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Public Health Services.THE MARRIAGE BAR.

THE injustice that may be involved in the applica-tion of a general principle to a particular case is wellillustrated by current events in the Borough of St.Pancras. The Borough Council recently passed a

resolution to terminate the appointments of marriedwomen on their staff whose husbands are in receiptof salaries sufficient to support their wives. Thisresolution is now found to apply to the assistant medicalofficer for maternity and child welfare, and theMinistry of Health, which pays half her salary, wasasked to sanction a request to Dr. Gladys Miall-Smithto resign her post in view of her recent marriage.The Minister observed in reply, that, while the

proposal did not require his sanction, he consideredthat in view of the special qualification and capabilityof Dr. Miall-Smith, and the present shortage of womenmedical officers trained in this work, the BoroughCouncil would be well advised to retain her servicesprovisionally if their rules permitted. The case as putby the assistant medical officer herself was, briefly,that no marriage disqualification or resignation clausewas inserted either in the advertisement of the postwhich appeared in the medical press in January, 1920,or in the forms of application or appointment submittedto her ; that in fact a married woman was among thethree applicants finally selected by the Public HealthCommittee. She points out that the attitude of thecouncil up to the present has led her to suppose thatthey concurred in the general view that marriagewas an added qualification for any work connectedwith maternity and child welfare, inasmuch as a

large proportion of the doctors appointed and paidby the council to work at the infant-welfare centres,and in particular those recently appointed, are marriedmedical women. Moreover, there being no unemploy-ment problem at the present moment amongstmedical women, the question of her keeping a singlewoman out of employment does not arise. Sinceher appointment Dr. Miall-Smith has obtained theD.P.H., thus further qualifying herself for the workshe undertakes. Letters in support of her claim werereceived by the Council from the British MedicalAssociation, the Society of Medical Officers of Health,the Federation of Medical Women, the NationalAssociation of Local Government Officers, the LondonSociety for Women’s Service, and the superin-tendents of local welfare centres. The arguments inthese letters were largely amplifications and extensionsof those advanced by Dr. Miall-Smith herself, exceptin so far as they emphasised her exceptional qualifica-tions, efficiency, and local popularity. The BritishMedical Association urged that, whatever the council’sattitude on the general question of the employ-ment of married women, there could be no

doubt of their suitability for child-welfare work, andasked that the council should seriously consider theadvisability of retaining Dr. Miall-Smith’s services.The Federation of Medical Women spoke of the specialsuitability of work with fixed hours for married women.and of the value to the community of one who mayhave intimate knowledge of children of her own ; alsoof special arrangements whereby absence for confine-ment would involve no loss to ratepayers. Eventually,after some discussion, the decision to ask Dr. Miall-Smith to resign was upheld. It remains to be seenwhether the council will now proceed to ask forresignations from the married women doctors employedby them at the local welfare centres and whether theywill presently extend this attention to married menin their employment whose wives are in receipt ofsalaries sufficient to support their husbands.AN-0--IE-N PRACTITIONERS AND A RESTRICTED PAXEL.

Early in the 3-ear four women practitioners on

the London medical list, preferring not to undertakethe treatment of men patients, were deprived ofa per cent. of their share in the practitioner’s fund,

and this in accordance with the terms of the 1921contract as interpreted bv the London InsuranceCommittee. W’e expressed a doubt at the timewhether Section 5 of the Distribution Scheme wasintended to have this construction placed upon it.Later the Committee decided that, subject to theapproval of the Ministry of Health, a reduction of3ï per cent. only in the practitioner’s credit shouldbe involved in the limitation of the panel list topatients of one sex. The Ministry have approvedthe amendment of the clause bv the addition of thewords : "by 3 per cent. in the case of a womanpractitioner limiting her list to patients of her ownsex." As the converse case is hardly likely to occurthe Ministry presumably decided to legislate in thisinstance for women only.

SCHOOL MEDICAL SERB’ICE.- Le:cee?’sM’e.

