View report page

174
in whom doctors suspect some disability and these can form only
a small proportion of the whole.
In the case of the elderly, the elimination of disease and the
identification and treatment of precursor states are long term
measures to be taken to benefit future generations of old people
Rather is it the early detection of established but unreported
disease, its arrest and/or treatment of accompanying disabilities
which is of immediate value to a substantial majority of the community's
older citizens and, for reasons outlined above, neither
hospitals nor general practitioners can be counted upon to play a
major role in this sector. It falls, therefore, to the local authority's
health and welfare departments to cover these preventive aspects.
Detection of unreported illness and disability in the aged demands
a degree of medical or nursing experience not normally found in
social workers. It is, however, a basic discipline of the health
visitor and it is the Directorate's policy of relying upon her skills
to seek out and ascertain the extent and seriousness of the hidden
disabilities of our elderly residents which has proved so successful.
Our experience shows, without doubt, that the most acceptable
approach to the elderly is by one with a nursing background.
Often local government is accused of failing to move with the
times and it is true that incipient legislation in this particular field
is challenging our present attitudes and existing practices. Yet
this is a sphere in which Greenwich has always been recognised
as an avant-garde authority. Premature abandonment of principles
upon which are based the services, so painstakingly but soundly
built up over a number of years, would not only be foolhardy but
could well mean settlement for mediocrity, if not worse, during
the next vital 20 years.
Future Prospects
Our present geriatric services are directed towards practical
and material support with the declared intention of delaying the
as yet, irreversible processes of ageing and maintaining our elderly
people more happily in their own homes so that, if or when,
hospitalisation becomes necessary, it will be of short duration. In
this connection, there is the closest of liaisons between this Directorate
and the housing departments of this and the Greater London
Councils and with the Department of Health and Social Security
and other statutory or voluntary bodies with similar aims.
But, without doubt, health is man's most precious possession and
nothing is more important to the older citizen than that he should
reach retirement physically and mentally fit. However, patterns