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accommodation and certain domiciliary services under the
National Assistance Act; and
"(c) the Executive Councils, who are responsible for the general
practitioner service."
A circular to local health authorities defines their responsibilities:—
"Apart from the active elderly person who is in need of residential
care and who is clearly the responsibility of the welfare authority, the
latter's responsibility also extends to the following:
"(i) Care of the otherwise active resident in the welfare home during
minor illnesses which may well involve a short period in bed.
"(ii) Care of the infirm (including the senile) who may need help
in dressing, toilet, etc., and may need to live on the ground
floor because they cannot manage stairs, and may spend part
of the day in bed (or longer periods in bad weather).
"(iii) Care of those elderly persons in a welfare home who have to
take to bed and are not expected to live more than a few weeks
(or exceptionally months) and who would, if in their own
homes, stay there because they cannot benefit from treatment
or nursing care beyond what can be given at home and whose
removal to hospital away from their familiar surroundings and
attendants would be felt to be inhumane.
"All these are persons for whom any necessary nursing care would
be given by relatives, etc., with the help or advice of the home nurse if
they were living in their own homes. In welfare homes, that care should
be given by attendants, assisted or advised by the visiting home nurse in
the small welfare home, or by a small staff with nursing qualifications or
experience in the larger homes."
The responsibility of the hospital authorities is set out:—
"Apart from the acute sick and others needing active treatment, who
are clearly the responsibility of the hospital authority, the latter's
responsibility also extends to the following:
"(i) Care of the chronic bedfast who may need little or no medical
treatment but do require prolonged nursing care over months
or years.
"(ii) Convalescent care of the elderly sick who have completed
active treatment but are not yet ready for discharge to their
own homes or to welfare homes.
"(iii) Care of the senile confused or disturbed patient who is, owing
to his mental condition, unfit to live a normal community life
in a welfare home.
It is not regarded as the responsibility of the hospital authority to
give all the medical or nursing care needed by an old person, however
minor the illness or however short the stay in bed; nor to admit all those
who need nursing care because they are entering upon the last stage o
their lives."
This circular then says: "The Minister has no doubt that provide
it is recognised by local authorities and hospital authorities alike that one