade unions to show restraint inwage claims when the very first act of the present Govern-ment was to cover up for this highly inflationary award ?Mr. Carr said the Government’s view was that we shouldnot get responsibility in any level of industrial relations orpay negotiations until bodies which were given responsi-bility for coming to settlements were allowed to have theirsettlements stand. That was the basis for order in collective

bargaining.

Appointments

BARNES, E. G., M.D. Edin.: consultant in chest medicine, City Hospital,Aberdeen.

DAVIDSON, D. G. D., M.B. Edin., F.F.A. R.C.S., D.OBST.: consultant

ansesthetist, United Manchester Hospitals.DOUGLAS, J. B., M.B. Cantab., F.F.R., D.M.R.D.: consultant radiologist,

Northern General Hospital, Sheffield.ELLIS, R. H., M.B. Lond., F.F.A. R.c.s., D.OBST.: consultant anesthetist,

St. Bartholomew’s Hospital, London.GIBSON, G. L., M.D. Glasg., M.R.C.PATH. : consultant pathologist, York

County Hospital.KOCEN, R. S., M.B. Leeds, M.R.C.P. : consultant neurologist, the National

Hospitals for Nervous Diseases and Edgware General Hospital.LASCELLES, R. G., M.B. Aberd., M.R.C.P., D.P.M. : consultant neuro-

physician, United Manchester Hospitals and Manchester R.H.B.

Newcastle Regional Hospital Board:DEVLIN, H. B., M.D., M.CH. Dubl., F.R.C.S., F.R.c.s.i.: consultant in

general surgery, North Teesside hospital group.HADI, S. S., M.B. Punjab, D.P.M. : consultant in mental subnormality,

Aycliffe hospital group.Oo, M. M., M.B. Rangoon, M.R.C.P., D.C.H.: consultant peediatrician,

North and South Teesside, and Northallerton hospital groups.OSWAL, V. H., M.B. Poona, F.R.C.S.E., D.L.O.: consultant otolaryngolo-

gist, North and South Teesside, and Hartlepool hospital groups.SALTER, R. H., M.B. Lond., M.R.C.P. : consultant in general medicine,

East Cumberland hospital group.SAUNDERS, MICHAEL, M.B. Lond., M.R.C.P., M.R.C.P.E.: consultant

neurologist, North and South Teesside, Darlington district,Hartlepool, Northallerton, and Newcastle-upon-Tyne hospitalgroups.

SINGH, LAKHINDAR, M.B. Punjab, F.R.C.S., D.o.: consultant ophthal-mologist, Darlington district, South West Durham, andNorthallerton hospital groups.

WACKS, HARVEY, M.B. Manc., M.R.C.PATH. : consultant pathologist,Sunderland area.

Notes and News

BRITISH RED CROSS SOCIETY

IN 1864 the first Geneva Convention was signed, givingprotection to the sick and disabled in war and to those whowent to help them. The British National Society for Aidto the Sick and Wounded in War was established inAugust, 1870, and, since this was the forerunner of the BritishRed Cross Committee (formed under the threat of the BoerWar in 1898), it is this event which is being commemoratedby the British Red Cross Society in their centenary celebra-tions this year. In 1905 the British Red Cross Committeeand the National Aid Society were amalgamated, and in 1909the first Voluntary Aid Detachments were formed andtrained for service in time of war. During the 1914-18and 1939-45 wars the Red Cross and the Order of St. Johnformed a Joint War Committee which organised theV.A.D.s, provided medical supplies, searched for missingsoldiers (a service which is still being operated), andpacked parcels for prisoners-of-war. At the end of the1939-45 war, when the two organisations resumed theirseparate identities, the Joint Committee was re-formed tocare for those disabled in both wars, and for those elderlynurses who had seen war service. During the 1939-45 warhelp was needed as much for civilians under air-raid attackas for soldiers in the field, and in the years after the warconcern for civilians became a permanent feature of RedCross work.

