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136
by the State, whereas previously this responsibility had rested on the authorities providing
the establishments. The new agreement fixed the remuneration to be paid by
local authorities for services rendered by visiting medical officers outside the ' family
doctor ' services paid for by the State. Because of the national economic situation the date
of operation of the agreement was deferred for nearly two years. The Council took the
opportunity presented by the need for reviewing the terms of remuneration of its
visiting medical officers to bring up to date the duties of these officers and to standardise
their conditions of service.
Dental
officers
A number of dental surgeons offered their services to the Council as whole-time dental
officers and for the first time for some years the Council was in a position to appoint
whole-time dental officers to the staff. The number of dental surgeons prepared to give
part-time service to the Council also increased, following appeals made to the London
Local Dental Committee and a more intensive advertising campaign, coupled, perhaps,
with an improvement which the Council made in the sessional fees for this work.
Health
visitors
The Council's scheme for the training of health visitors continued to play an important
part in providing qualified staff for this work and once again the number of health
visitors showed an increase during the year. Since the commencement of the scheme
155 student health visitors have been appointed including 40 at present under training.
Of the 114 students who had qualified as health visitors, by the end of 1952, 86 were
still in the service at that date. The work of health visitors is dealt with on page 68.
Co-operation
with the
borough
councils
Co-operation between the Council and the metropolitan boroughs in public health
matters was further extended during the year. Details of joint appointments of medical
staff are given on page 36.
Staff medical
examinations
The number of references made to the department for medical examination or
advice concerning the health of staff, or the fitness of candidates for appointment,
totalled 13,436, compared with 12,455 in 1951; 189 members of the staff were found
to be permanently unfit for further duty with the Council and 252 candidates unfit for
appointment. The Council's staff medical examiners made 70 home visits to examine
members of the staff who were unable to travel, compared with 95 during 1951.
Reciprocal arrangements with provincial authorities for the examination locally of
new entrants were continued. Provincial medical officers of health arranged for the
examination of 21 entrants to the Council's service and the Council's medical officers
examined 38 candidates for provincial appointments.
Staff of the
department
A statement showing the staff employed in the department is given on pages 192-3.
SPECIAL INVESTIGATIONS
the following research projects were undertaken in 1952 :
Inquiry into virus infections during pregnancy
In the Report for 1950 (page 55) details were given of an investigation sponsored by the
Ministry of Health to estimate the frequency with which certain virus diseases (rubella,
measles, chicken-pox, mumps, poliomyelitis) during pregnancy are followed by congenital
abnormalities in the children. The Ministry of Health were able to obtain a
sufficient number of mothers for the purposes of the main inquiry and up to the end of
the year 951 women (290 virus infection, 661 control) had been registered in London.
Some of these were lost to the survey by removals out of London, refusal to co-operate
and other reasons. London, in common with a few of the larger authorities, was asked
to continue to register and follow up any rubella cases occurring in their areas as it was
hoped to obtain additional information on the effects of this infection.