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Superintendent Health Visitor gave talks at Queen Mary's Hospital School of Nursing to the
student nurses, who in turn spent a day with a health visitor as part of their training.
On some matters more formal arrangements prevailed. The Deputy Medical Officer of Health
was a member of the Kent Local Medical Committee and Reinstate Ltd. The Medical Officer
of Health and later the Acting Medical Officer of Health were members of the Thamesmead
Joint Health Services Advisory Committee and the Committee on Applied Epidemiology of the
Public Health Laboratory Service. Later in 1970, in accordance with the policy of the South
East Metropolitan Regional Hospital Board, the Acting Medical Officer of Health was amongst
those who received invitations to serve as Honorary Consultants on the Control of Infection
Committees for local hospitals, thus recognising the co-operation already apparent in this field.
Since 1965 the Deputy Medical Officer of Health and the Supervisor of Midwives have served
on three maternity liaison committees themselves representative of the three main branches of
the National Health Service. Through this liaison, three schemes, similar in nature but with
interesting variations, for the early discharge of women from hospitals after their confinements
were put into operation, thus to some extent anticipating the Peel Report (1970).
Against this background of co-operation, and prompted also by definite requests for nursing
attachments from three medical practices, the Acting Medical Officer of Health proposed, and
the Council accepted, two schemes designed to promote a measure of integration of the nursing
services likely to be in line with subsequent legislation. These two schemes were: —
1. Nursing Attachments to General Practice (see Appendix A)
2. Midwifery Training (see Appendix B)
A further attempt was made to introduce physiotherapy as a community service because
in the first place there were domiciliary cases who could benefit from it, and secondly the
Department had the physiotherapists. Unfortunately it was not possible to obtain a dispensation
from the Department of Health and Social Security for this purpose because nationally the
resources of such staff were too scanty to permit their employment outside the hospital services.
The administrator's insight into the merits of liaison, co-operation and eventually integration
must be compatible with the basic freedoms of good medical practice. Community medicine
should serve the health interests of the community as distinct from medical practice, which
is essentially for the individual. This is no new recommendation, rather it is a repetition of
what has always been a tenet of the Health Department at Bexley, but it must go further and
become better defined. It is to be hoped that out of the transpositional changes made by the
Social Services Act and the Green Paper there will emerge a useful new pattern. It is inherent
in both of these documents that the patient or the client should be spared a duplicati'on of
either services or personnel.
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