1256

mainly chronic, maternity, or mental. Three main setsof figures are worked out : (1) the total inclusive net costper week of maintaining a patient ; (2) the same costafter allowing for outpatient expenditure (this is done byassuming that five outpatient attendances equal, for

costing purposes, one inpatient day), and (3) the same costfurther adjusted -to allow for " vacant-bed factor"- (beds staffed but not occupied)., For the purpose of comparin-g the cost per patientbetween hospitals of the same type or between one typeand another, it is considered that the inclusive net costafter allowing for outpatient expenditure (where applic’-able provides a reasonable basis for comparison. Inthe accompanying table this figure is used to comparethe average cost per patient in various types of non-teaching hospitals in the fourteen hospital regions of

England and Wales together with national averages. Forteaching hospitals classified as wholly general the averageweekly cost per inpatient, computed on the same basis,was E23 16s. 10d. in London and :E17 5s. 10d. in the

provinces. -

-

Mr. lain Macleod, the Minister of Health, has toldhospital authorities that the primary object of these

costing returns is to enable them to make comparisonsbetween the costs of comparable individual hospitalsand between those costs and the regional and nationalaverage figures where these have been provided. Headds : "

Investigation of the causes of the differencesthrown up should be of value in securing economy andimproving efficiency in administration, and regional.hospital boards, hospital management committees, and

p

boards of governors are asked to make the fullest possibleuse of the figures."

.

1. Annual Epidemiological and Vital Statistics, 1939—46. Part 2.Cases of and Deaths from Notifiable Diseases. W.H.O. Geneva.1952. Obtainable from H.M. Stationery Office, P.O. Box 569,London, S.E.1. Pp. 202. £1.

HEADQUARTERS STAFF OF REGIONAL BOARDSThe Medical Whitley Council (Committee " B ") have

reached the following agreement on the salary scales forassistant senior medical officers and medical officers onthe headquarters staff of regional hospital boards.The Minister of Health has approved the new scale, whichis to be retrospective to Oct. 1, 1950.

Assistant senior medical officers in all regions of Englandand Wales, and in the Western and South Eastern Regions ofScotland : n500 x n5(4) x nOO(I)-n900 per annum.

Assistant senior medical officers in the Eastern, NorthEastern and Northern Regions of Scotland : E1500 x £75—JE1800 per annum.

Medical officers in all regions : E1250 (at age 33 or over) XjE50-1500 per annum.

Officers in the Metropolitan Police Area will receive aLondon weighting allowance of E50 per annum.

Public Health

Notifiable Diseases

THE division of epidemiological services of the WorldHealth Organisation has new prepared the second partof its Annual Epidemiological and Vital Statistics,1939-46.1 The first part, devoted to population andvital statistics, appeared last year. The latest volumedeals with notifiable diseases, and contains the figuresreported by more than 150 States and territories. When-ever possible both the number of cases and the deathsfrom each of 19 diseases are given for every monthof the eight years. Annual figures are tabulated foranother 12 diseases. Clearly and painstakingly compiled,this publication represents the only official source ofinformation covering so large a part of the world’spopulation. It continues the sequence of Annual Epi-demiological Reports issued from 1923 to 1938 by theLeague of Nations.

In England Now

A Running Commenwry by Peripatetic CorrespondentsFOB some time we have dabbled in embryology to the

extent of drawing red blue and yellow diagrams on ablackboard before the assembled multitude, and to usExperimental Embryologists have acquired the statusof mythical Culture Heroes. It was therefore disturbingto meet one in the flesh and to discover that he isbesieged by misgivings like other men. From his dis-course we gathered that chromosomes are outmoded,since triploid rabbits and haploid mice are indistinguish-able from normal ones. Haploid newts, we noted withsatisfaction, are sterile. We learnt that the insertion ofa piece of bootlace will induce differentiation of theneural ectoderm, and our eyes became glassy at themention of mosaics, cytoplasmic gradients, and greycrescents.That a man who habitually scrambles the contents of

a sea-urchin’s egg with ultrasonic waves, and who oncedivided the nucleus of an embryonic axolotl with a thinsnare, should ever be in doubt seems to us incredible,But so it is : under the thin crust of our red blue andyellow diagrams lies a seething morass of uncertainty.We are buying some green chalk tomorrow.

* * *

It is a big step forward for the young medical author(and a welcome one for his editors when he appreciatesthe niceties of bibliographical abbreviation as laid downin the World List of Scientific Periodicals. This willshow him how to avoid such betises as B.M.J. andJ.A.M.A. and works of supererogation such as J. Pharma-col. & exp. Ther. or Proe. Staff Meet. Mayo Clin.After a couple of days with the World List at his elbowhe will be clearing such hurdles as J. Lab. clin. Med.and Proc. Soc. exp. Biol., N. Y.; with never a stop orcapital misplaced or a superfluous syllable. He willenjoy the very special thrill of pruning oversize titleslike Bollettino della JJI alattie dell’ Orecchio, della Gola, dellaNaso, di Tracheo-Bronco-Esofagoscopia e di Fonetica tothe laconic Bol. Mal. Orecch.

Foreign publishers are apt to follow a code of abbre-viations of their own, and this morning, when runningthrough a Belgian abstract journal, we were shaken tofind a paper on the aetiology of peptic ulcer credited toWikliwo, 62, 674, 1950. This raffish-looking title sug-gested one of those, glossy Continental weeklies, filledwith risque cartoons, which one finds in the betterHarley Street waiting-rooms. With bitter memories ofinstigating library searches for the current volume ofIbid, we appealed to a learned colleague, schooled inmilitary terminology, who identified it* in a few secondsas the journal known in our chaster code as Wien. klin.Wschr. NATO, SHAEF, NATSOPA, ROSPA, and now

’BVIKLIWO; only a little farther down the slippery slopeand we shall find ourself figuring as a case-history inthe J. ment. Sci. (or will it be JOMESCI ?).

* * *

Our new projector arrived the other day, in a coupleof imposing packing-cases, and we all assembled eagerlyon the chance of being allowed to play with it. TheInstruction and Service Manual began in a restrainedmotherly key :

" Unscrew the lid of the large case and lift out the cabinet,taking care not to scratch the finish... clean out the insideof the cabinet and dust the screen carefully ... gently lift itfrom the case and remove the cross batten... make sure youhave thoroughly washed behind the ears."For the next two pages all was sweetness and light;a paragraph was devoted to the discovery of the mainswitch A, and another to the identification of the earthwire marked Earth. A fleeting chill ran down our spinesover two sinister nuts T1 and T2 which had to be exactly729/32 in. (19-97 cm.) apart ; but otherwise the gentleflow of Instruction soothed and relaxed us. It was justlike ’ Meccano.’

This could not last, and by the fourth page a peevishadmonitory note had crept in: " Ensure that the shutter-operating pin P, if removed, is replaced square end up/’This began the rot. Search as we might, we could dis-