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Notes and News

CHILDBIRTH IN HOLLAND -

IN Holland, unlike other Western European countries, homeconfinement is still common. Apart from women who are judgedantenatally to have high-risk pregnancies (==15%), mothers inHolland have the option of a home delivery, but are increasingly lesslikely to exercise it. The percentage of home confinements hasdropped from 72% to 34-7% in 1980. This may be because the.media, particularly women’s magazines, have encouraged the viewthat birth in hospital is safer. Women may choose to stay in hospitalfor 24 h or 7 days after delivery. Since 1980, insurance schemes inHolland have not provided cover for hospital admission for thepuerperium unless there are complications, and the demand for theshorter stay has increased accordingly.99-3% (1692) of mothers having babies in Groningen in 1981

took part in a survey three weeks after delivery to compare theoutcome of hospital delivery with that of home confinement. Thepercentage of home confinements in Groningen is much lower

(18 - 4%) than the national average because of the higher proportionof first pregnancies and the fact that the cost of delivery plus 7 days’admission to the University Hospital maternity clinic (where nearly5007o of births occur) is no higher than that of home confinementplus 7 days care by a home maternity nurse. Women who had chosenhome confinement were less often (15’ 607o) referred to an

obstetrician during labour or early puerperium than those who,without known antenatal risk factors, had opted for hospitaldelivery plus a 24 h stay (22-9%) or 7 day (27 - 8%) stay, and theirinfants were also less often admitted to a special care unit—2 - 8,8 - 2,and 10 . 8°70, respectively. One explanation for these results is thatwhen facilities for coping with high-risk deliveries are available, asin hospital, intervention and subsequent iatrogenic damage aremore likely.

HOSPITAL WAITING LISTS

DOUBTS about Government figures for NHS hospital waiting listshave been expressed by Mr Frank Dobson, the shadow HealthMinister. Up to 1979, published hospital waiting-list figuresincluded those for day patients. In late 1979 the Governmentinstructed health authorities to omit people waiting for day treat-ment from the figures. Mr Dobson has written to the Secretary ofState, Mr Norman Fowler, demanding that he also publish figuresthat include day patients. Mr Dobson has also asked whether anyother changes have been made since 1979 in the way the waiting listfigures are put together or verified.

FOOD AND HEALTH

THE introductory programme in a forthcoming Channel 4 tele-vision series Food for Thought,2 produced in association with theHealth Education Council, shows a warehouse full of the amountsof food consumed by one individual in the United Kingdom in alifetime. As well as mountains of grains, stacks of conserves, andpiles of vegetables, there was talk of swimming pools of milk andseveral head of livestock. Over the past few years nutrition has

acquired a respectability far removed from its earlier associationwith poverty. In describing the "diet revolution", the programmetraced this official respectability back to the Boer War, when theGovernment, intent on empire building, noticed the stamp of mal-nutrition on troops of stunted soldiers. Expediency in the face of1939-45 shortages created food rationing, which had the well-documented effect of improving the nation’s health. Conspicuousconsumption since the war, as a result of developments in foodprocessing and transportation, has resulted in the so-called diseasesof affluence which, in turn, seem to have provoked interest in pre-vention. This interest, whatever its roots in narcissism and fear of

1 Damstra-Wijmenga SMI. Home confinement: the positive results in Holland. Roy CollGen Pract 1984; 34: 425-30.

2 Food for Thought a Series for People who Eat. Transmission on Channel 4, Fridays,10 30pm, starting Sept 7.

death, seems to originate in the individual, whose demands aregradually shaping the output of the food industry. Succeedingprogrammes in the eight-part series will chart the fluctuations indietary advice from nutrition experts, the emotional and socialsignificance of food, and the part played by the Government,farmers, and factories in what we eat. The links between nutritionand disease remain largely controversial but of great popularinterest.

Chair of Health Education

Dr John Catford, specialist in community medicine in the WessexRegional Health Authority, has been appointed Europe’s firstprofessor of health education, to be based at the University of WalesCollege of Medicine and combined with directorship of the WelshHeart Programme. Both posts are funded by the Health EducationCouncil.

National Development Team for Mentally HandicappedPeopleThe Secretary of State for Social Services has appointed Dr

George Kerr to be the new director of the National DevelopmentTeam, an independent body which visits and advises health andsocial services authorities and voluntary bodies in England on theplanning and development of their mental handicap services. DrKerr has been a consultant in mental handicap since 1968 andmedical administrator at Dovenby Hall Hospital in West Cumbriasince 1975.

Mr R. P. Rosswick, FRCS, will speak on Surgery of the Thyroid at theRoyal Masonic Hospital, London, on Wednesday, Sept 5, at 7 pm Post-

graduate Secretary, Royal Masonic Hospital, Ravenscourt Park, London W6OTN (01-748 4611 ext 306).

The annual one-day conversazione and exhibition of the QuekettMicroscopical Club will be held at the Natural History Museum, London,Saturday, Oct 13: Administrator, Quekett Microscopical Club, c/o BritishMuseum (Natural History), Cromwell Road, London SW7 5BD.

A joint afternoon seminar of the Scottish Medical Royal Colleges and theRoyal College of Nursing, Scottish Board, on Systematic Nursing (The

Nursing Process) will take place at Ninewells Hospital, Dundee, onMonday, Oct 15: Royal College of Nursing, Scottish Board, 44 Henot Row,Edinburgh EH3 6EY (031-225 7231).

The Philip Noel Baker memorial lecture will be given by Johan Galtungwhowill speak on Can Disarmament Negotiations Hope to Work? at Friends

House, Euston Road, London NW 1 on Thursday, Oct 18, at 7.30 pm: UnitedNations Association, 3 Whitehall Court, London SW (01-930 2931).

A postgraduate meeting on Operative Gynaecology, Basic Problemswill be held at the Royal College of Obstetricians and Gynaecologists, London,on Friday, Oct 19: Postgraduate Secretary, RCOG, 27 Sussex Place, Regent’sPark, London NWI 4RG (01-262 5425).

A National Institutes of Health consensus development conference onLimb-sparing Treatment of Adult Soft-tissue and OsteogenicSarcomas will take place in the Warren Grant Magnuson Clinical Center.National Institutes of Health, Bethesda, Maryland, on Dec 3-5. Peter

Murphy, Prospect Associates, Suite 401,2115 East Jefferson Street, Rockville,Maryland 20852, USA (301-468 6555).

The scientific and technical group of the Royal Photographic Society willhold a symposium on Recent Advances in Medical and PhysiologicalImagery at the Clinical Research Centre, Watford Road, Harrow, Middlesex.on April 10-12, 1985: Mr M. Goff, Thermographic Unit, Clinical ResearchCentre.

The annual conference of the Ophthalmological Society of the UnitedKingdom will be held in Harrogate, North Yorkshire, on April 17-19: 9:

Tourist Information Centre, Royal Baths Assembly Rooms, Crescent Road.Harrogate HG1 2RR (0423 65912).

An international conference on Frontiers in Colorectal Disease to rnarkthe 150th amversary ofSt Mark’s Hospital will be held at the Barbican Centre.London, on Mav 29-31: 150th Anniversary Conference, Concorde ServicesLtmtted, 10 Wendell Road, London W 12 9RT (Ol-743 3106).