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137
SECTION V
COMMUNITY CARE
The die is cast. Realisation of this Council's long-held vision
of a fully integrated and comprehensive Community Care Service
for Greenwich residents is not to be—certainly not for some time
to come. Efforts by the Council to ensure the continued existence
and refinement of a single department designed to resolve problems
arising in one or any combination of the health, welfare and
social fields have been negated by the recent Social Services Act.
Introduced to separate predominantly social problems from those
mainly medical, this legislation fails to take account of the fact
that most problems lie between these two extremes; indeed, it
appears almost as if it were planned to widen gaps between the
various disciplines. In practice, it will prove difficult to maintain
the efficiency of existing services in the face of the demarkation
situations which are sure to present themselves. Much more than
this, however, is the complex and distasteful task of disengaging
existing integrated services with a minimum of disruption to public
and staff alike.
It is precisely because of the element of danger to existing facilities
and of possible financial chaos brought about by violent
change that avant-garde authorities in local government are scarce,
a fact which merely serves to emphasise the courage and worth of
the Council's progressive policies. Its concept of an integrated
community care service, which found favour with all shades of
opinion, clearly deserved a better fate. Consolation, however, may
be found in an observation made recently by the Secretary of
State for Health and Social Services to the effect that "if we were
starting from scratch we would have one health structure, not
two". Future years may yet see a re-union of these important
services and a vindication of the Council's foresight.
This particular statement of the Secretary of State was made in
relation to the impending amalgamation in April, 1974, of the local
authority health services (excepting certain environmental functions)
with those of the hospitals and general practitioners and
such a consolidation is undoubtedly logical. But in terms of
improvement to community care, success of the coming merger will
now depend largely on the building, by the community physician,
of firm and defined channels of communication between the social
and health services. In the interim we must ensure that involvement
of one service will not, by default, lead to the disengagement
of the other.