Because the organisation is international, aid can becollected from all over the world and distributed to thoseareas where it is most needed. The society is perhapsmost noted today still for its relief work in disaster areas-both man-made and natural. In times of hostility theInternational Committee, as the generally recognisedneutral intermediary, may be called on to distribute aid(money, services, supplies, food) to victims on both sides ofthe conflict. One of the society’s most constant activities issending aid to refugees. The scope of Red Cross activityis vast, both at home and abroad. Among functions

performed by society members are: manning first-aid

posts (at theatres, exhibitions, sporting events); helping inoutpatient clinics and blood-donor sessions; providing anauxiliary nursing service, both in hospitals and in the home;organising holidays and clubs for the elderly and the handi-capped ; running homes for old people, the young chronicsick, and training homes for the young disabled; distribut-ing meals-on-wheels; giving training courses in first-aid,nursing, and allied subjects; raising funds and collaboratingwith other voluntary organisations when relief campaignsare launched; helping Red Cross Societies in the developingcountries to provide health, medical, and welfare services;providing a language service to help foreign patients inBritain to communicate with doctors and nurses; offeringlibrary, telephone, shop, and hairdressing services forhospital patients; running medical loan depots to provideequipment for people who are sick or disabled at home;escorting the sick and disabled on journeys. The society issupported entirely by voluntary contributions, and, with itsincreasing emphasis in the U.K. on welfare, it must

count as the most important single voluntary agency nowbolstering up the statutory services.

Dr. C. A. Boucher has succeeded Major-General F. C. Hilton-Sergeant as medical adviser of the British Red Cross Society.

MAKING THE MOST OF DISTRICT NURSES

WHILE shortage of medical staff-nurses in particular-remains acute, schemes for making more efficient use ofprofessional skills are receiving a great deal of attention.The Queen’s Institute of District Nursing has carried out

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studies of two different types of nursing attachment, andhas published its results. The first study describes theattachment of a district nurse to the surgical department ofa general hospital, with the object of providing home carefor patients, who can thus be discharged from hospitalearlier than is normally the case. After the district nursehad spent a month as an observer in the surgical outpatientclinic and on surgical wards, in order to familiarise herselfwith treatment methods and techniques, patients wereselected (with their consent) who could be sent home beforethe normal discharge date. Before the patient left hospital,the nurse visited him in the ward, in order to get to knowhim and ascertain what treatment was needed. Duringthe 6-month period of the experiment 126 patients weredischarged early, with an overall saving of 590 bed-days(based on average lengths of stay). It was estimated that,after increased costs to the local authority had been deducted,the 590 days saved the National Health Service over E3000.To assess the effects of early discharge, the views of thepatients, general practitioners, consultants, matrons, andlocal authority were sought, and the work-load of thedistrict nurse was analysed. The 126 patients together hadjust under 700 district-nursing visits after discharge; almostall of these entailed some kind of nursing treatment-surgi-cal dressings and removal of sutures and clips being com-monly undertaken. The consultant could find no differencein the rate of progress of patients who had been dischargedearly and of those who had been allowed the normal lengthof stay in hospital; general practitioners on the wholefavoured the scheme, and did not find that it involved themin making many extra visits. The nurse herself enjoyed thework, valuing the opportunity to learn new techniques anddiscuss patients’ treatment and care with hospital staff.The patients were also well satisfied with the care theyreceived. The scheme, of course, increases the expenses ofthe local authority, and the medical officer of health con-sulted was doubtful whether local authorities would be

prepared to increase their expenditure at this juncture. Amodified plan might, however, be workable, whereby alldistrict nurses in the area would have a period in hospitalin rotation, and a liaison system could be operated to passinformation about patients to the nurses who would becaring for them. The basic object of this experiment wasto reduce the surgical waiting-list by cutting the post-operative stay, but it was found impossible to make asubstantial impact on the waiting-list because surgical andother resources were already fully used.The second report concerns the attachment of district

nurses to general practice. Seven practices of different typesare described. Some nurses were trained to carry out

