of the food supply through inspection and analysis of foods is still largely within the jurisdiction of the department of agriculture in its bureau of dairy products and bureau of veterinary service. The primary object of the regulation of the milk supply, for example, is not the promotion of the milk-producing industry nor the protection of the producer, but rather the protection of the public against diseases which are transmissible through milk and the prevention of contamination of milk by dirt or adulterants. This is essentially a health measure. Similarly, the inspection of cattle by the veterinarians of the department of agriculture is not merely for the purpose of seeing that the cattle owners are protected against loss of their animals from disease, but to prevent the spread of those diseases to man through the consumption of the flesh of disease-contaminated animals slaughtered for food, or directly from living animals to man. The majority of the diseases of domestic animals. are transmitted to man in one of these three ways, and the elimination of animal diseases is therefore of primary importance in the promotion of public health. 2. As previously shown the department of labor maintains a division of industrial hygiene, which conducts investigations of industrial processes with a view to the prevention of industrial diseases, and also a division of industrial accidents and diseases, which is charged with the collection, tabulation and compilation of statistical and other material regarding poisonings from lead, phosphorus, arsenic, brass, wood alcohol, mercury or their compounds, or from anthrax, or compressed air iliness, contracted as the result of the nature of the patient's employment (Sec. 65 of Art. 5, Labor Law). The law requires physicians to report all such cases to the commissioner of labor and prescribes the information to be furnished by physicians. It is evident that the success of registration and prevention of industrial diseases depends, in large measure, upon the co-operation of private physicians who are called upon to treat cases of industrial disease, and such co-operation is much more easily secured by the state department of health, which is in daily contact with the physicians of the state. Research and laboratory investigations, which may be carried on with reference to these diseases, require medical expertness in the highest degree. The state department of health already has a staff of experts in both field and laboratory research and investigation. The prevention of industrial diseases and the promotion of industrial hygiene is not exclusively a labor problem, but rather part of the general problem of the promotion of public health. Tuberculosis, for example, is so prevalent among workers in certain trades that it has come to be regarded, in certain of its forms, as an industrial disease, but the prevention of tuberculosis in all its forms is one of the state's great health problems, which to be effectively dealt with must be considered in its relation to other communicable diseases, the food supply, including milk, general sanitation and hygiene, and all other matters which pertain to public health. 3. The inspection and supervision of the conditions under which workers are employed in their homes, which service is now rendered by the division of homework inspection of the department of labor is intended as a health measure. In our larger cities considerable work is done for factories in the homes of employees and much of this work is done by children. The most fertile field for the promotion of public health is that of prevention of diseases and mortality among children. Conditions which might have little or no effect upon adults quite often result in serious impairment of the health of children. The correlation of all existing activities designed to promote child health is therefore very desirable. 4. Up to the present time supervision of private, municipal and county hospitals and dispensaries throughout the state, as well as the supervision of the state hospital for the treatment of incipient pulmonary tuberculosis, has been in the hands of the state board of charities. Here again the object of such supervision is primarily that of promoting public health and not of providing relief for the indigent. For the best supervision of such activities, it is essential that that department, which is charged with the prevention of disease, should be also responsible for the measures necessary to provide proper treatment. 5. The various regulative organization units previously described, namely, the state superintendent of weights and measures, the state racing commission, the state athletic commission, the harbor masters and the board of port wardens now act entirely independently. Each is responsible directly to the governor, whose supervision of these organization units must, of necessity, be only a nominal one, and is based almost wholly upon the reports which are submitted to him by the heads of these various bodies. The result of such supervision has in certain instances been detrimental to the public welfare as well as unnecessarily costly. a. The office of the superintendent of weights and measures, which performs a purely regulative function, has up to this time been considered as a separate and distinct unit, not allied in any way with other regulative functions of the government. To a certain extent this is true, but it is also true that the office of the superintendent of weights and measures is more closely allied to those functions which are promotive of the public health than to any other functional grouping. The regulation of matters relating to weights and measures is very closely concerned with the question of control of the food supply, which is a primary health function. The inspection of weights and measures throughout the state may, by close correlation with the food inspection service, be made to render signal service in the protection of goods against adulteration or misbranding. It is therefore suggested that the service now rendered by the office of the state superintendent of weights and measures should be considered in its relation to the state's plan for the promotion of public health and should be placed under the same supervision as other functions in health control. b. The state racing commission and the state athletic commission are very similar in purpose. They are both created for the purpose of regulating recreational activities, which it is assumed the citizens of the state demand and which must be properly supervised, in order to prevent the exploitation of the public to its disadvantage. The functions of both these commissions are perhaps more closely allied to those functions