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47
The Council's health service capital building programme for 1959-60 included
six major schemes costing more than 10,000 and eight minor schemes, details of which
are shown in Table (iii).
Projects for
1959-60
As part of the long-term development plan, an annual programme of minor building
and engineering works for alteration or improvement of existing health service buildings
is undertaken: over 250 schemes of this nature, varying in cost between .£15 and
£250, have been completed during the past five years. In addition, it has been the
practice since 1948 for cleaning and painting to be undertaken on the basis of complete
external painting and internal redecoration of all health service buildings once in six
years supplemented, where necessary, by intermediate washing of interior paintwork.
Improvement
programmes
Comprehensive health centres
The importance of the role which the comprehensive health centre could play in
securing the fullest collaboration between the personal health services provided by the
Council and those provided by the hospital and specialist services and by general medical
and dental practitioners has long been recognised.
The Council's proposals for carrying out duties under Section 21 of the National
Health Service Act envisaged the ultimate provision of a comprehensive health centre
for each health service area. It was, however, appreciated that it would not be possible,
or desirable, to provide health centres on this scale except over a period of many years,
and immediate proposals were limited to the early erection of one specially designed
comprehensive health centre on the Woodberry Down estate, Stoke Newington,
and the provision of one centre in each of the nine health divisions as and when circumstances
permitted. Provision was also made for the acquisition and adaptation of
premises to provide accommodation for doctors and dentists who wished to establish
a group practice.
Although the Woodberry Down Health Centre*was opened within four years of
the inception of the National Health Service long standing restrictions on capital
expenditure and, more especially, the unwillingness of local general practitioners to
engage in group practice from a health centre, have precluded the provision of further
health centres.
The many problems associated with the establishment of health centres have been
discussed on numerous occasions with both the London Executive Council and the
Ministry of Health, and the Minister finally advised the Council in 1955 that he would
be unable to approve of their erection except in areas where existing health services,
including general medical services, were inadequate and additional services urgently
needed and where, moreover, general practitioners had signified their willingness to
work in a health centre.
In view of this advice and the practical difficulties in securing the vital co-operation
of general practitioners in the provision of general medical services from health centres,
it was decided that it would be unrealistic and, because of the shortage of land in London
for housing development, undesirable to continue the policy of long-term reservation
of health centre sites. Following consultations with the London Executive Council
and the Local Medical Committee the latter suggested that on sites where health centres
might be needed later, blocks of flats might be so constructed that ground floor flats
could be converted into health centre suites, if required. The Council approved in
principle this suggestion and the use in this way, as far as practicable, of sites reserved
for health centres.
Relinquishment
of
health centrc
sites
The future use of each of the 28 site? which had been acquired or reserved for
health centres is accordingly being reconsidered in consultation with the London
Executive Council, and 14 sites had been released for other development by the end
of 1958.
* A full description of the building and services is contained in a descriptive brochure (No. 3784, price 6d) published by
the Council.