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11
APPENDIX TO REPORT OF THE
SPECIAL (REORGANISATION OF SOCIAL SERVICES)
COMMITTEE, 9th DECEMBER, 1970
PREVENTIVE MEDICINE AND COMMUNITY HEALTH
The main streams of Preventive Medicine. Preventive medicine has
been defined as the science and art of preventing disease, prolonging
life, and promoting physical and mental health and efficiency. This
compact and refreshingly positive definition of the broad spectrum of
prevention—ranging from the promotion of health and the provision
of specific protection at one end through the early recognition and
prompt treatment of disease to the limitation of disability and rehabilitation
at the other—recognises that it is as much the concern of the
clinician in relation to individual patients as it is of the public health
practitioner vis-a-vis the community.
Public Health can be regarded as that part of preventive medicine
which requires organised effort or action on the part of the community,
whether undertaken by a voluntary or a statutory agency. Traditionally
it embraces measures for the sanitation of the environment, the control
of communicable disease, the education of the individual in the principles
of personal hygiene, the promotion in particular of maternal and
child health and mental health, and the organisation of medical and
nursing services for the early diagnosis and preventive treatment of
disease.
The historic role of the Medical Officer of Health as the medical
adviser on all matters affecting the health of the community is now
more than a century old and over the years this has extended to include
the medical aspects of cremation ; of the occupational fitness of local
authority staff; of applications for rehousing; of the refusal of help
by old people who are suffering from grave chronic disease or living in
insanitary conditions and in need of care and attention; and, most
recently, of radiological safety in relation to the hazards of ionizing
radiations.
Thus modern public health engages the attention of doctors, dentists,
public analysts, chemists, physicists, public health inspectors, health
visitors, nurses, midwives, social workers, psychologists, speech therapists,
physiotherapists, occupational therapists, chiropodists, administrators
and, last but not least, of an increasingly valuable body of
ancillary technical, clerical and manual support. Such a variety of
disciplines reflects the need for a co-ordinated effort and also serves
to highlight the absolute necessity for the closest collaboration between
health and social service departments in the future.
Only through such teamwork will the main streams of public health
activity merge and attain that momentum which will enable the community
health services to make a maximum impact on both the local
and the national scene.
The contribution of the Community Health Services. This has
never been more vital. Co-ordination of effort on a broad front involving
the hospital, general practitioner, and local authority health and
social services has become a matter of increasing urgency with the
growing complexity and expense of medical treatment in meeting the
challenge of the prevailing pattern of disease—the cost of the National
Health Service now approaches £2,000 million annually. This has
stimulated the current trend in favour of medical care in the