1052

Member has in mind circulars issued to hospital authorities.Some consolidation on particular subjects has already beeneffected, and this will be extended as circumstances permit.A useful index to all circulars is prepared annually by theBirmingham Regional Hospital Board and is widely circulated.

Tuberculosis Among Immigrants ,

Mr. SAMUEL STOREY asked the Minister what" proportionof the notifications of tuberculosis referred to persons who hadrecently entered the country from Eire.-Mr. MACLEODreplied : The present returns from medical officers of healthmake no distinction as to nationality.

, Mr. STOREY : In view of the fact that the incidence oftuberculosis is 50% higher in Eire than it is in this country,and also that in some parts of the country a large proportionof infections are amongst persons who have recently comefrom Eire, does the Minister not think it a good thing to insistupon radiographical screening and a certificate of fitnessbefore allowing people to come from Eire to seek employmentin this country ?-Mr. MACLEOD : There are a number ofother people and Ministries involved in this. The hon. memberis quite right that a certain amount of difficulty has beencaused by people coming from Eire, and I will see whetherwe ought to get more information on this subject and whethersteps should be taken at the ports and airports.

Mass RadiographyDr. BARNETT STBOSS asked the Minister how many mass-

radiography units were in use in England and Wales ; whatwas the approximate number of cases X-rayed per week ormonth ; and how far the number of units in use was to beincreased in the near future.—Mr. MACLEOD replied : 63 unitsare now in use. Last December the 62 units then in use made190,386 examinations. 5 additional units have recently beenallocated and arrangements are in hand to bring them intooperation.

Bone-conduction Hearing-aidsReplying to a question, Mr. MACLEOD stated that up to

April 18, 958 patients in England and Wales had been suppliedwith bone-conduction hearing-aids.

Fibre-glass and Industrial InjuryIn answer to a question Sir WALTER MoCKTOj-r, the Minister

of Labour, stated that the Factory Department had main-tained a close watch on the manufacture and handling offibre-glass in factories, but there was no evidence to showthat it was injurious to the lungs, although it might give riseto a mild skin irritation which soon disappeared. Samplesof materials consisting of fibre-glass and resins which werenow being used in the aeroplane industry were being investi-gated microscopically by the chemical branch of the FactoryDepartment to determine the size and nature of the dustgiven off when components made from these materials weremachined.

Vivisection LicencesMr. PETER FREEMAK asked the Home Secretary how many

certificates were issued last year to perform experiments onliving animals under the Cruelty to Animals Act, 1876 ; inhow many cases no experiments were performed ; andwhether he would consider curtailing the issue of such unneces-sary certificates.-Sir DAVID MAXWELL FYFE replied : In1952 I granted 678 licences, valid for five years. During thatyear 1335 licensees performed no experiments under the Act.Every year the revocation of licences which have not beenused during their currency is reviewed.

Mr. FREEMAN : Many of these 1335 have never performed asingle experiment since they first received a certificate ; andwill the Minister not consider curtailing the number ofcertificates issued in this way ?

Sir DAVID MAXWELL FYFE : We keep a check on currentyears to find the licensees who have not performed an experi-ment. When we have discovered this we work back to seewhether they have up to that time not performed an experi-ment for, say, four or five years. If they have not we prunethe list.

Use of Agene in FlourLord HANKEY asked Her Majesty’s Government for lists

of countries in Europe and North America in which theuse of agene in flour for human consumption was permitted,and of those countries in which agene was prohibited.Lord CARR-flTGTO14, the joint parliamentary secretary to the

Ministry of Agriculture and Fisheries, replied : The treatmentof flour for human consumption with nitrogen trichloride

(agene) is permitted in the United Kingdom, Eire, Holland,

Germany, Norway, Donmark, Italy, Sweden, and Finland.’It is prohibited in Canada, the United States, France, Belgium,Spain, Portugal, Switzerland, Turkey, and Greece.

Medical Posts in the Civil Service

Dr. A. D. D. BuouctiTTON asked the Secretary to the

Treasury in which medical journals he now advertised thevacancies for appointment of registered medical practitionersin the Civil Sorvico.-Mr. J. A. BOYD-CARPENTER replied:None, Sir. Since no recruitment is taking place, vacanciesare not a,t present being advertised at all.

Dr. BuouctHTON : Can the Financial Secretary state in termswhich are more easy to understand why there have been noadvertisements of civil servant medical-officer posts in themedical journals recently ? Is it possible that the FinancialSecretary is in disgrace with the medical profession, and thatthe British Medical Association has imposed a ban upon thepublication of advertisements of this sort ? If that is so,would he inform the House what the trouble is about ?

