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Each divisional health committee is responsible for current administration of the
work carried out in the divisions, i.e., maternity and child welfare, school health,
health visiting, local liaison with district nursing associations on home nursing, domestic
help, prevention of illness, care and after-care and certain other matters.
Organisation
and staffing
of local
health
divisions
Of the medical staff, in general only the divisional medical officer and the deputy
divisional medical officer in each division undertake administrative work, and some of
them hold a joint appointment from the Council and a metropolitan borough council
or councils, devoting up to 40 per cent. of their time to borough work. Other medical
staff in divisions are engaged almost exclusively on clinic duties.
The nursing staff has recently been strengthened by increasing the establishment of
centre superintendents (health visitors with supervisory duties).
Lay administration is generally organised in three sections, a maternity and child
welfare and general section, a committee and staff section and a finance section. The
review has disclosed that there is room for more uniformity between divisions and
further delegation of work to less senior staff. In future the second administrative
officer will act also as head of the committee and staff section, thereby enabling an
administrative position in the next lower grade in each division to be given up, the
remaining staff being strengthened in some divisions.
The duties of clinic clerks were considered to require definition and consideration
is being given to the possibility of attracting more voluntary workers for general
clinic duties, and to the employment of sessional clerical assistance instead of using
full-time officers.
Methods and procedures in the divisions have been examined and there are to be
improvements in regard to recording of information about births, the form of vaccination
and immunisation statistics, the handling of recommendations for preferential
housing on medical grounds, accounting for unaccompanied children sent on recuperative
holidays, debt collection, the design of forms and other matters.
Domestic help service—A special section of the reviewing committee's report was
devoted to this service. Each division is divided into between two and five home-help
districts. A home-help organiser, assisted by one or more assistant organisers and clerical
staff is responsible for the service in each district. When the review began the total
staff comprised 29 organisers, 33 assistant organisers, 46 clerical staff and 3,004 (equivalent
to 1,919 full-time) home helps. Over 80 per cent. of the service given is for the chronic
sick, aged and infirm, and the service is expanding; the number of hours worked by
home helps has increased by 30 per cent. and the cost has nearly doubled in four years
since 1950. The organisation was examined thoroughly and comparison made with the
service of six other authorities.
There is considerable variation in standards of service from district to district and
from division to division and there is scope for greater uniformity. Suggestions for
increasing supervision and adjustments in staffing have been remitted for examination
to a departmental working party, who will also consider suggestions concerning district
organisation and boundaries.
Training of
students
health
visitors
The University or London Institute or Education continued to provide the theoretical
instruction for the majority of the Council's health visitor students, some of the remainder
receiving it at Battersea Polytechnic and the others at the Royal College of Nursing
During the course, field experience was provided by the Council. Of 235 of the Council's
student health visitors trained since 1948, 228 have been successful in the examinatior
of the Royal Sanitary Institute for the health visitors certificate and, of these, 121 are
still in the Council's service while a further 40 students are in training.
Staff medical
examinations
The number of references to the department for medical examination for advice
concerning the health of staff and for the fitness of candidates for appointment totalled
14,657, compared with 14,040 in 1954. Members of the staff found to be permanently
unfit for further duty with the Council numbered 298 and 289 candidates were found
to be unfit for appointment. Reciprocal arrangements with provincial authorities for
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