IN this county the school nurses carry out theduties under the Notification of Births Act; they arealso inspectors of midwives and infant life protectionvisitors. The school doctors, too, are medical officersto the infant welfare centres, in this way ensuringcooperation of effort in dealing with children from birthto the end of school life. Dr. T. Robinson, however,has to deplore the number of changes in the nursingstaff. During the past year over 12,000 children weresubmitted to routine examination ; of these, 684required treatment for defective e vision, 487 forenlarged tonsils and adenoids, 673 for dental disease,and 93 for ear troubles. Six hundred and forty-four ofthe defective vision cases obtained treatment, 473 ofthose suffering from enlarged tonsils and adenoids,299 of them being operated on. Out of 6899 childrendentally inspected, 3092 were referred for treatmentand 2791 actually treated. A central dental clinic isabout to be opened in Leicester for the treatment ofchildren on Saturdays ; it will be interesting to seewith what success, as Saturday clinics so far have notproved popular.

Leeds.The total cost during the past year for medical

services was high-just over 8s. per head of attend-ances at the elementary schools. The efforts of thelate Dr. W. Angus, when medical officer, are bearingfruit and Leeds is coming into line in respect of carefor its children. Children found to be defectiveseem to be given some six weeks in the hope that theparents will provide remedy ; then they are markedoff to clinics-Leeds excels in clinics. Seven of thesehad 174,446 attendances, and this total apparently doesnot include cases of enlarged tonsils and adenoids,for which the authority does not provide treatment.On the fate of these " no detinite information isavailable." Dental attendances were 16,735, makinga total of over 190,000. The work of the schoolnurses appears very satisfactory ; two-thirds oftheir time is spent in the clinics, and only one-tenth in home visits. This determined effort toclear diseased conditions out of the schools is notequalled by preventive measures, for although thereare some playground classes and nine play centresLeeds has no open-air schools, which would be muchappreciated in a town. Other lacunae, such as absenceof schools for cripples and for epileptics and classesfor the dull and backward, are also noticed. A househas, however, been purchased to serve as a nurseryschool. The number of children examined during theyear was 26,759 in the elementary schools and 1792in the secondary and special schools. The totalnumber of cases referred for treatment was 14,528,defective vision accounting for 2366 and uncleanlinessfor over 3000. Ten per cent. of the secondary schoolchildren were suffering from malnutrition. It isunfortunate that the medical officer does not attendthe advisory committee for juvenile employment,where his advice would be helpful.

l’-orthamptonsh ire.The most noteworthy feature of the school medical

work this year is the new scheme for dental treatment

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which proposes to deal, as a start, with children of6 and 7 years of age, including a few older children.It is hoped, however, that all children will eventuallybe passed under review each year. During the yearit was found that only 31-8 per cent. of the childrenhad sound teeth, as against 32-4 per cent. last year ;amongst " leavers " the rate was only slightly higher,34-3 per cent., as against 35-8 the previous year.Under the new scheme this percentage should beconsiderably raised in a few years’ time. Normalvision was found among 77-4, and normal hearing in99-8 per cent. Operative treatment was received by41 per cent. of the nose and throat cases, and Dr.Charles E. Paget urges regular breathing exercises asa routine part of physical education in the schools.There were 13 definite cases of pulmonary tuberculosisin the county. Physical deformities were detectedin 1 per cent. of the children examined, and inaddition 1-6 per cent. were found to be suffering fromheart disease. There was a marked diminution in theamount of anaemia amongst leavers, 0-67 per cent.,as against 2-6 per cent. the previous year. Duringthe year 59 schools were closed for measles-in thiscounty the old order evidently still prevails in the caseof infectious disease.

INDUSTRY AND PREVENTIVEMEDICINE:

CONFERENCE AT OXFORD.

A CONFERENCE organised by the Industrial WelfareSociety was held at Balliol College, Oxford, fromSept. 15th to 20th. Here, sent by their firms, therewere gathered for a few days in college life representa-tives of great industrial concerns, including engineeringworks, textile mills, railways, coal mines, shipbuildingyards, chemical works, and food factories. The

programme included lectures by distinguished experts,but much solid work was done at informal meetingsof groups held in rooms or in the quadrangle whichwere always taking place from morn to midnight ;indeed a far more businesslike atmosphere was presentthan is usually found at scientific conferences.The proceedings were opened by Lord GORELL, who

announced that acceptance of office in the Air Ministryhad necessitated his retirement, in favour of LordChelmsford, late Viceroy of India, from the Chairman-ship of the Miners’ Welfare Committee establishedunder the Mining Industry Act, 1920. He dwelt uponthe epoch-marking provision of this Act which makesa levy on the industry to be devoted to bettermentpurposes, and sets up a committee to allocate the fund.The scope of the work is to include education, healthand safety, recreation, and research, so covering thewhole field of human life.

