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recognised disorder which was unknown to them.
I am of the opinion that a reasonable balance has to be struck in relation to the
future of our work. This approach is based on the experience we have gained. Of course a
whole host of minor disorders need not be searched for, but the substantial remainder
have to be critically examined. Possibly a briefer but more incisive history; a shorter
physical examination confining more care to the agreed hazard areas; are aspects which
r ust be considered by the various Advisory Committees who helped to prepare the
history and examination forms.
When these procedures have been fully streamlined and assessed, we hope this
work, together with any suitable newer advanced technological aids, will gradually be
taken over by the general practitioner aided by the area health authorities and hospitals.
We know he is a very busy man, but we feel that such an important part of medicine
should be blended into his work, for which he ought to have the status and, to match it,
the payment of a reasonable fee for the agreed examination and the keeping of
appropriate records. I am sure there would be less shortage of general practitioners if this
preventive element in general practice were introduced. It could galvanise the situation,
bringing back the family doctor's rightful status and providing interesting and worthwhile
work as part of his duties.
Introduction
The National Health Service Act, 1946 gave certain powers and duties to local
health authorities, including the prevention of illness and the care and after-care of
persons suffering from illness. Environmental health measures and vaccination and
immnunisation have been largely responsible for the control and eradication of
communicable diseases. However, the early detection and diagnosis of chronic illnesses
has tended to be minimal due mainly to lack of adequate techniques. Local health
authorities have helped pioneer early disease detection, particularly in the field of
maternity and child welfare and in the school health service.
Routine medical examinations are undertaken regularly from before birth to
school-leaving age through the ante- and post-natal clinics, the child welfare service and
regular school health examinations. It would be true to say that medical care is never far
from the young mother and her children. The period of 16 years and over is one where,
for the greater part of the population, no routine health checks are carried out—people
visit their family doctor for treatment for an ailment, but very rarely has the General
Practitioner the time to carry out a full medical check.
In 1965 in Southwark "well-women" clinics were commenced. At these clinics a
full gynaecological examination is carried out for women between the ages of 25 and 60;
urine testing, blood-pressure readings and breast examinations are also carried out and
cervical smears are taken. So far each year approximately one-third of women seen at
"well-women" clinics were found to have some pathology.
In 1967 it was decided to open advisory and preventive clinics for Southwark's
over-60's age group, and since January 1968, three sessions each week have been held in
various clinics in the Borough. These clinics have proved successful with the "senior
citizens".
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