Mr. BoYD-CARPENTER : Those issues, particularly the onerelating to myself, are of an intriguing character, but theyare wholly different from the point raised in the question.The hon. gentleman asked in which medical journals vacanciesare advertised, and the answer that I have already given himis "None."

Synthetic Detergents InquiryMr. HAROLD MACMILLAN, Minister of Housing and Local

Government, in a written reply said that after consulting theSecretary of State for Scotland and the Minister of Healthhe had appointed a committee with the following terms ofreference :

" to examine and report on the effects of the increasing use ofsynthetic detergents and to make any recommendations that seemdesirable with particular reference to the functioning of the publichealth services."

The chairman of the committee is Sir Harry Jepheott,F.R.I.c., and the 14 members include the following doctors:

Dr: N. R. Beattie, principal medical officer, Ministry of Health(attached to Ministry of Housing and Local Government); Dr.J. C. Cruickshank, professor of bacteriology as applied to hygiene,London School of Hygiene and Tropical Medicine ; Lieut.-ColonelE. F. W. Mackenzie, director of water examination, MetropolitanWater Board.

Public Health

SmallpoxX 0 new cases were reported from Yorkshire in the

week ended at noon on May 19, but the Baildon minerwho was admitted to hospital with smallpox on May 5.died on May 13. The total number of confirmed casesin the outbreak is 30, including 8 deaths. The lastpatient who might have spread the disease was taken tohospital on May 5. Although the period of surveillanceof known contacts has almost expired, special vigilancemust be lnaintained for a longer period because thesource of infection of 4 patients who fell ill several weeksago has not been traced.

Diphtheria Immunisation in AntriinIn his report for 1951, Dr. P. V. Pritchard, medical

officer of health for county Antrim, says that not enoughchildren are being immunised against diphtheria tomaintain a safe level of protection in the county. Figuresfor 1951 indicate that less than 30 % of the children arebeing immunised. Dr. Pritchard points out that thefacilities for immunisation in the county are not as

extensive as elsewhere, for the county health committee’sinstructions are that immunisation should be carried outsolely by general practitioners, except in a small minorityof cases dealt with by medical officers of the public-health department at long-established clinics. The com-rnittee lately reconsidered the matter, but decided tocontinue the present system and not to extend immunisa-tion in clinics.. Some Antrim doctors claim that a satis-factory number of children are being immunised and thatthe figures are unreliable because returns are incomplete.But Dr. Pritchard says that an inquiry into the quantityof diphtheria prophylactic supplied to doctors in thecounty has failed to support this claim. In his view.the only solution is to offer the public the alternatives ofimmunisation by the family doctor or at a health-committee clinic.

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Medicine and the Law

The State-aided Plaintiff

A CORRESPONDENT has taken exception to a few sen-tences in our leading article of May 2, where, in speculatingon the causes of the undoubted increase in claims againstmedical practitioners and hospitals, we mentioned theinfluence of the Legal Aid and Advice Act, 1949. TheState-aided, plaintiff, we suggested, has his free run ;" State-aided litigation tends to be fought to a finishwithout compromise " ; the ordinary deterrents of

having to pay his own costs and the costs of a successfuldefendant do not apply. Our correspondent’s unfor-tunate experience contradicted this view. Though a

State-aided plaintiff, he found himself obliged to com-promise his claim for a sum less than his disbursements.The Act and its attendant regulations, he found, imposedupon him a liability for payments to the Legal AidFund which came near to a threat that he might be madebankrupt even when he had succeeded in a claim broughton solid grounds.His case indeed was hard ; we may hope it was

exceptional. He was claiming damages for professionalnegligence on the part of his family solicitors who hadignored a specific direction. When they denied liability,he put the matter into the hands of a second firm. Heunderstood himself to be entitled to legal aid ; the firm

thought otherwise, but, after reference to the LawSociety, he was found to be qualified. The defendantsolicitors offered to settle on the basis of some three-fifths of his claim. He was persuaded to accept thisoffer, whereupon the defendants paid into court a verymuch smaller sum and the action went on. He was

naturally indisposed to accept this smaller sum thus

paid in ; but his own solicitors warned him that, if theverdict he might obtain should not exceed that sum,he would be personally responsible for all the costs

accruing after the date of payment into court.Though this is not the place in which to set out, or

even to summarise, the Act and regulations, it is certainlytrue that the new Legal Aid system is a flexible schemewhich rightly seeks to satisfy the needs of the citizenand yet to protect the Exchequer and the taxpayer.In effect the State-aided litigant makes what contribu-tion he can to the Legal Aid Fund. If the assisted

