PAGE VI. PREVENTION AND RELIEF OF DISTRESS. State-assisted schemes of relief work Failure to accept work offered Relief to persons leaving a parish Casual relief to persons travelling in search of work Persons relieved receiving arrears of unemployment benefit Public kitchens Distress in the Outer Hebrides ... Cost of relief and numbers assisted by parish councils 198 ... 198 199 204 205 207 208 208 208 209 209 210 ... 210 211 212 213 214 Unemployed Workmen Act, 1905 214 VI. Circular Schemes under Section 2 of the Blind Persons VII. Circular-Blind Persons Act, 1920-Grants in aid of the VIII. Inspection Report Card for Inspection of Dairy Farms X. List of Institutions approved as Venereal Diseases Treatment ... XI. Infectious Disease Notifications, 1920 II. Circular-Port Sanitary Administration I. Report by Inspector of Public Cleansing and Salvage for the PAGE 223 ... ... 225 229 ... 231 ... 233 ... ... ... 233 ... PAGE XII. Infant Mortality : ... 248 ... I. Table shewing for the year ended 31st December 1920 the ... XIII. Report by Dr. Gerald Leighton, Medical Officer (Foods) HOUSING AND TOWN PLANNING. XIV. Memorandum-Preparation and submission by Local Authorities and Public Utility Societies of final statements of ... ... XV. Decision of Rents Tribunal in question between the Board and the Burgh of Renfrew XVI. Memorandum Suggestions for the guidance of Local Authorities in the management of houses erected by them under the State scheme of financial assistance XVII. Acquisition of land for housing : : 250 252 256 261 ... 266 Table I. -Particulars of cases in which the Board have Table II. :-Particulars of cases referred to the Official ... ... Table III.Particulars of cases referred to an Arbiter (other XX. Summary of proceedings by Local Authorities under the NATIONAL HEALTH INSURANCE XXI. Report by Chief Inspector, Insurance Inspectorate 271 273 273 274 275 276 278 279 289 ... 291 XXII. Report by Dr. J. R. Currie on the work of the District XXIV. Extract from Report to the Insurance Committee of the Burgh XXV. Extract from Report to the . . . Insurance Committee upon the prescriptions issued by sixteen of the doctors of the medical list during the year 1920 XXVI. Report of Committee of Enquiry appointed to determine whether prophylactic treatment comes within the scope of treatment to be given by an insurance practitioner in terms of his agreement with an insurance committee XXVII. Note of circulars issued to approved societies during 1921 XXVIII. Summary of the provisions of schemes of additional benefits approved during the year 1921... XXIX. Statement shewing (a) 1921 mean count; (b) insured population according to census returns, and (c) percentage of totals in each case XXX. Claims for refund of contributions XXXI. Certificates of exemption ... XXXII. Payments to deposit contributors XXXIII. Table shewing security given by approved societies and the number and amount of cash deficiencies reported XXXIV. National Health Insurance Fund (Scotland)-Abstract of cash receipts and payments for the year to 31st December 1921... POOR LAW. PAGE 312 313 314 315 316 XXXV. Reports by General Superintendents of Poor Table I. -Summary of the number of poor (excluding Table II. Summary of destitute able-bodied unemployed XXXVIII. Applications for relief XL. Abstract of capital receipts under the Poor Law Acts and XLI. Abstract of half-yearly poorhouse returns 317 328 338 343 344 346 348 349 XLIII. Statement of the average weekly cost of lunatic poor in poor- 356 357 LOCAL GOVERNMENT. XLV. Circular-Parish Audit 358 persons PREVENTION AND RELIEF OF DISTRESS. XLVI. Memorandum for information of parish councils to whom application for relief is made by able-bodied men in acute distress through unemployment XLVII. Circular-Scale of relief for destitute able-bodied unemployed XLVIII. Circular-Co-operation of parish councils with employment exchanges in the relief of distress 359 360 360 XLIX. Circular-Co-operation between parish councils and other 362 L. Circular-Loans to Poor Law Authorities in connection with 364 MISCELLANEOUS. LI. List of members of Consultative Councils 365 THIRD ANNUAL REPORT. = TO THE RIGHT HONOURABLE ROBERT MUNRO, K.C., M.P., PRESIDENT OF THE SCOTTISH BOARD OF HEALTH. SCOTTISH BOARD OF HEALTH, EDINBURGH, March, 1922. SIR, We, the Scottish Board of Health, have the honour to submit this our Third Annual Report, being that for the year ended 31st December, 1921. The matters coming within our jurisdiction are dealt with in this Report in the following order :-(1) Public Health, under which are grouped the following subjects, viz. :-Infectious Diseases (including Tuberculosis and