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THE STAFF HEALTH SERVICE
The medical arrangements made by the four amalgamating authorities which now form the
Borough of Camden varied widely both in the screening of their new entrants and in dealing with
cases of sickness occurring amongst those already upon their staff. That this should have been
so is not surprising, for such arrangements were the product, perhaps, more of evolution than
planning, and their development was conditioned not only by the size, structure and duties of the
authorities concerned but also by the varying attitudes of past councils and chief officers alike.
With the advent of Camden, there was the opportunity of a completely fresh approach to
the problems involved.
The Deputy Medical Officer of Health has been directly responsible to me in the creation
of this "new look" of the staff health service. We are both indebted to Dr. Michael Warren, Senior
Lecturer in Preventive & Social Medicine at the London School of Hygiene and Tropical Medicine
for his helpful guidance freely offered.
However, a new authority the size of Camden must to some extent remain an unknown
quantity until actually in being, and in a field as vital as this mistakes and miscalculations (albeit
made in good faith upon facts available) can do damage far beyond the size of the original error;
for this reason it was decided that initially the medical examination of new entrants should be
limited to officers entering the Council's service and should in all cases include a chest X-ray:
the former London County Council practice of requiring Home Helps to complete a medical questionnaire
and have a chest X-ray being continued.
During this time cases of prolonged sickness (including those of superannuation upon
medical grounds) were dealt with by the Staff Committee who were advised by me in each case. This
system has worked well and no change has been made in the revised arrangements set out below.
In looking at a staff health service for Camden two main points emerged. Firstly the routine
medical examination of new entrants to the Council's Service was probably less valuable than the
completion of a questionnaire by the candidate, with selective medical examination where indicated,
complemented by a chest X-ray examination in certain cases. This step had already been taken by
many other local authorities and by blending their experience with our knowledge of our own particular
needs, a comprehensive questionnaire was devised. Accordingly from 1 December routine
medical examinations were replaced by a questionnaire and chest X-ray with selective medical
examination where indicated. Secondly it was apparent that there was a need for an occupational
health service within Camden.
Questionnaires and X-ray forms have been distributed to all departments, the former being
enclosed in a prepaid envelope addressed to my Deputy to ensure both its speedy sorting and its
confidentiality. The new scheme has started well, and has diminished the delays inherent in the
previous arrangements. The main cause of delay is the failure of candidates to return their questionnaires
or to attend for X-ray (perhaps sometimes because they have other irons in the fire but wish
to keep their Camden offer open!).
During this time progress has been made in two other directions. My deputy has informally
discussed with all chief or deputy chief officers both the aims of the new service ana difficulties
which they may face. The result has been uniformly gratifying, and more pleasing still has been
their response to the idea of a consultative service to help staff; increasingly my deputy is seeing
members of the staff who have worries or problems, or about whom the chief officer concerned is
anxious. In all cases a close liaison is maintained with general practitioner and other agencies
which may be concerned.
It would be idle to suggest that in all such cases his intervention can bring about an
immediate change for the better, and here as elsewhere in life one tends to recall one's successes.
That this new service is worthwhile cannot I feel be doubted and that it will expand must
be true. Its value, however, is two-fold; for the Council it provides the assurance that the working:
conditions of staff are satisfactory, even in the individual sense, whilst for the employee it gives
a background of medical care from colleagues who are familiar with the problems particular to local
government; such a state achieved cannot fail to benefit both.
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