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word disastrous, the views expressed were in accord with most
of the informed opinion with extensive knowledge of the preventive
and personal health service. That the views and advice
were ignored is now history and the Social Services Act has been
operative for almost a year.
Next to the Education Department, that of the Social Services
is now the government's biggest spender and, as in the Health
Services before, it will find itself short of resources to match its
ever-growing needs. Moreover, much more will be expected than
it can ever hope to achieve and it is at this point that it will
find wisdom and experience in this field of community health
invaluable. Even so, such a sudden and unprecedented increase
in expenditure resulting from the deliberate separation of health
and social work will surely have its repercussions and will need
to be justified, health-wise and cost/benefit-wise. Only history
will reveal whether this dichotomy was a stroke of genius or a
serious error of judgement.
It is true we were forewarned, nationally, that in the transitional
period there was likely to be a diminution both in the
quality and quantity of service but we were assured that, eventually,
improvement would be dramatic.
However, at the outset it was obvious that the new Directorate
would have to operate under great difficulties for it was faced
with two major problems—it was about to enter into a field in
which preventive and personal health has an equal, if not a
dominant role, and that it was to attempt to undertake this
task not only with insufficient staff but of whom only 25% were
qualified. Inevitably much time and effort would be needed, first
to recruit and then to train entrants into this new service, the
majority of whom were likely to be young and inexperienced.
Clearly, it is during this rather extended interim period that
the greatest danger exists of a hiatus developing particularly in
the more firmly established and traditionally health-based services
such as child and geriatric care where a change of visiting personnel
as well as duties is involved. A side effect of these function
transfers will be that efforts to reduce the number of callers at
particular households will be frustrated and demarkation problems
intensified.
Already some alienation has taken place among psychiatrists
and social workers as a result of the introduction of the Social