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the structure of local government outside London and to publish a Consultative Document on the former
and a White Paper on the latter, both of which were still awaited at the end of the year. The end result of
this series of administrative unheavals will be the complete separation of the health from the personal social
services, as a consequence of the departure of the personal health services from local government to the
proposed area health boards. While recognising the political factors which have rendered this at the present
time virtually inevitable, one would venture to forecast that the fundamental disadvantages of such a
situation must eventually lead to a further major reform. Changes of this magnitude, however, are
infrequent and it must be accepted that for probably the next two decades much effort will need to be
expended by both health and social service administrators in surmounting the barriers which are currently
being erected between them.
Dr. Johnson once said "Depend upon it Sir. When a man knows he is to be hanged in a fortnight it
concentrates his mind wonderfully." It behoves those of us who are responsible for local authority health
departments during the final two or three years of their existence to concentrate our minds upon two
fundamental tasks: firstly, to foster the development of a relationship between the new social services
departments and the health services which will survive the re-organisation of the health service and provide
a foundation on which the social services departments can relate to and co-operate with the new health
service authorities; and secondly, to develop the preventive and community health services so as to prepare
them for the new and broader role which will be theirs in the re-organised health service. As far as the
former point is concerned, planning for the transfer of functions from the health to the social services
department commenced in the autumn and, in addition to consideration being given to the need for a
continued close liaison between officers of the two departments, the geographical service areas were also
reviewed in order, as soon as possible, to render them co-terminous. In the latter respect, efforts continued
to bring the borough's personal health services into closer relationship with both the hospital and the
general practitioner services. Examples were, on the hospital side, the participation of borough nursing staff
in hospital nurse study days at the Whittington Hospital and reciprocally the arrangement of day visits by
hospital nursing staff to the community nursing services, the attachment of borough nurses and medical
staff to paediatric and geriatric ward rounds in the local hospitals and the commencement of plans for
student nurses at the Royal Northern Hospital to spend a period of their training attached to the borough
nursing service. On the general practitioner side, progress was made in the attaching of local authority
nursing staff to work directly with designated practices. By the end of the year there were eight members of
nursing staff in full attachment, seven members of nursing staff in partial attachment/liaison — a total of
fifteen nursing staff covering twenty-two general practitioners.
The borough's health centre programme continued to develop; arrangements were made for two general
practitioners to be provided with practice accommodation at the Finsbury Health Centre, the construction
of the River Place Health Centre approached completion by the end of the year and that of Highbury
Grange commenced.
Despite the unsettling effects of the impending transfer of functions to the Social Services Department
steady progress continued in the development of all the services for which the department was responsible.
It is, of course, impossible to refer in detail here to all the department's activities. These are covered in
detail in the pages which follow. Matters which do seem worthy of special mention are the extension of
facilities for the day care of pre-school children by the opening in May of the Council's first purpose-built
day nursery at Lough Road, the increase in the number of registered playgroups from twelve to
twenty-eight, and the Council's agreement towards the end of the year to accept financial responsibility for
the playgroup fees of children who were in need of such provision for social or medical reasons but whose
parents were unable or unwilling to pay the fees.
Further growth took place in the provision of family planning, which is jointly undertaken by the
borough and the Family Planning Association, and a substantial increase was recorded in the number of
attendances. The service was extended in April to entitle all residents of the borough over the age of sixteen
to free advice and in medical or necessitous cases to free supplies also. In November the Council agreed to
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