proportion of such children come from families of the" problem " or

" derelict " type.Steps should be taken to reconstitute such families

before the final stage of breakdown is reached. The timehas come to make health authorities responsible for

supervising "

problem families " and to give thempowers with which to carry out the work. Registration of"problem families " is advocated, with powers to effectrehabilitation of homes and to appoint special staff forteaching and supervision.

There is also a need to change the law and the presentprocedure of magistrates so as to assist in keeping familiestogether against the increasing tendency to break themup. Placing the family on probation is most likely to beof practical value ; removal of the family as a unit to careand protection, a more drastic step, might be a valuable-power to give magistrates for use in extreme cases.

Delinquent children should not be taken from theirparents without a report from the school medical officerand resort, wherever appropriate, to child-guidance.The tables in this article were prepared for a subcommittee

of the County Councils Association and, with some of thesubject matter, formed part of a memorandum of evidenceapproved by the executive council of the association forsubmission to the Curtis Committee. The subcommitteeconsisted of Sir Joseph Lamb (chairman), Sir,James Aitken,Sir Robert Doncaster, o.B.E., Sir Arthur Hobhouse, J. K.Hope (clerk of Durham c.c.), R. Beloe (director of education,Surrey c.c.), F. B. Matthews, M.B.E. (public assistance officer,Lindsey c.c.), and myself.

I wish to acknowledge my indebtedness to the CountyCouncils Association for their permission to use for the

purposes of this article certain information appearing in thememorandum. The views expressed in this article are,however, my personal views, and the association is notidentified with them.

GENERAL MEDICAL COUNCIL

PROPOSALS FOR REFORM

THE annual report of the London and Counties MedicalProtection Society, published this week, gives in fullthe proposals for reform of the General Medical Councilwhich the society, jointly with the two other defencesocieties, is presenting to the council. These are :

1. (a) That the General Medical Council be empoweredand required to establish two distinct and separatecommittees to be known as (i) the penal cases committeeand (ii) the disciplinary tribunal ; (b) that a member ofthe penal cases committee be not eligible to sit as amember of the disciplinary tribunal to hear a case thathas already been before him as a member of the formercommittee ; (c) that the disciplinary tribunal sittingwith a legal assessor consist of 7 members drawn’ froma panel of 12 members elected by and from the councilof the G.M.C., that its quorum consist of 5 members,and that it be vested with the full disciplinary andjudicial powers of the G.M.C.

2. (a) That complaints received by the G.M.C. beexamined in the first instance by the penal cases com-mittee to determine whether a prima-facie case existsfor reference to the disciplinary tribunal for determina-tion ; (b) that the G.M.C. be incompetent to presentany case in which a Government department or a con-stituent body is the complainant and that the burdenof the presentation of any complaint be undertaken onlywhen the council is satisfied that justice would be deniedin the absence of its intervention.

3. That the initial complaint in all cases, includinginformation laid by a Government department, besupported by an affidavit or affidavits setting out allmaterial facts.

4. That a copy of the affidavit or affidavits be fur-nished to the respondent with any request addressed tohim to provide a reply and explanation.

5. That the respondent be given not less than fourweeks’ notice of any inquiry to be held by the disciplinarytribunal with discretionary power vesting in the presidentto extend the time on the receipt of an application tothis effect.

6. That the attendance of witnesses and the productionof documents before the disciplinary tribunal be enforce-able by subpoena.

7. That all evidence before the disciplinary tribunalbe given orally on oath save for good and sufficient reasonexcept evidence as to character which may be given inwriting.

8. That each party furnish to the other not later thanten days before the hearing of the case a list of the docu-ments on which they propose to rely.

9. That notice to produce and admit be not permitted.10. That the Evidence Act, 1938. be not made applic-

able to the proceedings of the disciplinary tribunal.11. That the parties be entitled to require the dis-

ciplinary tribunal to subpoena any deponent to an

affidavit to give oral evidence.12. That only those documents which are agreed by

the parties and such others as are proved in evidencebe placed before the disciplinary tribunal.

13. (a) That a summing up by the legal assessor benot required unless it is requested by the disciplinarytribunal or one of the parties when in the opinion of thatparty a point of law is involved ; (b) that if and whenthe legal assessor sums up, he be obliged to do so in thepresence of the parties ; (e) that the legal assessor bea barrister or a solicitor experienced in the practice ofthe Courts of Common Law and of not less than tenyears’ standing.

14. That provision be made for a right of appeal tothe High Court by the respondent on points of law only.

15. That in the event of an appeal any order forerasure be suspended until after the hearing of theappeal, subject to the appeal being entered within sevendays from the date of the order.

16. That the disciplinary tribunal be empowered (inaddition to the present penalty of erasure) to administerother penalties short of erasure, viz., suspension forvarying periods or censure of differing degrees.

17. That the disciplinary tribunal be empowered toaward costs against a Complainant or respondent andthat machinery be established for taxing the costs.

18. That the G.M.C. be given the power, but not theexclusive power, to conduct prosecutions for infringe-ments of the Medical Act, 1858.

19. That the words " professional misconduct " besubstituted for the words " infamous conduct in a pro-fessional respect " and used in the same connexion.

20. That the rules of procedure relating to penalinquiries be not subject to the approval of a judicialauthority.

21. (a) That the appropriate provision of the MedicalAct be amended to permit of the imposition of a maximumpenalty of 2500 and the alternative of a term of imprison-ment for persons convicted of falsely holding themselvesout to be registered medical practitioners ; (b) thataddition be made to the present protected designationsappearing in section 40 of the Medical Act to embraceabbreviations of recognised medical qualifications, thecourtesy title of " Dr." when associated with the healingart, and any other description in common use that is

accepted by the public and the profession as indicatingthat the user is a registered medical practitioner.

INFECTIOUS DISEASE IN ENGLAND AND WALES

WEEK ENDED JUNE 8

Notifications.-Infectious disease : smallpox 3 (1 atBirkenhead, 2 at Liverpool) ; scarlet fever, 987;whooping-cough, 1749 ; diphtheria, 304 ; paratyphoid,2 ; typhoid, 4; measles (excluding rubella), 3896;pneumonia (primary or influenzal), 546; cerebro-spinal fever, 47 ; poliomyelitis, 9 ; polio-encephalitis,0; encephalitis lethargica, 2 ; dysentery, 149 ; puer-peral pyrexia, 134; ophthalmia neonatorum, 60. Nocase of cholera or typhus was notified during theweek.Deaths.-In 126 great towns there were no deaths from

enteric fever or scarlet fever, 2 (0) from measles, 9 (0)from whooping-cough, 5 (2) from diphtheria, 49 (1) fromdiarrhoea and enteritis under two years, and 3 (1) frominfluenza.The number of stillbirths notified-during the week was

236 (corresponding to a rate of 29 per thousand totalbirths), including 26 in London.