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Surgical Registrar at the King George Hospital, Ilford! Most Barking
patients have to be admitted to the St. George's Hospital, Hornchurch,
which is administered by the Romford Group Hospital Management
Committee, and admissions to which are controlled by the Medical
Superintendent of the Oldchurch Hospital, Romford! In neither case
does the physician in charge of the beds see the patients before admission
in order to assess medical needs, and routine reports on social
conditions are not requested, although we send health visitors' reports
where home conditions are exceptionally bad. It is thus not surprising
that on occasion we feel those with the greatest need of a bed are not
necessarily admitted first.
The position is aggravated by the fact that many hospital beds are
blocked by patients who no longer require skilled nursing or medical
attention but who cannot look after themselves. There are seldom
vacancies in the County Welfare Department's hostels to which they can
be transferred, and difficulties also arise where a patient considered
too fit for hospital is classed as too infirm for a hostel!
I have the feeling that many old people at present in hostels could
have been kept at home had suitable facilities been available, and this
aspect is one to which we must devote more attention in coming years.
It involves the provision of special housing accommodation—ground
floor, compact and easily managed—and routine visiting so that
appropriate supporting services such as home helps and meals-onwheels
can be brought in to assist before deterioration sets in. The
elderly prefer to remain in the familiar surroundings of their own
homes—let us do our best to keep them there whenever possible.
LOCAL GOVERNMENT RE-ORGANISATION.
The last major re-organisation of local government in this country
was effected by the 1888 Act which created County Councils and County
Borough Councils. This, you will recollect, was only a few years after
your first Medical Officer of Health was appointed. Since then the
services provided by local authorities have increased in nature and in
scope out of all recognition, but the framework of local government
has hardly altered. The 1929 Local Government Act concentrated
certain powers into the hands of County Boroughs and County
Councils, a process which has been taken a step further by post-war
legislation. During 1953 the various local authority organisations have
been giving detailed consideration to the problems involved, but their
reports were not available by the end of the year and in any case it is
not for me to comment on the problems of local government in general.
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