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Health Service Trends
The practice of medicine was initially concerned with the immediate cure of
physical manifestations of disease processes; psychiatry, a later branch of medicine
is mainly concerned with the psychological disorders.
Gradually it has been appreciated that human beings do not have two separate
entities of physical body and mind with their own specific disorders and diseases; but
that the psyche and soma are indivisable components of a whole person.
This concept has enormous importance in the development of the medical services.
It can perhaps be shown in an over simplified manner by considering peptic ulcerations.
A doctor with his scientific training and skill is able to diagnose that the
symptoms and signs of ill-health in a particular patient are caused by peptic ulceration.
A strictly physical approach to therapy would be to alter (by the use of alkaline
drugs and a regulated diet) the environment of the ulcer to assist healing to occur.
As the effects of emotional tensions on physical processes of the body became
appreciated, the so-called stress disorders, such as peptic ulceration were recognised
and therapy progressed to include attempts at resolving the individuals emotional
tensions. It has subsequently been realised that a person's emotional reactions are
often largely determined in his family relationships.
It is apparent therefore that medicine must not only treat physical diseases of
bodily systems but relate treatment to the individual as a psychosomatic whole and as
a component of his family.
This carries broad implications in the future development of the health services.
The influence of the family unit is the important background environment which must be
considered in prevention and treatment of psychosomatic and mental disorders.
Our existing services are organised in the main on a clinic team basis and it is
your policy to maintain this pattern for present and future services so that as far as
possible all of our medico-social workers concerned with any one family are from the
same clinic team (e.g. report on clinic services, page 41).
There are, however, many others in the health and allied social services who are
also concerned in family health and welfare and it is to the public benefit if we
actively co-operate with our colleagues in the medico-social services. This is one of
the underlying reasons behind the establishment of a Leyton Medical Liaison Committee
and a Leyton Social Workers Luncheon Club.
Handicapped Pre-School Children
Family counselling is of major importance in families who have young children with
impaired physical or mental development. It seems important that an accurate assessment
of the defects should be made as soon in the child's early life as possible so that
adequate treatment and management can be planned. Experience is indicating, particularly
with hearing defects, that early treatment gives substantially better results. It is
also of prime importance that the parents should feel that skilled help and understanding
is available to them.
Towards the end of 1961 we began special clinic sessions for this purpose with the
help of the consultant paediatrician, Dr.Hinden, but it is too early yet to properly
(3)