patient efforts of British taxpayers to put the pound sterling again on a par with the soundest currencies of the world. The very success of these efforts has, for the present, handicapped British trade. If France, on the other hand, has recovered Alsace and Lorraine with their actual and potential wealth, she has suffered more severely than Great Britain in the loss of economic manpower, and from the obliteration of thriving industrial centres in her north-eastern departments. But Englishmen feel that, apart from niceties of political account-keeping, one factor deserves special consideration. It is that there can be no return to political or economic health in Europe without such an approach to stable conditions of international trade and intercourse as shall avail to cure the anæmia from which the whole life of Europe is suffering. This factor, France seems not to take fully into account.

Nevertheless, I still believe that the peoples of Europe have now a fleeting and, probably, a last chance to set their feet on the road towards recovery-if the British Government will take some risks, and if the French Government will join it in thinking more of Europe and less of the immediate and special claims of France.

Great Britain should face unreservedly the 'risk' of having to pay, in course of time, the total British debt to the United States. In truth this is no risk, but an obligation which a solvent country cannot evade; and it may well be found that the greater the alacrity of the Chancellor of the Exchequer in meeting the wishes of the American Funding Commission the less onerous, in the long run, are those wishes likely to prove. The only precaution which British negotiators in Washington need observe is that their readiness to meet American requirements shall not be qualified by any condition, antecedent or other. They should trust the good faith and good sense of the eminent American statesmen who form the Funding Commission.

If, concurrently but separately, the German Reparations Debt of 6,600,000,000l. were reduced approximately to 2,000,000,000l. by cancelling the German Reparation Bonds of the 'C' category (4,100,000,000l.), together with 500,000,000l. of the (1,900,000,000l.) Reparation Bonds of the 'B' category, in consideration of the simultaneous extinction of European inter-Allied debts, a basis might be found upon which the European Allies could intimate to Germany their joint and definite resolve to hold her to the payment of the reduced debt in such manner and at such times as might be equitably determined. It is so manifestly in the interests of Germany to work her way back into a comity of nations enjoying ordered relationships and facilities for international credit, that a practical agreement upon these terms should not be beyond reach. Some readjustment of the interAllied percentages of Reparations payments might be expedient.

Political provision for the security of France, England, and Belgium by a defensive pact, providing, inter alia, for the demilitarisation of the Rhine Provinces under the supervision of the League of Nations, should also be feasible.

The effect upon the United States of a successful European attempt to grapple with the European problem upon these or similar lines could hardly be over-estimated. If made independently of the funding of the British debt to America, it would assuredly modify the American disposition to hold aloof from European affairs. Great Britain would have used, in two distinct operations on each side of the Atlantic, the key that can alone unlock for the world the doors now closed upon a better future. She would gain in renown, in moral strength, and, ultimately, in wealth; and France would share them with her. In this truly fateful hour England stands to-day as a potential link between Europe and America; but with the French Government may lie the decision whether France shall in future stand with England as her partner.

December 14, 1922.

WICKHAM STEED.

MINISTERS OF HEALTH-DEFEND US!

CAN anyone imagine what would happen in the minds of the public in general, and the members of the legal profession in particular, were any man not a lawyer placed in the position of Lord Chancellor? The consternation that would occur would be difficult to exaggerate the belief of the nation in the proper administration of the law would be threatened immediately. The position of Lord Chancellor in its mind would be rightly regarded at once as being the perquisite of brilliant politicians who deserved well of their party, but whose knowledge of law and its administration would be first acquired when they entered the doors of their new position, and law would suffer in consequence. The unsettlement in the mind of the public would be like the introduction of Bolshevism into business affairs. The uproar in the legal profession would be beyond the bounds of wild imagination.

It is with the same consternation that I view a Ministry directly concerned with public health placed in the hands of any person other than a member of the medical profession. It is essential, in the interests of public health, that the office of Minister of Health should of necessity be held only by a medical man of recognised position in the medical profession, as the office of Lord Chancellor can be held only by a man of recognised position in the legal profession. Public health can never be authoritatively and effectually controlled until the Minister responsible in Parliament to the people and to its Government is a member of the medical profession. It seems to me that the fundamental mistake was made at the creation of the Ministry of Health when it was not definitely arranged that a member of the medical profession should always hold the controlling office of Minister.

