View report page

5
who need to be admitted to the surgical or a medical ward of a hospital,
or to have the services of a home nurse. These persons, although in
their tens, hundreds or even in some cases thousands, do not add up to
the 220 odd thousand of all those living in Harrow. The public health
services—the health, not the sickness, services—deal with those conditions
designed to keep in health that 220,000. The activities under
the National Health Service Act are designed to deal with the treatment
of those who have become ill, or who need treatment. So much has
been heard of the introduction of the National Health Service Act and
especially of the transfer of powers under the Act from the minor to the
major authorities, that it is liable to be overlooked that the essential
health services of a district are still the concern of the county district
council and that what these authorities have lost are their responsibilities
for arranging to deal with those who, for any reason, need treatment,
those who in a way may be evidence of the breakdown of the fundamental
health services.
For obtaining a knowledge of the operation of the Part III Services
of the National Health Service Act, the Medical Officer of Health for
this area is fortunately placed. The scheme of delegation was designed
to allow of the day-to-day administration being in the hands of a local
committee and local staff, It seems to be general that the workings of
the local committees and the local staffs are hedged in by restrictions
imposed by the county councils. For the arrangements to work smoothly
and efficiently, it is essential that the Area Committee be given a real
job; only if this is so, can it be hoped that the interest of members can
be retained and a strong committee assured. The committee should be
given full responsibility for the administration of the local services and
full regard should be paid to any recommendations it makes. The other
main weakness in the administration of these services is the inordinate
delay. Part of this is possibly due to the cumbersome machinery, but
it is one of the powerful factors contributing to the feeling of frustration
felt by so many of these who are concerned in any way with the local
administration of the Part III Services. The Health Service Act
will bring about material improvements in the health services to be
made available to those who need them. Many of these benefits
are now being made available at a much earlier date than they
would have been had progress been on the lines of the development
of personal services since the beginning of this century. It is, perhaps,
inevitable that the gain in this way should be offset to some degree
by the position of some being worsened. Advantage was taken
in the passing of the Act to further a movement which started with the
Education Act, 1944, of handing over powers from the minor to major
authorities. There were many local authorities with quite small
populations which were responsible for the provision of personal services.
There must be some limiting figure below which a district of that
population could not be a satisfactory functional unit for such purposes,
and the Act will probably result in an improvement in the services in
such localities up and down the country, now that they are provided
by the county councils. It is unfortunate though that this district,
and so many others which for years provided really satisfactory services,