Venereal Diseases); Sanitary Administration; Maternity and Child Welfare; Nursing; School Health Administration; Highlands and Islands Medical Service; Welfare of the Blind; Inspection and Supervision of Food; (2) Housing and Town Planning; (3) National Health Insurance; (4) Poor Law; (5) Local Government; (6) Prevention and Relief of Distress; (7) Old Age Pensions and Pensions to Blind Persons; (8) Miscellaneous. The need for economy has dominated our policy throughout the year. In all the social services administered by us expenditure has been severely restricted and few extensions have been possible. But although we have spared no effort to economise, we have been conscious of the peculiar danger of cutting down services that are manifestly improving the nation's health. There is the twofold danger that indiscriminate economy in any one year may merely create the necessity for swollen expenditure in following years, and that definite advantages won in the fight against disease and illhealth may be lost for want of a little judicious spending. In reducing expenditure we have made special efforts, therefore, to ensure that the limited funds available have been so distributed to and administered by local authorities and other agencies as to ensure the best possible results. We think that these efforts have not been without success, and that the Report will bear out that the various services are performing efficiently their several functions. It was with special reluctance that we found it necessary to curtail services or stop developments that, but for the serious financial condition of the country, we should have been bound, in the interest of the people's health, to encourage. There are several developments in this class that are clearly called for and that must be encouraged whenever financial circumstances permit. The acute trade depression which has affected practically all trades in Scotland showed at the end of the year but few signs of lifting, and the strain on our resources for relieving distress continues. At the end of the year there were on the live registers of the labour exchanges 1,886,000 wholly unemployed, and 316,000 on short time in the United Kingdom; and, apart from persons receiving ordinary poor law relief, in Scotland over 30,000 able-bodied unemployed persons with fully 75,000 dependants were receiving assistance out of the poor rates. A full account is given in the Report of the measures taken to relieve distress. The Poor Law Emergency Provisions (Scotland) Act, 1921, which regularised the granting by parish councils of relief to able-bodied persons, the provision of food on an extensive scale for mothers and infants and school children by public health and education authorities, the National Health Insurance (Prolongation of Insurance) Act, 1921, which prevented large numbers of unemployed from falling out of insurance, and the institution by local authorities of works for the relief of distress are among the matters that have claimed our anxious attention during the year. Any success that may have attended our efforts to secure uniformity of policy throughout the country, to ensure that the scales of relief by parish councils were neither too lavish nor too meagre, and to co-ordinate all the agencies for relieving distress, has been due largely to the generous spirit in which the authorities and voluntary agencies concerned have co-operated with us. The manner, too, in which these bodies have adapted their organisations to meet this unprecedented demand on their resources is worthy of special recognition. These emergency measures may not be ideal in principle, but as improvisations to meet an exceptionally difficult situation we think they are fully justified both on grounds of humanity and of administrative expediency. We are apprehensive of the effect of the continued industrial distress on the health of the people. There has been a considerable increase in the claims for sickness benefit under the health insurance scheme, and much of this increase is genuinely attributable, we think, to lowered vitality as a result of unemployment. This experience is in accord with the generally accepted view of the relation between industrial conditions and the health of those whose wages ordinarily are only sufficient to enable them to meet the week to week expenditure. Moreover, although good progress is being made with housing schemes, housing conditions in Scotland are still very far from satisfactory. We anticipate, therefore, that the cumulative effect of the industrial distress continued over a long period will be to lower the power of the people to resist disease, and |