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Services might ultimately be adopted curtail immediate post-war progress
? The district badly needs premises in which the maternity and
child welfare clinics can be held ; the unsatisfactoriness for this purpose
of the buildings which have to be used in default of our possessing these
adds considerably to the difficulties of the staff, and must seriously
impair the quality of the work undertaken there. The Health Centres
of the White Paper, though at present in a very nebulous state, are
probably to be buildings of very different design. Is the fact that
sometime or other a number of these buildings may have to be erected
in the district, and if erected are conceived to abolish the work done at
the infant and ante-natal clinics, to prevent the erection of those other
buildings which are so badly needed ? Then there is the case of the
Isolation Hospital—the existing institutions are admittedly far from
ideal. If the future infectious cases in the district are to be admitted
not to a new isolation hospital to be erected by the Council but to some
other institution—either because of the desirability of having institutions
of a certain minimal size or because of the administration of the isolation
hospital service by the Joint Boards—then it is desirable that the decision
should be taken early, and even though it might mean the closing of the
local hospitals administered by the local council, this step should be taken,
rather than indefinitely continue to provide a service which might not
be of the best.
As to the effect on the local health services of the three White Papers,
the proposals most advanced are those relating to education. Whatever
the advantages of the administration of education being in the hands of
larger authorities, the general effect here in regard to health services is
that there is the possibility of the school medical service being administered
by the same staff as that dealing with maternity and child welfare, a
most desirable arrangement. Much is heard at times about continuity
of treatment, but the real advantage of the linking lies not so much in the
fact that the same medical officers are dealing with the children in both
groups so that they see at school those whom they knew at the clinics,
but in that the health visitor will embrace in her activities the school
child whose home she already visits for those of under five years of age.
As to the existing health activities of the Council, the proposals of the
White Paper on the Health Services leave alone the environmental
services provided by the Council as the local Sanitary Authority, excepting,
of course, the responsibility for the treatment of the infectious sick.
The Council will presumably continue to administer the maternity and
child welfare services for which it is at present responsible—but as the
agent for the County Council. In these circumstances the real test of
responsibility and therefore of interest will lie in the degree of delegation.
The proposals in regard to the supervision of milk production are again
very logical and administratively tidy. In an urban district such as this
in which even the years since amalgamation have seen further reductions
in the amount of milk produced locally, this duty is only one of those
undertaken by the sanitary inspectors ; and the loss of these duties will
only very slightly affect the volume of their work, though they as a body
perhaps do not view with favour any restricting and curtailing of the very
wide field of their activities. In milk producing counties though, the