NOTES OF THE WEEK .sx Town Planning .sx The definite announcement of a new town planning Bill will have been received with trepidation by local government officers .sx Of its necessity in the public interest there can be no doubt .sx Town planning is a relatively modern local government service and it is still in the stage of experiment .sx That not all experiments have been successful is evident to anyone who takes advantage of the coming of Spring to visit the green fields and the whispering woods .sx Bungaloid growths , ribbon development , ugly red roots , these are the common sights of the countryside .sx Nor can it be doubted that there are elements of urban organisation that we have not yet touched .sx Those of us who have the good fortune to possess a little cottage in the country ( carefully placed , of course , so as not to offend the eye , off the skyline , away from the road , screened by trees , and built so as to harmonise with its surroundings ) cannot repress a shudder as we come into the great towns where we labour , as we pass the monstrous relics of industrial development , where there is no beauty and no peace .sx The slums we can now help to clear away ; what we cannot yet do is so to organise future development of built-up areas so that when the opportunity occurs they shall cease to offend .sx This the new Bill ought to enable us to do .sx But the performance of this new and essential service will fall upon the already overladen backs of local government officials .sx Life consists in a perpetual struggle to keep pace with Parliament .sx We are still concerned with the Local Government Act of 1929 and its consequences .sx We are working out the effects of the Housing act of 1930 ; we are considering where we stand under the Road Traffic Act , the Land Drainage act , and a number of minor amendments to the general law , not to speak of our own local Acts .sx We are now promised a new Town Planning Act , and that will be followed by a consolidating measure .sx We are expecting consolidating Acts for Local Government , Public Heath , and Housing .sx We are not sure that soon there will not be a new Representation of the People Act .sx We must assume that what Parliament commands is necessary , and we shall in any case obey .sx But there is no chance of economy while new legislation makes us continually add to our staffs , and we ourselves would be glad of a breathing-space .sx The District Audit .sx Mathematicians assure us that if a pebble were thrown into a perfectly elastic sea , the ripples would go to the ends of the earth .sx Compared with the sea of local government activity , the Local Government Act of 1929 was a pebble as big as Mount Everest .sx But we are continually meeting its ripples in most unexpected places .sx It is just announced that as a result of the Act a reorganisation of the district auditors is to take place .sx On consideration , the reason is clear .sx The abolition of some hundreds of boards of guardians must have resulted in a considerable diminution of the accounting authorities , even though the poor law accounts of the country boroughs are brought in , and even though the number of accounts is not diminished .sx But we do not suppose that anyone not a district auditor thought of this effect of the Act before it was passed .sx True it is that every act and every event has an infinite number of consequences which we cannot foresee .sx This is not , of course , a reason for not acting .sx It is a reason for deep thinking before any act is done or Act is passed which may have substantial results .sx The Supply of Nurses .sx The Lancet interim report on the reasons for the shortage of nurses is an interesting document .sx Long hours , menial work , inadequate social amenities , the absence of superannuation schemes , are among the reasons suggested .sx The hospitals are opposed to any lowering of the educational standards demanded at present .sx But it must be remembered that girls leaving secondary schools have to find something else to do before the hospitals are ready to take them , and that , though of necessity the nurse's life must be a hard one , there is no necessity for all the unpleasant and hard labour to which the young probationer is subjected .sx She is usually quite incapable of putting in in addition the study which must be demanded of her .sx Thus , there is a long gap between the end of her school education and the beginning of her medical education in the third of fourth year of her work as probationer .sx It is not surprising that the demand is greater than the supply .sx It is suggested in the Report that education authorities might collaborate with the hospitals in the provision of schools for the preliminary training in the theoretical principles of nursing .sx But what is really needed is a change in conditions .sx Let the public hospitals lead the way .sx The London County Council , as our leading article shows , has already increases its nursing staff by increasing the attractiveness of their conditions .sx Others can do the same .sx WATCH Committees are being asked by the Home Office , with reference to the model conditions recommended by that department in December last , relative to the control of cinematograph exhibitions , to be furnished with information as to the extent to which these conditions have been brought into force , and the measure of control which they afford , particularly over the character of films which are shown to young people .sx THE POOR LAW MEDICAL SERVICE .sx A comprehensive report just made by the Central Public Health Committee of the London County Council to that council is of great interest , since it raises questions with which all poor law authorities have to face on a slightly smaller scale .sx The Public Health Committee took over , as from the 1 st April , 1930 , the treatment of the sick poor in hospital , the district medical service , and the institutional care of children under the age of three years separated from their parents .sx Its functions include the provision , classification and management of hospitals , their visitation and inspection , consultation with representatives of the voluntary hospitals , the conveyance of cases to and from