person wins, his position as regards costs is much thesame as if he had received no legal aid ; his unassisted

opponent has apparently to pay full "

party and party "costs-not merely 85% of them. The Fund has a

first charge on any property, wherever situated, recoveredby or preserved for the assisted plaintiff. If the assistedperson loses, his liability for the sum awarded is thesame as that of an unassisted person who has lost.As regards costs, hoivever, the Act limits his liabilityto "the amount (if any) which is a reasonable one forhim to pay, having regard to all the circumstances,including the means of all the parties and their conductin connection with the dispute." His house, his furniture,and the tools of his trade must be left out of account in

assessing the amount of costs that he must pay. Underthe regulations the court may order him to pay " suchamount, if any, as the court thinks reasonable, havingregard to all the circumstances." Much will dependon the interpretation given by the courts to that flexibleword " reasonable." Meanwhile, in the phrase of theauthor of the leading textbook on the subject (himselfan active participant in the framing of the new procedure),the privileges given by the provisions of the Act " maywell provide an assisted person with a bargaining weaponof the Heads I win and tails you lose’ variety againstan unassisted opponent." That opinion, despite theconverse experience of our correspondent, goes far to

justify the general tenor of our previous statement.

ObituaryKENNETH NORMAN ABBOTT HERDMAN

M.A., M.D. Edin., D.A.

Dr. Herdman, consultant anaesthetist to Leith Hos-pital, who died on May 7, had approached his specialtyby way of general practice. After graduating at theUniversity of Edinburgh as M.A. in 1924 and as M.R.four years later, he held house-appointments at LeithHospital, a clinical tutorship at the Edinburgh RoyalInfirmary, and a clinical assistantship at the Eye, Ear,and Throat Infirmary.As a Territorial he was called up from his busy practice

in Edinburgh at the beginning of the late war. ebecame a specialist anaesthetistat No. 23 General Hospital inthe Middle East; then he wentas anaesthetist to one of theunits in the Eighth Army, the15th (Mobile) Casualty ClearingStation. With No. 15 he tookpart in the memorable advancefrom the Battle of Alameinalong the North African coastto the end of the campaign atCape Bon.

Returning to civilian life, hegave up general practice toconcentrate entirely on anges-thesia, and J. A. R., on behalfof his fellow-surgeons, writes," Kenneth Herdman was one ofthose invaluable and all too raredoctors who specialise aftera long experience in general

[James Bacon & Son

practice. His experience in general medicine, and hisgifts as a well-qualified and expert physician, allied tohis own sound judgment, gave him the power of accuratelyassessing patients’ general conditions before, during, andafter operation. This was a great boon to his surgicalcolleagues, who sought his advice freely in the handlingof their cases. They knew that his experience, com-bined with superlative technical excellence, made himabsolutely safe and reliable for their own work and also,when need arose, for themselves and their relatives.

" Tall, gallant, and debonair, Kenneth Herdman

never spared himself, and never complained, thoughhis health had been precarious for some time. Everconsiderate of others, it was characteristic of him thathe was invariably punctual at all his engagements.This punctuality, with his unassuming cheerful efficiency,was particularly appreciated by the operating-theatrestaffs with whom he worked. He was an outstandingman, and he set us all a noble example of courage,unselfishness, and skill."

Dr. Herdman leaves a widow and two sons.

CHRISTOPHER JOSEPH McSWEENEY

M.A. Dubl., M.D. N.17.1., F.R.C.P.I., D.P.H.Dr. McSweeney, medical superintendent of the Cork

Street, Fever Hospital, died on April 17 at the age of 54. Aman of energy, ability, and character, he was about toenter the most important stage of his life’s work.He was born at Cork and educated in that city at the

Christian Brothers’ College and at University College,from which he graduated as -M.B. with first-class honoursin 1921. After holding an extern assistantship at TheRotunda Hospital, Dublin, he took the D.P.H., and in1925 he was appointed assistant M.o.H. for Cardiff,where two years later he was promoted to be deputyM.o.H. He also lectured on infectious diseases at theWelsh National School of Medicine.

In 1930 McSweeney took his M.D. degree ; in 1933he became M.R.C.P.I. ; and in the following year hereturned to Dublin to take charge of Cork Street FeverHospital. He brought with him a reputation for medicaladministration, and during the years, through manyvicissitudes, he persisted in his purpose of providingnew buildings for the hospital. The task was latelycompleted, and he moved his residence to the newhospitals only a few days before his death.