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Vibration arthrometry is a new non‐invasive technique which detects, records and analyses vibrations elicited during clinical examination of human joints. In congenital dislocation of the hip, the computer‐based method has been developed to achieve a more objective and earlier diagnosis than is otherwise available. This is a condition of 0.2 per cent incidence with which a child may be born or which can develop shortly after birth. If a diagnosis is achieved soon after birth, the treatment is simple, cheap and effective. However, if the disease is not diagnosed until the child is walking, treatment is complicated and expensive and the child will need lengthy hospitalisation with a poor prognosis. An evaluation was made of three options: existing screening system, higher level screening and use of the Belfast Hip Screener.

The workload of acute hospitals in the United Kingdom is largely determined by referrals by general practitioners (GPs), and there have been studies that show great variation in the rate and pattern of referrals by different GPs. The other major route is to attend the accident and emergency department (A&E) without attending the GP. It is argued in this paper that the ‘problem’ of variations in GP must be seen in the general context of patient flows to hospital, since little is known of the relationship between referrals and self‐referrals. If it is the case that self‐referral behaviour depends on the likelihood of being referred by a GP, then differences in GP behaviour will not have a direct effect on hospital workload. Equally, changing their behaviour will not reduce the demand for hospital services. Two other options are worth considering — attempting to change the behaviour of patients by public education, and controlling access to hospital by triage. The paper sets out a research agenda to help resolve some of these issues.

The Equal Pay Act 1970 (which came into operation on 29 December 1975) provides for an “equality clause” to be written into all contracts of employment. S.1(2) (a) of the 1970 Act (which has been amended by the Sex Discrimination Act 1975) provides:

Discuss in detail the uses which might legitimately be made of the following passage by the writer of a profound study of economic life and thought in France at the end of the reign of Louis XIV. In answering the question make full use of your knowledge of (a) historical criticism; (b) French economic and general history.

THE first library in connection with an English University was founded at Oxford by Richard d'Aungerville, better known as Richard de Bury, Bishop of Durham. At the time of its foundation it was considered one of the best collections of books in England. It was housed in Durham College—now Trinity—and the donor drew up copious rules for its management and preservation. It appears that this library was destroyed in the days of Edward VI.

Dr. COLLINRIDGE, the Medical Officer of Health to the City of London, had occasion recently to call attention to the diseased condition of certain imported meats, and it is most disquieting to learn that some of these were apparently sent out from the country of origin under official certificates.

