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9
genesis of defectiveness and how to eliminate it from our communities.
Meanwhile, we must do all we can to alleviate the distress and
guilt feelings which tend to overwhelm the parents of defectives, and
educate individuals and families in environmental hygiene and mental
health, to form proper person relationships and to prevent mental and
emotional stresses which may lead to breakdown. This useful work
should be started in the maternity and child welfare clinics and, pursued
successfully in our schools, could make a useful contribution in the
application of preventive medicine to a medico-social evil.
We should not dissipate our energies by striving to regain the
therapeutic services that we have lost to the Regional Hospital Boards.
Rather should we concentrate on those preventive aspects of community and
environmental hygiene which have won golden opinions for the Public Health
services in the past and will gain for us equal success in the mental
health field in the future.
To this generalisation one exception could boldly be asserted.
The control of the "Chest Clinic" by the Regional Hospital Board has
created difficulties in the carrying out of preventive measures in
tuberculosis. The medical staff come under the administrative control
of the Board, the nurses remain the responsibility of the Local Authority.
This anomaly Is overcome by good relations and co-operation with the able
Chest Clinic staff, but the fact remains, the therapeutic, radiological
and general diagnostic work of the Clinic can hardly meet the heavy demands
of the practitioners in the area, and little remains in effort and
opportunity and even working space, to devote to preventive tuberculosis.
In my opinion this is a grave error of policy. The diagnostic
and therapeutic aspects of tuberculosis could be dealt with adequately in
the out-patient departments and wards of general and special hospitals and
sanatoria. The prophylactic, educational and community aspects of this
disease surely should be centred in the "Chest Clinic" free from the
trammels of dichotomized administration, and under the control of the
medico-social specialist, the Medical Officer of Health.
During the greater part of 1950 I was without the assistance of
a Deputy and I owe to the Council and to the Chairman of the Health
Committee and the Sub-Committees my grateful thanks for the consideration
and painstaking study they have given to the many problems set before them.
To my colleagues in other Departments for their advice and
willing co-operation, to.my Chief Clerk Mr. T.B. Clark, who has prepared
the statistical sections of this report and all members of my staff for
their loyalty and industry, I tender my grateful thanks for a year's work
which I hope will prove productive of good to the burgesses of East Ham.
I have the honour to be, Mr. Mayor, Ladles and Gentlemen,
Your obedient Servant,
J. S. COLEMAN,
Medical Officer of Health.