BRITAIN AND THE POPULATION CRISIS
1
189 BRITAIN AND THE POPULATION CRISIS Prof, Paul Ehrlich, of Stanford University, in his presidential address to the Conservation Society in London on Jan. 14, said that in our desperately overcrowded planet food would be the first asset to go, Ten to twenty million people a year were already starving to death, and there was no prospect what- ever of slowing down world population growth before the year 2000. It might seem that a small country like Britain, with only 1-5% of the world’s pdpulation, could have little influence on such a situation. In his travels about the world, however, he found that many countries still looked to her for intellectual and political leadership. In his opinion the adoption by Britain of a positive population policy with clearly defined goals could greatly advance the cause of world popu- lation control. The aim should be to attain zero population growth as soon as possible. A compre- hensive family-planning service and the Bill on vasectomy soon to be introduced in the House of Commons were certainly steps in the right direction. As to pollution, the immediate necessity was to reduce the demand for power, and heavy taxation of the big users would have to come. The motor-car was one of the worst generators of pollution and sooner or later would need to be banned in city centres. Over- developed countries had an enormous problem of values to sort out. They had to get rid of the insane aspects of the growth component in their economies; 45% or more of the world labour force was engaged in work which was useless or dangerous to the rest of humanity and ecologically disastrous;$200,000,000,000 per year were spent on arms production alone. The problem of unemployment was already enormous, however, and we were going to have to get away from total reliance on the Protestant ethic of hard work for its own sake and develop instead a balanced philosophy of living. In developed as well as developing countries more labour intensive systems were needed. Economi- cally we could not go on as we had been doing. If we did, our options would be severely reduced. The global pie was finite, and international cooperative action was needed to provide fair shares for both this generation and those to come. In politics the old dingdong battle between left and right was likely to go on, and there was just not time enough to resolve it. We had to work with the political set-ups we had and promote measures which could be seen to be sensible and effective in the general interest. He had been greatly heartened and encouraged by the recent initiatives of British doctors and scientists. Britain should certainly not underestimate her influence in this field. Many of Professor Ehrlich’s views are endorsed in the Blueprint for Survival published last week. This document, drawn up by a group of environmentalists and supported by a number of eminent scientists, spells out in some detail the probable consequences of uncontrolled expansion of our present industrial way of life. Disruption of ecosystems by pollution and reckless use of pesticides and fertilisers, exhaustion of natural resources, and failure of food-supply are the more obvious results, and overpopulation lies at the root of many of these problems. Whether a stable and in- definitely sustainable society can be achieved smoothly - nor, indeed. at all-is difficult to say, but the environ- mentalists have at least taken some positive action in the formation of a Movement for Survival. The aim of this organisation is to influence Governments, and in particular the British Government, into taking measures most likely to lead to the stabilisation and survival of our society; and if the movement attracts the support it hopes for, it could become a powerful pressure-group. WHAT SORT OF COLLEGE? SOME of the founding fathers of the young Royal College of Psychiatrists see it as a citadel to enshrine the highest standards; and to this end a membership examination, to be completed at the end of a stipulated period of training, is being instituted. Even those fortunate trainees who work in academic centres look forward to this examination with lively dread; and the unlucky ones in outlying hospitals, with an excessive clinical load, have even greater cause for concern. Indeed, one unhappy byproduct of starting this examination is likely to be a drift from peripheral hospitals and further consolidation of the favoured main centres. There are no two ways about what this membership means: the M.R.C.PSYCH. is going to be the qualification for British psychiatrists. The D.P.M., it seems, will remain for those who fail the membership, for those from overseas who are unable to fulfil the training requirements, and for those interested in a brief exposure to psychiatry. For the psychiatrist in training, the important early years in his specialty will be shaped, or distorted, by the coming examination. This examination, to judge from the published details, differs little in design from that for the M.R.C.P. It will test psychiatric skills in so far as they resemble those of orthodox medicine. But British psychiatry is in a phase from which British neurology is painfully emerging-a phase in which rigid formulation of disease entities is paramount and the diagnostic con- clusion is an end in itself. The membership examina- tion can be expected to buttress the situation in which the potential psychiatrist is expected to distinguish catatonic from hebephrenic schizophrenia; he will not be assessed in any way on his ability to establish a satisfactory relation with patients-an ability described in 1969 by Sir Denis Hill as " a vital requirement for the future psychiatrist and for many other doctors who will undertake the personal care of patients ".1 Such competence cannot be tested by a single, once- for-all examination. This is a task which could well be allotted to teams of assessors, perhaps regionally based, which would assess not merely training pro- grammes but also trainees. Clinical skills apart, if the College sets its sights exclusively on academic excellence, it will soon land in trouble; for it cannot expect its membership examination to act on the one hand as a guarantee of academic standards and on the other as a passport to a consultant post. If the examination sustains the first of these functions, the pass-rate will be too low to fill 1. Hill, D. Br. med. J. 1969, i, 205.
