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RENAL DIALYSIS
Arrangements for patients to carry out renal dialysis in their own homes first commenced in this Borough in
April 1969.
Patients with diseased or non-functioning kidneys accumulate waste products in the blood and renal
dialysis is the method needed to clear the blood of these products. The patient is connected to the kidney
machine, sometimes three times a week, for as long as 10 hours.
Experience has shown that patients carrying out dialysis at home do better than those returning to hospital
for the treatment. Travelling to a hospital centre can be both time consuming and exhausting and dialysis at
home enables the patient to do a full week's work and lead a normal family life. More importantly, it reduces
the risk of infection to the patient himself and to other patients and staff in a hospital dialysis unit.
The demand for renal dialysis is increasing, and to meet this demand it is essential for patients to be trained
to carry out the procedure in their own homes so that the hospital staff can treat and train more patients.
In some instances a room in a patient's home is adapted to accommodate the dialysis equipment, but in
others it is housed in a Portakabin in the garden of the house. This latter method is sometimes more
satisfactory from the point of view of the family as it leaves more living accommodation for them. The cost of
converting the property or supplying the Portakabin is met by the Council, but the dialysis equipment is
supplied by the hospital authorities.
During the year, arrangements were made for three patients to dialyse themselves in their homes. One
patient and his family were rehoused in Council property as the flat he was living in was inadequate to meet the
necessary requirements. A room in the house was then adapted for the purpose. The other 2 patients lived in
their own property which they were buying on a mortgage and, again, suitable rooms were adapted to house
the dialysis machines.
By the end of the year, arrangements were being made for a further 2 patients to undergo renal dialysis at
home.
WEST LONDON HOSPITAL—MARTHA & LUKE CLINIC
During the year 1972 the total number of cases seen in the department were 18,747 as opposed to 18,898 in
1971. This is the first time in 10 years in which no increase has been registered but it is doubtful if this signifies
any substantial reduction or change in the trend of the conditions treated here. The waiting room and
reception facilities provided were inadequate to deal with the enormous influx of patients who often had to
stand in crowded conditions, and this undoubtedly deterred a number of people from attending.
The total number of cases from Hammersmith was 6,281 and this showed a decrease of 509 over the
previous year, but this was offset by the more peripheral boroughs.
The total number of cases of infectious syphilis seen in the clinic was 136 with a further 97 of latent syphilis.
This is virtually unchanged from recent years. The corresponding figures for Hammersmith were 45 and 37;
the number of cases of gonorrhoea were 2,652. 825 of which were from Hammersmith which shows a welcome
reduction. A marked improvement in the laboratory services for the diagnosis of this condition in women
coupled with intensive and highly efficient methods of contact tracing may have contributed to this welcome
result but it is too soon to draw any firm conclusion.
The incidence of all other conditions continues to rise and the problem of non-specific genital infection has
now become a major one and much improved research is required before any solution is likely to be achieved.
In conclusion it seems that the rapid increase in previous years is mercifully tending to slow down. Shortage
of staff continues to be a major problem although efforts are being made to ameliorate this difficulty.
THE CHIROPODY SERVICE DURING 1972
The development of the Chiropody Service is hampered by the acute national shortage of State Registered
Chiropodists. The situation is so serious that other methods of expanding the workforce must be considered.
One possible method, for instance, would be to train foot hygenists or auxiliaries to augment the work of the
Chiropodist by undertaking the more simple routine treatments. Under a scheme of this nature, such
treatments would, of course, be supervised by qualified Chiropody staff.
Since the work of the Chiropodist is no luxury, but makes a vital contribution to the health of the
community, there is need for more training schools to increase the number of qualified personnel. The present
rate of producing 150 newly trained Chiropodists each year is so inadequate that it barely replaces the annual
wastaige from the profession, which because of low pay and poor career prospects, loses almost as many as it
trains. In addition, the more lucrative work of private practice adds to the drain of staff from local health
departments. All these factors contribute to the difficulties of developing the Chiropdy service to deal with
unmet need in the community.
In Hammersmith during the latter part of 1972 the Section had to cope with severe staffing problems. The
sad death of Mr. Astley, a senior member of staff, has been a great loss to the service. A further full-time and
two sessional staff resigned, two of whom decided to leave the profession completely. These latter events
resulted in a diminished establishment and regretfully weakened the efficiency of the service.
The decision of the Council to raise the establishment from 14 to 16 full-time staff as from 1 st April 1973 was
welcomed, together with the introduction of full-time clerical assistance from 1st September 1972. The
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