PREVENTION OR TREATMENT? the title of a conference the Queen's Institute of District Nursing on May 22nd in London and attended by about 300 was

THISorganised by

the breakdown of work in a practice with and without nursing assistant' The quality of service rose when the G ' worked with a supportive team.

delegates. Dr. D. Thomson, of the Ministry of Health, spoke on "The Demanding Diseases," for which he produced charts and statistics on the patterns of national morbidity and hospitalisation. He re-

ferred to the variations in different areas in lengths of hospital stay for similar conditions, and showed that the trend was towards shorter stay.

STRANGE OMISSION This obviously affected the provision of after-care. The incidence of psychoneurotic diseases in general practice was included in one chart, but psychiatric illness did not appear in his analysis of hospitalisation figures?a strange omission which completely belies the actual situation.

NO GUIDE This was rectified by Dr. F. M. Martin of the Department of Social Medicine, Edinburgh, who gave an excellent paper He said on "Emphasis on Sanity." that it was impossible to assess whether mental illness was on the increase or not, and that hospital admission rates were no guide. He wondered whether modern treatments, with the emphasis on physical methods and short stays in hospital, were leading to an excessive concern with rapid turnover and a "conveyor belt" attitude to psychiatric patients. He pleaded for more understanding of the social concomitants of illness, and warned the audience that "putting people into the community" was not synonymous with community care. Professor Richard Scott, Professor of General Practice at Edinburgh, spoke on the "Quantitative/Qualitative Dilemma." Today, the G.P. had more resources available, but could do less by himself. He needed allies, particularly in the field of preventive medicine. Professor Scott produced tables showing



In discussion, Dr. J. P. wondered whether the role of the distnc nurse needed reconsidering in relation' psychiatric patients, and whether alteration in her training was The afternoon session was filled by; 1 succession of ten speakers working the community, most of whom d?5 cribed or demanded a team approachtl care and treatment. Mr. J. Prentice,, district nurse working with 1,1 patients, said the patient should be tea111' the most important member of Dr. D. W. Shedden, a G.P., cribed with enthusiasm the Wesse f' Training Scheme for young doc to which included part-time hospital part-time work as a trainee in a geneI/ practice, and considerable study | Local Authority Services and medicine. He thought such a was essential for the G.P. today, aI\ was particularly valuable in relation


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Prevention or Treatment?

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