which have been grouped as promotive of public health than to any other grouping of functions. For the sake of improved administrative control, these two commissions have been included among the functions herewith, considered as promotive of public health. c. Two other organization units, namely, the harbor masters and the board of port wardens, are created primarily for regulating and insuring the safety of navigation. The report on the board of port wardens indicates very clearly that there is need for better supervision of this work. The correlation of the functions now performed by the harbor masters and port wardens, under the single head responsible for the promotion of public health activities, would do away with many of the defects of the present organization. It is therefore suggested that these functions be also included in the grouping herein described of functions for the promotion of public health. Need for Closer Relation of Legislative Council to Executives The present organization plan of the state department of health under a single executive responsible directly to the governor and assisted by an expert legislative staff, namely, the public health council, is well calculated to secure best results in public health administration. The difficulty which now exists in the enforcement of the sanitary code, which has been drawn up by the public health council, is the result of the division of health functions among several departments of the state. It is essential in carrying out thoroughly a plan for the promotion of public health that the body which makes regulations shall be an integral part, or at least very closely allied with the organization charged with the enforcement of these regulations. Regulations may need modifications or amendment in order that the peculiar conditions found by supervisors or inspectors in the various fields of health service may be met, and the closer the contact and cooperation of the legislative council with the executive officers, the easier it is for the council to fit its regulations to the conditions in the field. Economy Through Better Organization The lack of correlation of functions promotive of public health means, of course, increased cost for overhead, as well as special service. Each division of work, whether it be under the control of the department of health, the department of agriculture, the department of labor or other organization unit of the state government, requires its own directing officers or staff, its own clerical and stenographic force, its special inspectors and its special reports. The consolidation of many of these functions, now so widely separated, would inevitably reduce the amount of supervision needed, the clerical and stenographic force required and the cost of reporting results. Cooperation in the working out of a comprehensive inspectional plan would mean fewer inspectors and lower cost. Indeterminate Tenure of Office Desirable The commissioner of health is appointed for a term of six years. This means that every third governor has the appointment of a commissioner of health. While it is desirable that the term of the commissioner of health should be more than two years, it is very undesirable that the governor, who may be held accountable for the acts of his subordinates, should not be always responsible for the selection of those subordinates. He should not find it difficult to remove them when they fail to carry out the policies upon the basis of which his administration has been supported by the people. It is important, also, in carrying out any program for the promotion of public health that the offices responsible for the conception of the plan, the organization of the force, and the performance of the work shall be continued in office long enough to work out his program. Six years is not long enough, and it has been the experience of public health workers that a long term of office of the commissioner of health or health officer almost invariably results in progressive efficiency of health service. If power of removal is freely given the appointing officer, that officer must, of necessity, exercise such power wisely, for in removing a competent subordinate he is certain that the public will review his act to his own disadvantage. Such a plan of indeterminate tenure PART VI.-ORGANIZATION FOR THE ADMINISTRATION OF STATE ACTIVI- There are peculiar difficulties in any attempt to appraise the existing governmental machinery for dealing with industrial relations in New York state. The legislature has just passed a comprehensive statute completely reorganizing the state labor department and combining with it the workmen's compensation commission, thus constituting an industrial commission with new and extensive powers. If the new commission is thoroughly and efficiently organized along the lines projected and implied in the Spring Bill, which has just received (May 22, 1915) the governor's approval, the grounds for many of the criticisms and suggestions contained in this chapter will doubtless be removed. The comments herein are based, however, on the existing order before the industrial commission comes into being. That order corresponds to the description to be found on pages 229-247, 269-277, and elsewhere, in the survey of organization and functions reported by the New York bureau of municipal research and the New York state department of efficiency and economy, January 1, 1915. Scope of State Function of Regulation of Industrial Relations New York heads the list of states both in the number of its industrial establishments and in the number of its industrial workers. The United States Census Bureau in 1909 enumerated 44,935 manufacturing establishments and 1,003,981 as the average number of wage earners in those establishments for the state of New York as compared with Pennsylvania, the second state in order of importance in this matter with 27,563 establishments and 877,543 wage earners. The relatively large number of small establishments in New York is the significant fact indicated by these figures and complicating the question of state regulation. The reports of the New York state department of labor showed an even greater task accomplished in that, its division of factory inspection alone, in September, 1914, covered 51,118 manufacturing establishments and 1,364,070 employees, of whom 88,022 were office employees. These figures do not cover the persons affected by the division of mercantile inspection, the division of inspection of mines, tunnels, etc., and the division of home work inspection. No adequate figures are available to show how many persons are affected by the labor law enforced by these divisions of the inspection bureau of the department of |