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46
HEALTH SERVICE PREMISES
As soon as it was known that the Council would become responsible for the personal
health services under the National Health Service Act, 1946, a detailed survey was
undertaken of the premises which would be transferred to the Council.
This investigation showed that maternity and child welfare centres varied considerably,
both in standard and type, and were mainly accommodated in church halls,
shops and converted dwelling houses: these were generally sub-standard and in need
of replacement. Only a small proportion (about 10 per cent.) of the transferable
premises had been specially built for the purpose for which they were used and, while
a number of these provided excellent facilities, others, built earlier, were too small to
be regarded as adequate by modern standards. Furthermore, an analysis of the distribution
of buildings showed that certain areas were not adequately served either by
maternity and child welfare centres or day nurseries, partly as a result of alterations
in the density of the population within the County which had occurred during and
since the war.
It was thus apparent that a radical replanning both of the location of the centres
and the type of building required would be necessary in order to place the services
on a firm basis.
Health
service areas
The preparation of a comprehensive plan for the organisation and future development
of the local health services necessitated the sub-division of each of the Council's
nine health divisions into a number of smaller planning units for the purpose of
assessing both the immediate and long-term needs of individual localities. These smaller
units, known as health service areas, were formed by grouping together two or more
contiguous Town Planning 'neighbourhood units' included in the County of London
Development Plan. Each health service area thus contains a unit of population (about
20,000) forming a socially complete entity, small enough to enable contact to be maintained
between the health services and the people for whom they are provided, but
sufficiently large to ensure maximum efficiency and economy.
Building programmes
In formulating plans for the development of the newly transferred services it was
recognised that prevailing shortages of materials and labour would preclude the erection
of many new centres and other health service buildings, and that the rate at which
progress could be made would be very largely dependent upon the country's economic
position.
Initial building programmes were accordingly designed to secure the completion of
building works already begun by the metropolitan borough councils before the
'appointed day' and the provision of additional accommodation, either by improvisation
or, where practicable, by new building, in areas where there existed serious deficiencies.
Five-year
building
programme,
1954-59
Following a reappraisal of the accommodation requirements of the health services,
the Health Committee approved a five-year capital building programme for the period
1954-59 prepared with the object of securing that building works should be carried
out, as far as practicable, in order of priority and phased so that they might become
available at the time they were required. In the light of advice from the Minister of
Health, schemes for replacement clinic buildings were excluded from this programme
and included in a reserve list of works from which the most urgent could be brought
forward if circumstances permitted.
Works
completed
1949-58
Although restrictions on capital expenditure have prevented the Council from
carrying out much of its five-year health service building programme a substantial
number of high priority projects were completed, or nearing completion, by the end
of 1958. Particulars of these schemes and of other major building works completed
during the first ten years of the National Health Service arc set out in Table (i).
Works in
hand
Projects in hand at the end of 1958 together with those approved but not commenced
at the end of the year are indicated in Table (ii).