Postwar developments in child health study in Great Britain

Abstract

~'~ HE past twenty-five years in Britain have seen the curious paradox I of a steady improovement in the health of almost all children combined with a growing dissatisfaction with the medical services available for the care of children. This period has been one of great expansion in the child welfare services for the care of the young infant, and much original work has appeared from individual pediatricians on subjects of importance in the study of diseases of children. Yet these two streams of the medical care of the young have been flowing apart. On the one hand, the medical officers in the child welfare and school medical services have received little training in pediatrics, and the hospitM pediatrician was either not interested or not allowed to be interested in the care, of the child in health. Behind all this lay the fact that pediatrics had little or no academic recognition. The subject received only scant attention in either the curriculum or the final examination of medical students, yet often a third or more of g general medical practitioner's work dealt with sick children. It has been estimated that for every s ($400) allotted each year in grants to the provincial universities of England and Wales, only 5 ~ pence (about 10 cents) was spent on the special teaching os child health. Recent developments indicate that this unsatisfactory state Of affairs is coming to an end. The new departments of child health in the,,:University of Durham and Liverpool, the promised development o~ an Institute of Child Health in London, together with,~ihe steady growth of existing departments in Edinburgh and Glasgow, all show that there is a new awakening of interest in the care of the child. HistoricMly, the work in Glasgow and in Birmingham may be mentioned first, in the former, a Chair in Medical Paediatrics was founded in 1924, a special lectureship having existed since 19i9, but although the staff includes four lecturers and three assistants in addition to the professor, there is no direct cooperation between the University Department of Paediatrics and the Local Authority (that is, the local government) as regards child welfare work or the school medical service. Yet most valuable work has been achieved in Glasgow, most notably the research on rickets, carried out by the first holder of the university chair and his colleagues.