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killed in action or died on war service, apart from those killed in London by bombs.
Except for a few who have not yet been demobilised, the remainder resigned their
positions to take up other forms of work.
Staffing
position after
the war
The acute position with regard to medical and laboratory services began to be
relieved by September, 1945. The supply of male domestic staff improved, and by
the end of 1946 practically all vacancies had been filled. There was, however, no
corresponding improvement in the recruitment of nursing staff and female domestic
staff. The shortage has continued to be acute. The war-time practice of employing
women in place of men began to be reversed, and a number of male domestic assistants
and male assistant cooks were engaged in the place of women.
The war-time pressure on dispensary, X-ray and massage staffs also continued.
Although the number of available beds in hospitals had through bombing fallen
considerably below the pre-war level, the increased rate of turnover of in-patients,
combined with substantial increases in the number of out-patients, brought about a
general increase of work in these special departments. The widespread use of new
drugs, e.g. sulphonamides and penicillin, added considerably to the duties of pharmacists,
while modern medical practice made new demands on radiographers and
physiotherapists. To augment the number of these medical auxiliaries by locum
tenens staff, it was necessary to offer enhanced rates of pay, and the staff thus
secured were utilised not only as sick and annual leave reliefs, but also for the temporary
filling of vacancies which could not be filled in the normal way. To ameliorate
the situation in the larger X-ray departments, clerks were allocated for duty so as
to enable radiographers to spend their whole time on technical duties.
Training of
radiographers
During 1943, a scheme for training State-registered nurses who desired to qualify
as radiographers was introduced at Hammersmith and Lambeth Hospitals. Practical
and theoretical training for the Diploma of Membership of the Society of Radiographers
was provided for fifteen pupils for two years. The scheme proved successful
and the arrangements were extended in 1946 to include students, other than qualified
nurses, eight of whom were accepted for a two-year course of training. In addition,
a short course of training in radiotherapy was provided during 1946 for ex-service
radiographers.
Postgraduate
training of
doctors
In 1945 a scheme developed by the Ministry ot Health tor the post-graduate
training of doctors released from H.M. Forces was adopted by the Council, and about
250 medical officers were allocated to hospitals in a supernumerary capacity as assistant
medical officer (post-graduate), class I, and trainee specialist, class III, covering all
branches of medicine.
Clinical
responsibility
for patients
Under the original organisation of the general hospitals, the medical superntendents
had responsibility not only for the administration of the hospitals but also,
at least nominally, for the clinical care of the patients. Some years before the war
there had been several breaches of the latter principle and obstetricians, surgeons and
a physician had been appointed with full charge of beds. During the war there were
several extensions of this method of staffing, which placed clinical responsibility on
the specialists, and left the medical superintendent in the large hospitals concerned,
more free for his administrative work. Further extensions of this method of
organisation are contemplated and, also, in those smaller hospitals, where the medical
superintendent is a specialist, combining in him full clinical responsibility for a section
of the work of the hospital and administrative responsibility for the whole hospital.
Training of
nurses
Several measures designed to stimulate the flow of candidates for the nursing
profession were adopted in 1946. Among these was the modification of the
curriculum of student nurses to enable the period of training in general nursing to be
reduced from four to three years, plus a short period in the preliminary training school.
In addition, approval was given to the inauguration of a pre-professional course, to
bridge the gap between school leaving age and the age at which girls can commence
nursing training in hospital. Under this scheme, girls—to be known as nursing