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London County Council
REPORT OF THE
COUNTY MEDICAL OFFICER OF HEALTH
AND SCHOOL MEDICAL OFFICER
FOR THE YEAR 1948
By Sir Allen Daley, M.D., F.R.C.P., K.H.P., County Medical Officer of Health
and School Medical Officer
INTRODUCTION
During the year 1948 there were vast changes in the functions and administrative
structure of the Department. They were a consequence of the coming into operation
on July 5th, of the National Health Service Act, 1946. The Council said "Farewell"
to the great municipal hospital service which it had built up particularly since 1930.
It comprised 98 hospitals with a pre-war bed complement of 70,120 and a staff, all
told and including head office hospital staff, of about 32,000. It was a complete
hospital service in that it catered for all types of illness—mental and physical.
The Council expressed its warm appreciation of the devoted work done by all those
who had served on committees responsible for the hospital service, and by the staff
who were transferred to the new national service. The Chairman of the Council
invited the Hospital Committee members and representatives of all grades of the
staff to receptions at County Hall. The Council's best wishes for a happy and
successful future in the new administration were given. It is a tribute to both the
old and the new administration that the change-over was effected without a hitch
and, except that a patient who had formerly been assessed under the then Statute,
to pay in whole or in part for his treatment, received it without charge, the sick
person in a hospital bed was not aware that overnight there had been a change in
the administrative body responsible for his welfare. This was accounted for, partly,
by the fact that the Council provided on an agency basis, for some months after
the " appointed day " the supply, engineering and finance services for the hospitals.
Further, from the beginning of the year the Regional Boards had been building up
their staffs and Council officers were gradually absorbed by them and by Hospital
Management Committees.
The new hospital authorities also took over the Tuberculosis Dispensaries and
Venereal Diseases treatment clinics and the clinical staffs.
The Council's hospitals were transferred to one or other of the four Metropolitan
Regional Hospital Boards, except that the Hammersmith Hospital was transferred
to the Board of Governors of the Hammersmith, West, London and St. Mark's
group of hospitals, the Maudsley Hospital to the Bethlem Royal and Maudsley
Board of Governors, the St. Pancras Hospital to the University College Hospital and
the North Western Hospital to the Royal Free Hospital. These are all Teaching
Hospitals. To the first is attached the Postgraduate Medical School of London and
to the second the Institute of Psychiatry. The last two are undergraduate medical
schools.
Though the hospitals are no longer the direct responsibility of the Council,
preventive and curative medicine are so interwoven that extremely close contact
has to be maintained between the Local Health Authority and the Hospital
Authorities. Each of the four Regional Hospital Boards and each of the twenty-six
Boards of Governors of Teaching Hospitals contains members appointed by the
Minister after consultation with the County Council. The day by day administration
of the non-teaching hospitals is entrusted to Hospital Management Committees,
each Management Committee being responsible, except in the case of very large
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