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*This figure includes 338 cases on licence who are visited at regular intervals by officers of the Council on behalf
of the Regional Hospital Boards.
†In addition to the 3,964 cases under supervision, 970 cases of persons known to the local authority to be mentally
deficient but not subject to be dealt with are visited on a voluntary basis. The department has continued to carry out
the work of placing in employment mentally deficient children who leave E.S.N, schools and supervising them up to 18
years of age. On 31st December, 1949, 439 mentally deficient children were being afforded the benefits of this scheme.
This work was performed by the Council as paid agent of the Ministry of Labour until 30th September, 1949, but on that
date the Education Committee undertook responsibility for the work as part of the Youth Employment Service although,
for the time being, the Public Health Department carried on the work. Arrangements have been made for the work to be
transferred to the Education Department on 1st April, 1950.
‡Of these 135 were awaiting the provision of institutional care.
Accommodation
in
Institutions
Throughout the year the shortage of beds available for the mentally defective
(especially children) caused grave concern to the Council. When the institutions
for the mentally deficient were transferred to the Minister of Health in July, 1948,
there were approximately 26 beds per 10,000 of the population available for the reception
of mentally deficient persons in the County of London. Under the "catchment
area" schemes introduced by the four Metropolitan Regional Hospital Boards a substantial
part of this accommodation was allocated to other local health authorities
who had made little or no provision for patients from their areas. As a result,
notwithstanding a slight revision of the schemes in the Council's favour during the
year, the accommodation available for London cases, based on the proportion of
vacancies allotted, was at 31st December, 1949, only 17 per 10,000 of the population.
Thus the accommodation for London patients has been reduced by approximately
one-third and the division of this accommodation among the four Regional Boards
imposes further restrictions upon its use.
The result is that the Council is unable to secure the provision of institutional
care for London patients needing it without serious and, in some cases, prolonged
delay. At December 31st, 1949, the number of patients awaiting admission was 135,
which included 107 children awaiting admission to the Fountain Hospital. The
position is most serious in respect of infants and low-grade children of the type
suitable for admission to this hospital. Of the 107 London children on the hospital
waiting list, 68 were classed as urgent. As there is no other institution to which
these children can be sent, and vacancies at the Fountain Hospital arise
infrequently, it will be many months before even the urgent cases can all be
admitted.
Representations as to the inadequacy of the provision for London patients
have been made by the Council to the four Metropolitan Regional Hospital Boards
and to the Minister of Health. The problem is a national one and the institutional
provision made by London before the National Health Service began must contribute
towards the needs of other authorities who had not made adequate
provision. No early solution of the problem appears to be in sight.
Guardianship
There was a substantial reduction in the number of cases under guardianship
during the year. This was almost entirely due to the fact that the National
Assistance Act, 1948, enabled mentally deficient persons over 16, who were in need
of financial assistance, to receive a grant from the National Assistance Board, which
rendered unnecessary the continuance of guardianship orders which had been made
to enable financial assistance to be given under the Mental Deficiency Acts. Fiftyone
patients were discharged from the Mental Deficiency Acts during the year after