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APPENDIX A
REVIEW OF THE LOCAL HEALTH SERVICES
Since the inception of the National Health Service in 1948 my annual reports have
included detailed accounts of one or more aspects of the local health services
administered by the Council. This present comprehensive review of the first ten years
of the local health services is undertaken in accordance with Ministry of Health
circular 22/58 and necessarily deals in rather broader outline with the development of
the Council's services since 1948 and the manner in which these services have functioned
within the wider setting of the National Health Service.
The services transferred from the City of London and the 28 metropolitan borough
councils varied considerably in scope and much of the early work was therefore concerned
with creating a comprehensive service of a uniform standard throughout London
and integrated with other Council services in the field. At the same time there has been
constant endeavour towards co-operation with other branches of the National Health
Service in London.
While general policy is a matter for central decision, the oversight of the day to day
administration of the council's health services has been delegated to Divisional Health
Committees. This has enabled the general service to be adapted to local needs and to be
administered by officers intimately acquainted with the localities and their special
problems.
To assist in a comparison of the services provided under the National Health Service
Act, 1946, in the earliest stage and now, figures for 1949 have, wherever possible, been
inserted in tables appearing in the relevant sections of this report. The year 1949 has been
chosen as the first complete year of service. An ambulance service was provided by the
Council before 1948 and so that the full effect upon this service can be seen, figures for
1947 have been inserted in addition to those for 1949.
Following the publication of the report of the Royal Commission on the Law
relating to Mental Illness and Mental Deficiency the Council's mental health services
were made the subject of a special feature in my Annual Report for 1957. This
contained a comprehensive review of these services which in the circumstances have
not been included in this review. Brief references to decisions and developments during
1958 and statistics for that year appear in the section beginning on page 95.
Health Centres
The situation in connection with health centres in London, together with the provision
of health service premises generally in the period under review, is dealt with fully on
page 47.
It is appropriate here to comment on certain developments at Woodberry Down
health centre, the first purpose-built health centre to have plans approved by the
Ministry of Health. Experience has shown that some of the accommodation provided
has not been much used. The minor operations theatre has been discontinued and the
accommodation is now used by officers of the Council's children's department. The
second of the Executive Council dental surgeries has also been discontinued after a period
of full-time occupancy by a health service dental surgeon, whilst the dental workshops,
apart from casual use by dental surgeons on the premises, have not so far been required.
A number of other services at the centre have developed in addition to the introduction
of the children's services already mentioned; the Care Committee organisation
(education department) have an office on the premises and a tutorial class for
maladjusted children is held in accommodation originally designed as a health service
ophthalmic room. Pathological services for general practitioners practising within a
two-mile radius of the centre are provided under the direction of the pathologist at a
nearby hospital and are available to the medical staff of the Council at the centre.
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