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STAFF
the staff employed in the public health department is set out in Appendix D on
page 190.
Review of the public health department
In 1953, the Council decided to institute a continuous programme of comprehensive
reviews of the work, organisation and staffing of each of its departments, the aim being
to complete each cycle of reviews in five years or thereabouts. A review of the public
health department was completed towards the end of 1955.
A steering committee including senior officers from the public health department
and other departments, under the chairmanship of an assistant clerk of the Council,
was appointed to conduct the review whilst the detailed examination of the various
branches and divisions was carried out by a small team of trained organisation and
methods officers allocated by the Council's director of establishments.
Proposals were approved by the Council during the year to transfer to the Metropolitan
Borough Councils (subject to any necessary legislation being forthcoming and
to certain other conditions) some of the Council's health functions, and for this reason
certain major aspects of the department's work were left for future consideration.
Despite these limitations, the review was a formidable undertaking, as the public
health department is the third largest in the service, with a staff of over 7,000 and an
annual salaries and wages bill of approximately £3,384,000 a year.
The full report which the steering committee submitted contained a number of
recommendations. One of these was concerned with the determination of staffing
ratios for professional and auxiliary staff, several with the organisation and staffing of
services run centrally, with divisional organisation and staffing and with matters for
future reconsideration. These recommendations were accepted by the Council. In
addition many matters of lesser importance were discussed with departmental officers
during the course of the review and action was taken or active consideration given to
them without the need for specific recommendation. The acceptance of the proposals
will result in the immediate or near future in a net reduction of 32 staff positions,
representing with the regrading of certain other positions, a financial saving of £23,300
a year.
A brief resume of the principal aspects of the report, and of action taken on it,
follows.
Functions and general organisation of the department
The present structure of the department was designed to enable the Council to undertake
the duties for which as local health authority it found itself responsible from
5th July, 1948, when the National Health Service Act, 1946, came into operation.
The principal factor governing the present departmental organisation was the decision
of the Council that, in order to permit the largest practicable measure of decentralisation
of its personal health services, London should be divided into nine divisions, each
consisting of the area of two or more metropolitan boroughs, and each with a divisional
health committee as a sub-committee of the main Health Committee. About 60 per
cent. of health service expenditure is incurred locally, and about 80 per cent. of the
staff of the department work in services locally controlled.
Work at head office falls naturally into three main spheres, to which the three
branches of the department correspond :
Head office
organisation
Branch 1—Maternity and child welfare; school health; domestic help; home
nursing. This branch is the responsibility of the senior principal medical officer, and
is served not only by medical staff but by the chief dental officer, the chief nursing
officer and the principal organiser of children's care work.
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