Family planning in community medicine (1973)

in 1972 live births in England and Wales exceeded deaths by 211,000 the world population in inreased by 80 million during 1972 that is England and Wales contributed the entire increase in the world population for one day of the year now the World Health Organization estimates that each person requires 2 and a half acres for the production of his food the catchment and storage of fresh water and the disposal of sewage in England and Wales we now have only6 of an acre per person what really worries me is the quality of life this is Liverpool and I am the medical offic of health of this city and I've been the medical offic of Health for 20 years so I think I know something about Urban living now Liverpool has always had a problem of too many people since ever the first medical officer was appointed we've been struggling against over over crowding and overcrowding is a problem that creates not only physical difficulties but it creates moral difficulties if a child can't have room to live in then he tends to get bored he tends to go out run the streets and all the time I'm trying to convince the people in Liverpool that Family Planning that a balanced community is what we want to aim at we want to aim at a balanced community enough young people enough working people enough old people and a great respect for all of us to be together and live together and help each other but we cannot do this without some Family Planning program and one of my main objectives has been to try to improve the overcrowding situation [Music] [Applause] for a good one and a very good and this is why to some extent the crime rate has been higher in Liverpool than we would like to see it this is why the illegitimacy rate has been higher Liverpool would like to see and we used to have the highest blood rate in the United Kingdom and glad to say we don't have it now because we've moved a great many of our young people out to the new towns in the periphery but we've only spread the problem particularly whenever we move people from one place to the other they're Disturbed and we know this and this is a time that very often more children are [Music] [Music] conceive in an area like this that you see here we've lost the coziness of the old town and we realize that they're not as happy here sometimes but you don't rehouse for this generation you rehouse to help the Next Generation and I think that we're doing this for that these children that are going to be happy and they're going to live and enjoy life here now we've got to get a balanced population in these new areas 12 years ago the local Authority took over the family planning role and now we offer Family Planning at clinics we offer uh Family Planning service which people can be brought to Family Planning because we feel this is most [Music] important what we find is that we need to take family planning to the woman because she's reluctant this is a highly personal thing and she's reluctant to come along to the clinic so we have for the past 10 years operated a domiciliary family planning service in which we virtually visit the mother in her home this doil service is most important and we do it everywhere but above all we need to do it in the older areas of Liverpool where we meet most of our families who have problems I go to the door I don't immediately on the doorsteps say I'm the Family Planning sister I just say that I'm from the hospital when I get inside the house I then you know when there are no neighbors to over here announce that I am the Family Planning sister I discuss all the various methods the pill the cap the coil sterilization of husband and wife don't tell her what she should have but get the patient to decide which appeals to her now this may not be the best on the long run but it seems the best one to start off with having done that I explained that she has her blood pressure taken her weight watched and she has cancer smears every year if she doesn't come to the clinic you know they make very many promises they don't always keep them then I would pass it on to the domicillary doctor who can actually give pills in the home that's the only thing the nurses can't do is actually prescribe on give out pills so then the domiciliary doctor would come and provide her if necessary coming every month delivering a packet of pills now there's another important thing and that is should this be free in my own opinion it should be a free service for 12 years we've off op at under the existing Family Planning acts but I think that it should be available it should be free because I am convinced as a doctor that anything is better than a unw wanted child and particularly an unwanted child born out of wedlock more than 156,000 pregnancies were legally terminated in England and Wales during 1972 in that year there were approximately 3/4 of a million live birs this means that approximately 20% of pregnancies were unplanned and to a greater or less degree unwanted now I have done my fair share of terminations of pregnancy uh since the abortion Act was introduced but increasing experience convinces me that abortion is a rather messy and slightly dangerous way of applying contraception 3 months too late I am convinced that the answer to the unplanned pregnancy is not more and more abortion but more and more contraception that is prevention is better than curage you may wonder why I'm here well this is one of the last pieces of Countryside left in Liverpool and if we don't have a population policy in the city sooner or later and probably sooner this will become a housing estate just as many of our other Open Spaces have become I'm convinced that uh Family Planning program is an essential component of every Community Public Health Service and that it is desirable not only from the point of view of creating a balanced population but also for all the other benefits that it provides the recent work in abine has shown that the benefit of Family Planning undoubtedly outweighs the cost of this service this country is one of the most overcrowded in the world if we don't do something about it and fast classrooms at the T of the century May easily change from [Music] this getting on a bus now is bad enough imagine if an ordinary queue changeed to this as a matter of [Music] course with determination and the right methods we can change this to this but let me say finally that we can afford a family planning program we cannot afford not to have it otherwise we cannot leave all this to our children and grandchildren the Parliamentary select committee on population recently estimated that an average family size of 2.1 children would stabilize the English population whereas our average family size is 2.4 and the world average 3.5 children now unfortunately many doctors never think beyond the end of their scalpel and they do not realize that it is their reduction in the death rate rather than the population that larges increase in the birth rate which has produced the current explosion in the population we the doctors have produced this dragon and now it is up to us to slay it and just as we have had to learn that we must not take human life so we must now realize that we must not thoughtlessly give human life [Music] go [Music] oh [Music]