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(b) Lunacy and mental treatment—Central administration of the work of securing
that persons of unsound mind are placed under control, now undertaken by a mental
welfare staff of 24, based on the County Hall, has been made permanent. No case was
found for combining this work with mental deficiency work.
A slight reduction in the current strength of the headquarters administrative staff
has been agreed upon.
Scientific branch—This branch undertakes chemical analysis and scientific investigation
for all departments through a central laboratory at the County Hall and laboratories
at the main drainage outfalls. When the review began, it was known as the chemical
branch, and its head as the chemist-in-chief. To indicate its wider range and to accord
with civil service practice, these titles have since been altered to scientific branch and
scientific adviser, and more appropriate titles given to other grades of staff.
The analysis of samples of food, building materials, fuels, etc., and the research
undertaken is either necessary in the interests of the public or of direct financial benefit
to the Council, and could not be done so efficiently or economically by other means.
To avoid unnecessary or unprofitable work, the department is giving requests for
service stringent examination before acting on them and is keeping under review the
need for frequent and extensive analysis of food from stock, and of sewage.
Inspectorate—The chief inspector and his deputy, who are available for advice or
consultation in relation to the Council's services generally, had under them 13 inspectors
organised rather flexibly in two groups; one concerned with housing and town planning,
and the other with the other functions of the inspectorate which include health questions
at Council establishments and at nursing homes and other general public health matters.
To reduce pressure on housing and slum clearance work, two temporary inspectors
have been added. Action is being taken to simplify procedure at the hearing of objections
to clearance orders and compulsory purchase orders, and to regulate the frequency of
inspection.
Tuberculosis—Diagnostic and curative work is the hospitals' function ; the Council
is responsible for prevention, care and after-care. The focal points of both are the
32 chest clinics; the chest physicians in charge are appointed and paid by the hospital
authorities, but undertake certain of the Council's duties for which the Council
reimburses 3/11ths of their salary. Both the hospital authorities and the Council employ
other staff at the clinics. For most clinic areas there is a voluntary tuberculosis care
committee, which raises and uses voluntary funds for patients' benefit. The Council's
clinic staff is 24 local tuberculosis care organisers, the equivalent of about 19 clerical
staff, one shorthand-typist, a few part-time senior occupational therapists and the
equivalent of 90 health and tuberculosis visitors; the cost of a further 7½ clerical staff
provided by the hospital authorities is reimbursed. Day to day administration of the
Council's tuberculosis work is, with certain exceptions, through the divisions.
The difficulties arising from the division of responsibility for tuberculosis work
were the subject of part of the evidence submitted by the Council to the Guillebaud
Committee. Pending that committee's report and the conclusions of national working
parties on social workers and health visitors, consideration of the questions of rationalisation
of the chest clinic service, the use by the Council of local tuberculosis care organisers
and the specialisation of health visitors in tuberculosis visiting work were deferred.
It was concluded that so long as the present allocation of functions between the hospitals
and the Council obtains, the existing arrangements appear to be the best that can be
expected. A position of organiser of tuberculosis care work will eventually be withdrawn
and a slight reduction in strength of other staff in the headquarters section has
been made.
Minor procedural changes and staff adjustments have also been made in the staff
medical examinations, school health and miscellaneous public health sections and some
saving effected.
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