diagnostic tests and immunisation, while others were moreoccupied with home general nursing care and midwifery.Some, but not all, doctors referred patients to nurses forfollow-up care, while some of the nurses organised theirown surgery sessions. The nurses enjoyed cooperating withthe doctors and felt that their skills were being used to goodadvantage, though a few complained of having to make toomany visits just for bed-making and bathing. The successof such an arrangement depends largely on the ability ofdoctor and nurse to work together, but all the doctors feltthat they had gained from their nurses a great deal in termsof patient care and alleviated work-load. Two nurses saidthat they felt inadequate to cope with calls when they weresent in place of the doctor to make a preliminary assessment,and one of the local-authority nursing administratorsremarked that it was important to ensure that nurses " workuith the doctors, and not for them ". The chief conclusionto be drawn from both studies, however, is that attachment

1. Cooperation in Patient Care: Studies of District Nurses Attachedto Hospital and General Medical Practices. By LISBETH HOCKEY,S.R.N., and ANNE BUTTIMORE, S.R.N. Queen’s institute of DistrictNursing, 57 Lower Belgrave Street, London S.W.1. 1970. 10s.

of nurses benefits the patient by providing him withcontinuity of care, helps the doctor, and gives the nursegreater interest and satisfaction in her work.

SUICIDE PREVENTION

THE proceedings of the Fifth International Conferencefor Suicide Prevention (held last September) have beenpublished 1 with admirable speed and efficiency. First comethe reports on the existing state of suicide prevention inmany parts of the world, including South America, Turkeyand the Near East, East and South Asia, and South Africa.As is to be expected, America and Europe are most aware ofthe problem of suicide, but all countries reported anincreasing readiness to discuss the subject. The paperswhich follow these reports cover almost every aspect of thesubject: suicide in old age, in adolescence, in pregnancy, inmarriage, in students, in prisoners. Statistics have beencollected and analysed for different countries and groups ofpeople, and the causes of suicide and methods of preventionare discussed. One conclusion which can be extracted fromseveral papers is that more could be done, in practicalterms, to prevent suicide. Suicide-prevention centres

are not the only answer, even though it is generally recog-nised that their existence has coincided with a reduction inthe suicide numbers and that this is not entirely fortuitous.The Samaritans and similar agencies are available to providehelp and comfort to the would-be suicide, but they presum-ably see only those people who have already made a pre-liminary step towards helping themselves in contacting theorganisation. It is, moreover, significant that, accordingto one survey, a third of the people who had contacted theSamaritans had committed suicide within one month ofmaking the contact. One paper from the conference

proceedings suggests that agencies designed to cope withone particular kind of emergency are not as effective as a"

cooperative emergency service ", ready to deal with alltypes of crisis: " an individual in distress should not beexpected to define for himself what type of crisis he has, orwho is to aid him ".One writer states plainly that " an improvement in

psychiatric practice ought to reduce suicide ". The peoplemost at risk-those with one or more suicide attemptsbehind them-are often seriously neglected. One set ofstatistics for the city of Edinburgh shows that as many as19% of those who had been seen because of attemptedsuicide had made a further attempt within twelve months.The psychiatric contacts of those attempting suicidein Camberwell, London, in 1966 were analysed for the years1965, 1966, and 1967. In 30 cases, the occasion of the

attempt was the only time the patient saw a psychiatrist;for 13 there had been a long gap between the attempt andany psychiatric contact; in 12 cases the attempt was madeduring a series of contacts; in 12 cases the individual hadpreviously been in contact with services, but not at the timeof the attempt, and not after it; and in 60 cases the attemptstarted a series of contacts. By no means all patients whoare admitted to casualty departments after suicide attemptsare referred for psychiatric treatment. Yet many of thoseat the conference shared the conviction that psychiatriccontact in the three months following a suicide attempt isinversely associated with a further attempt. As one meansof remedying this state of affairs, a 12-bed unit has beenestablished in Halifax General Hospital specifically for self-aggressors. The policy is to admit anyone who has resortedto any act of self-aggression, no matter how feeble, to

investigate what sort of help is needed. Another possibility1. Proceedings of the Fifth International Conference for Suicide

Prevention, 1969. Edited by Dr. RICHARD Fox. The Inter-national Association for Suicide Prevention, Spitalgasse 23,A-1090 Vienna, Austria. 20s. Copies obtainable from theI.A.S.P. Conference Secretary, 43 Queen Anne Street, LondonW.1. £1 (post free).

