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NATIONAL ASSISTANCE ACT, 1948—SECTION 47
This provision authorises the Medical Officer of Health to effect the compulsory removal to
a suitable place of any person who by reason of age, illness or infirmity is living in insanitary
conditions or is unable to care for himself, and is not receiving such care from others. It was not
necessary to take such action during 1971. The old lady compulsorily removed in 1970 was
subsequently transferred from hospital to one of the Council's homes where she remained happily
until her death from a stroke early in 1971.
It is usually possible to avoid compulsory removal by the use of the domiciliary health team
of home nurses, home help, social workers and doctors. Good relationships between the department's
staff and the local consultant geriatrician also avoid the need for compulsion when hospital
admission becomes inevitable.
A considerable amount of time and energy is, however, expended in supporting certain old
people, and during the year a special observation register was started. This was in no way similar
to the list of persons over 65 years living within the Borough, which is being compiled as a result
of the social services survey, but constitutes a much smaller collection of people likely to need
urgent removal to hospital or other residential accommodation under compulsion. The situation
is a familiar one to all who work in this field; the elderly person (or couple) lives alone with fierce
independence. Physical powers have declined and dust and dirt have settled on the accumulation
of old boxes, newspapers, etc., in the one room in the house which is favoured. Domestic pets
have added their contribution and their offspring. The home help, when allowed to do so, battles
in vain against the rising tide of dirt. The home nurse tends her patients with increasing difficulty,
her ingenuity stretched to the utmost. Meals on wheels are delivered as frequently as possible
and keep the recipient strong enough to resist all enticements of "Holidays", warmth, cleanliness
or company. The purpose of the new register is to bring forward the names of such people at
intervals so that they are not forgotten, and so that they are visited by someone when all supportive
services have been rejected. In this way it is hoped to identify the moment of crisis when really
effective action can be offered and accepted voluntarily without recourse to legal channels. During
1971 a total of 14 people were placed on this register, and it is anticipated that as more experience
in its use is gained this number will increase.
MASSAGE AND SPECIAL TREATMENT
Licences, which are renewable annually, are issued in respect of premises used for the
reception or treatment of persons requiring massage or special treatment, in accordance with
the Middlesex County Council Act, 1944.