London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
London County Council 1956
[Report of the Medical Officer of Health for London County Council]
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The following table shows the initial action taken by mental welfare officers in age groups under 65 and over 65 :
| Action taken | Under No. | 65 Percentage | Over No. | 65 Percentage | Tote No. | Percentage |
|---|---|---|---|---|---|---|
Initial action
No action was possible or necessary at the time of the visit in 1,133 cases under 65
and 518 over 65 years of age. This represents approximately 20 per cent, of the total
cases seen.
The figures in this table indicate the practice to avoid admitting persons over 65 to
observation wards. This prevents the limited accommodation in the wards becoming
congested as these patients tend to remain in the wards longer than the younger patients
before final disposal. The mental welfare officers do, however, exercise discretion in each
case as to the most suitable procedure having regard to the patient's mental and physical
condition.
Disposal of
patients from
observation
wards
The ultimate disposal of the patients admitted to observation wards (including 17 out-county cases) is shown below :
| — | 1 | 1 | ||
| — | ||||
| — | — | — | ||
| 1 | — | 1 | 1 | |
| 1 | 1 | |||
| — | 6 | — | ||
More detailed analysis of these cases reveals that the discharge rate is highest in
respect of patients admitted from the casualty departments of hospitals (particularly
teaching hospitals), followed closely by the rate for patients admitted from the wards of
general hospitals. The discharge rate in respect of all patients admitted from hospitals
is 42-2 per cent, compared with 29-8 per cent, for other cases.
It seems probable that some of the patients referred from hospitals could be adequately
observed and treated in the hospital itself if facilities were available, even temporarily,
for further medical assessment. The lack of such facilities necessitates the admission of
these patients to observation wards and this in turn swells the discharge rate from these
wards.
Also revealed are the facts that in the five major observation wards there are wide
differences in (a) the percentage of cases transferred to mental hospitals as voluntary
patients and (b) the percentage of discharges by the medical staff. These are as follows :
Observation ward
Admitted as voluntary patients to mental hospitals .
Discharged by medical officer
A B C D E
percentage
19-3 45-3 22-6 32-8 43-2
44-3 25-3 45-4 20-1 22-6
It would be interesting to know what factors explain these differences as there is no
special selection of cases for individual observation wards by the mental welfare officers.
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