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is to make it obligatory for the coroner to notify successfulsuicides and other violent deaths to the psychiatrist andothers concerned with the person’s mental health. At

present, many psychiatrists are unaware of the suicides offormer patients.

THE GIANT HOGWEED: EARLY DAYS IN KENT

LORD AMULREE has sent the accompanying photographof Heracleum mantegazzíanum, taken in his garden at

Cranbrook, Kent, in 1907 or 1908. This must have been

Giant hogweed at Cranbrook.

one of the rare specimens in private hands at the time. Thegardener shows no signs of phyto-photosensitivity; perhapsit was a poor summer.

University of LeedsDr. A. M. Barrett has been appointed professor and

head of the department of pharmacology.Dr. Barrett, who is 38, is at

present head pharmacologist withOrganon (Holland). He holds thedegrees of B.PHARM. and PH.D.

from London University, and hasheld posts at Western Reserve

University (U.S.A.) and the Schoolof Pharmacy in London. He wasformerly with I.C.I. pharmaceuti-cals division. His research inbiochemical pharmacology hasbeen concerned notably with thedevelopment of drugs to controlcardiovascular disorders, such asthe beta-blocking drugs propran-olol and practolol. Other researchincludes studies of gastric secre-tion, the mode of action ofclofibrate in lowering blood-lipids,interactions between monoamine-oxidase inhibitors, hypoglyceemic agents, and the regulation ofpituitary-adrenal function.

University of EdinburghThe Cameron prize in practical therapeutics has been

awarded to Prof. Georges Mathe (Paris) for work on thetreatment of leukaemia and reticulosis. Prof. Mathe will

give a lecture in Edinburgh on Oct. 14, on immunologicalapproaches in the treatment of cancer.Mr. M. A. Leonard has been appointed lecturer in

orthopxdic surgery, Dr. John Jacques lecturer in pathology,and Dr. R. C. Borthwick lecturer in respiratory diseases.

The following degrees and diplomas have been awarded:D.Sc. (in the faculty of medicine).-J. B. Brown.M.D.-Sheila F. M. Cleator, J. J. C. Cormack, M. R. Eastwood

(commended), J. T. Ireland (commended), Margaret F. Jamieson,B. W. Lassers (commended), J. A. G. Watt.M. Ch.-T. L. Barclay (commended), C. V. Ruckley (commended).Ph.D. (in the faculty of medicine).-P. C. Doherty, Ijaz Haider,

Ravinder Lal Kapur, Candiah Nadarajathilagaratnam, J. A. O’Brien,D. J. C. Shearman.M.Sc. (in the faculty of medicine).-Anne M. Spikesman, F. M.

