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considers, for instance, that whilst in Southwark, at least,
the recording of infectious disease notifications remains the
responsibility of the Public Health Department, Diphtheria and
Whooping Cough immunisation and investigation into certain
infantile diseases as well as puerperal sepsis are undertaken
by Health Visitors now controlled by the London County Council;
likewise, the clinical treatment of tuberculosis is now dealt
with by the Regional Hospitals Board.
At the same time, it must be emphasised
that the personal health services, important and progressive
as they are, are not the whole essence of Public Health.
The earlier functions of the abatement of sanitary nuisances,
the safe-guarding of the purity of our food, the control of
infectious diseases, and the medical, overcrowding, and
sanitary aspects of housing, are still the responsibility of
the public Health Department as fundamentals upon which the
whole structure of Public Health and Social Welfare are built.
The work of the individual sections of the
Department is reported upon in detail in the following pages,
but I feel constrained to refer here to the problem - perhaps
one of our most difficult and distressing - of the aged and
infirm. There are many hundreds of old people living alone
without relatives, or at least without anyone who is either
able or willing to help them. Many are afflicted with some
degree of physical or mental sickness and existing in deplorable
conditions through their age, infirmity or lack of assistance;
almost all of them arc suffering from the psychological
devastation of helpless old age, bereft of companionship or
care. The imaginary thread of independence to which they cling
somotimes an obstinate pride and sometimes a fear of becoming
an unwanted burden to others - only serves to make more difficult
the sadly limited assistance it is sometimes possible to offer.
The continuing difficulty of the hospital
situation, with it3 grievous lack of accommodation and trained
staff, offers practically no help for these old people.
Whilst many of them are not chronic sick cases, they are also
not fit to bo left alone, and the frequent and immediate
medical attention desirable cannot adequately be provided by
harassed general practitioners. The Social Welfare Department
of the London County Counoil is coping admirably with the
provision of institutional facilities, and in a short while
have done much to banish the stigma of the old "Workhouse" by
providing hostels where these old people can retain their
personal freedom without degradation or undue restrictions,
and enjoy comfort, companionship and proper care and attention.
Unfortunately, however, there are at present far too few of
these hostels, and they are obviously tinable to cater for the
aged who are unable to look after themselves, and in need of
constant medical attention. Their problem remains at present
pathetically irremediable.