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15
district nurse working in close collaboration with the family doctor.
This mutually beneficial project will relieve the heavy burden at
present borne by the out-patient department of the Hospital and add
vitality to the home nursing service of the Department. Such developments
are only to be encouraged.
Good co-operation also flourishes vis-a-vis general practitioners.
In addition to the invaluable assistance given by the district nurse, the
domiciliary midwife renders essential support in relation to ante-natal
care, confinements whether undertaken at home or in the general practitioner
obstetric unit at the Weir Hospital, and in coping with the
post-natal care of the increasing number of mothers discharged from
maternity hospital wards 48 hours after delivery. Advice on family
planning is an increasingly important facet of preventive medicine and
although some doctors undertake this in their own surgeries, many
prefer to utilise the comprehensive service provided by the Family
Planning Association—acting as the agent of the Council—both at
special clinics and, where appropriate, in the home.
Cervical smears are frequently taken during family planning sessions
and this screening procedure to detect pre-cancerous conditions of the
neck of the womb is also made available to all women who live or
work in Wandsworth through seven cervical cytology clinics, run
directly by the Health Department. An important by-product of
cervical cytological screening is the incidental detection and correction
(through the family doctor) of common minor infections and local
abnormalities; not infrequently these have been the cause of some
time of appreciable physical discomfort or mental concern. Looking to
the future, screening of apparently healthy people to exclude the
presence of symptomless but important conditions requiring early
treatment may well prove extremely rewarding once those groups
particularly at risk have been clearly identified and a reliable test is
available. In this regard, the Department has recently been invited by
Charing Cross Hospital to participate in a research project designed to
detect silent infections of the urinary tract; these can be treated effectively
but, if they remain undiscovered, such infections may cause progressive
renal damage leading eventually to the need for an artificial
kidney machine. Invitations to explore this new frontier of prevention
are therefore as exciting as they are welcome.
Chiropody is another supporting service of great value provided by
the Health Department since it enables the elderly to keep mobile and
thus to avoid becoming housebound; inactivity is inimical to good
health in old age
Undoubtedly, with the growing trend towards group practice, the
present close relationship with the family doctor will develop further
through the attachment of health visitors—whose traditional role in
promoting health and preventing illness which embraces the whole
family from infancy to old age will receive fresh impetus—district
nurses and, where appropriate, midwives to groups of general practitioners.
This support is given most effectively in purpose-built accommodation
such as a group practice or health centre. The quality of
medical care is thus enhanced in the vicinity of the patient's home,
offsetting the inconvenience inevitably associated with the closure of
small hospitals. In such modern surroundings, there is no reason why
a general practitioner, who wishes to do so, should not perform minor
surgery; hospital consultants already undertake domiciliary