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made for regular meetings between numbers of general practitioners and health visitors
working in their areas. Health visitors discuss with the family doctor questions relating
to a patient's treatment which may arise in the course of duties in the home or centre.
There is no doubt that this co-operation is of benefit. Not only are the health visitors
able to advise the general practitioners on the various local health authority and voluntary
services available in particular cases, but they are able to supplement the treatment given
by the doctors by visiting the patients in their homes. Further development of such
co-operation between health visitors, hospital staff and doctors in general practice is
restricted only by the general shortage of health visitors.
Liaison is maintained with the mass miniature radiography services of the four
Metropolitan Regional Hospital Boards who assist the Council to carry out its duties for
the prevention of tuberculosis. The tripartite nature of the tuberculosis services in London
creates continuous need for liaison which is not always easy, smooth or effective. Nor
does it always ensure that the Council's viewpoint or wishes necessarily prevail.
Publicity
In 1949 a pamphlet was prepared for general distribution to the public. There were
nine editions of the pamphlet, the appendix of clinic addresses and times differing in each.
Similar information is supplied from time to time to local information centres, etc., as
part of a loose-leaf publication on all services of the Council. Special information is
supplied on request for directories, borough guides, etc. Information on the health services
is often given in newspaper and magazine articles and through B.B.C. programmes.
Every facility is offered to journalists for this purpose. On the introduction of the
National Health Service, all general practitioners in the County were notified by letter
of the services provided by the Council as local health authority. A further circular is in
course of preparation reminding them of the services available and the method of
obtaining them for their patients.
Joint use of staff
About 180 doctors in general practice are employed by the Council on a sessional
basis, about 115 on work under the National Health Service Act, and the remainder in
the school health service. The general practitioners work on an average two sessions a
week each and are responsible for about one-third of all sessions taking place. General
practitioners carry out all types of work for which non-specialist medical staff are
employed, e.g. ante- and post-natal, child welfare, vaccination, immunisation and dental
anaesthetics.
The Council's proposals for carrying out duties under the National Health Service
Act envisaged discussions with the four Metropolitan Regional Hospital Boards with a
view to making joint appointments, on an agreed basis, of medical specialists to be
employed in both the hospital and local health authority fields. Arrangements have now
been made with all four regional boards and with a number of the teaching hospitals
for the payment by the Council of three-elevenths of that part of the salary of chest
physicians that is attributable to work in the chest clinics. In certain cases the Council
also contributes towards the salaries of clerical and social workers employed by the
hospitals in the chest clinics, as an alternative to the practice, in the majority of cases, of
the Council itself providing staff in these grades for the care and after-care work of the
chest clinics.
By the end of 1952 arrangements for the exchange of medical officers, employed by
the Council at maternity and child welfare centres and undertaking child welfare sessions,
with pediatric registrars were operating at the following hospitals:
St. George's Hospital (Tite Street Branch).
The Hospital for Sick Children, Great Ormond Street.
Westminster Children's Hospital.
Paddington Green Children's Hospital.
Queen Elizabeth Hospital for Children (Bethnal Green Road and Shadwell Branches).
King's College Hospital.
Guy's Hospital.