1024

This, in time, must bring about a considerable improvementin the condition of the lowest and the poorest.

Wages and the Act.At Hull, as elsewhere, there is of course the problem of

malingering, and the desire for the establishment of a

medical referee was expressed in several quarters. The

panel doctor has not the time to play the part of a detective,especially if he has a large list and his waiting-room iscrowded with impatient sufferers. The man with the pain inthe back who says he cannot stoop or carry would have tobe stripped and examined and put through a great variety oftests before it could be ascertained whether he was malinger-ing or ,not. It stands to reason that sometimes, if the practi-tioner is over-worked, his story being probable, is believedwithout much testing. The greatest difficulty is with womenand girls, because their wages are so low. For instance, Icame across a charwoman who never earns more than Is. 6d.a day and a little food, but as she is not employed every dayher income hardly exceeds the 7s. 6d. a week she wouldreceive as sick allowance under the Act. It often happenswith badly paid women and girls that life is more enjoyableon their sick allowance with nothing to do than when workinghard to earn about the same sum. Then, as these unfortunatewomen are very susceptible to illness as a natural consequenceof the hard lives they lead, it requires very little malingering,a mere exaggeration of symptoms, to get on the sick-list.Thus better wages become an essential condition to thesuccessful working of the Act. Also, it must be borne inmind that the general standard of health will decrease asless robust persons come into the scope of the Act, so thatthere will be more to do, and yet there is to be no increasein the payment. The profession is insisting on adequateterms for dependents, so that there should be a good pre-cedent to work upon should an attempt be made to bringthem into an enlarged insurance scheme. To-day the pro-fession is undoubtedly receiving more money than was thecase before the Act, but will this continue if other sectionsof t he community are also forced to insure ?

(To be continued.)

SCOTLAND.

(FROM OUR OWN CORRESPONDENTS.)

Housing Acts in Scotland.SOME valuable hints on the provision of houses by local

authorities have been published by the Local GovernmentBoard of Scotland. They have not been formally issued tothe local authorities, but can be obtained from the Board onapplication. It is pointed out that either common lodging-houses or separate dwellings (including cottages and gardens)may be provided within or without the district of the localauthority, and that there is no statutory restriction upon theclass of house that may be erected, provided that it is forhabitation by the working classes. But a local authorityshould first satisfy themselves that there is an unsatisfieddemand for working-class houses, and that such are notlikely to be provided by private enterprise, ’and should alsoconsider whether they can do anything to stimulate privateenterprise by drawing attention to the scarcity of houses, byfeuing municipal land at a cheap rate, or by developing thisland by forming roads and laying sewers and gas and watermains in advance. No selected site should be purchased untilthe Board’s consent has been obtained to borrowing, andurban or built up sites should be avoided on the score of

expense. Discretion is given to a local authority to acquireland either by agreement or by compulsory powers underSection 2 of the 1909 Act. In the preparation of plans acareful regard should be had to local conditions and to therequirements and means of the prospective tenants, whilestudied attention should be given to the Memorandum of theLocal Government Board on the Provision and Arrangementof Houses for the Working Classes." It is recommended thatsketch plans should be submitted informally to the Board’sarchitectural inspector before they are finally adopted by thelocal authority. The consent of the Board is required to

loans for building purposes, and the maximum periods of

repayment advised by the Board are (1) 60 years for houses(with shorter terms for roads, drains, fences, &c.) and (2)80 years for land. Either the annuity or instalment system

of repayment may be adopted. If feasible, housing schemesshould be on a self-supporting basis, though the Board donot make this a condition of their consent to borrowing.

Glasgow Parish Council and the Treatment of Phthisis.For some years there has been a considerable diversity of

opinion in Glasgow as to the relative responsibility of theparish council and the corporation in the matter of dealingwith patients suffering from tuberculosis of the lungs. At aconference held in 1906 the corporation and the parishcouncil were agreed that phthisis should be included as anotifiable disease under the Public Health Act, but little wasdone until the year 1908. At that time the Local Govern-ment Board drew attention to the respective obligations oflocal authorities and parish councils, and indicated that thelocal authority should bear the whole expense, even if, untilother arrangements were made, the parish council hospitalswere utilised. In 1909 the corporation adopted the principleof compulsory notification, but since then they have done littleto carry out their responsibilities. The parish council sometime ago proposed to take a test case to the Court of Session,but this was deprecated by the Local Government Board, andfurther efforts were made to get the corporation to assumethe burden of costs. At the present time there are over400 patients suffering from phthisis in the institutions of theparish council, costing about R30 per year each, equivalentto an annual expenditure of R12,000. All this has to beborne by Glasgow ratepayers, whereas if the corporation orpublic health authority paid this annual cost the sum ofR6000 would be saved to the city, because under the newtuberculosis maintenance grant one-half of the expenditureby the local authority on tuberculosis would be repaid out ofGovernment funds. On the other hand, as things existat present, no contribution is made to parochial autho-rities. The parish council naturally feel that money isbeing lost in this way to the city ratepayers, and theyare making another effort to force the local authorityto take up the question. The corporation also have appa-rently decided that the time has come for them to move inthe matter, and it is a step in the right direction that wastaken when last week the health committee of the corpora-tion recommended the purchase by the corporation ofBellefield Sanatorium. This sanatorium was opened in 1904,and conducted by the Glasgow and District Branch of theNational Association for the Prevention of Consumption. Thesanatorium, situated in Lanarkshire, provides accommoda-tion for 52 patients. The suggested purchase price is £7500to £10,000 for the sanatorium with all fittings as it stands,and to this suggested agreement certain conditions are tobe attached by the corporation as to the money being useddirectly or indirectly by the association in behalf of personsresiding in the city of Glasgow suffering from tuberculosis.At the present time also an extension is being made by thecorporation to Ruchill Fever Hospital for the treatment ofphthisical patients, and it has been arranged that the small-pox hospital at Robroyston, when occasion permits, shallbe used for the same purpose.

Memorial Portrait to a Dundee Practitioner.

On Sept. 24th a memorial portrait to the late Dr. GeorgeLawrence, who died last year, was unveiled at the DundeeArt Gallery. The portrait has been painted by Mr. W. B.Lamond, and bears the following inscription :—

George Lawrence, M.B., C.M. Born 1871 ; died 1912. Presented toDundee Permanent Collection by grateful patients and friends to marlr,their appreciation of valuable services to the community. September,1913.Sept.30th.

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IRELAND.

(FROM OUR OWN CORRESPONDENTS.)

The Health of Belfast during 1912.THE report of the medical officer of health of Belfast for

the year 1912 is fuller, more complete, and more satisfactorythan any of its predecessors. The statistics in the report arebased on a population of 391,974, as estimated by theRegistrar-General in the middle of the year. In 1912 thebirth-rate was 27.8 per 1000, being 0-6 6 less than in 1911,and it was, as might be expected, highest among theinhabitants of working-class districts, and lowest amongthose resident in the better class areas. The death-rate per