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84
social service, and it is clear that the domestic help service is
expanding at such a rate that it will soon be one of the most
important and costly of the services administered by the health
authority.
Domestic Help Service—Accommodation.
In my last Annual Report I drew attention to the increasing
number of applications for domestic help on behalf of certain types
of patients (aged and infirm, chronic sick and tuberculous) for
whom accommodation could not be found in institutions owing
to the shortage of hospital beds, and expressed the opinion that
such shortage of beds would probably prove to be a great strain on
available domestic help facilities for some time to come.
Since that time the Ministry of Health has addressed to Local
Health Authorities a letter from which the following is an extract:—
" I am directed by the Minister of Health to inform you
that he has had under consideration the action which can be
taken to relieve the growing pressure on hospital accommodation
in the London area and which, according to past experience,
is likely to increase during the next three months.
" In this connection every effort is being made by the
Hospital Service to increase the number of beds available,
1 ut it is clear that immediate relief can only come by making
the fullest and best possible use of existing beds, a procedure
which may involve a slow up in the present rate of admissions
to hospitals of non-urgent cases so as to enable emergency
cases to be admitted.
" The Minister is aware that if this action becomes
necessary it. will place a still heavier burden on the Local
Health Authority's Home Nursing and Domestic Help Services
but he is confident that during these critical winter months
the Authority will co-operate with the Hospital Service and
do their utmost to meet the needs of sick persons at home."
Since its inauguration your Domestic Help Service has grown
rapidly ; and, even without the additional expansion which will
be required to meet the shortage of hospital beds, I anticipate that
it will manifest the growth of any healthy young organism by
progressive expansion until it becomes one of the most important
of the local health services. Although there has been a progressive
increase in the amount of help supplied and in the number of
domestio helpers employed, the central administrative arrangements
are of a primitive and makeshift nature.