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An important development for which the Council can claim credit is its hospital
laboratory service, made up of large and comprehensive group laboratories at certain
hospitals and subsidiary laboratories at the others.
The nursing services received much attention from the Council. Numbers were
increased and hours of duty and other conditions improved. Training was improved,
and co-ordinated and centralised preliminary training schools instituted. It is most
unfortunate that during and since the war, recruitment of nurses was very unsatisfactory.
Reference should be made to the important part played by the Council's hospitals
in medical teaching. Hammersmith Hospital was developed into the most important
postgraduate medical school in the country. Fever hospitals provided both underand
postgraduate instruction. The general hospitals played an increasing part as
ancillaries to the undergraduate schools based on the voluntary teaching hospitals.
On the outbreak of war the Council was presented with the double problem of
providing for the ordinary sick and for air-raid casualties which it was assumed would
be heavy.
These activities and the great extension of the ambulance and other services
required by the war do not need detailed description, but it can be said that through
all the dangers and hazards of war and the damage, often severe, caused by enemy air
attacks, the hospital service never failed and the citizens of London owe a debt of
gratitude to the devoted members of the staff of all grades who made this possible.
Many acts of personal heroism received suitable recognition by the award of decorations
from H.M. the King.
The aftermath of war left a heavy accumulation of work in the restoration of
damaged hospitals, the redecoration of wards, etc., which had remained unpainted
for a period of nearly six years, and the replacement of furniture, linen and equipment
of all kinds; and this, with a general shortage of men and materials, prevented the
resumption of major works of improvement on a large scale.
Other problems were created by the continuance of the rationing of foods and
materials of various kinds.
The Council has been a mental hospital authority ever since it came into being,
consequent upon the passing of the Local Government Act, 1888. At that time, the
Council had four "asylums" and was responsible for some 10,000 patients, about half
of whom were housed in the institutions of other authorities. It took over from the
Middlesex Justices the task of building another large institution in accordance with
plans prepared and on a contract already let. Since then the Council has itself built
and opened six more hospitals for the mentally sick, one of which was appropriated
for use as a certified institution for the mentally defective; it adapted three other
premises for use for defectives; it built a special hospital (the Maudsley) for voluntary
mental patients and research, which in addition, is recognised as a school of London
University for postgraduate teaching in psychological medicine; and after the passing
of the Local Government Act, 1929, it took over from the Metropolitan Asylums
Board and a Board of Guardians, six other institutions housing cases of mental defect
and chronic harmless persons of unsound mind. At the outbreak of war in 1939, two
of the smaller mental deficiency institutions were closed and have not since been
re-opened, so that up to July, 1948, the Council was administrating 19 separate mental
institutions of all types and was responsible for the care of some 30,000 patients—
either mentally sick or mentally defective—in addition to Sutton Emergency Hospital
with accommodation for 500 psychoneurotic patients under the emergency hospital
scheme.
During the war, the mental hospitals made their contribution to the emergency
medical service and, in addition to the accommodation at Sutton Hospital, about
6,000 general hospital beds were provided in the Council's mental institutions by a