“What are the advantages?” I asked, for so far I had seen no advantage except the possibility of checking expenditure upon drink.
“The use of these accurate family budgets and household accounts to the Sociological Department is simply indispensable. To the Department of Trade and Industry also they are very valuable. In fact, you may take it that all our Meccanian institutions are so arranged that they serve several purposes and fit in with the whole Meccanian scheme of life.”
Incidentally, in connection with the family expenditure on food, he mentioned model dietaries. I was curious to know what these were. He explained that there were three recognised kinds of dietaries. First, the Food Department prescribed model dietaries for families of the three lowest classes in normal health. Secondly, when each person was medically examined—and this happened at least once a year—the medical officer might prescribe a dietary for the individual; and lastly, if a person were positively ill, it would be the duty of the medical officer in charge of the case to prescribe a dietary. I was going to ask some further questions about the Medical Department, when Sheep reminded me that we had still several other municipal departments to visit before we came to the Medical Department, and that we must not depart from the programme of our tour.
The Department for the Inspection and Regulation of Clothing came next. I was rather surprised that this should be a municipal institution, seeing that the regulations were uniform for the whole country.
Sheep explained that it was just because the regulations were so perfectly uniform that the function of administering them could be entrusted to the municipality. The department was quite a small affair. Only about ten inspectors were required for Bridgetown. Their duties were to see that no person wore any uniform to which he was not entitled, and that on ceremonial occasions full-dress uniform was worn. It was quite easy to ensure that a uniform of the right colour was worn, but in addition to that the various grades of each class were indicated by the various facings, stripes, buttons and badges, as were also the different occupations within each class and grade. The penalties for wearing unauthorised decorations were very heavy, and infringements were very rare, as detection was almost certain.
“I should have thought that the whole clothing trade would be in the hands of the Government,” I remarked.
“That is not part of our system,” replied Sheep. “The production of all the kinds of cloth for all the uniforms is so standardised that there would be no advantage in the State taking over the mere manufacture. Each person chooses his tailor from a small panel. Naturally the members of the higher classes have the best tailors. In fact, a tailor of the first grade would not be allowed to make suits for the three lowest classes; it would be a waste of talent.”
“And what about the women’s clothing?” I inquired. “They do not wear uniforms. Is their dress regulated in any way?”
“Only in two ways,” answered Sheep. “Every woman must wear, on the front upper part of each of her outdoor dresses, a piece of cloth of the regulation pattern and colour, to indicate the class to which she belongs. Also the expenditure on dress is limited according to the social class.”
When we came to the offices of the Department of Health, Sheep said I had made a grave error of judgment in choosing Tour No. 1—the tour for a single week only—as there was enough to occupy us for a week in the Department of Health alone. It included the Sanitation Section, the Medical Inspection Section, the Medical Dispensing Section, the Medical Attendance Section, the Hospital Section, the section of the Special Medical Board, the Marriages and Births Section, the Post-Mortem Section, and the Buildings Section.
After this I was not surprised to hear that over a thousand persons were employed in the Health Department, in addition to the workmen—chiefly of the Sixth and Seventh Classes—who did the actual menial work of keeping the sewage system in order and keeping the streets clean. I might write a whole chapter on the Health Department, but it will perhaps suffice if I mention the most singular features.
Inspectors visit every house twice a year to see that each house and flat is kept in a sanitary condition. Each person is medically examined once a year—this is in addition to the system of medical inspection in schools—and whatever treatment is prescribed he must submit to.
“What happens,” I asked, “if a person declines to submit to treatment?”
“He would be taken before the Special Medical Board,” answered Sheep.
“And what is that?” I asked.
“We shall come to that presently,” said Sheep reprovingly. He went on to explain that the Dispensing Section treated all persons of the three lowest classes who did not require to go into a hospital. The doctors were municipal officials and there was no choice of doctor.
“Why do you not allow choice of doctor?” I asked.
“That would interfere with the proper classification of the diseases,” he answered. “As soon as a complaint is diagnosed, it is handed over to the appropriate doctor for treatment. The same applies to the Medical Attendance Section; but persons in the three lowest classes are not generally attended in their homes, they are brought into the hospitals. The chief work of the Medical Attendance Section is in connection with births; consequently we employ a number of women doctor-nurses in this Section. Now we come to the Special Medical Board. It is a sort of Higher General Staff. It collates the results of the work of all the other medical sections, and is responsible for the annual report. It receives the instructions of the Central Medical Department of Meccania, and sees that these are carried out. It directs special investigations in all abnormal cases. In the case of so-called incurable diseases it pronounces its decree as to whether the case is incurable, and in that event it authorises the death of the patient.”
“Authorises the death of the patient?” I said. “Without the patient’s consent?”
“The patient can hardly be the best judge,” said Sheep.
“What about the relatives then?” I asked.
“The relatives have no voice in the matter,” said Sheep.
“That sounds very drastic,” I remarked; “and what about the sort of case you mentioned a little while ago?”
“The case you mentioned?” said Sheep. “I do not remember any such cases, but if one occurred it would be dealt with under Section 143 of the Medical Regulations, which prescribes that in case of persistent disregard of the instructions of the authorised medical officer, with the consent of the Special Medical Board, the person guilty of such refusal is to be removed to an asylum for mental abnormality.”
“A lunatic asylum!”
“We do not call them lunatic asylums. The term is obsolete; it does not accord with our system of classification.”
Sheep next dealt with the Marriages and Births Section. This is in some ways the most remarkable of all. It appears that a licence to marry is issued to all persons in normal health, the Department prescribing the number of children to be born within each period of five years. Persons classified as abnormal are specially dealt with, and on this subject Sheep referred me to the Report of the Central Medical Department, which I could obtain in the Great Meccanian Library at Mecco. The Post-Mortem Section carried out an examination in all cases of interest to the Health Department before cremation.
I asked what the Buildings Section was. It seems to be a sort of link between the Architectural Department and the Health Department, and supervises the building regulations from the hygienic point of view.
The next day Conductor Sheep called punctually at nine o’clock to continue the tour of observation. We had come to the end of one section, as marked out in the mind of the ‘Authority,’ and were now to begin another, namely, the institutions controlled