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180
At hospitals for the treatment of pulmonary tuberculosis, again, additional
staff was found to be required in consequence of the changes in the treatment of
this disease in recent years. The various forms of collapse therapy and chemotherapy,
and the greatly increased use of radiological examination and blood
examinations in guiding treatment and estimating prognosis, have made treatment
more individual and intensive, thereby increasing the work of the medical staff.
The net effect of the variations in the establishment following this survey was
an increase in the special hospitals staff by two positions of senior assistant medical
officer, grade II, and five positions of assistant medical officer, grade II. At the
same time some change was introduced in the conditions of employment of the
junior grades of medical staff. The appointments of assistant medical officers,
grade II, had hitherto been limited to one year. It had been found, however, that
this limitation was unsatisfactory to the Council because of the need for frequent
appointments and because officers left the service at a time when they became
most useful. The limitation was also disadvantageous to the officers, who often
wished to stay in the service if no other openings were available. The Council
accordingly decided to authorise the extension of the appointment of officers in
this grade for a further period of one year, on condition that the second year was
spent in another hospital, or if this was not practicable that the duties were varied
during the second year.
Experience showed that there was difficulty in filling vacancies in the positions
of house physician, house surgeon and clinical assistant, and that the officers
appointed often stayed only for a short period. It had become apparent that the
Council's hospitals did not attract, at the existing salaries, the type of medical
officer for which these positions were intended. It was felt to be desirable to
maintain the positions, and the Council accordingly decided to increase the rate of
pay from £80 with residential emoluments for house surgeons and house physicians
to £120 a year with the same emoluments. The rate for clinical assistants (nonresident),
formerly £100 a year, was raised to £150 a year.
Laboratory
services—
Fixed staff.
During the year a further measure of unification was introduced in the staffing
of the hospital laboratory services. The subordinate technical work at hospital
laboratories (as opposed to that at the group laboratories where the major pathological
work is performed) had formerly been carried out by women hospital
laboratory technicians. These officers had been appointed in pursuance of a scheme
for securing and training a number of suitably qualified persons to staff the hospital
laboratories on their establishment. Difficulty having been experienced in filling
vacancies in this staff owing to the time taken in training, it was decided to merge
the women technicians in the hospital laboratories in the general pool of technicians
in the laboratory services. The positions of women hospital laboratory technicians
were replaced by an equivalent number of positions of laboratory technicians
(grade B) (62s. by 4s. to 90s. a week), which can be filled either by men or by women.
At the same time the numbers of subordinate technical staff in the laboratories were
reviewed, and some increases were authorised in order to cope with the growing
work of this branch of the service.
Dental staff—
Rates of
pay.
The dental services provided by the late poor-law authorities were based
partly on the service of whole-time dental officers and partly on the engagement
of part-time dentists who were free to engage in other employment outside the
Council's service.
In formulating a scheme for the provision of dentistry in the Council's hospitals,
it was necessary to consider the relative advantages of the whole-time and the
part-time system. There were found to be undoubted advantages in employing
part-time local staff in outlying hospitals because of the saving of time and travelling
expenses. On the other hand, dentists in private practice were sometimes unwilling
to visit special hospitals in which infectious diseases are dealt with. In
large areas where hospitals are within convenient distance of each other a wholetime
service is of definite advantage. It was accordingly decided to maintain both
principles, and to apply them according to the special needs and circumstances of
the various hospitals.