Public health and insurance: American addressesNewsholme, Arthur, Sir
History
Public health and insurance: American addresses
Newsholme, Arthur, Sir
Health insurance -- Great Britain; Public health; Public health -- Great Britain
The further fact that about one-third of the total deaths in the
first year after live-birth occur in the first four weeks of life,
adds force to my plea for the establishment of these ante-natal
consultations in connection with all lying-in institutions and at
child welfare centres, where infants and children up to school age
will be submitted to periodical medical examination and supervision.
It has been erroneously asserted that the greater part of this early
infant mortality is unavoidable; but careful examination of national
and local statistics shows that in some places it is twice as high as
in others, and examination of the causes of death in the districts
with more favourable mortality shows that their experience can be
improved. All experienced obstetricians and pædiatricians will agree
that, given adequate care of the mother during pregnancy, skilled
care by a competent obstetrician during labor, and satisfactory
medical and nursing care in the following month, there can be secured
large reductions in the early infant mortality of the first month
after birth, as well as in the number of still-births and in the
present toll on maternal life.
In early infancy, as in advanced old age, the hold on life is
slight, normal and abnormal are soon interchanged, and there is
needed not only more knowledge on the part of mothers and nurses,
and even of physicians, of the hygienic side of medicine as applied
to the physiological life of the mother and her infant, but also
personal care and assistance to enable the mother to apply the
useful information and advice given by the public health nurse. I
lay special stress on this association of counsel and assistance.
It is important also that nursing and medical assistance should
be so given as not to create a feeling of dependence. In view of
the wide provision of medical assistance from public funds which
already obtains, I submit that poverty tests in the giving of such
assistance should be abolished, or that, at least, the availability
of such assistance should be greatly extended. Given the fulfilment
of this condition, it will be practicable to enlist the remunerated
coöperation of the medical profession in a general provision of
medical and nursing facilities, which will secure the early detection
of disease of every kind and its prompt and adequate treatment. Not
only so, but the same service can be utilized for the preservation of
health by securing the change of habits and customs and conditions of
housing or work which are likely to prove detrimental.
I have laid stress on the ideal after which we must, in my opinion,
strive. Meanwhile, it is essential that we should not regard the
mere removal of ignorance as the _summum bonum_. This is plain when
we come into close contact with the facts of life as lived by the
greater part of the wage-earning classes.
Public-domain text, read in full here on John Shaqi.
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