Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Harrow]
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47
The household whose need arose from acute illness was the one helped
rather than that requiring help because of some long term and even
lifelong condition. To those households where the need is likely to be
of indefinite but long duration the help would be given only for a short
time to enable other arrangements to be made. Not only is this practice
one by which more households are enabled to receive some assistance
in their difficulties, but it tends to prevent the service becoming one
closely allied to a domestic service agency to which application is made
for domestic assistance on grounds unrelated to the illness of any member
of the family.
In regard to publicity, it was felt unwise to invite applications from
all who came across families in difficulties until there was some assurance
of help being available. Of the first few helps offering their services a
number came from one locality, so those in this area were first informed,
approach being made to the general medical practitioners, district
nurses and hospital almoners. A gradual development on these lines
meant that ultimately it was possible to advise those who might come
across these difficult cases throughout the entire district that there was
now a domestic help scheme in the area.
It was soon found that the uncertainty of employment made some
of those helps who had offered their services unwilling to remain. The
possibility of whole-time or part-time engagement was debated and the
Committee authorised the engagement of helps on a guaranteed 20-hour
week, it being thought that the availability of the greater number in
the mornings would be more welcome than the smaller number of wholetime
workers. It turned out though that these conditions were not
sufficiently attractive to provide a nucleus. Apart from the rate of
pay which is less than women can earn in other ways criticisms were
raised about loss of time in travelling, no provision of overalls, etc. By
the summer months, too, the volume of work was falling, so there was
the greater risk of losing what helps were available. It was felt then
that it was necessary to provide at least a firm nucleus of helpers, the
additional help being obtained by the engagement of part-time casual
helpers. To retain those of this whole-time nucleus they were given a
guaranteed minimum of remuneration. Time in travelling was counted
for payment and they were provided with overalls. This nucleus
enabled the service to continue through the summer months when the
demand fell off.
It may well be helpful to engage some on the 20-hour week, though
the raising of the hourly rate of remuneration of those on less than 30
hours from 1s. 9d. to 2s. an hour may increase the numbers of those
willing to help on a casual basis.
It is felt that the service can be extended by increasing the number
of those engaged whole-time if that part of their time not taken up in
households of the more acute cases could be made available in houses
where the need is long standing, such as where there are the elderly, the
chronic arthritics, the blind, etc., who would so welcome this assistance.
Even were the numbers of whole-time helps increased it is felt the services
of the casually employed will always be needed to meet times of
exacerbation of demand. These casual cases can be retained only if
they are fairly regularly offered some work.