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General Provision of Health
Services.
Hospitals.—The arrangements set out in previous Annual
Reports relating to the provision of special and general hospital
accommodation, together with the provision of maternity beds,
remained unaltered during the year. The remarks which I made
in my Annual Report for 1945 regarding the inadequacy of hospital
accommodation in this area have even more point to-day. This
inadequacy applies to all types of hospital accommodation, with the
exception of that required for infectious diseases, for which we have
been able to make ample provision. Beds for the chronic sick,
accommodation for patients suffering from pulmonary tuberculosis
in all stages, and maternity beds are particularly short. Even
where actual space is available, shortages of staff have made it
impossible for empty beds to be filled. This is, of course, not
only a local problem; the country as a whole is suffering in the same
way to a greater or lesser degree. Until the number of beds required
to meet existing demands are ready, and until the necessary nursing
staff can be recruited, we must continue to fall back upon such
expedients as are available to us. These expedients include the
provision of Domestic Helps, Home Nursing Services, Post-natal
supervision to an even greater extent than has been undertaken in
the past, and an adequate service of Home Helps after confinement.
But whatever they are, they still remain expedients. No matter
how well organised and adequate such alternatives may be, they
can never take the place of a proper hospital service. It may be that
the setting up of the new Regional organisation under the National
Health Service Act will improve the situation, although one takes
leave to doubt whether this will, in fact, be the case. The problem
is not one which can be solved by legislation; it is basic, nationwide
and physical, and will require corresponding methods of
approach if present ills are to be overcome. In the meantime, we
must accept the position, and do what we can locally to alleviate the
hardships and actual dangers which it brings in its wake.
Under the National Health Service, and for the first time in
the history of this country, preventive and curative medicine are
to be almost wholly divorced. One can only hope that the new
Regional Hospital Boards will be made fully aware of and attempt
to meet the varying needs of each of the areas constituting the
Region. The fact that the newly constituted Health Authorities,
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