What has happened is this: the Ministry of Health is only another name for the old Local Government Board. The duties assigned to it include only some of the problems of public health together with a general assortment of other matters which have nothing directly connected with it, and all these things are under the control of politicians whose knowledge of the great subject of medicine in relation to public health is at zero. To place an appointment so tremendous in its potentiality in the hands of a

politician, however brilliant, is a mistake, and must be totally subversive of all sound practice. Moreover, it is a mistake that shows a profound ignorance of what the profession of medicine can do for public health when scientifically led.

It appears that those who framed the constitution of the Ministry allocated to it duties that no other department cared to adopt, and gave to it a few only of the functions with which it alone could efficiently deal. At present public health matters are separated and have no unity or direction of action.

Is there not more than a touch of bathos as well as pathos in the following facts?

'Model Byelaws issued from the Ministry of Health: VII.— Hackney Carriages' shows that this Ministry has the supervision of the behaviour of taxi-cab drivers and the place where they and their cabs can stand, etc., etc.

Sir George Newman writes annual reports upon 'The Health of the School Child' to the Board of Education, showing that it has the supervision of this important branch of public health.

In his Third Annual Report of the Ministry of Health, 19211922,' which deals with such curious subjects as emigration, vagrancy, and assistance to destitute aliens, Sir Alfred Mond states, 'As in previous years the report of the Chief Medical Officer of the Department will be published in a separate volume 'showing that the Minister's report is comparable with the play of Hamlet without the Prince of Denmark.

The relations between the diseases of animals and human beings are under the control of the Board of Agriculture.

The direction of Research is in the hands of the Privy Council. What a state of things! And how do they agree with the Ministry of Health Act, 1919, which says:

2. GENERAL POWERS AND DUTIES OF MINISTER IN RELATION ΤΟ HEALTH. It shall be the duty of the Minister, in the exercise and performance of any powers and duties transferred to or conferred upon him by or in pursuance of this Act, to take all such steps as may be desirable to secure the preparation, effective carrying out and co-ordination of measures conducive to the health of the people, including measures for the prevention and cure of diseases, the avoidance of fraud in connection with alleged remedies therefor, the treatment of physical and mental defects, the treatment and care of the blind, the initiation and direction of research, the collection, preparation, publication, and dissemination of information and statistics relating thereto, and the training of persons for health services.

The matter surely requires adjustment by Parliament.

The Ministry of Health, to be more than a name, should deal with and be responsible for all questions that directly concern public health. These would not encumber the Ministry, but would make it what it ought to be, and what it will one day

become, one of the most important Ministries of the State. Should it ever be considered desirable to introduce a Bill which is only remotely connected with questions of public health, the Minister of Health should not be entrusted with its charge during its perilous journey through the House of Commons. Why should any Bill or any Ministry be placed in the hands of men whose training and knowledge of the subjects with which they have to deal is outside the provinces of their life, education, and training? The fact of the matter is that, on the whole, this is the scheme of government adopted in this country. It is absurd and Gilbertian in its humour that the country should be run by men who know nothing of the subject for which they are responsible, and whose qualifications for the posts they occupy depend upon the readiness and astuteness they have shown in juggling with political issues. It is a bad, inefficient scheme, and if the Labour Party, or any other party, would conceive it as part of its programme radically to alter the scheme, it would receive the support of the nation and would bring the party into great and honourable power.

I will attempt to explain how it is that (1) the public and (2) the medical profession should tolerate for a moment such an appalling state of things as the Ministry of Health being in the hands of a politician, however brilliant, who is not a doctor of high and special qualifications for the post.

1. The Public.—Though the medical profession has shown itself capable of exerting its stupendous influence on public health, the public ear has never been able to listen to a collective, authoritative, and efficient opinion delivered by this great profession. It has been able to hear opinions only from individuals by means of special interviews, of letters in newspapers, or from occasional addresses delivered to professional bodies. Important as these opinions may be, they are only opinions of individuals, and consequently their value is lost by their inability to possess a collective consensus of opinion. Take, for instance, Mr. James Berry's address before the Surgical Section of the Royal Society of Medicine at the opening of its winter session. It contains many outstanding problems (one in particular) that directly concern the health of the public, yet probably, apart from members of the medical profession, no one has read a word of this address. Again, sometimes the public manages to hear of isolated inefficiently reported statements concerning its health made at the yearly meetings of the British Medical Association. The Royal Colleges of Physicians and Surgeons are composed of men capable of making individual statements of the utmost importance with regard to public health, but it is not their province to make collective pronouncements on this subject. These colleges possess no right to state the collective views of these institutions, their main function