It is generally admitted that the professions are much over‐crowded. While the condition of affairs which exists in professions of older standing such as medicine or the law is fairly well known, even to the unprofessional man, and the qualifications requisite for advancement and success are generally appreciated to a certain extent, the same degree of knowledge does not obtain in the case of chemistry, about which, as a means of livelihood, the profoundest ignorance prevails—even among the better‐educated classes. The opportunities which are apparently held out to aspirants and the greatly increased facilities for chemical study have given rise to an absolutely false idea in the mind of the public at large as to the positions obtainable and the prospects offered. Chemistry is, perhaps, the most over‐crowded of all professional careers, for, although the science has gained enormously in importance and in technical application within a comparatively recent period of time, the supply of highly‐trained chemists greatly exceeds the number of positions available, while the remuneration to be obtained is, from a professional point of view, extremely low, and is quite out of proportion to the scientific qualifications possessed and to the nature of the work exacted. The causes of the over‐crowding are too many and too complex to be considered in detail here, but there may be cited as among the principal factors in this respect the greatly increased popularity of the science as a specialised study, the entrance into the profession of individuals who are in reality personally unsuited for a professional career, and the failure of the educationalists to grasp what the exact meaning and aim of the education of a community should be. While, however, the ultimate prospects of advancement and success are influenced greatly by the growing tendency of crowding out, there are, in this respect, other factors to be considered which are liable to be overlooked, namely, the actions of the members of the profession themselves, and, following from this, the degree of respect accorded and the value attached to that profession by the general public. A profession retains its status before the world, or loses it, according to the nature of the individual and concerted actions of its members, both in their relations with each other and in their intercourse with the public. The particular type of person who enters a profession might appear at first sight to be a factor of comparatively minor importance, provided that a thorough training had been undergone and good qualifications obtained. Such, however, is far from being the case. If it is to maintain an honourable position before the world and a recognised place among other intellectual callings, a profession must endeavour to attract the best type of man—the man who, apart from his scientific qualifications, possesses the true professional instinct and ideals, and the ambition to raise his calling and himself to as high a level as possible. “Qualifications” alone are not sufficient. To attract the man of higher type it is necessary to offer a reasonable prospect of adequate reward. It is open to question whether the chemical profession can, at present, offer the necessary inducement, from this point of view, to enter its ranks. It cannot be pretended that chemistry can present ultimate prospects compared to those offered by the other professions. The reward of the man of science is fixed unless his discoveries have a commercial value, and he himself possess the commercial instinct necessary to profit by them. It will be admitted that this is not the case with the specialist in medicine or with the leader at the Bar. The common objections put forward against such considerations as these are that a man devotes his life to the pursuit of a science purely out of love for that science and with little consideration for remuneration or for social status, and that questions of reward or remuneration being purely mercenary considerations should not be brought into the discussion. While such objections may appear reasonable at first sight, a little reflection will show that the matter lies somewhat deeper than this. The future of the chemical profession itself, and not only the pecuniary profit of the individual, is involved. To offer low remuneration for scientific positions is to ensure these positions being ultimately filled by men of mediocre capacities, and it must be understood that this applies as much to a junior assistantship in a technical laboratory as to a chair in a university or to a public position of trust. The prospects which there are at present in the chemical profession can be regarded only as being more likely to attract the mediocre person than the man of superior capabilities, and mediocrity cannot be considered as conducive to the advancement of a science. In these days of excessive competition it is imperative to consider many facts before choosing a particular professional career. Men of attainments superior to the ordinary will not voluntarily enter a profession in which the reward for their labours is to be in no way proportionate to their abilities, and that particular profession will necessarily suffer by their absence. It is a common fallacy to suppose that a man's intellectual capacity is measured by the number of examinations he has passed or by the number of degrees and diplomas which he may possess. Under our present Chinese system of examination it is possible for anyone, even if he be of really very modest attainments, to make a collection of degrees and diplomas. Originality in thought and the power to apply the knowledge obtained during training are not asked for. There is a type of man extremely common to‐day whose capacity for absorbing existent scientific facts (i.e., the ideas of other people) is as great as his incapacity for originating ideas of his own. To this particular type of person the obtaining of qualifications is a comparatively easy matter, especially in the case of chemistry, which is, strictly speaking, a non‐mathematical science. Whereas originality and individualism in thought makes for advancement in science, the mere repetition of the ideas of other persons can only result in stagnation. These facts are generally lost sight of by those persons who assert that the interest of his particular subject should prove an ample compensation for a low remuneration provided that that remuneration be sufficient in order to live. It is not recognised that if such a prospect of affairs becomes general those persons whose ideas are bounded by a narrow horizon (and such form the majority in any community) are attracted in preference to those whose ambitions take a wider scope, and who will naturally turn to another field of operations where their abilities will be more amply rewarded. The competition to‐day in the chemical profession has become even keener than that among the quill‐drivers; the early prospects are about the same as, or are little superior to, those of the latter calling, while ultimately there is the reward of a position at a remuneration very little better than that obtained by a head bookkeeper, and generally very much inferior to that of a small merchant or fairly successful tradesman—the supposed intellectual inferiors of the man of science. Again, with respect to public chemical appointments, there is the growing tendency to create “whole‐time” appointments at a fixed and insufficient remuneration, with no prospect of advancement or certainty of superannuation, and, in many cases, no security of tenure. In the purely technical world the position of affairs is even worse, while the prospect of making a living by practising privately as a technical and consulting chemist is limited, since the demand from the public is not large, and much of the work formerly obtained by the private practitioner is now done much more cheaply by a “tester” of some kind at a works. The consultant is certainly needed in certain cases, but these are of such comparative rarity as to have but little influence upon the general position. There is no doubt that much harm has been done by the nonsense emitted from time to time by unthinking persons and by those who describe themselves as “pure” chemists, to the effect that much of the work carried out in a technical or analytical laboratory can be performed quite as satisfactorily by the untrained person as by the skilled chemist. These opinions, which may perhaps find excuse in the ignorance of the persons holding them, are based upon the supposition that, as the work in such laboratories may tend to be of a routine nature, unskilled labour is quite as valuable as scientific training. The harm done by the promulgation of such statements is to be found in the fact that untrained persons conceive the idea that employment may be obtained in a chemical laboratory without any previous scientific education, and hence there is introduced a further tendency to lower the status of the chemical profession by the admission