Perfection in man and freedom from disease may mean longer life, or more abounding enjoyment of every moment of living; and to attain it will be no easy task. Hitherto we have not understood how that perfection was to be sought. To-day, while we cannot yet attain it, we can claim to know the methods to be used and the tests to be applied.
Many of them are far beyond the compass of this book and have been mentioned in earlier chapters only in passing. To some we have applied the term “social medicine,” but the use of that phrase must not blind us into supposing that it is new, or that it solves any problems by itself. Medicine is a social science, a science with a great social purpose, and it is only because it has become involved in financial methods of doubtful social value that it has been necessary to re-emphasise and reiterate its social message.
Other methods of attaining perfection belong to the general political system, and can be achieved only by changes which a few years ago were darkly alluded to as “Socialist” but are now seen to be the real aim of a democracy which recognises that the people can rule, and therefore legislate, only for the people as a whole. All that a socialist state attempts to provide for every citizen in houses, diet, clothing, recreation, leisure, education and social security are essential to health ; and not until they are in the possession from birth, as they are the birthright, of every citizen will we be able to tackle the final problems of individual health. When we have ensured the removal of all those environmental defects we now recognise, we shall be able to begin the examination of the individual and to isolate other factors, inherited and eugenic, for study and improvement.
In this, research on a scale not previously attempted in this country will be essential. State efforts in the field of medical research have been poor measured in terms of money, although the results achieved— and some of the control carried out— by the Medical Research Council have been very good indeed. The Minister of Health, under the Bill, is given wide powers to carry out or assist others by grants of money or in other ways to carry out “research into any matters relating to the promotion, diagnosis or treatment of illness or mental defectiveness.” Similar powers are given to the Boards of Governors of teaching hospitals and to Regional Hospital Boards. No further indication of what will be done is given, but in public speeches Mr. Aneurin Bevan has shown that he is fully aware of the many problems to be tackled, and on some he has evinced a burning desire for results that will save the lives of sufferers everywhere. It may be some indication of how much should be spent that, in Labour Party publications on the subject, estimates of the cost of a national health service have included a sum of seven million pounds for research. The Medical Research Council has usually received from past Governments £250,000 or less.
By the establishment of health centres it will be possible to bring into research investigations the family doctor. This will be a most important development, for year in and year out he observes the course of disease in hundreds of cases yet seldom does he record his observations or have contact with those who could correlate his results and test them statistically. New discoveries which in the research laboratory have appeared to be marvellous have sometimes failed when tested under conditions of general practice. A close link between the laboratory, the hospital and the health centre will give many opportunities for realistic testing of new materials as well as new observations on problems yet unsolved.
But just as medicine cannot be isolated from the general social problems of this country, so the health services of Britain cannot be segregated from those of other countries. It is not only that disease recognises no frontiers, not merely that a discovery in one country may save lives in all nations; it is essential to medicine and to its power to liberate and elevate man from his past and present dangers that medical knowledge should be as freely available to all men as this new service is to be to all citizens.
In so far as our service succeeds, others will study it and apply it, with their own modifications, to their own countries. Interchange of knowledge will be followed by interchange of personnel (and for convalescence, interchange of patients), with redoubled effects on the spread of new discoveries and new thought. In Britain’s great, four-tiered structure of social security she gives a lead to the world as great as any she has ever given in the past.