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46
All nursing staff take part in the school health service; regular medical examinations and surveys
proceed as in previous years. There is excellent co-operation between nursing staff, head teachers
and school medical officers.
There has been no increase during the year in group practice attachments, of which there are four,
but some enquiries are being explored.
Health visitor students come forward for sponsorship in adequate numbers but it is more difficult
to recruit trained staff; the national shortage is inevitably reflected in Westminster. As usual, every
effort has been made to keep the staff up-to-date by sending them on appropriate refresher courses;
seven attended such courses during the year.
A more detailed report on training undertaken in the Department is set out in the General section
of this Report, page 16.
HEALTH DEPARTMENT SERVICES FOR OLD PEOPLE
In April 1966 the Health and Establishment Committees agreed in principle that the establishment
of health visitors should be increased by four posts per annum until the level recommended by the
former Ministry of Health was reached (62 posts). This decision, which was subject to review
annually in the light of circumstances then obtaining, was based on the 1966 Westminster population
of 270,140; since then the decline in population to 240,360 would make the target number 55.2
posts. In 1969 the authorised establishment was 54 posts and the final increase of two posts to the
recommended level would take place in September 1971.
During the past few years there has been a steady decline in the number of births in Westminster
with the result that the health visitors' duties relating to mothers and young children have correspondingly
decreased. Conversely, the number of persons in Westminster above pensionable age is
higher than the average and statistics produced by the Greater London Council Research and
Intelligence Unit show that Westminster has the sixth highest number of persons above pensionable
age out of the 32 London Boroughs. In this connection the following statistics based on the 1966
census are of interest:—
Distribution of population by age and sex in London Boroughs—1966 Census.
Distribution per 1,000 population
Children Older Persons
Persons Males Females
0-4 5-14 65+ 60+
Westminster, City of 55 77 48 120
Greater London 77 124 44 110
Rest of England and Wales 87 149 47 107
England and Wales 85 145 47 108
The Medical Officer of Health had discussions during 1969 with the City of Westminster Old
People's Welfare Association to determine the best method of ensuring the ascertainment of old
people in need and their referral to the appropriate agency. As a result it was agreed that health
visitors should accept responsibility for discovering and keeping under observation all old people on
their districts and for ensuring that those in need are under the close supervision of a named case
worker who is in turn responsible for bringing in such supportive services as may be necessary. It
was agreed that the case worker be supplied by the Old People's Welfare Association where support
required is mainly of a social nature, that the Health Department would supply a social worker where
more intensive care is needed including home nursing, and that the Welfare Department social
workers would supervise those registered as handicapped or awaiting admission to Part III
accommodation.
This revised system has worked well, but it has resulted in the discovery of an increasing number
of old people in need of the services of home nurses and who require home bathing.
Having regard to this changing situation the City Council agreed early in 1970 that in lieu of the
four health visitor posts which were due to be filled with effect from September 1970 four State
Enrolled Nurses should be recruited in order to undertake the additional nursing duties involved.
Furthermore, it was agreed that the need for home bathing should be met by increasing the number
of home bathing attendants from the present establishment of 5J posts to 6 posts.