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61
when the Act was put on the Statute Book; but it can at least
be claimed as an outstanding administrative achievement that the
Act came into operation so smoothly and with so little inconvenience
to those making use of the services available.
Since 'the appointed day' certain administrative difficulties
have been brought to light, such as the acute shortage of hospital
beds due to lack of nursing and domestic staff, the delay in provision
of spectacles due to the unexpectedly large number of
persons applying for glasses, and the fact that dental surgeons
are leaving the service of local authorities in alarming numbers
in order to take advantage of the greatly-enhanced remuneration
available in private practice. Whereas the first of these difficulties
may be considered to be only indirectly the concern of local health
authorities, the last (i.e., the drift of dental surgeons into private
practice) will assuredly have a disastrous effect on the dental
welfare and health of expectant and nursing mothers and young
children lor a generation unless steps are taken forthwith to accord
to them that priority of dental inspection and treatment which
was envisaged in the new Act. More detailed observations on the
new dental arrangements and their effect will be found on pages
71 to 73.
Local Administrative Arrangements.
It is with Part III of the Act—that dealing with local government
services—that Leyton Borough Council, as the Maternity
and Child Welfare Authority before the appointed day, has the
most direct concern. On 5th July it handed over to the new Welfare
Authority (Essex County Council) its former responsibilities in
respect of midwifery, maternal and child welfare, dental service for
exp ctant and nursing mothers and children under five, domestic
help, day nurseries, health visiting, care and after-care, immunisation
and ambulance service.
Such a radical change in the administration of these personal
health services naturally caused a certain amount of administrative
difficulty and dislocation; and there is no doubt that during the
first six months of the new 'set-up' the administrative staff have
been severely taxed in their efforts to deal with the great increase
in clerical work and correspondence. Other difficulties, those
inherent in any system of remote control, have arisen. Whether
these are merely teething troubles, or whether they will become
permanent features of the new administrative arrangements, time
alone will tell.