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purpose. The district nursing organisations have also continued to maintain their 'loan
cupboards', from which they lend equipment to their own patients, and their expenditure
on this account is approved for grant purposes.
Since January, 1953, the Council has undertaken the responsibility for supplying
large and expensive items of equipment and all loan equipment needed for tuberculous
patients, as the voluntary organisations were experiencing difficulties in storing and
maintaining the extensive stocks of equipment needed for long-term loans to tuberculous
patients. The voluntary organisations now supply only such small articles as rubber
sheets, enamel bowls, bedpans, etc.
The demand for expensive and unusual equipment continued to increase during the
Year, possibly due to the fact that many chronic sick and disabled persons, who were
formerly considered to be 'hospital' cases, can now be nursed at home. Striking
examples of this are the many paraplegic patients who are able to live and care for
themselves as a result of the work of the National Spinal Injuries Unit at Stoke Mandeville,
and who need a large selection of equipment, including special beds and mattresses,
which is lent by the Council. Various types of hoist are needed for some patients, and in
addition to those which can be used by partially paralysed patients to move themselves
a few hoists which can be used by the district nurse or relatives to lift heavy immobile
patients were purchased.
Hospital authorities, general practitioners and the Council's Welfare Department are
also empowered to provide various types of equipment and appliances, the dividing line
between the various responsibilities is not always easy to determine, and close liaison
with all three and with the Ministry of Health is maintained in order to ensure that the
patient obtains the necessary equipment from the correct source with the least possible
delay.
DOMESTIC HELP SERVICE

Of all the cases assisted during the year, 77 per cent. were aged and chronic sick
(75 per cent. in 1953), 5 per cent. were maternity (6 per cent. in 1953), 4 per cent. were
tuberculous (4 per cent. in 1953), and 14 per cent. were assisted for other reasons (15
per cent. in 1953).
The substantial 'hard core' of aged and chronic sick cases assisted, which was referred
to in the 1953 report, continued to increase, as the following figures show :
On the books at the end of 1949 7,833
1953 17,166
1954 19,417
These cases often remain on the books for many years and the regular supply of
adequate help to the large numbers of aged and infirm persons who live alone and are
entirely dependent on the home helps for shopping as well as housework, is a great
problem, particularly in the winter when many old people become housebound and
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