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CO.OPERATION WITH HOSPITAL AND
MEDICAL SERVICES
General
liaison
Ante and
post.natal
care
Employment
of general
practitioners
Local
meetings with
general
practitioners
in the report for 1952 reference was made to the machinery for co.ordination and
the general field of co.operation with the various branches of the Health Service in
London. The constitutions of the Health Committee and the divisional health committees
provide for the representation of many bodies concerned with the Health
Service including the London Executive Council and the Local Medical Committee
for the County of London. Conversely, the Council has the right to nominate eight
members of the London Executive Council and the Medical Officer of Health is a
member of the Local Medical Committee for the County of London. There are
periodical conferences at officer level with the senior administrative medical officers of
the four Metropolitan Regional Hospital Boards, the medical officers of health of the
Home Counties, representative house governors of Teaching Hospitals and representative
metropolitan borough medical officers of health. Each of the nine divisional
medical officers is a member of at least one hospital management committee and they
and other senior divisional staff also serve on many voluntary committees concerncd
with health. Hospital staffs co.operate fully with the divisional organisation and there
is a strong link between the hospital maternity and paediatric departments and the
ante.natal and child welfare clinics at welfare centres. The joint use of staff in the
hospital and local authority services and the employment by the Council of general
practitioners on a sessional basis in the maternity and child welfare and school health
services encourage a closer working together in the field. The composite nature of the
tuberculosis services in London calls for continuous liaison between all those concerned.
Information about the health services is disseminated through many channels, e.g.,
directories, guides, leaflets, local information centres, etc.
Efforts were made during the year to develop further the ties with other parts of
the National Health Service and attention was focussed particularly on general practitioners
by the publication of the report by the Committee on General Practice within
the National Health Service under the Chairmanship of Sir Henry Cohen and by the
issue by the British Medical Association in conjunction with the Society of Medical
Officers of Health of the statement entitled ' The General Practitioner and the Health
Visitor'. Reference has also been made in previous reports to measures adopted to
foster co.operation with general practitioners ; the present position is summarised
below.
Both ante.natally and post.natally the doctor and domiciliary midwife work together
to give the mother advice and attention. Indeed in some instances midwives attend
doctors' surgeries and this kind of co.operation has been encouraged.
General practitioners are employed in the Council's health services on a sessional
basis for many types of work, e.g., ante and post.natal, child welfare, vaccination,
immunisation, and in the school health service. At the end of the year an average of 700
sessions a week in the school health and maternity and child welfare services were being
conducted by 360 medical officers employed sessionally, about half of whom were
engaged in general practice. Co.operation has been furthered also by the presence in
the service of sessional medical officers holding appointments in hospitals, industry, or
working as private specialists or in other capacities.
Meetings with general practitioners have been arranged locally at which the part
of the health visitor was given prominence and the wide range of her duties stressed.
The fact that there are only some 400 health visitors in London and over 2,200 general
practitioners on the Local Medical Committee's list limits the amount of effective help
which the health visitor can give, but in some instances consultation is frequent.
Co.operation has been very fruitful in dealing with the medico.social problems of
families where difficulties have not come singly : the family doctor in giving treatment
and influencing the family to accept specialised local authority services and to follow
the skilled guidance of the health visitor. In some districts there are experimental schemes
whereby a health visitor is allocated to a group practice.
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