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36
Each divisional health committee includes representatives of the Local Medical
Committee for the County of London, the London Local Dental Committee and the
district nursing associations. Representatives of the Royal College of Nursing, Royal
College of Midwives, Women Public Health Officers' Association, Local Pharmaceutical
Committee, and of branches of the British Postgraduate Medical Federation
(i.e., Institute of Obstetrics and Gynaecology, Institute of Child Health) are also
included on individual committees.
Arrangements have been made for the medical officers of health of the City of London
and the City of Westminster and of all the metropolitan boroughs except St. Marylebone
to participate in the day-to-day administration of the divisionalised personal health
services.
Particular mention may be made of the special tripartite organisation in one division,
comprising the Boroughs of Battersea and Wandsworth, where an officer has been jointly
appointed to act as divisional medical officer for the Council and as medical officer of
health for the two boroughs. He has two assistants, each of whom acts as assistant
divisional medical officer and as deputy medical officer of health for one borough. In
addition to these special arrangements, two of the Council's divisional medical officers
have been appointed by metropolitan boroughs (Paddington and Stoke Newington) as
their medical officers of health, on a part-time basis. Other divisional medical officers
have on occasion acted as borough medical officers of health, e.g. during sickness or
holidays of the regular incumbent or hiatus between two regular appointments. Five of
the Council's assistant medical officers are at present regularly employed for part of their
time as deputy borough medical officers of health (in Finsbury, Fulham, Hampstead,
Islington and Paddington). All the regular arrangements include appropriate financial
adjustments between the Council and the metropolitan boroughs concerned and the
officers carrying out the additional duties receive appropriate allowances in accordance
with the relevant Industrial Court awards governing medical salaries generally.
Conferences with appropriate officers from head office are held at regular intervals
in order to ensure co-operation and co-ordination throughout the service, viz., with
divisional medical officers ; divisional administrative officers; divisional nursing officers;
chest physicians.
In addition conferences are held at divisional level with the borough medical officers
of health concerned with the day-to-day administration of the Council's health service.
Arrangements are made for whole-time medical staff to attend short refresher courses
from time to time. About 100 medical officers have so far attended, the majority of them
at week-end courses arranged by the Society of Medical Officers of Health.
Co-ordination and co-operation with other parts of the National Health Service
Whilst an excellent spirit of co-operation exists throughout the various branches of the
health service in London, co-ordination in the complex circumstances of the metropolis
is not easy. Whilst there is one Local Health Authority and one Local Executive Council
for the whole of the County area, there are parts of four Metropolitan Regional Hospital
Boards whose boundaries cut across no less than five metropolitan boroughs. There are
also, under the Boards, 25 hospital management committees, and in addition, 12 undergraduate
and 14 postgraduate teaching hospitals each with independent boards of
governors.
The constitutions of the Health Committee and of the divisional health committees
as set out in paragraphs 4 and 5 indicate the extent to which co-ordination has been
achieved at member level with other bodies concerned with the health service. The
report of the Central Health Services Council on co-operation between hospital, local
authority and general practitioner services is receiving careful consideration and preliminary
consultations are proceeding with the other bodies concerned to decide whether
the Council could usefully convene a regional conference to devise further machinery
for co-operation.