accidents and hospital contributory schemes,

525

of an experiment ill the prevention of the commoncold by means of a vaccine. In the experimental.group were 80 medical students, and in the controlgroup were 82. He concludes that the statisticalresults of the experiment show little, if any, advan-

tage to the experimental group. The mean numberof colds suffered by the experimental group (overseven months) was 1-85, with a mean duration of7.4 days, while the corresponding figures for the,control group were 2-17 and 7-6. These figures donot differ significantly, but on the other hand theestimated average duration of colds during the pre-vious years amongst the experimental group was10-5 days, while the same average for the controlgroup was 7-6 days. This suggests that some improve-ment may have taken place amongst the experi-mental group, but it also points to the weakness ofthe investigation. Any method of investigation thatallows the experimental group to be unduly weightedwith " susceptibles," as is here apparent, must be

unsatisfactory. To prove that the groups are com-parable with regard to such factors as the amountof water (and/or alcohol), tobacco, chewing-gum,-and ice-cream they consume, the time when they goto bed, and the number of baths they take weekly{to mention but a few for which this paper providesstatistics), seems an idle refinement in the face ofsuch a fundamental difference with regard to sus-

ceptibility as is suggested by the previous historiesof colds.

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ACCIDENTS AND HOSPITAL CONTRIBUTORY

SCHEMES,

MOST of the annual reports and meetings of theprovincial hospitals which come thick and fast atthis season are concerned with the burden placedupon them by road accidents. In a recent broadcastspeech Lord Moynihan stated that Leeds Infirmaryis losing E2000 a year in this way ; Bradford Infirmarylast year spent :f600 more than it recovered uponsuch cases ; Southport Infirmary lost z373 ; theDevon and Exeter Hospital complains that the

suggested uniform charge of seven and sixpence a dayfor the treatment of victims of road accidents is

" totally insufficient." In every part of the countrythe story is similar, and in some places contributoryschemes are becoming inadequate to meet the swollenexpenses, in which motor accidents are one of theitems. Birmingham has already raised its contribu-tion ; Sheffield is thinking of doing likewise ; andthe Merseyside Hospitals Council is seeking to widenits scheme by, among other means, appealing forthose annual subscribers who in most places show atendency to fall away. Just now Liverpool is havinga rather unhappy experience. Last year its portsanitary and hospitals committee spent nearly:f37,OOO in excess of the estimates, almost the wholeof which was attributable to capital expenditureupon transferred institutions to bring them into line i

with the modern type of hospital. Meanwhile Liver-pool, undaunted, is hastening the completion of itsnew Samaritan Hospital for Women which is to costabout 150,000.

Contributory schemes, under various names, are

becoming increasingly important to every hospitalfed by them, and several new ones are being launched.An outstanding example of success is the LeedsHospital Fund which last year increased its incomeby 10,500 ; it now exceeds E56,000. In ten yearsthe workpeople’s hospital committee of Gloucester-shire Royal Infirmary has raised just under 100,000 ;last year the Torbay Hospital contributory scheme

collected over 7000 ; in 1931 the Exmouth andDistrict Hospital League increased its membershipby 1537 ; the Newton Abbot contributory scheme,with over 5000 members, brought in f:l500. In viewof these and similar figures there is small wonderthat other hospitals of varying degrees of importancehave decided to establish contributory schemes.Thus Walsall General Hospital, the scene in its earlycottage hospital days of the devoted labours ofz Sister Dora," sees no other way of making neces-sary enlargements, and it is proposed to make a

reciprocal arrangement for treatment of its memberswith the neighbouring Wolverhampton Royal Hos-pital which has recently established a highlysuccessful scheme with a large basis of miners.

Simultaneously Goole is considering a scheme thatwould enable its Bartholomew Hospital, in return fora contribution of twopence a week, to give free treat-ment to persons whose weekly income is under 5,with special arrangements for the neighbouringvillages. Since Wolverhampton has 210 beds, Walsall100, and Goole 24, the advantages of a contributoryscheme are seen to appeal to hospitals of very varyingdimensions.

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DISTRICT NURSING IN LONDON.

IN her survey of district nursing in London,published by the London County Council last year,Dr. Margaret Hogarth paid a remarkable tribute tothe thoroughness with which care of the sick poorin their homes is organised.

" I was impressed,"she wrote, " with the tremendous amount of individualand collective voluntary effort expended in securingfor the poorer classes a free nursing service of thehighest quality obtainable. This service is never

denied to anyone who cannot pay for the services ofa private nurse.... The qualifications of the nursesemployed are the best obtainable in the nursingprofession." Much of the responsibility for eoordinat-ing the work of the different bodies engaged in

domiciliary nursing falls upon the Central Councilfor District Nursing, a voluntary organisation foundedfor this purpose in 1914. Nursing care for the sickpoor of London in their homes is provided in threeways : by district nursing associations, eitherindependent or affiliated to the Queen’s Institute ;by nurses attached to the nursing branch of the

Ranyard Mission ; and by a few parish nurses.

It speaks highly for the work of the Central Councilthat Dr. Hogarth found only one part of London-the new Grove Park Estate-uncovered by the

organisations now at work ; and even there stepswere being taken to provide a nurse. The changes inadministration following the enforcement of theLocal Government Act of 1929 could not fail to affectthe position of the Central Council to some extent,and at the end of 1929 a deputation was sent beforethe London County Council to explain the CentralCouncil’s work and to offer their experience andmachinery for the distribution of any future subsidywhich might be made to district nursing in place ofthe inadequate and unequal grants previously givenby the boards of guardians. The annual report ofthe Central Council for the year 1931 tells us thata committee was formed by the London CountyCouncil to consider the question of grants, but thatno definite conclusion has so far been reached. Thedecision can hardly fail to be one of grave importanceto district nursing organisations, since the economiccrisis makes it increasingly difficult for them toobtain financial assistance. It is significant of theirposition that the City Parochial Foundation in making