Tulley.M.B., Ch.B.-M. R. Achong, G. M. Appleton, A. C. Baird,

P. D. Bartlett, C. H. Barton, J. V. Basson, R. T. Baxter, J. B. Bayne,Christine H. Beard, G. C. Bennet, J. H. Brash, Patricia F. Brien,R. J. Buckle, E. G. Buckley, A. J. Burt, Joan P. Burt, D. I. Butterworth,Sheila M. R. Byrne, R. H. A. Campbell, Rosamund B. Carson, G. M.Channon, Virinder Kumar Chatrath, Utheshtra Chetty, SangamithraUrvashi Dharini Choudree, I. T. Christie, G. G. Coleshill, T. J.Constable, Margaret J. Crawford, Catherine H. Crawley, C. S. Cuerden,C. T. Currie, Deryn J. Cussons, M. S. da Costa, M. B. Dobson,George Dodds, D. H. Doull, D. W. M. Dow, Morven C. L. Downie,M. J. Duncan, W. R. Easy, A. N. W. Evans, B. R. G. Fletcher, F. G. R.Fowkes, N. C. Fraser, Wendy J. B. Froud, Deirdre M. Gilchrist,N. W. Gillies, D. I. Gladstone, J. D. McE. Gould, Rosalind P. Greig,C. F. J. Grindle, R. D. Grundy, Timothy Habeshaw, Elizabeth S.Hamilton, J. E. Handley, Erik Hauge, D. M. Henderson, D. W. Holton,R. H. A. Holzman, Joseph Hope, I. N. Hudson, D. J. R. Hutchon,C. F. Innes, J. A. Innes (honours), Heather M. Johnston, J. A. Kanis,A. G. Leitch (honours, Ettles scholarship), D. G. Littlewood, R. F. A.Logan, C. M. Ludgate, Wijdan Ali Luqman, J. W. McCrone, K. M.Mackay, Mary E. MacLennan, J. J. McPhee, I. N. F. McQueen,Heather E. Martin, C. A. Mellis, G. B. Miller, C. J. Mitchell, Loma J.Mitchell, R. D. H. Monie, W. J. Morgan, George Munro, A. G. Nor-bury, Madeline F. Osborn, L. C. C. Osborne, J. H. Palmer, John Park,P. O. Pern, William Pollock, J. S. Powell, R. D. Prentice, Margaret L.Raeburn, Vishnudut Ramyead, A. D. Revolta, M. E. Richardson,S. A. Roberts, R. J. Robertson, 1. R. F. Ross, Patricia M. N. Ross,J. A. Sandiford, Richard Tsoi Mook Sang, D. C. Seegobin, B. M. Sevitt,Kamal Ezoury Shamash, George Sing, T. T. Singh, Anne V. Smith,E. M. Smith, M. F. Smith, R. C. Smith, J. D. Steven, Keng Heng TanR. A. Tarala, Joan Thomson, P. G. Thomson, S. J. Urbaniak, J. J. WWaight, Angela R. Wall, John Wallwork, D. G. Watt, Louise H. Weir,J. N. Westhead, P. G. White, M. F. Whitfield, Nelun Wijeyesekera,K. S. Wilson, Rosalind A. Wilson, Kow Yam Wong, Peter Wood,J. G. Wrench.D.M.R.D.-E. J. McKay, J. B. Murray, J. B. Rowlands.D.P.M.-Carlos Mario Chan, Judith M. Heron, David Johnson,

Olakayode Olatunde Ogunremi.Dip. Soc. Med.-Jenny Eastwood, J. C. C. Millen, 1. G. Simpson,

Mary Spencely.D.T.M. & H.-Dhirendra Chandra Dhar, Abrar Hussain, Ahmed

Abdul Momin, J. K. Prosser, Sami Zahi Saba, Kourosh Shariat-Zadeh,Padma Nand Singh, Sharifuz Zaman.

National University of IrelandDr. R. G. G. Barry has been appointed professor of

paediatrics at University College, Cork.

Society of Apothecaries of LondonThe Society’s gold medal in therapeutics has been

awarded to Prof. Cyril Clarke, F.R.S., and the mastery ofmidwifery, honoris causa, has been conferred on Sir JohnPeel.

M.R.C. Clinical Research CentreDr. D. A. J. Tyrrell, F.R.S., has been appointed deputy

director of the Medical Research Council Clinical ResearchCentre at Northwick Park, in succession to Prof. R chardDoll, F.R.S.

General Medical CouncilThe Disciplinary Committee of the Council has ordered

restoration to the Medical Register of the names of PatrickUwaezuoke Aghadiuno and of Walter Rudolphe Chishohn-Batten. It has ordered the erasure of the name of PaulZammit Hammet, subject to appeal within 28 days; anderasure, with immediate suspension, of the name of ThomasJoseph Martin Carney.

Dr. Herman Peter Tarnesby is to have registration of hisname suspended for a year. This decision has been an-nounced by the Judicial Committee of the Privy Council inrejecting Dr. Tarnesby’s appeal against the DisciplinaryCommittee’s finding that he had been guilty of infamousprofessional conduct in advertising.