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33
could well be that the assessment of the problem and the discovery of the
solution can be dealt with only by someone such as the Medical Officer of
Health. This problem was debated in the House of Lords towards the
end of the year. It was submitted by one that—"The great and glaring
need was for one authority or person in each area to be responsible for
the old people and he believed that person should be the Medical Officer
of Health." Against that view it was submitted that as it was important
not to associate the care of the aged too much with ill-health, it should be
put under the social-care department rather than the Medical Officer of
Health. This is the view of a doctor who said—"What is essentially a
social problem has been looked at through the haze of the ordinary mental
and physical disabilities of old age and wrongly labelled a medical
one. We have tried to cope with it by providing beds and places without
realising that a negative policy of this kind has no chance of keeping
pace with the rising tide If we could persuade others to look
after the welfare side, we could best contribute by understanding that far
from being an illness, old age is largely an attitude in mind."
The present position about the responsibility for the arrangements
for meeting the needs of the elderly is strange. Of all officers engaged by
local authorities, the Welfare Officer would seem to be the one whose
duties are most closely allied to those of whoever should be responsible for
the administration of the services for the aged. Some elderly are his
responsibility; not though because of their age but because of some disability.
In the same way he has responsibilities for others who are aged;
but again not because they are old but because they are in need of care and
attention. His responsibilities for those in this class though are limited
to those who need to go and are prepared to go to a welfare home. If they
do not need to go to such a home or alternatively, if admission to a home
is what is wanted but they refuse to go there, then these people pass out
of his hands. The work of the Welfare Department is closely associated
with that of the Health Department. So much is this the case that some
authorities have appointed the Medical Officer of Health as the Welfare
Officer. Where this has been done, it would seem that the natural step
would be for the Medical Officer of Health to be made responsible for the
overall supervision of the arrangements for the aged. What does not
seem right is that authorities, while bearing the financial burden of the
cost of much of the service, should not be responsible or directly control
its running. There is room and there will continue to be room for the help
of volunteers, either as individuals, or as members of voluntary organisations.
It ought to be possible for their help to be made available in just
as unfettered a manner if the general consideration of the various forms of
helP are the responsibility of a committee of the local authority as if they
were that of an ad hoc committee.
Many very different kinds of service are made available in different
districs for the elderly. In so far as many depend for their running on the
help of volunteers, and in so far too as for some of them accommodation
needed, with extensions of these services the time will come when a