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Transcript of BRITAIN AND THE POPULATION CRISIS
189
BRITAIN AND THE POPULATION CRISIS
Prof, Paul Ehrlich, of Stanford University, in his
presidential address to the Conservation Society inLondon on Jan. 14, said that in our desperatelyovercrowded planet food would be the first asset togo, Ten to twenty million people a year were alreadystarving to death, and there was no prospect what-ever of slowing down world population growth beforethe year 2000. It might seem that a small country likeBritain, with only 1-5% of the world’s pdpulation,could have little influence on such a situation. In histravels about the world, however, he found that manycountries still looked to her for intellectual and politicalleadership. In his opinion the adoption by Britainof a positive population policy with clearly definedgoals could greatly advance the cause of world popu-lation control. The aim should be to attain zero
population growth as soon as possible. A compre-hensive family-planning service and the Bill on
vasectomy soon to be introduced in the House ofCommons were certainly steps in the right direction.As to pollution, the immediate necessity was to reducethe demand for power, and heavy taxation of the bigusers would have to come. The motor-car was one ofthe worst generators of pollution and sooner or laterwould need to be banned in city centres. Over-developed countries had an enormous problem ofvalues to sort out. They had to get rid of the insaneaspects of the growth component in their economies;45% or more of the world labour force was engaged inwork which was useless or dangerous to the rest ofhumanity and ecologically disastrous;$200,000,000,000per year were spent on arms production alone. The
problem of unemployment was already enormous,however, and we were going to have to get away fromtotal reliance on the Protestant ethic of hard work forits own sake and develop instead a balanced philosophyof living. In developed as well as developing countriesmore labour intensive systems were needed. Economi-
cally we could not go on as we had been doing. Ifwe did, our options would be severely reduced. Theglobal pie was finite, and international cooperativeaction was needed to provide fair shares for both thisgeneration and those to come. In politics the olddingdong battle between left and right was likely togo on, and there was just not time enough to resolve it.We had to work with the political set-ups we had andpromote measures which could be seen to be sensibleand effective in the general interest. He had been
greatly heartened and encouraged by the recent
initiatives of British doctors and scientists. Britainshould certainly not underestimate her influence inthis field.
Many of Professor Ehrlich’s views are endorsed inthe Blueprint for Survival published last week. Thisdocument, drawn up by a group of environmentalistsand supported by a number of eminent scientists,spells out in some detail the probable consequences ofuncontrolled expansion of our present industrial wayof life. Disruption of ecosystems by pollution andreckless use of pesticides and fertilisers, exhaustion ofnatural resources, and failure of food-supply are themore obvious results, and overpopulation lies at the rootof many of these problems. Whether a stable and in-
definitely sustainable society can be achieved smoothly- nor, indeed. at all-is difficult to say, but the environ-mentalists have at least taken some positive action inthe formation of a Movement for Survival. The aimof this organisation is to influence Governments, and inparticular the British Government, into taking measuresmost likely to lead to the stabilisation and survival ofour society; and if the movement attracts the support ithopes for, it could become a powerful pressure-group.
WHAT SORT OF COLLEGE?
SOME of the founding fathers of the young RoyalCollege of Psychiatrists see it as a citadel to enshrinethe highest standards; and to this end a membershipexamination, to be completed at the end of a stipulatedperiod of training, is being instituted. Even thosefortunate trainees who work in academic centres lookforward to this examination with lively dread; and theunlucky ones in outlying hospitals, with an excessiveclinical load, have even greater cause for concern.Indeed, one unhappy byproduct of starting thisexamination is likely to be a drift from peripheralhospitals and further consolidation of the favouredmain centres.There are no two ways about what this membership
means: the M.R.C.PSYCH. is going to be the qualificationfor British psychiatrists. The D.P.M., it seems, willremain for those who fail the membership, for thosefrom overseas who are unable to fulfil the trainingrequirements, and for those interested in a brief
exposure to psychiatry. For the psychiatrist in training,the important early years in his specialty will be
shaped, or distorted, by the coming examination.This examination, to judge from the published
details, differs little in design from that for the M.R.C.P.It will test psychiatric skills in so far as they resemblethose of orthodox medicine. But British psychiatry isin a phase from which British neurology is painfullyemerging-a phase in which rigid formulation ofdisease entities is paramount and the diagnostic con-clusion is an end in itself. The membership examina-tion can be expected to buttress the situation in whichthe potential psychiatrist is expected to distinguishcatatonic from hebephrenic schizophrenia; he will notbe assessed in any way on his ability to establish asatisfactory relation with patients-an ability describedin 1969 by Sir Denis Hill as " a vital requirement forthe future psychiatrist and for many other doctorswho will undertake the personal care of patients ".1Such competence cannot be tested by a single, once-for-all examination. This is a task which could wellbe allotted to teams of assessors, perhaps regionallybased, which would assess not merely training pro-grammes but also trainees.
Clinical skills apart, if the College sets its sightsexclusively on academic excellence, it will soon landin trouble; for it cannot expect its membershipexamination to act on the one hand as a guarantee ofacademic standards and on the other as a passport toa consultant post. If the examination sustains the firstof these functions, the pass-rate will be too low to fill
1. Hill, D. Br. med. J. 1969, i, 205.
