London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1934

[Report of the Medical Officer of Health for London County Council]

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Numbers of diabetes cases and visits paid in six selected districts.

District Nursing Association.Number of cases.Number of visits.Average number of visits per patient.
East London (South)7220,146280
Metropolitan (St. Pancras)3771257
Metropolitan (Bedford-place)122,979248
North London82,153269
South London856871
Woolwich and Plumstead72,190313

It will be seen that in five out of the six areas the number of visits per case for
the year bears a more or less common relation. The low average of
visits in south London is due to the fact that this association endeavours
to teach every patient how to administer insulin himself, or, if this is impossible, a
member of the patient's household is shown how to do it. It is gathered that in
east London there is a marked unwillingness among the majority of the patients
coming under the Council's scheme to administer insulin to themselves, although
when it is calculated that each patient has to be visited at least once a day, and
sometimes twice and three times daily (certain cases were shown in the returns to
have had 600 and 700 visits in the year), it is apparent that a certain number do
arrange for the administration of insulin themselves.
Casual wards.
Section 12 (1) of the Public Assistance (Casual Poor) Order, 1931, as amended
by instrument, provides :—"If any casual appears to require medical attention the
master shall, as soon as practicable, obtain the attendance of the medical officer,
and make arrangements for the transfer of the casual to an appropriate ward or
establishment unless the medical officer is of opinion that he can properly be treated
in the casual ward. The master shall also bring to the notice of the medical officer
any casual who appears to be suffering from mental illness."
Most of the casual wards have accommodation for between sixty and eighty
casuals, and in practice, in order to fulfil the requirements, the medical officer of
each ward usually visits at least every morning.
Section 12 (4) of the Order provides :—"The medical officer shall on one day
at least in every month medically examine every casual in the casual ward at the
time of his visit."
In accordance with this requirement, arrangements have been made under
which a medical examination is held simultaneously once a month at each of the
casual wards, at which every inmate present is seen by the ward medical officer.
By arrangement with the county medical officer of Middlesex, the monthly
examination in the Middlesex casual wards is now held on the same day as the
examinations in the London wards.
Monthly examinations were also held at the Hostel during the earlier part of
the year, but these were discontinued following a review of the arrangements for
the examination and treatment of the casual and homeless poor.
The great majority of the inmates of the casual wards are habitual casuals,
and there is reason to believe that very few escape for long the monthly examination.
Casuals found to be in need of medical treatment are transferred to the appropriate
hospital or institution.
It is considered that the existing arrangements for the ascertainment and
treatment of illness amongst casuals are reasonably adequate, subject to certain
minor administrative reforms which have since been effected, and are discussed in
a later paragraph.