Industrial Welfare as a Science.The correctness of this view of welfare was shown

by the subjects dealt with by other speakers ; thusDr. C. W. ElMMiNS (London County Council) dealtwith the educational aspect and pointed to the mag-nificent opportunity opening up before welfaresupervisors as juvenile education under the 1918 Actcomes to be carried on part-time with occupationallife, and to the scope so afforded for vocationalguidance. The theme so opened was developed onthe industrial side by Mr. Epic FARMER, who claimedthat industrial psychology could be considered as acontinuation of education, that it should be concernedwith the human element and not be tied down by theneeds of efficiency or production. Efficiency andproduction will certainly benefit, but this benefitshould not be the only aim of industrial psychologistsand physiologists ; their aim should be to improveindustrial activity and discover the boundary whereactivity becomes overstrained, the parent of irritabilityand discontent.The principles of physiology underlying health were

laid down by Prof. E. L. COLLIR (Cardiff), who pointedout the part the public can play if only these simple

principles are grasped. He claimed that industrialwelfare was a science, although yet a young one ; hepointed out that no science could exist without meansof measurement. The means in this case were labourturnover and lost time. He urged welfare super-visors to use these means and become masters of them ;through them research could be carried out, withoutwhich the welfare movement could not progress. Heuttered a warning that a science which was not

progressing must become retrograde.The subject of recreation was taken up by 3[1’.

R. S. WOOD (Secretary of the Juvenile OrgallisationsCommittee), who dealt with camping-the rightfulheritage of every boy. He placed before the conferencemuch useful and practical information on the economicrunning of camps, and advocated that two or threesmaller camps were more advantageous than one largeone. Another aspect of recreation was delightfullydemonstrated by Mr. G. J. SHARP, a well-knownauthority on folk dances and folk music. Only the bestof these dances and songs have come down to us.

Their value becomes apparent from the way in whichthey are quickly adopted and practised when oncethey are introduced. Play is as necessary to life aswork. especially in a country long known in Europeas Merry England. Folk dances and songs whichhave stood the test of centuries should not be dis-regarded in favour of modern and less tried forms ofrecreation.

The Practice of JVelfare.The strength of the industrial movement was,

however, made more obvious when it was spoken ofe by employers such as Sir ANDREW DUNCAN (Ship- building Employers’ Federation), and representatives>

of labour, Mr. F. BRANLEY (Trade Union Congress)J

and Mr. F. S. BUTTON. In each case the speakers- presented their point of view with what they thought some temerity. Each welcomed the welfare movement, but saw the necessity for limitation of its activities. The surprising matter was that when the two positions

’ were thus stated no conflict whatever was found, nor

3 did either position conflict with the work which

welfare supervisors are undertaking. Both Sir Andrew’ Duncan and Mr. Branley considered that welfare work)

should concentrate upon juveniles, and only seek topermeate industry as these juveniles grow up to adult

life and carry with them the spirit which welfare hasimplanted. Sir Andrew Duncan particularly pointedout that the outward form of welfare work was of

,

minor importance compared with the spirit, and withrecognition that there is an obligation and burdenL upon an industry with regard to the welfare of thoseengaged in it which it must itself discharge. Mr.Branley’s point of view was that organised labourwould give its unqualified support, without reserve,to genuine schemes of factory and workshop welfare.He looked upon the welfare movement as the ally oforganised labour, working in a field particularly itsown. There could be no doubt that an employerwho became an enthusiast for welfare could not atthe same time advocate low wages or unreasonablylong hours.

Aspects of the subject put forward by differentspeakers were all submitted to keen discussion. Theduty lay with Mr. R. R. HYDE (Director of theIndustrial Welfare Society) to report present progress.He was able to state that the movement, which saw itsbirth in the stress of war-time and grew during the tradeboom that followed, had held its own in a wonderfulway during the unprecedented slump from which weare only just beginning to emerge. Now he couldstate that firms who have once adopted welfare werecontinuing it whatever the conditions of trade. Apartaltogether from its high aims and aspirations as abranch of social service, welfare had value in providingcommon ground upon which employers and employedcould meet in amity.Those who attended this Conference could not help

being struck bv the earnestness and enthusiasm whichinspired it. All present were bent upon ensuring thesuccess of what promises to be the foundation of a new

spirit of health and contentment in the industrial world.