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Branch 2—Co-ordination of planning within the department and with other
bodies; social and preventive work relating to tuberculosis and other diseases;
after-care; mental health; health education; epidemiology; housing; statistics;
research. This branch is under the supervision of the deputy medical officer of health;
besides medical staff it includes the chief inspector and the scientific adviser with
the staff of the laboratories at the County Hall and at the main drainage outfall works.
Branch 3—Lay administration, including co-ordination of the work of all divisions
and the London ambulance service. This branch is in the charge of the administrative
officer, and is organised in four divisions as follows:
A—Work broadly corresponding to that of branch 1.
B—Co-ordination of planning; acquisition of sites and provision of new
buildings; ascertainment and after-care of mental defectives and the mentally
ill; social and preventive work relating to tuberculosis and other diseases;
after-care generally; epidemiology; and various other related functions, including
slum clearance and the registration of nursing homes.
C—Health education and propaganda; estimates and finance, including the
preparation, on a mechanised system, of wages sheets for head office and
divisional staff; recovery of expenses; statistics, supervision of committee work,
annual reports, examination of new legislation, and other administrative matters
not dealt with elsewhere.
Divisional
organisation
D—Staff and establishment matters.
The administration of the London ambulance service is at present largely selfcontained
and forms, in effect, a fifth division of branch 3.
The divisions, of which there are nine, vary in size approximately from 6½ to 22½
square miles, and in population from under a quarter of a million to over half a million.
There is liaison with the Metropolitan Borough Councils, who are responsible for
the'environmental health services, both at member and at officer level. The membership
of each divisional health committee consists of approximately twice as many representatives
from the Metropolitan Borough Councils within the division as there are
members of the Council and/or Health Committee, together with local representatives
of professional and other bodies. Under an agreed scheme, some borough medical
officers of health or their deputies act for part of their time as divisional medical staff
of the Council and vice versa.
The divisional medical officer is responsible for general supervision of the Council's
health services and staff in the division, and is the principal local adviser to the divisional
health committee. Lay administration is the responsibility of the divisional administrative
officer. Nursing staff, who are allocated to divisions centrally, are under the supervision
of the divisional nursing officer, who, like the divisional treatment organiser in her
sphere, is responsible to the divisional medical officer for local arrangements.
This complex organisation, in which professional and lay officers work side by side,
and where some services come under central, some under divisional control, and some
are divided between the two, led the steering committee to consider the following
three questions before reaching conclusions on the organisation and staffing of individual
services or divisions :
(a) The numbers and status of professional and administrative top-level staff at the
department's central office.
On this, the conclusion was reached that existing numbers and gradings were
appropriate.
(b) The divisional system, which has two aspects, namely whether more (or fewer)
services should come within its scope and whether the degree of divisional autonomy in
regard to services under local control should be extended or limited in any way.
(c) How to secure even loads and levels of professional work and service, and the
determination where practicable of standards of output to help in determining staff numbers.
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