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Management is not as new as its recent prominence might suggest and the health and social
services have not been bereft until now of good administrations or of administrators sensitive
to improvements in management. The Medical Officer of Health for Greenwich London Borough
writing critically on this subject in his Annual Report for 1969, "the year when management consultants
arrived in the Borough", sounded a note of caution about the danger that in some forms
of management, the way local government must work in a democracy has not been clearly
understood and the means are often more deeply considered than the ends. This concern was
also being expressed at the time of the dialogue of management in Bexley. Those probing the
management of the Department must have learned much from their studies of these particular
services, much by volume of information and, one suspects, much of value to their own work.
Their critics within these services certainly wanted to know what were management's own
achievements. Successful or no, management must expect to submit to the criteria it uses in
judging others.
All too often local authority personal services have to operate under a general financial
control which is insensitive to the true economy of these services. Already non-profit making,
their effectiveness is very much at the mercy of available national and local financial resources.
If these are reduced below a certain level, services must be cut. To measure such circumstances
according to human needs rather than as a business transaction is a task rightly belonging to
the heads of these service departments. Likewise because of its nature, the evaluation of a health
or social service should be a built-in feature of that service and not part of the general statistical
enquiry arrangements for the Borough, although association with a statistical unit would have
undoubted value. The obvious setting for such work would be within the planning and
development section of the Department.
Apart from the legislation which led to the creation of two new departments, the main
administrative change was a trisection of the Borough into three geographical areas for three
area teams of social workers. This was in line with the philosophy of the Seebohm Report
to bring services and offices closer to the people. The basis for this decision was the size and
location of the case loads in each of the social work disciplines as deduced from the 0. and
M. enquiries. Although the need for area health teams was not so pressing because of probable
further health centre development, it was agreed nevertheless that such an approach to the health
service administration would be acceptable. In the first place it would help to preserve the long
association between health and social work, secondly it might attract staff more readily being
novel to the tradition of this type of employment in the London area, and thirdly it could
be thought of as experimental because the administrative base for the health teams would still
remain at the central office. The social work teams under an area social services officer would
include a senior social welfare officer, a senior mental welfare officer, a senior child care and
family care off icer, and an area home help organiser. The health teams under a principal medical
officer would include a senior dental officer, an area nursing officer and representatives of the
professions ancillary to medicine. The Social Services Department would also have a central
administrative division and a division for residential care services and certain central services
such as adoption and social work training. The Health Department would also have a central
administrative division, and an environmental health division (later accommodated at Gravel Hill).
School Health, including the Child Guidance Clinic services would continue to be administered
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