of unqualified persons. Whatever the condition of chemistry may be at present from an intellectual standpoint, it is manifestly unfair to give the preference to unskilled persons over those who have at least studied their subject, simply on the ground that such labour is cheaper, and it is suicidal that such a preference should be encouraged by the members of the chemical profession themselves. It is necessary to admit that much of the unsatisfactory condition of affairs in the chemical profession is due directly to the behaviour of the members themselves. They have never really appreciated the necessity of acting together for the benefit of all and for the profession as a whole; they have never recognised that, whatever the specialised branch of each may be, all are linked together by a common training and by common interests, that that which adversely affects an individual member adversely affects the whole profession, and that their actions and the value they themselves put upon their services determine the degree of respect accorded to their profession and to themselves by the outside public. The chemist who is engaged in teaching cares little if his technical colleague is underpaid, because he himself is not a technical chemist, and the latter, on the other hand, does not concern himself with the condition of affairs in the teaching branch of the profession. This policy of “sauve qui peut” is disastrous. Combination among its members is absolutely necessary if a profession is to “live.” A number of individuals having a general common training in a particular branch of knowledge, each one working for his own special interest and without regard for that of his fellows, no more constitutes a profession than a people possessed of no laws or constitution and bound by no social obligations constitutes a nation. That the necessity of efficient combination is not understood may be seen from a statement made by the President of the Institute of Chemistry at the last annual general meeting of that body. In the course of his address, the President said: “If the Institute were … . to become, as some critics have suggested it might become, a professional trade union for the regulation of fees and the suppression of competition, I feel sure that the larger proportion of its members would rightly lose all interest in its affairs.” If the Institute of Chemistry is to be regarded solely as an examining body, this particular statement of the President may be held to be excusable, if not justifiable, but if the Institute be considered as a professional body for controlling the interests of its members and acting for the advancement of the whole chemical profession, two possibilities are presented. Either a condition of affairs exists in the Institute of Chemistry which is lamentable, and which it would, perhaps, have been kinder to the Institute to have kept secret, or the statement of the President is not justified by the facts. The word “rightly” has, logically and morally, no place in the sentence in which it occurs. It would appear from a passing reference by the President to the Institute as “a great professional organisation” that the body in question does desire to be considered a professional institution. Under these circumstances, the statement above quoted amounts to this: as the Institute of Chemistry is not to concern itself with the fees paid to its members, or with the fees which those members choose to accept, it becomes open to any member (although a member of a “professional” body) to accept any fee, however low, for any work, and by a slight extension of this free and easy principle, any member may undercut any other member by performing the same work for a lower fee, and, given a sufficient scope for such “competition” without any restriction (and the only restriction possible is the veto of a firm professional authority), an impossible state of things would soon be reached. It will be noted that no account has been taken of length of service, years of experience, and professional position. A man with these extra qualifications is not to expect his own professional organisation to recognise them or to aid him in making others recognise them. Those for whom the regulation of fees has an interest are, for the most part, men in responsible public positions, or in private practice, who are endeavouring to maintain their profession and themselves in as high esteem as possible—in spite of the ignorant opposition offered to them by the public who do not appreciate their services and by their “professional” brethren who cannot understand what a professional man should be. It is these men who represent the Institute of Chemistry before the public, and without whom that Institute would be practically unknown. It is only to be expected that such men would be in the minority. The initiation of all wise things comes from individuals—generally from some one individual—and never from the mass. The general tendency of things throughout the world is to render mediocrity the ascendant power among mankind, and this applies as much to small bodies of men as to society at large. In questions of policy and future action the opinion of the majority of the mass may be discounted, for while the reasoned opinion of an individual may be biassed, it is an opinion (and, therefore, right or wrong, worth consideration); but, in the case of majorities, the opinions expressed by them do not represent the sum of individual ideas, but are simply the expressed preference of one or a few of the same type as those who constitute the majority, followed unthinkingly by the remainder—a state of things best comparable to a flock of sheep running round a tree. There is no reason for supposing that the majority in the Institute of Chemistry is any more capable of giving a wise and reasoned answer to a question of policy than are other majorities. In the present instance the reasons which can be brought forward against the assumption by a professional body of an indifference to the question of the remuneration of its members far outnumber any which may be advanced in defence of such a policy. We have drawn attention to the necessity of attracting the man of superior attainments to a profession, we have indicated what the ultimate effects of inadequate remuneration for scientific work will be, and we have urged the vital necessity of combination in calling attention to the policy of segregation which is having such disastrous results. Some of these points are referred to in the address of the president of the Institute of Chemistry, but from a different standpoint. “A large number of our Fellows are engaged in practice as analytical and consulting chemists, and questions of professional interest naturally appeal to this section of our membership, but an equally important section feel only a more remote interest in these questions, though they appreciate the wide influence of the Institute as a great professional organisation.” Again: “It must never be forgotten that an important part of the work of the Institute is the consolidation of the profession.” Nothing but unqualified approval can be accorded to this last statement. It is difficult to see, however, how the consolidation of the profession is to be effected by the Institute if one section of its members feel only a more remote interest in the questions which concern the advancement and success of the other, and if the majority of the members would view with disfavour an attempt on the part of the Institute to place the recognition of professional service upon a proper and a dignified basis. The problem of the regulation of fees is one of the most important questions with which a professional body has to deal, and it is not easy to comprehend how a body which deliberately ignores or avoids this point can, properly speaking, be called a professional organisation. There is now more than at any other time the crying need for a strong controlling authority in the chemical profession—an authority which would enforce professional conduct upon those under its control, and, passing the bounds of mere protestation, take a definite and severe line of action in all cases of infringement of its rules. Before joining a given professional organisation a man has a perfect right to inquire what benefits he is likely to gain from his membership. It is not sufficient to merely hold examinations and to grant diplomas—any examining institution can do that. In a body intended to deal with professional interests examinations are of secondary importance; the advancement of the profession and the welfare of the members demand the first consideration. If not, it becomes reasonable and perfectly justifiable for any member of the profession to refrain from allying himself with that body, and to refuse to recognise it professionally—a course of action which, although necessary in such a case, would not be beneficial to the profession; the fault, however, would lie with the controlling authority and not with the individual.