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12
provision of services from these pioneer health centres. Reports
were submitted to the Policy Sub-Committee and the main Committee
and meetings were held with representatives of the Local
Medical Committee and the Executive Council. Against the background
of the serious situation in general medical practice arising
from problems of recruitment and retirements which had not been
alleviated by the setting up of group practices and the policy of the
Committee to attach Local Authority staff wherever possible, the
Committee decided to investigate the probable grouping and the
setting up of a Feasibility Study for an area shown to be one of
maximum need. This logical approach tempered with caution was
necessary in spite of enthusiasm on both sides because of the
probable cost and scarcity of sites for such a project, the more
urgent need to develop other services, and the restrictions on
attachment of local authority staff.
Personal Health Services
In spite of full publicity through co-operation with voluntary
services, there has been a disappointing fall in first attendances for
cervical cytology. This is part of a national pattern, and it is
interesting to speculate why the general public has less faith in this
method of health screening than in mass radiography for chest
diseases. The finding of only 11 cases of carcinoma-in-situ out of
2,144 examinations is justification enough from a medical point of
view but perhaps not enough from a lay point of view.
The report sets out the organisation and rationalisation of a
screening system for the earliest detection of deafness entailing
co-operation between Assistant Medical Officers and Health
Visitors and full follow-up and supervision. This is one of many
services where medical and nursing staff of the Authority are
developing special skills and side by side systems of record keeping
of babies born at risk of handicap are being developed in full
co-operation with the Hospital Paediatric Services.
Amenity provisions of Nursing Homes vary but close and
friendly supervision is maintained by the regular visits of a Senior
Medical Officer who is also responsible for the supervision of
private Day Nurseries and Playgroups in the Borough.
Full clinic facilities have been granted wherever possible on
request to the Family Planning Association and it is possible, from
statistical evidence already mentioned, that the efforts of the Association
added to private action, are succeeding in this area of
Greater London.
Reports of the Home Nursing, Home Help and Chiropody
sections show the increasing demands of this service for the domiciliary
care of the elderly.
Geriatric Units discharge to home care increasing numbers of
patients needing more time and more specialised nursing attention
and equipment. Full-time Home Helps cannot be recruited and it