hospitals , laboratory services , the training of nurses and midwives in connection with hospitals , and the direction of the various staffs .sx In short , the committee has the functions which can best be administered by a public health committee of county council , and which involve problems applicable to all the hospital services of county borough councils , whether under the poor law or the law relating to public health .sx Organisation .sx The organisation for the exercise of these multifarious services is of general interest .sx The central co-ordinating control is exercised through seven central sub-committees , to whom considerable powers have been delegated .sx A sub-committee has also been established for each hospital or institution , except in a few cases in which it was convenient to include two or more establishments under one sub-committee .sx Such sub-committees act as " house committees " in accordance with par .sx 72 of the Public Assistance Order , 1930 .sx Other functions appropriate for local administration have from time to time been delegated to these hospital committees .sx The hospital committees report to the appropriate central sub-committee , such as the General Hospitals Sub-Committee , the Special Hospitals Sub-Committee , or the Staff Sub-Committee .sx The committee had transferred to it on the 1 st April 1930 , 61 hospitals , one children's infirmary and nursery , and 12 institutions allocated for use as hospitals .sx These came from the Metropolitan asylums Board and 25 boards of guardians .sx A large number of problems was therefore created by the variety of conditions to be found in the institutions and hospitals .sx Some of the buildings were not in a good condition .sx The internal arrangements in some of them were obsolete .sx Each had its own staff working under its own peculiar conditions .sx And so on .sx Every branch of administration had its own problems .sx Not all of these could be settled within the space of nine months , and in many cases the committee found it necessary to continue existing arrangements until it had the time and opportunity of discussing what should take their place .sx Classification .sx One of the most important problems to which attention has already been given is the question whether it is advisable to have hospitals reserved entirely for acute sick ( i.e. , persons needing treatment for various ailments whose stay in hospital need not be prolonged ) , and others solely for the chronic sick ( i.e. , patients who are generally cases of senility and other chronic ailments) .sx It will be remembered that one of the arguments put forward in 1929 for the abolition of the guardians was the desirability of the separation ; between these classes it would be made possible so soon as the larger authorities took over poor law functions .sx The committee reports :sx " There was authoritative opinion that this was a desirable arrangement , but experience has shown us that it has serious disadvantages .sx Not only would it involve taking patients to places at some distance from their homes , but - an even more material point - we do not consider that it would be possible to secure the same standard of medical and nursing care in an institution containing only patients of the chronic type as in a hospital in which a variety of cases , including the curable , are treated .sx In the interests of both patients and staff we consider that the best arrangement is to aim at having hospitals in which both the acute and the chronic sick are accommodated in the proportion of about three to one .sx " " Rationalisation .sx " Apart from reorganisations of special hospitals for specific types of diseases , the new central control has made possible a number of administrative improvements .sx The committee has approved standard patterns and styles for nurses' uniforms and scales of allowance of the various articles , which , while costing no more , are likely to be more satisfactory .sx Arrangements have been made for a standard badge inscribed with the name of the hospital to be issued to each nurse .sx In place of the different patterns of crockery in use , standard patterns have been approved for general issue in future as required .sx Dietary scales have not yet been considered , but some improvements have been effected .sx Christmas allowances and allowances for the supply of periodicals and newspapers have been provided .sx New arrangements have been made for funerals , and the practice of combined funerals has been discontinued .sx Care of children .sx It will be remembered that the reference to the committee included the care of children under the age of three who are separated from their parents .sx By agreement with the Public Assistance Committee , this duty was defined as arising for any child who was separated from its parents for a period of more than two months .sx There was obvious difficulty in carrying out this duty , for the children were scattered through the county in various institutions , and there was no institution suitable for their segregation .sx But the centralisation of the poor law schools under the control of the Education Committee enabled arrangements to be made for the care of the children in these schools by a specially trained staff .sx Consultation with voluntary hospitals .sx By section 13 of the Local Government Act , 1929 , the new poor law authorities are under the obligation of consulting representatives of the voluntary hospitals in their provision of hospital accommodation .sx The Public Health Committee adopted the desirable understanding that such consultation would not be limited to the matters expressly set out in the section , while the representatives of the voluntary hospitals on their side have waived their right to be consulted on every small matter .sx Thus , a working arrangement has been arrived at which will be of the utmost advantage to the public .sx For instance , the Voluntary Hospitals Committee was consulted on the proposals for uniform scales of salary and conditions of service for medical staff , nurses , stewards and clerical staff and laboratory staff .sx Problems relating to the provision of medical instruction in the hospitals were also discussed .sx 1 .sx