Simon, in 1868, had urged the inadvisability of continuing _ad hoc_ authorities, and had urged that, at least, sanitary should be made coterminous in area of administration with poor-law districts. His advice was not adopted, and there followed years in which sanitary authorities were allowed to subdivide areas, until the total number became 1,807 instead of 635, the number of poor-law authorities; and in which they concerned themselves chiefly with nuisances and water supplies and with inadequate provision for the prevention and treatment of infectious diseases. With the creation of county councils and the more complete autonomy of the councils of county boroughs, the large centres of population developed and improved their sanitary administration more rapidly; and it became practicable to undertake every division of sanitary work on an efficient scale. Although much remains to be done, it can be claimed that in our larger towns, containing more than half of the total population of the country, the public health work in nearly all its branches is of a high order. It would have been still more efficient had the poor-law guardians been merged in the Town Council, and had the relationship between the school medical service and the other branches of the public health service been closer than has been the case. What is now needed is that the defects just named should be made good; that more complete autonomy should be given to the authorities which come up to a required standard, and that especially they should have greater freedom in developing local possibilities of improved administration. Central grants in aid of local sanitary administration are steadily increasing. Already the Government pays one-half of local expenditure on a large program of maternity and child welfare work, one-half of the expense of local tuberculosis work, and three-fourths of the expense of local work for the diagnosis and treatment of venereal diseases, and for propaganda work concerning these. These grants should be the means of greatly increasing good local administration; but if,—this is improbable,—they curtail local experimentation and extension, and bring local public health administration into anything approaching the subservience of local poor-law administration, the value of these subventions will be doubtful. _Education Authorities and Health_