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VOLUME XVI WELSH OUTLOOK Where there is no vision the people perish NOTES OF THE MONTH THE last annual report of the Welsh National Memorial Association discloses the deplorable fact that out of 2,823 per- sons who died from tuberculosis in Wales during 1928, 1,121 were not seen by the tuberculosis officers of the Association and that in 725 of these cases no reason is known why they were not re- ferred to the tuberculosis officers during life. The Principal Medical Officer of the Association, in commenting on these facts, states in his report that the figure of 725 throws a lurid light on the way in which the facilities provided by the Association are still neglected by a section of the public and profession, and demonstrates very strikingly the partial manner in which the Mem- orial is permitted to grapple with the work it has set out to do." The hope of stamping out this disease speedily depends upon the notification and treatment of early cases. At present less than half of the pulmonary patients treated by the Association are early cases. It is, at least, gratifying to know that the Association has de- cided to make full inquiry into this urgent matter and we would urge Insurance Committees to in- vestigate the cases of insured persons. A large number of sanatoria beds provided by the Association for early cases are not fully occu- pied. On the other hand there is a waiting list for hospital treatment for advanced cases. If the tuberculosis officers were called in during the early stage of the disease, the sanatoria would be full and the need for more hospital beds might be avoided. The vision of a Wales free from tuberculosis was what inspired those who established the Memorial and has inspired those who have worked so assiduously for many long years since. The dream will come true, but unless there is a drastic change in NUMBER X THE OCTOBER 1929 the notification of early cases the progress, though considerable, is bound to continue to be slower than it should be. In spite of handi- cap, the death-rate from tuberculosis has been reduced from 1,500 per million of population in 1911 to 1,050 per million in 1928. In spite of the increase of population the total number of deaths in 1928 was 840 less than it was in 1911. ALTHOUGH some progress has been made in recent years in the installation of rural telephones, the facilities provided in many Welsh villages compare very unfavour- ably with those in other countries. Taking one county alone, we could name about thirty villages which are not connected to the telephone system. The guarantees required are prohibitive, and we have heard of one case in which the telephone had been installed and be- cause the inhabitants were unable to continue the payments demanded, the powers that be," hav- ing incurred the expense of providing the installa- tion, incurred the additional expense of removing it. Is it fully realised that there are many places in rural Wales which are at least ten miles from the nearest doctor or the nearest telephone and that an hour's delay may mean life or death? How often must we repeat that infantile mortality in our rural counties is appallingly and unnecessarily high? Thousands of pounds have been provided by the generous public for the provision and maintenance of maternity wards. The same amount spent out of public money would go far to provide telephone facilities without which no county can be regarded as reasonably up-to-date. The late Chancellor of the Exchequer evidently realised this, for in his Budget speech in April last he announced