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was considered by the Health and Welfare Committee and, as a result,
certain amendments and improvements were made to the scheme.
Circular 13/70 recommended a new management structure in the
Local Authority Nursing Service with three levels of nursing management
—top, middle and first line. The top post to be designated Chief
Nursing Officer, who would co-ordinate and direct health visiting, home
nursing and domiciliary midwifery in the area. Appropriate action was
taken to comply with the circular with effect from the 1st April 1971.
A joint Circular 15/70 set out the timetable for the implementation of
the Education (Handicapped Children) Act of 1970. This Act provides for
local Education Authorities to assume as from the 1st April 1971, responsibility
for the mentally handicapped children when local Health
Authority will cease to have power for the training of these children. The
Health and Social Services Departments will, of course, still maintain an
interest in the children and all will work in unison to mobilise as soon as
possible the services for the treatment and care of the handicapped child
and for the support of the family in general.
Finally, the Chronically Sick and Disabled Act 1970 brings together
a number of provisions with regard to the welfare of chronically sick and
disabled persons. Most of the services, which are now made mandatory
by the Act, are already provided by the Council under permissive powers
having been taken over from the Middlesex County Council in 1965. These
include the provision of practical assistance in the home, provision of
adaptations in the home to provide greater safety, comfort or convenience,
assistance in relation to wireless, television, library or similar recreational
facilities, assisting travel in certain circumstances and provision of meals
in the home or elsewhere. The new provisions are the ascertaining of
information with regard to the numbers and needs of chronic sick and
disabled persons and the provision or assistance in obtaining a telephone.
All-in-all, a formidable battery of legislation, which, with the
expectation of more to come in 1971, will definitely keep all departments
of the Council extremely busy for some time to come!
I regret to report that the water supply to the Borough is still deficient
in fluoride to the extent of about 0.9 p.p.m.(F)!
The standard procedures of inspecting and advising set up in past
years in the School Health Service still works very well. Consideration was
given to the gap in time in inspection services for the junior schools and, to
cover this, it is hoped to introduce a selective medical examination about
the 8-9 year level some time in 1971. Great emphasis is placed on the
early detection of defect in a child so that remedial work can be instituted
in order that the maximum benefit can be derived by the child from the
education provided. This detection of defects begins in infancy and comes
under the terms of developmental paediatrics and can be likened to a
routine screening process. Links with the assessment units in hospital play