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130
Examples of Lack of Co-operation;
The following examples—taken at random—may serve to show
the nature and extent of the existing overlapping and confusion.
When a case of infectious disease occurs in a family we may have
as many as five different members of the staff of the health department
visiting the house at different times and for different purposes,
r.q. :—
1. Public Health, (a) Fever Hospital Nurse to arrange
for removal of patient to hospital; (b) Disinfector to disinfect
premises; (c) Sanitary Inspector to report on sanitary arrangements.
2. Maternity and Child Welfare. Health Visitor
to deal with children under five and foster children under
nine.
3. Education. School Nurse to deal with children of
school age.
A pre-school child may be suffering from a severe defect or
deformity requiring prolonged supervision and treatment. Up to
five years of age the child is under the care of the Maternity and
Child Welfare Committee and its staff; but as soon as the child
becomes five years old a new Committee and a new set of officials
(medical, nursing and administrative) proceed to apply different
methods of dealing with the same child and the same defect.
Tn the same family two children may be receiving the same
form of medical, orthopaedic, ophthalmic, dental or convalescent
treatment; but whereas the payment for the pre-school child is
assessed on one scale, the school child's liability is assessed on a
quite different scale.
With the ever increasing scope and activities of the health
services it is becoming increasingly difficult for any one of the three
committees dealing with the work of the health department to take
any action which does not concern the other two, the result being
delay and possible confusion occasioned by the necessity for
referring matters from one Committee to another or to a Joint
Committee.
Suggestion.
The best way to ensure co-ordination is to do away with the
necessity for it, and thus bring the practice of preventive medicine
into line with modern knowledge regarding it.