In England and Wales in 1963, 187,023 deaths were certified as due to diseases of the heart. These included 154,815 deaths due to arteriosclerotic and degenerative heart disease of which 107,856 were due to arteriosclerotic heart disease, including coronary disease.
In becoming aware of the size and severity of the problems of mental illness it is easy to overlook the great strides forward which have been taken in the lifetime of many of us towards the goal which I believe we can and will reach. That goal will be reached on the day when we shall have won against mental illness a victory as splendid and as much to the credit of mankind as the victory we have now won over tuberculosis — that adversary which for so long seemed unconquerable.
In 1964 there were estimated to be 55,000 doctors actively engaged in medicine in England and Wales. In addition to these probably some 8000 to 9000 qualified doctors were not practising of whom about half had retired on grounds of ill-health or age. The two largest groups of those professionally employed were the 22,000 general practitioners and the 21,000 hospital doctors.
In Great Britain during 1963, over 9¼m. new claims for sickness benefits were registered with the Ministry of Pensions and National Insurance. A total of nearly 300m. working days were lost during the year from June, 1962 in certified spells of sickness absence. This represents an average of 14 working days lost for each person covered by the insurance scheme. The amount paid in sickness benefits during 1962/63 exceeded £160m., a sum equivalent to approximately one-sixth of the total expenditure on the National Health Service.
One of the consequences of ill health which can have the profoundest social and economic effect is a legacy of chronic and permanent disability. It may arise from many different disorders, and can take as many different forms as blindness, deafness, mental sub-normality or paralysis. Not only is each person disabled a unique individual, but each type of disability presents fundamentally different difficulties.
The structure of the National Health Service today is tripartite in form. There is the Hospital Services sector accounting for about two thirds of the total cost; there is the General Medical and Pharmaceutical Services sector, which between them account for about one fifth of the total cost. The third major part of the National Health Service consists of the services provided by county councils and county boroughs in their role of Local Health Authorities which account for about one tenth of the total cost.
Expenditure by the National Health Service in England and Wales on patients suffering mental disorders currently exceeds £130m. a year, about one-eighth of the total health services' expenditure. This large amount spent on mental disorder is only one side of the picture. The cost of treating diseases must be set against the cost of not treating them. More effective and expensive medical procedures may in fact reduce the total costs of sickness.