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whereas most of the previous health services were second tier under the Essex
County Council. As well as this, a new executive council dealing with the family
doctor services was created covering Metropolitan Essex with which new relationships
had to be made so that the domiciliary services in the borough could be
adjusted as far ae possible to local needs as expressed by the local medical
committee.
Because the new borough is situated in the Greater London Area, a multiplicity
of committees had to be set up under various names to co-ordinate
inter-borough services and to look at ways of overcoming difficulties created by
new boundaries and by differing practices in different areas. By the end of the
year, one felt that the department was still leading a hand to mouth existence
because of the enormous amount of extra work undertaken by staffs who in many
cases were still learning their way about unfamiliar services. Initially it was
agreed that the committee structure would consist of a Health Committee dealing
with main policy matters to be referred on to the Council. It was also agreed
that environmental health, domiciliary services and mental health sub-committees
would deal with the detail of these three aspects of the service. Later it was
felt that the environmental health service could operate within the main Health
Committee.
During the year, the new Borough Council informed the Metropolitan Water
Board and the South Essex Waterworks Company that they favour the addition of
fluoride salts to their water supplies. In December a communication was received
from the London Boroughs Committee to the effect that the British Waterworks
Association had recommended the Water Associations that they should only take
action in connection with the fluoridation of water on the request of all the
health authorities within the area of their supplies. The London Boroughs
Committee proposed to take a consensus of opinion of their delegate authorities.
The Barking Borough Council informed the London Boroughs Committee that they
favour the fluoridation of water and indicated that legislation was desirable to
achieve this. There the matter rested at the end of the year.
Staff shortages, particularly of trained field workers, were a major problem
during the year, and the Council had already begun to discuss the need for
provision for training staff. It was agreed, for instance, that the Council
would sponsor up to six health visitor students a year and up to six district
nurses and midwives a year for training, and no doubt this policy will extend
during 1966 to other sections of the health department.
The period of the changeover did not, I feel, adversely affect the ordinary
citizens or their use of the services to any great extent. Progress towards an
improved service should follow as improvements in staffing and organisation occur.
I must thank the staff of the department for having worked so hard and so loyally
during the first nine months, as well as the new Chairman and Members of the new
Health Committee for the support they have given me.
J. ADRIAN GILLET
Medical Officer of Health
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