HH62/2/STIRLI/27

Transcription

[Page] 26

hospitals; the assessment must be over the county District as a
whole, even if the hospital be in practice available only for a
part of the District. (2) Strictly speaking, Districts cannot com-
bine for a joint hospital open to only part of their population. In
theory, every joint hospital must be open to receive patients from
even the most distant parts of each of the Districts whose Local
Authorities have a share in the hospital.
There has been a tendency to take this Opinion as destructive
of all such joint proposals as are set forth above. For the fol-
lowing reasons it appears to me that this is not so, however;
and the Midlothian Council has evidently arrived at a similar
finding, as it is going on with arrangements for a joint hospital
for parts of two separate Districts and two police burghs.
(1) Clearly enough, under the Public Health and Local Govern-
ment Acts, a District must be assessed as a whole. But if hospital
accommodation is provided, as it ought to be, for all parts of a District,
the assessment will tend to equalise itself. Supposing that my
suggestions were carried out, it is true that Campsie, using the
Kirkintilloch hospital, would be rated also for the hut at Buchlyvie.
But, on the other hand, the parishes in the northern part of the
District would be assessed for Kirkintilloch hospital, on account of
its being used by the people living in Campsie.
(2) Though in theory every hospital in which any District has a
share must be open to all the infectious cases in the District, in
practice every case will go to the nearest hospital. There is no
likelihood of a man in Banton wanting to be taken to Bannockburn
or Buchlyvie instead of to Kirkintilloch. And in arranging terms
of combination between two or more Local Authorities the practice
and not the theory would naturally be kept in view. If, as is
suggested in my Report, the main basis of payment per Local
Authority were the cases sent in annually by each, the agreement
as to cost of site and buildings should not be very difficult to
arrive at.

Vital Statistics. - In a first Report it seems desirable to put
on record, as standards of comparison for future years, some facts
going further back than 1891.
The Birth-rate, as has already been indicated, has a certain
bearing on the death-rate. Children under one year have the

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highest mortality of all, and children from one to five have the
next highest. Of course if a population is not migratory, the
births come to add to the healthiest as well as to the unhealthiest
ages of life, but in rural districts where youths of both sexes
tend citywards, a high birth-rate has as its immediate effect the
raising of the death-rate. Too much weight, however, is apt to be
attached to this factor. The following are the rates for the decade
1880-89:-

(SEE TABLE III.)

It will be seen from this table that the birth-rate of the County
in each of the ten years was above that of Scotland. In the
decade there were in Stirlingshire about 1920 births more than if
average rates had prevailed.
Illegitimate children have as a rule less parental care than
those born in wedlock, and have a higher mortality. In Scotland
in the ten years in question, the percentage of illegitimacy in the
total births was 8·36. In the County it was 6·66.
The following are the Death-rates of the County for the ten
years 1880-89, with the corresponding rates for all Scotland:-

(SEE TABLE IV.)

It will be seen that in every year but one of the decade the
Stirlingshire mortality has been under the general mortality.
On the average in every 10,000 of population in Scotland 191
deaths occurred in a year, while in Stirlingshire 181 occurred.
Taking the population of the County at 112,000 during the period
in question, then in the ten years 1120 fewer deaths occurred
than if ordinary rates had prevailed.
Deaths from Certain Causes. - From the Registrar General's
Detailed Annual Reports I have extracted, for the five years 1885-89,
statistics bearing on the prevalence of zymotic and tubercular
disease in the County.
The Registrar General in these Reports divides Scotland into
five Population Groups:- (1) The principal towns, with a popula-
tion of over 25,000; (2) the large towns, with from 10,000 to
25,000; (3) the small towns, with from 2000 to 10,000; and
(4) and (5) the Mainland-Rural and Insular-Rural Districts,
with populations under 2000. Speaking generally, it may