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I am not suggesting the Medical Officer of Health should be the person in charge of the new
Service. I have long advocated that the Medical Officer of Health should be responsible for
environmental and preventive services and another medical officer of equal status should control
all the personal services, i.e. the Medical Officer of Health would be concerned with matters affecting
the community and with preventing illness and disease, whilst the other Medical Officer would
control the services supporting the individual sick or handicapped person. This type of arrangement
existed in London prior to 1965 when the Metropolitan Borough Medical Officer of Health concerned
himself with environmental and preventive matters and the London County Council
Divisional Medical Officer controlled the personal services, and in my experience was very
successful.
The Seebohm Committee fully recognises the important part the medical services have to play
in their proposals and I should have thought it would be logical to place a service in which ill
health and handicap loom so large, under a person qualified to assess the needs of patients and
their progress in a first-hand professional manner. It has been said that the Seebohm proposals will
produce a chasm between the Social and Medical Services into which the patient will fall!
The report has been called a "Charter for the Social Worker" — not for the patient! Social
workers can become very involved emotionally with the problems of the persons for whom they
are responsible and if unable to make progress in alleviating the patient's lot could sublimate
their frustration by blaming imagined short-comings of the service instead of their own inadequacies,
or their failure to realise that they were dealing with an insoluble problem.
As regards the widespread dissatisfaction with the existing services referred to by one member
of the Seebohm Committee, I would suggest many patients are encouraged by the press, radio and
television to expect too much from both medical science and the social services on which they
have come to depend so much. When their condition does not improve as they may have hoped,
they will then blame imagined inadequacies of the service, instead of themselves or their
condition.
The increased emphasis which is proposed to be given under Seebohm to the socially handicapped
will only aggravate this problem further and will not alleviate it. It is well known that the
elderly, and others too, will invent complaints in order to get attention.
Social workers tend to over prescribe for their charges, thereby often encouraging the patient to
become more and more dependent on the social services. There is a school of thought which
considers too much welfare is bad for patients and they they should be encouraged to live with
their handicap and as far as possible to ignore it. This could be done in many cases with benefit to
the individual and to the economy. Too much support from social workers tends to discourage this
attitude in the patient and must engender in all but the strongest characters a feeling of evergrowing
dependence on others.
Far too much publicity is given today to disease and illness and the public are encouraged to
try and find something wrong with themselves, either medically or socially. If there is as much real
illness, physical or mental, in the community as the National Health Service figures suggest, then
something must be radically wrong with us as a race and we are basically poor stock, or else there
something very seriously wrong with our way of life which should be ascertained and rectified
immediately.
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