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13
out pilot studies; but now its successful implementation throughout
the Borough is anticipated.
Dr. Jones indicates in her report the extent of the transfer
of certain responsibilities to the new Social Services Department,
and the transfer from that Department for responsibility for the
Chiropody Section.
The inevitable expansion of that Section is shown by the
increase in number of patients and treatments by 591 and 5,196
respectively. Clearly such a service can only be restricted at the
expense of increased waiting lists and intervals between treatments.
The National shortage of entrants to this occupation in
both private and local Authority sectors continues. The shortages
in the private sector from retirements throws greater pressures on
the local Authority sector. Above all the need for a contractual
service between local Authority and private sector increases costs.
Though smallpox vaccination ceased as a routine procedure—
Rubella and BCG vaccination are offered as a routine in the
schools, and tables show the protection that is offered against
measles, diphtheria, whooping cough, tetanus and poliomyelitis.
Miss Chandler comments on the shortage of staff in the
Health Visiting Service and the pressure of work, some of which
is linked to these important immunisation schemes, resulted in a
decrease in number of home visits—a vital function of the Health
Visitor. However, more mothers were visited antenatally and
first visits to elderly increased.
Infectious and other Diseases
This report by Dr. Kelynack stresses at various points the
substantial necessary surveillance of travellers returning from
abroad as contacts or as possible incubating cases of infectious
diseases not endemic to this country. In 1971 cholera contacts
provided a new alarm to add to the yearly total of typhoid fever
and smallpox suspects.
A general outbreak of food poisoning is reported, and reminds
one of this ever present risk greatly increased by communal feeding
and sophisticated methods of food production.
Liaison between Medical Officers and Public Health Inspectors
is vital, and when these services are separated by National
Health Service Reorganisation speed in communications and
action must be preserved.
Environmental Health
The report by Mr. Kermode indicates that work in connection
with some aspect of housing occupies one third of the
Public Health Inspector's time. Clearly it is difficult in a working
day neatly to parcel out time between housing and health, and
from time to time new pressures arise. In 1971 increased