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7
Directorate of Health Services,
Municipal Offices,
Royal Hill, S.E.10.
To the Mayor, Aldermen and Councillors,
London Borough of Greenwich.
Ladies and Gentlemen,
I have pleasure in presenting this account of the Health and
Social circumstances of Greenwich for 1971. This is the year
during which the present Health and Social Services began to
form separate organisations; the process of division continues and
it will be some time before the two Directorates are operating as
distinct entities.
The late 60's will be remembered as the halcyon days of management
consultants and the early 70's will present local authorities
with difficult problems of readjustment to new systems and ideas.
The fact that the Health Services will be unified in 1974 outside
local government means that special efforts must be directed to
seeing that care within the community is closely related to the
health services and that both are relevant to the ascertained needs
of the population. This effort of co-operation is of paramount
importance in respect of four main groups: the under-fives, the
handicapped, the mentally disordered and the elderly. Neither
service can develop in isolation. Some form of acceptable de facto
integration must be devised, at least in major capital spending and
in assessing professional and supportive manpower requirements.
In the new Area Health Authorities, the proposed joint consultative
committees hold out hope of the two planning authorities
deciding their priorities in unison and in accordance with mutually
accepted planning standards. Any arrangements whereby each
authority proceeds independently of the other will be disastrous.
By way of illustration, let us examine very briefly and superficially
the geriatric problem. A recent Office of Population survey reveals
that some 70 per cent of all the handicapped in the country are
elderly and, in this Borough, 67 per cent of the home nursing
resources is devoted to citizens over the age of 65. Local surveys
have indicated that about 16,000 elderly require health visiting of
varying intensity. Early warning systems, rapid and accurate
assessment of need and the provision of appropriate practical help
are of paramount importance when dealing with such large numbers.
We therefore have the situation that a majority of elderly
requiring social services also require health services and their needs
stem very largely from an underlying physical or psychological
infirmity. Because of the ever-increasing numbers of elderly and