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81
of the nine divisions into which the county had been divided for health purposes.
These positions of Divisional Medical Officer, Divisional Administrative Officer and
Divisional Nursing Officer were filled partly from the Council's own staff and partly
from suitably qualified staff employed by the metropolitan borough councils. These
officers did a considerable amount of preparatory work before the "appointed day"
in connection with their new tasks and to them is due, in no small measure, the
credit for the smoothness with which the transferred services were absorbed into
the Council's organisation.
The health services taken over from the borough councils were staffed by about
4,850 whole-time and part-time officers and employees comprising medical staff,
administrative and clerical staff, health visitors, tuberculosis visitors, nursery nursing
staff, domestic staff and home helps. In addition a few officers were taken over from
voluntary bodies who had decided not to continue to provide personal health services
after the "appointed day"; also a number of health visitors employed by voluntary
organisations who were continuing with their functions were taken onto the Council's
staff in order to facilitate the creation of an integrated service for the county as a
whole.
Transferred
staff
After the urgent initial problems inseparable from the transfer of a large body
of staff had been dealt with, the task of applying standard scales of pay and conditions
of service to the several categories of staff had to be considered. This task was a
good deal lighter than it would have been if the Council had been faced with it a few
years ago because of the extension during recent years of wage negotiating machinery
for Local Government staffs. Thus, there was found to be a good deal in common
as regards pay, and to a lesser extent conditions of service, between the nursing and
domestic staff of the Council and of the metropolitan borough councils. For other
grades, notably medical and administrative and clerical, the metropolitan borough
councils had common scales and conditions though not the same as those of the
Council.
Standard
pay and
conditions
The first grade of transferred staff to be co-ordinated with the Council s staff was
that of Assistant Medical Officer. The Council approved of the application of the
scale of salary paid to Assistant Medical Officers in its School Health Service to the
whole-time Assistant Medical Officers in the transferred Maternity and Child Welfare
Services with effect from 5th July, 1948, provided that the officers concerned accepted
the Council's standard conditions of appointment and service. This scale of salary
was an improvement on that paid by the borough councils. Specialisation in either
maternity or child welfare has been encouraged amongst all Assistant Medical Officers
in an endeavour to secure that, as far as possible, medical officers who are best fitted
by experience and choice to work in ante-natal and post-natal clinics are allocated
to that work and those who are more interested and experienced in child welfare are
allocated to child welfare clinics and the School Health Services. Efforts have been
made to create and maintain close liaison with the hospitals both as regards the
teaching of medical students in Council clinics and the "refreshing" of Council
medical officers by attachment for periods to the maternity or children's departments
of hospitals.
Medical staff
It was the Council's intention to combine the staffing of the newly acquired
dental service for mothers and young children with its long-standing organisation for
school children. Unfortunately, not long after the "appointed day" it became
apparent that this priority dental service was in jeopardy. The rates paid on a piecerate
basis to dentists employed in the general dental services resulted in an increase
in the attractions of this form of practice and many of the Council's dentists resigned
in order to take up this work. As it became clear that the setting up of negotiating
machinery to deal with salaries of Local Authority dental officers would be a lengthy
process, the Council, after consulting with other Local Authorities who agreed that
special action was justified in London to stem the flow of dentists away from the
Dental
services