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STAFF
Some account is given below of the problems and development of staff and establishment
matters since 1948.
During 1948 there were many staffing problems arising from the large changes in the
health services. During the first six months, in addition to carrying on the normal
administration of the hospital service, detailed arrangements were made for handing
over nearly 100 hospitals to the new Hospital Boards and a considerable number of staff
experienced in hospital administration were sent to the Boards to assist in the heavy task
of preparation. Concurrently, arrangements were made for taking over the personal
health services transferred from the metropolitan borough councils and for the general
assumption by the Council on 5 July 1948 of powers and duties under the National Health
Service Act, 1946. This creation of the nucleus of a new department within the framework
of one that was to end was achieved without the employment of additional staff.
It was realised at the outset that efforts should be directed towards co-ordination of the
services which the Council had taken over and those for which the metropolitan borough
councils continued to be responsible, viz. environmental health. A scheme was adopted
in October 1948 for the use of the services of borough medical officers of health as
administrative medical officers in the personal health services and as a corollary certain
of the Council's medical staff were seconded for part of their time to act as borough
medical officers of health and deputy medical officers of health. These arrangements
were maintained and extended during the ensuing years as opportunity offered; in addition
some borough medical officers undertook clinic duties in the Council's establishments.
Nearly 5,000 staff in many different grades were taken over from the boroughs and the
major task of assimilating most of these staff on to appropriate scales of pay and conditions
of service was progressively achieved in the ensuing three years. In some services, notably
health visiting and dental, there was significant under-manning and central recruitment
for a number of grades was introduced to ensure allocation of new entrants to areas
experiencing severe staff shortages. Reference is made later to the development of staff
training.
By the end of 1950 the general shortage of qualified nursing staff was acutely felt in
welfare homes and residential nurseries and schools; despite earnest efforts to improve
recruitment complete stability was unfortunately never achieved. Also by this time the
appreciable yearly wastage of health visitors largely made good by the induction of newlytrained
staff, under arrangements sponsored by the Council, emerged as the pattern for
the years ahead. The introduction in 1951 of the new grade of clinic nurse relieved health
visitors of certain clinic duties, enabling them to devote more time to district work. In the
dental service the first pay recommendations of the Dental Whitley Council were not made
until 1950. Although further pay awards were made subsequently, the shortage of dental
officers persisted for some years; unlike the position in most nursing grades, however,
and due in part to the decrease in demand for the service, the shortage became much less
acute.
Assimilation of the transferred services and staff was completed by 1952 and the steady
development of services in the next three years produced no staff changes of any magnitude.
The general upward trend of salary and wage levels was followed in varying degrees amongst
the department's staff. Some new grades appeared, notably those of night help and child
help, which were introduced as an extension of the home help service, in connection with
schemes for the care in the home at night of the aged and chronic sick and the care of
children temporarily deprived of their parents.
A comprehensive review of the work, organisation and staffing of the department was
completed in 1955. This review, started in 1953, of the third largest department of the
Council with 7,500 staff and a salary and wages bill at that time of £3,500,000 a year was
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