Aug. 37.
Subject to consideration of its financial programme, the Shanghai Municipal Council has approved in principle of the report of the Hospital and Nursing Commission, an account of which appears elsewhere in this issue. It is a most valuable document, and while it may come fas a great surprise to many, {there seems little reason to doubt that it contains many statements lof fact which sooner or later will have to be faced. As the 'Commission points out, much has already been done for hospitals Shanghai, not only by private enterprise or benevolence, but the Council itself, but, following the normal course of public health development, the time is approaching when' the Council has, perforce, to play a greater role in the future than done in the past. It. must b emphasised that that isa customary development in the history of public health services commencement by private endeavour and a gradual transi tion into something more muni [cipally or state controlled. Such change, of necessity, involves additional burdens upon those who pay rates and while that may cause for delay in the fulfil. ment of the ideal programme, it} Jdoes not offer much of a case in support of the "argument that because a certain step is costly it should never be taken. Once it is recognised that the community owes to itself the duty' to see that sickness of any kind shall be as effectively and as [speedily dealt with as possible—in the interests of the community itself—the question of the provision of the wherewithal to fulfil such a function is of comparatively minor importance.
It is not necessary here to out-Tine in any detail what the Commission proposes should be done, but it, is obvious that radical extensions have to NE made to the existing facilities for dealing with sickness, and that a development, not to be anticipated by those who have given but casual Inotice to the problem inthe has to be undertaken if health: a city of the size lof Shanghai, On the face of the report the improvements suggested should be costly. jin. money: they may, however, prove cheap in the long ran, and it is on such probabilities ' that the desirability of the recommendations put forward by the committee can best be judge?. It is not possible to admit that Shanghai has been careless of the sick in the past, The Council has done what it could in the light of considerations then prevailing, in exactly the manner as it has dealt with the subject of education. But the acceptance of new principles with regard to the Hatter, involving the recognition lof a greater responsibility than thas been admitted in the past, carries with it as a corollary the need for further expansion in direction of hospital services, effect Shanghai is now being called upon to assume the the greatness to attained, It is, however, obvious that the Inter: national' Settlement can be pected to do no more than its duty to its own residents, that each municipal administration should make provision for its lown civic responsibilities regard to hospital accommodation, and that where this 1s, for practical reasons, impossible, payment should be made either for services rendered or for such facilities og may be provided by ipalities. This nathe question of inter-municipal cooperation and though this ideal may Ve difficult lof complete achievement present it is not unreasonable to hope that so far as accom modation for tuberculosis and mental diseases are concerned it may be possible, by tackling these problems of the first magnitude, to pave the way for the wider' cooperation which is manifestly desirable.
Until that happy day. arrives it is necessary to consider th tial pro gramme which the Commission With the extensive education programme which has been adopted, and the cost which the ratepayer will be called upon to meet, there is naturally some diffidence in suggesting that the expenditure necessitated by the proposed departures should be thrown bodily upon the rates. Not that the present rates are unreasonably high, but because this is not the time to make any increases beyond those that are already "looming. For this reason the Commission are to be congratulated on making. a constructive suggestion with regard to the proposed amuse ments tax. The suggestion is not a new one; it was first mooted by the Municipal Economy Commission for the purpose of augmenting the revenue, On such grounds, innless in the case of urgency, it possible that there would have been some opposition, but, where the proceeds are to be devoted to a specific object, and such a specific object as, "the Commis. sion has in view, it is difficult to see what opposition can veasonjably be offered. But it is to bbe hoped that the second of the Commission's tivo schemes will be adopted for its collection, namely upon the tickets issued, is probable that the estimated average of seventy or sixty per cent. of the accommodation the local cinemas is somewhat too high, and probable that a tax on tickets may require the establishment of a certain amount of accounting machinery, but a tax upon a theatre's ing capacity irrespective of the number of seats occupied may either prove unfair to the theatre proprietor or lead him to make teneral increases in his " prices fof admission which may react to his and the public's—disadvantage, Another important argument in this respect is that such an arrangement involving a tax upon admission follows successful precedents established elsewhere,
Text read from the printed page and cleaned; old type leaves the occasional error.