563

taken to break the chain of contamination; alreadyvarious commercial organisations are improving meathygiene by retraining personnel, removing the piece-rate system of payment, and providing qualified super-vision with adequate laboratory facilities.The finding of a large number of drug-resistant

bacteria, many of which are capable of transferringantibiotic resistance to organisms such as Salmonellatyphimurium, is further evidence that intestinal bacteriaare being disseminated during the slaughtering process.The mere presence of transferable chloramphenicolresistance at this very early stage of food productiondoes not imply danger to human health; nevertheless,the situation requires strict surveillance and indicatesa definite need for further studies using marked strainsof bacteria to trace the fate of these organisms duringfood production.

I thank the owners of the two slaughterhouses concerned;Dr. K. C. Sellers and Dr. H. Williams Smith for helpful dis-cussion ; and Mr. R. Green and Mr. F. Bateman for technicalassistance.

REFERENCES

1. Smith, H. W. R. Soc. Hlth J. 1969, 89, 271.2. Shooter, R. A., Cooke, M., Rousseau, S. A., Breaden, A. Lancet,

1970, ii, 226.3. Walton, J. R. ibid. 1966, ii, 1300.4. Simmons, C. W. R. Meat Trades J. April 16, 1970, p. 12.5. Report of the Joint Committee on the Use of Antibiotics in Animal

Husbandry and Veterinary Medicine. H.M. Stationery Office,1969.

Population ProjectionsBased on 1969 data the Office of Population Census and

Surveys now projects the population of England andWales to 58,590,000 by the year 2001. This is an increaseof 9,700,000 (about 20%), and represents a compoundgrowth-rate of 0-6% per annum.

Projections have had to be revised drastically in thepast fifteen years, and there is no reason to suppose that thelatest turn-of-the-century estimate is any more accuratethen previous efforts. In 1955 the Registrar General waspredicting a fairly stable population up to the mid-1990s.Five years later he was thinking in terms of 56 million bythe end of the 20th century; in 1964 the estimate was upagain, to more than 67 million. It fell in 1968, and again in1969. The nroiected mid-vear totals are:

The elements of population change (births, deaths,migration, and emigration) are simple enough to measure,but much less easy to predict. Death-rates among malesunder forty and females under fifty are expected to fall to50% (or less) of the 1969 rates after forty years. Abovethese ages death-rates will fall progressively less strikingly.At all ages the rate of fall will be more rapid for femalesthan for males. Short-term fluctuations in birth-rate are aconstant problem for demographers: fortunately it seemsthat the long-term factor (i.e., completed family size) is

fairly stable. The completed family size is now put at2-41, compared with 2-50 in 1968. In terms of school,working, and retirement the pattern is not likely to changestrikingly from the 1969 picture of 23-5% under age fifteen,60 7%, of working age, and 15-8% of retirement age.

1. Registrar General’s Quarterly Return for England and Wales:

Quarter ended March 31, 1970, appendix. H.M. Stationery Office,1970. 4s. 6d.

Intercepted Letter

WHAT ABOUT THE COLLEGES?

THE TREASURER,ROYAL COLLEGE OF PHYSICIANS,EDINBURGH.

DEAR TREASURER,I have received your letter announcing that the Fellows’

annual subscription, initiated a few years ago, is to be raisedto E25Łor E20 for those working among the tribes south ofthe Border. As I read this heavy news, my hand flewprotectively to my pocket-book. A week later the hand isstill there. May I explain ?Back in the year dot I sat the examination for Member-

ship as an inescapable step on the promotional ladder. I gotthe Membership: the College got a fee. Both sides were

happy. (One reason, as you know better than I, for thejump in Fellows’ subscription-rates is the falling off inexamination fees.) Later, when I was accorded the richlyundeserved honour of Fellowship, much the same sort oftransaction took place, though this time without an

examination; and again the advancement could have beenvital to my future. I put it to you that if our College (amongothers) is lucky enough to hold one or more hoops throughwhich young men must jump (for a consideration) in orderto make their way in life, it can’t expect an automaticallygenerous response to subsequent claims for money. After

all, the university which, by accepting a thesis, converted myM.B. to an M.D. does not now seek to dun me.Here I tread tender ground. I hear voices saying: What

about the General Medical Council’s new annual sub-

scription ? But the G.M.C. conducts business essential tothe whole profession; and the profession would be foolish ifit failed to keep the Council strong and independent.

If, then, Fellows, need not automatically support theCollege in its admittedly difficult circumstances, what is thecase for supporting it from choice ? Two main reasons

spring to mind for not supporting it.The first is the shabby record of our College-among

others-in lifting money from overseas graduates attractedto this country by the cachet of a College diploma. Youngdoctors have come here in droves, have worked in hospitalsill equipped to provide any sort of medical education orhave swotted in the precincts of large institutions, and aftera year or two have returned to their own countries, with orwithout a diploma, or have settled here. How should welike it if in our own country, starved of doctors, we saw ouryoung graduates taking off for a couple of years in Chile orPeru, in Nigeria or Malaysia, just at the time when theyshould contribute most while they learn how to apply theirearly vocational training ? We should not like it at all.The second, and more important, reason for hesitating to

nurture the College lies in its constitution. Our College,like the other ancient ones, is blatantly elitist. The solemnprogression from Licentiateship to Membership to Fellow-ship to the inner councils encourages a reverence for rankwhich ill becomes a supposedly single and humane pro-fession ; and this respect is reflected in the relish with whichFellows of other Colleges savour their privileges: a Fellow-ship can be the in thing. (Maybe not much longer. Therush to elect Fellows, and thus, by a happy chance, to raisemore money, may soon make Membership the more

unusual, and therefore more desirable, state.)All this, you may say, amounts to no more than harmless

professional snobbery : after all, we are herd creatures, andwhat more harmless aggregations than a flutter of physicians