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Prevention of Illness, Care & After-Care (National Health Service Act, 1946 — Section 28)
Cervical cytology
A clinic for cytological screening for cervical cancer was set up in the Borough where
up to 15 women were seen at each weekly session and, in addition, cytological smears were
taken at Family Planning Clinics. This service was limited by the laboratory facilities available
for the examination of smears, but it is hoped to provide more clinics as soon as a greater number
of smears can be examined.
T uberculosis
I am indebted to Dr. H.C. Price and Dr. P. Stradling for the following reports:
Fulham Chest Clinic Annual Report, 1966.
From an epidemiological point of view, the present position of tuberculosis in the
Southern half of the Borough remains unchanged. This underlines the fact that the battle against
the tubercle bacilli is still not won. The increase in mobility of the population with the introduction
of fresh ethnic groups with very varied socio-economic backgrounds and uneven previous
contact with the tubercle bacilli increases the problem.
The number of new pulmonary cases notified shows no significant change, and the fall
in the non-pulmonary continues, in spite of the fact that many of the new residents in the Borough
come from areas where the milk is unpasteurised. The number of domiciliary calls made by the
clinic staff indicates that the number of problems arising shows no signs of reduction—this in
spite of reduced health-visitor staff.
The trend for the disease to appear in the later age groups and for deaths to occur
mainly in the 56 — 65 age groups continued as in previous years, although for the first time for
several years a case was notified under 6 years of age in both sexes.
The non-tuberculous work in general medicine with a bias towards cardio-respiratory
disease continues, in spite of interference caused by building work taking place on the inpatient
unit. The social effects of chronic non-tuberculous respiratory disease is in many cases just as
severe as the effects on tuberculous patients during the pre-therapeutic era. Unfortunately, the
welfare arrangements officially available for such patients fall far behind those provided for the
tuberculous.
The rapidly changing socio-economic situation taksn in conjunction with the reduction
in the respect that tuberculosis used to exact as the Captain of the Men of Death should spur all
those concerned with this scourge to greater efforts towards its final eradication. The fall-off in
popular fear of this disease has given rise to a feeling of false security based on the mistaken
conception of the power of modern drugs resulting in an increased unwillingness to attend followup
clinics; tracing contacts is thus more difficult. This problem is intensified by the archaic
communication system in the Health Service.
A more comprehensive community health information system is now an urgent necessity
for the sort of epidemiological work now done in many chest clinics. To attain such a system the
exploitation of the power of computers rapidly to sort, collate and recall relevant socio-medical
data is an essential tool. A Feasibility Study to explore the possibility of setting up such a
system is now starting in Hammersmith and Kensington.
Social Work
A close liaison has been established between the medical (health visitor) and socialwork
aspects of the work at the clinic. A more satisfactory number of chest patients were rehoused,
but unfortunately those who went to live at the new Townmead Estate found this lowlying
and air polluted area unfavourable and asked for transfers. The co-operation of the Housing
Department has been appreciated in this matter.
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