View report page

108
follow the practice previously taken by relieving officers in London of taking action
under section 20 of the Lunacy Act, 1890, in all cases of persons alleged to be of unsound
mind needing to be placed under control by removing them to an observation ward in
the first instance before taking steps to secure certification. Owing to the shortage of
beds in observation wards this has not been possible in a considerable number of instances
since July, 1948, and, as will be seen from the statistics submitted with this report,
during the year 1952, it was necessary for 1,130 patients to be brought directly before
a Justice of the Peace for examination with a view to certification without being admitted
to an observation ward and for 39 patients to be admitted directly to mental hospitals
under urgency orders made under section 11 of the Lunacy Act, 1890. As the following
table shows, the number of persons in respect of whom the duly authorised officers
have been required to take action has increased steadily since the appointed day :
Year
Number of cases dealt with
Male
Female
Total
1947 2,049 2,603 4,652
1948* 1,047 1,485 2,532
1949 2,333 3,017 5,350
1950 2,399 3,163 5,562
1951 2,488 3,303 5,791
1952 2,570 3,533 6,103
* 5th July to 31st December only.
These figures are now considerably higher than pre-war. Notwithstanding this
increase the number of beds available in observation wards in London is now 217
compared with 353 in 1938, making it necessary, as shown in the following table, to deal
with an increasing number of patients otherwise than by admission to an observation
ward.
Observation
ward
accommodation
Because of its concern at this situation and at the shortage of institutional accommodation
for mental defectives, referred to later (page 110), the Council, in December,
1951, sent a deputation to the Minister of Health to urge the pressing need for more
accommodation to be provided for London cases in observation wards and in mental
deficiency institutions, particularly in the latter case for infants and young children.
The accommodation position in observation wards remains unaltered but some minor
reliefs have been afforded as regards mental defectives (see page 110). The shortage of
accommodation in observation wards is aggravated by the inadequacy of the accommodation
in Tooting Bec and Abbots Langley Hospitals for senile patients and there is
little doubt that if additional methods of dealing with this type of patient were available,
the problem of accommodation in observation wards would be very much reduced.
The Council's medical adviser in mental health has recently reviewed the records of a
large number of patients over 65 years of age dealt with by the mental welfare officers
and he is of the opinion that the provision of an adequate number of psychiatric geriatric
units with in-patient and out-patient facilities would avoid the certification and admission
to mental hospitals of all old people, except those who are grossly disturbed and
obviously require immediate psychiatric care.
Conveyance
Patients are conveyed to observation wards and, in cases of direct admission, to
mental hospitals whenever possible by private car but ambulances are used when
necessary. Patients transferred from observation wards to mental hospitals are conveyed
by ambulance and are escorted by nurses from the observation wards as was the practice
prior to the ' appointed day'.