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been aware at the time of transfer of the magnitude and complexity of the operation,
which, to the great credit of everyone concerned, was carried out smoothly and
efficiently.
The change having been made the next step was to decide on plans for a comprehensive
service and for this purpose an ordered programme of development was
evolved. It was clear from the outset that this would prove an enormous task
involving much time and energy and a heavy expenditure of money. To march with
the improvements to hospitals by rebuilding and addition, the construction of new
nurses' homes and ward blocks and the introduction of new equipment of all kinds
from X-ray plants to kitchen machinery were also necessary.
Departmental committees were set up to consider and advise on such matters as
hospital standards, the treatment of tuberculosis, pathological work in group
laboratories, forms and records, an ambulance service, medical supplies, staffing and
other subjects, and these, in due course, submitted their reports.
The problem was not merely one of the administration of the hospitals and
institutions formerly maintained by different authorities, but of producing a central
organisation for hospitals which varied greatly in size and were in all stages of
development. Difficulties due to the wide divergencies of policy pursued by the
different authorities, the variation in the character and quality of the work carried on,
the overlapping or deficiency of services, had to be faced.
It was necessary to draw up a scheme for the provision of a service catering for
the needs of sick persons requiring hospital treatment of all kinds, the acute, the
chronic, the tuberculous, maternity, the mentally disordered, sick children, the
convalescent, the fever patient and others.
Arrangements were also necessary for the co-ordination of a domiciliary medical
service for those on relief and for the provision of medical and nursing services in
Public Assistance institutions.
One of the chief problems was that of releasing accommodation during alteration,
and, at the same time, of retaining sufficient beds to provide for admissions.
From 1930 to 1939, great improvements were made in hospital accommodation
and the Council had reason to look forward with high hopes to the future. Special
units for the treatment of certain conditions requiring expensive equipment or
highly skilled staff had been opened in certain hospitals, and an ordered programme
of development was well under way.
Just prior to the war the Council approved plans for the construction of a new
hospital in Tooting but this unfortunately was not started owing to the outbreak of
War
As an indication of the magnitude of the hospital service (other than that provided
by mental hospitals), it may suffice to say that in 1938, the last pre-war year,
there were available 16,210 beds in general acute hospitals, 4,367 in chronic hospitals,
5,067 in fever hospitals, 1,423 in tuberculosis hospitals and sanatoria and 5,821 in
long stay children's and other special hospitals. Total admissions of patients to these
hospitals in that year were 232,359 and there were 1,044,829 out-patient attendances.
Adequate and proper staff is even more important than adequate and proper
buildings and equipment, and great improvements in staffing standards were made by
the Council. Medical staff was much increased in numbers and at an early date a
comprehensive and co-ordinated service of consultants and specialists was introduced.
Further developments were prevented by the threat and outbreak of war but since
the war an important improvement was made by the appointment of a large number
of whole time specialists for the hospitals. Valuable though this step was, it nevertheless
represented only part of proposals which would have been made to the Council
but for the impending transfer of the hospitals to the Regional Boards.