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Its first notable recommendation in this respect(par. 34) is that certain provisions of the Health Acts,1919, which enable powers and duties of the Ministerof Pensions with respect to the health of disabledofficers and men to be transferred to the Ministerof Health, should be reconsidered with a view to theirrepeal. It can hardly be wrong thus to avoid thepossible overlapping of functions, and to retain thecare of pensioners requiring continued treatment inthe hands of the Minister primarily responsible fortheir welfare.As to the new regional arrangements proposed,

we note in the portion of the report devoted tothis subject a recommendation that the new regionaloffices should be obliged to deal carefully with com-plaints, and that awarding and medical officers shouldbe instructed to explain briefly, in answer to queries,the grounds of a decision given. This imposes acertain amount of additional trouble on the medicalofficer, but, so far as such instruction can be compliedwith, it may promote smoothness of working and thecontented acceptance of decisions. A statement ofthe grounds of a decision on a medical matter will,however, always be primarily of interest to the medicaladvisers of the pensioner whose opinion it may over-rule, and the knowledge that it will have to be givenwill be a valuable protection to the pensioner.Paragraphs 137-141 deal with means for renderingthe medical history of a pensioner more readilyavailable as an aid to his efficient treatment.

The Organisation of lledical Services.Part VI. of the Report is devoted to " Medical

Services," dealing, firstly, with their cost, and,secondly, with their organisation and duties. Theirapproximate total cost for the year ending March 31st,1921, is given as £9,187,271 ; of this, however, thesupply of artificial limbs and surgical appliances, andthe travelling expenses of patients, account for over£1,100,000. With regard to the duties to be per-formed by medical officers, the performance of theseby regional rather than by headquarters officers isadvised, and a strong recommendation is made as torelieving medical officers of clerical duties that canbe performed by a lay staff (par. 335). The con-sideration of the work of the medical boards occupiesseveral pages, and suggestions are made having to alarge extent the object of preventing complaints andsecuring the pensioner’s understanding of andacquiescence in the award to be made. The

reducing of the personnel of medical re-survey boardsis advised as a means for securing attendance only ofthose necessary, with the consequent quicker despatchof business. The continued use of civil hospitals forin-patient treatment is recommended (par. 352). Itis found that there has been no delay in admission tohospitals, except unavoidably in neurological cases(par. 353). With regard to the staffing of the Ministry’shospitals, recommendations are made with a view toeconomy, and as to details affecting the discharge andadmission of patients. The establishment of a

clearing-house at regional headquarters for dealingwith questions of in-patient admission to hospitals(par. 359) is suggested. With reference to the treat-ment of pensioner out-patients, the number of clinicsestablished by the Ministry amounts to 140. Thisnumber only has been sanctioned by the Treasury,and the proposal of the Ministry that an increase to250 should be allowed is endorsed by the Committee,with further suggestions as to the use to be made ofthe clinics.

The Care of Mental Cases.The care of certified mental cases is one of the

duties of the Minister of Pensions, and among theofficers appointed by him is a medical inspector(neurological), who, with a member of the Board ofControl, is employed in carrying out necessary investi-gation as to the treatment of service patients in insti-tutions. Less than one-fourth of the asylums madeuse of having up to now been visited, the Committeemake a strong recommendation that the process ofinspection should be expedited. The setting up of

mental hospitals for certified cases by the Ministryis not recommended, for the reason that they wouldbe few in number and often at too great a distancefor the patients’ relatives to visit them.

’Ve note that a certain amount of apprehension isexpressed by the Committee that the welfare ofthe tuberculous is not adequately cared for, andthat a warning recommendation is thought necessaryas to the better provision for them of sanatoriumtreatment (par. 378). More supervision over theprovision and standard of dental treatment is alsourged. The establishment of additional limb-fittingcentres is also advised.

" The Officers’ Friend."In Part VII. officers’ pensions and medical treat-

ment are discussed, the general result being that thepresent administration at headquarters is consideredsatisfactory, and will, subject to suggestions as todetails, the arrangements, so far as they dependupon the cooperation of the medical profession, becontinued. In conclusion, it may be noted thatunder the heading " Special Assistance

" the reporttestifies to the useful work done at the headquartersof the Ministry by the branch known as the " Officers’Friend." This is performed by a small staff of ex-officers, who assist officers and their relatives in regardto their claims, and explain the regulations to them’Medical officers suffering from the effects of their warservice, and the widows and dependents of deadofficers, if not satisfied that they have fully under-stood their right to pension and other assistance fromthe Ministry, should not fail to consult the Officers’Friend."

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ROYAL COLLEGE OF SURGEONS OFENGLAND.

Meeting of Council.THE quarterly Council meeting was held on July 11th. Sir

Anthony Bowlby. the President, in the cha;r..-Air. H. J.Waring, Mr. F. F. Burghard, Mr. W. Thelwall Thomas, andMr. C. H. Fagge were introduced, and took their seats onthe Council. A report was read from the Board of Examinersin Dental Surgery respecting candidates found qualified forthe Licence in Dental Surgery, and licences were granted to53 candidates namecl in the report. A report was readfrom Mr. F. G. Hallett, secretary to the Conjoint ExaminingBoard of England, respecting candidates found qualifiedfor the Diploma in Public Health, and it was resolved thatdiplomas be granted jointly with the Royal College of

Physicians of London to 23 candidates mentioned in thereport. A report was read from Mr. Hallett respecting candi-dates found qualified for the Diploma in Psychological lledi-cine, and it was resolved that diplomas be granted jointly withthe Royal College of Physicians to six candidates mentionedin the report. It was resolved that the best thauks of theCouncil be given to the President of the American Museumof Natural History, New York, for presenting a plaster castof the Chapelle skull and models of Dr. J. H. )IcG1’egor’sreconstruction of the Gibraltar skull and brain cast : andalso to Lieut.-Colonel R. H. Elliot for presenting a collectionof 46 specimens illustrating rare pathological conditions ofthe eye. A report was read from the Committee of MedicalEducation and Examination, and the Council expressedtheir general approval of the proposed course of study andexamination, and referred the report to the Committee ofManagement to consider. A report was read from theCommittee on additional examinations in Ophthalmologyand Oto-Rhino-Laryngology, which recommended thatcandidates for the examination in ophthalmology must beFellows of the Royal College of Surgeons, and that theymust produce evidence of having devoted, after becomingqualified, at least two years to the study of ophthalmologyas a clinical assistant, house surgeon, or registrar at a recog-nised institution. The report was referred to Mr. Burghardand Mr. R. Johnson, in consultation with Mr. J. B. Lawford,Mr. E. Treacher Collins, and Mr. J. H. Fisher, to prepare forthe approval of the Council the regulations for candidatesfor the proposed examination in ophthalmology. ThePresident reported that in response to an invitation to theCollege to nominate a member of the ’’ Hospitals Commis-sion " recommended in the report of Lord Cave’s Committee,he had nominated Sir George Makins to act in this capacity.The Council elected Sir Anthony Bowlby as President forthe ensuing year, and Sir Charles Ballance and Sir D’ArcyPower Vice-Presidents for the same period.