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4 REPORT OF THE MEDICAL OFFICER OF HEALTH FOR 1955
the public, an attempt should be made to tackle this problem of
coronary artery disease.
This raises another interesting and important point which possibly
is not always recognized. It is that the patterns of public health work
and public health problems are not static. They are changing slowly;
so slowly, in fact, that to the worker immersed in the daily routine,
it is not always apparent when the change has taken place. It is
nevertheless hardly possible to doubt that the problems which our
public health departments will be called upon to meet in the years to
come will be quite different from those which they have tackled so
successfully in the years that have gone and one of the problems to
which we must certainly bend our efforts is the problem of coronary
artery disease.
It is but a short step from a consideration of changes in the pattern
of public health problems to the staffing of public health departments.
Clearly, if in the future different problems are to be met, it
may well be necessary to give to public health staff a somewhat
altered form of training. It may be that the basis of the training will
remain the same but that it will be given a somewhat altered
emphasis so that public health staff will be able to understand and to
grapple with the newer problems which are likely to arise. This
question of training is, in turn, complicated by the fact that in most
categories of public health personnel there is a serious shortage.
This undoubtedly applies in the case of health visitors and sanitary
inspectors, who are key workers in the health department. Health
visitors are, at the present time, not the immediate responsibility
of metropolitan borough councils and in any case it might be possible
by methods of selective visiting to do something to combat
shortages of health visitors. I will say no more of the problem of
health visitors here. Sanitary inspectors are very much our concern
and we in Wandsworth like many other authorities have experienced
our full quota of worry and anxiety arising from the shortage of
sanitary inspectors. At the time of writing, the department is five
inspectors short of establishment, which shortage is accentuated by
sickness amongst other members of the staff. Even though the
pattern and the problems of public health may change with the years