London's Pulse: Medical Officer of Health reports 1848-1972

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Harrow 1948

[Report of the Medical Officer of Health for Harrow]

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The hospital service is running under great difficulties. The following
information obtained from a report of the medical director of
Edgware General Hospital, the hospital which deals with most of the
patients from this area, for last year touches on the difficulties experienced
at the hospital.
" During 1948, 10,579 in-patients were treated in the hospital,
but nevertheless, at the end of the year there were 860 cases awaiting
admission. Although the bed complement is 704, four wards containing
62 beds and children's cots were closed throughout the year, primarily
owing to shortage of nurses. This resulted in a 25 per cent. reduction
in the number of general surgical beds, and a 66 per cent. in the case of
ear, nose and throat accommodation. The medical side is much handicapped
by the blocking of acute beds by chronic cases. During the
year, chronic cases and cases of advanced pulmonary tuberculosis ranged
daily from 110 to 125, and blocked a daily average of not less than 20
per cent. of the occupied complement. These beds not being available
for acute cases prevented the admission of at least 2,000 cases, necessitating
waiting lists and the refusal to admit acute cases. The waiting
periods are as long as six months for surgical cases and 30 months for
varicose veins. Nevertheless, the number of patients treated during the
year showed an increase of 826, the improvement resulting from an
increased use of available beds and a reduction in the average length of
stay from 20-3 to 19-4 days. The average daily percentage of occupied
beds was 87. Waiting periods are four to five weeks at the skin and
gynaecological clinics, but are shorter periods at the other clinics, except
the newly instituted deaf aid clinic where the delay is four months."
To arrange for the admission of a patient a general practitioner
first approaches the nearest hospital direct. If he is unable to obtain
admission for his patient there, the emergency bed service is requested
to arrange for the patient's admission to any hospital in which suitable
accommodation is available.
Isolation Hospital Accommodation.
These hospitals were established up and down the country towards
the latter part of the 19th century, the object being the provision of
accommodation for the reception of infectious patients and so by removing
the infective focus, limit the spread of infection. They were therefore
provided by the local sanitary authorities, the bodies concerned with
the health of the district. Because so many who succumbed to the
infectious diseases are infectious, and in some cases most infectious, in
the very early stages of the disease, the damage is often done before the
disease has been recognised. The subsequent removal of the patient
to hospital then does not limit the spread. The provision of these
hospitals then failed in their purpose. Nevertheless the hospitals
continued to be used and new ones were provided, while at the same
time the list of diseases from which sufferers were admitted to the
hospitals was extended. This followed on a reorientation of the purpose
of the infectious hospital away from the idea of it being an institution
for the incarceration of infectious persons and towards the conception of a
hospital for the reception of a patient who was suffering from some condition
which necessitated skilled medical or nursing attention, but because