271

cooperation than vindictive retrospection in the applicationof penalties. As for the function of the re-established reviewbody, it would be an advisory body, no more and no less.It would be independent and impartial, but advisory. TheSecretary of State had had a series of meetings withrepresentatives of the medical and dental professions aboutthe remuneration questions withdrawn from the NationalBoard for Prices and Incomes. These discussions were still

going on. An announcement would be made at the

appropriate time.

Single Women who Care for DependantsThe plight of single women who give up their jobs in

order to care for elderly or infirm relatives was brought tothe attention of the House of Commons in an adjournmentdebate on July 24. Introducing the debate, Mr. JAMESKILFEDDER said that he hoped the Secretary of State forSocial Services, who had been interested in this problemfor many years, would not now find his hands tied byfinancial restrictions. According to a report just publishedby the National Council for the Single Woman and herDependants, most single women give up work to care forrelatives when they are between the ages of 40 and 50.They not only give up the financial benefits of employment,but the daily contact with people and outside affairs it

brought them; often they also relinquished hopes of

marriage and virtually all their social life. Many were tooold to return to work by the time the dependant had died,and thus forfeited their chances of a full pension, or some-times, a pension at all. Because of their reduced income,they were often forced to spend all their savings on day-to-day expenses, and were not entitled to claim the benefitof a housekeeper allowance against their income tax.

It seemed, therefore, that an effective case could be madeout for the incorporation in the national insurance schemeof a new category of unemployed, that is, those who havevoluntarily given up employment in order to look after arelative at home who might otherwise have to be cared forin hospital at the public expense. E5-the amount given atpresent to a single woman who is unemployed-seemed areasonable sum. Supporting the debate, Mrs. ELAINEKELLETT said the survey had revealed that there are 200,000women who were looking after, or had been looking after,dependent relatives. The number might, in fact, be muchgreater, and it was to be hoped that a question could beincluded in the forthcoming census to obtain the true

number. In his reply, Mr. MICHAEL ALISON (Under-Secretary of State for Health and Social Security) said thathe was in sympathy with the points raised, though he feltthat more help could be given by the community in thissituation than by the State. He pointed out that the newNational Insurance Act provided for an attendance allow-ance, and that the single woman caring for an elderlydependant was entitled to supplementary benefit. However,the Secretary of State would want to consider the " generalposition of single woman attendants and their elderlyrelatives "; this was " a definite undertaking". Mr. E. D. D.MONEY made the point that, when holidays were providedfor the old and infirm, the single daughter who had beencaring for her dependant could lose her supplementarybenefit during the period of the holiday, because she wastechnically capable of earning her living. Mr. Alison agreedthat this needed looking into, and concluded that there was" clearly much room for experimentation in this field".

New Acts

Among Acts which received the Royal Assent before theadjournment of Parliament for the summer recess are theNational Insurance (Old Persons’ and Widows’ Pensionsand Attendance Allowance) Act, 1970, and the Education(Handicapped Children) Act, 1970.

Public Health

Routine Vaccination against RubellaEARLY this year, rubella vaccine came on the market in

the U.K. At that time the Department of Health wasawaiting a report from the Joint Committee on Vaccinationand Immunisation, and deferred its general recommenda-tions.1 In a letter to doctors this week, the chief medicalofficer says that the joint committee endorses the view ofthe Department’s own advisers, that the vaccine-liveattenuated (Cendehill) strain-should be offered to girlsbetween their llth and 14th birthdays. While supplies arelimited, priority should be given to girls aged 13. The aimis to protect the girls before they reach childbearing age.

Routine vaccination of women of childbearing age is notrecommended, because the effect of the vaccine virus on thehuman fetus is not yet known. When vaccination of awoman of childbearing age is under consideration, a sero-logical test for rubella antibody should be done: if the testis positive, vaccination is unnecessary; if it is negative, andthe woman does become pregnant around the time ofvaccination, then a subsequent positive test means that thefetus may have been put at risk. Every effort should bemade to ensure that a woman is not pregnant at the time of

vaccination, and does not become pregnant in the succeed-ing 2 months. (There seems to be little or no risk that thevaccine virus will be transferred from vaccinated childrento susceptible contacts.) Other contraindications to rubellavaccination include febrile illness, malignant disease,immune-deficiency states, corticosteroid/immunosuppres-sive treatment, and hypersensitivity to components ofthe vaccine. The only troublesome short-term side-effectsso far noted are arthralgia and arthritis-both commoner inadults than in children.

Rubella vaccination of girls between their 11th and 14thbirthdays will attract an item-for-service fee for generalpractitioners. Until March 31, 1971, the Department ofHealth will supply vaccine to local authorities free of charge.

Appointments

AlTKEN, J. A., M.R.C.S., D.P.M.: consultant child psychiatrist, Readingarea.

DUNDAS, C. R., M.B. Edin., F.F.A. R.c.s.: consultant anaesthetist, Aberdeenteaching hospitals.

WHITE, R. H. R., M.D. Birm., M.R.C.P., D.C.H. : consultant paediatrician,United Birmingham Hospitals.

Western Regional Hospital Board, Scotland :DONALD, SHEILA, M.B. Edin., F.F.A. R.C.S.: consultant anaesthetist,

Stirlingshire area.FLEMING, GAVIN, M.B.Glasg., D.P.M.: consultant psychiatrist, Hart-

wood Hospital, Shotts.HIDE, T. A. H., M.B. Glasg., F.R.C.S.G.: consultant neurosurgeon,

Institute of Neurological Sciences, Southern General Hospital,Glasgow.

JACKSON, 1. T., M.B. Glasg., F.R.C.S.E., F.R.C.S.G. : consultant in plasticsurgery, Canniesburn Hospital, Glasgow.

MAULE, J. H., M.B. Glasg., F.F.A. R.C.S.: consultant anxsthetist,Victoria Infirmary, Glasgow.

MELLEN, CATHERINE H. M., M.B. Edin., D.A.: consultant anaesthetist,Stirlingshire area.

PATERSON, R. W’. B1<;’" M.B. Glasg., F.R.C.S.E., D.OBST., D.o.: consultantophthalmologist, Royal Victoria Eye Infirmary, Paisley.

RENNIE, G. G., M.B. Aberd., consultant anaathetist, Law and Stone-house Hospitals, Lanarkshire.

THOMSON, JOHN, M.B. Glasg., M.R.C.P.G.: consultant dermatologist,Glasgow Royal Infirmary.

WILSON, ROBERT, M.B. Glasg., L.R.LC.: consultant in biochemistry,Renfrewshlre area.

1. See Lancet, 1970, i, 305.