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7
the same officers as previously, there has been emphasis
placed centrally upon the need for bringing districts
with fewer services up to the standard of those with good
maternity and child welfare and educational facilities.
Our own efforts to continue with some experimental
and original work in conjunction with these particular
services did not unfortunately meet with the approval we
had hoped, but we have maintained to the best of our
ability the basic experimental work and have even on
occasion developed certain facets within the limitations
placed upon us by the similarity of the pattern imposed
by a central body upon individual areas. We can now look
forward to a freedom of approach towards new ventures in
co-operation among medical services in our area since
these are indeed the life blood of medical progress.
As the Council are well aware we have tried to inaugurate
a combined service with the Hospital Board for
the care of the physically disabled elderly. Since this
has been undertaken outside the scope of the County
Council control we have naturally had some freedom of
action and have been able to use this organisation to
give us a field for investigating the best practicable
methods of operating a medical service for the disabled
elderly without calling upon hospitals for in-patient
beds. Apart from some consultant services and with help
from the County Council by way of transport through the
ambulance service this has been achieved. We are operating
a centre which is unique in the country and does enable
general practitioners to secure a service for some of
their most difficult cases. The further development of
our Day Treatment Centre may well come within the scope
of the new arrangements of the new Ealing health services.
On lines such as these we may be able to make progress in
handling the enormous problems that are to be placed on
our shoulders as welfare authorities in the near future.
How far this type of approach may be related to mental
care through the Mental Welfare Section of the new authority
remains to be seen, but undoubtedly our present
experiences are giving us most valuable knowledge of the
necessary organisation. The great lesson that we have
learned in the last year has been the impossibility of
separating treatment necessary for the disabled elderly
into consultant, Local Authority welfare and the General
Practitioner services., together with the after-care
necessary once the patients have had their period of