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cannot really "order" his patient, or commanding officer, to do anything,
but only advise. To enable him to familiarise himself with matters that
affect his group, he requires wide contacts with institutions and individuals
that are important medically for his area. It must be noted that this
emphatically does not imply that he must control these institutions and
individuals. Unfortunately, many suspicious persons feel that any attempt
towards a closer liaison is but the beginning of an attempt to gain control.
This suspicion leads to a resistance to collaboration which every medical
officer of health probably finds out when he starts his appointment and
thereafter he devotes an appreciable portion of his official service trying to
dissipate. Of course this suspicion is not necessarily directed against the
medical officer of health personally but toward his office. The hospital
and general practitioner service may be suspicious of the take-over propensities
of the local authority. The County Council may be suspicious of the
ambitious and efficient district council, and even the various departments
within a District Councl may view with some reserve the activities of a
public health department, although, because of local personal contacts such
reserve can be, and is, more easily allayed. Voluntary societies may, with
good reason, suspect the "statutory body" of trying to do them out of
business, as so much now done by " statutory bodies " was once voluntary.
To come down to details, it would surely be obvious that the first
person who should be considered as a member of a hospital management
committee would be the one whose chief duty was the study of all that
appertained to the health of the community served by the hospital group.
Many progressive hospital management committees recognise the advantage
of this association. A specific relationship should exist between the medical
officer of health and the Isolation Hospital. I visit the local isolation wards
regularly (even though these days there is little infectious disease to fill
them). It must not be assumed from my present welcome there, that there
was not originally some resistance.
Multiple Sclerosis, hemiplegia, poliomyelitis. These are medical terms,
invented, defined and understood by doctors. Supervision of these sufferers
up to school-leaving age is my responsibility. But after that ! As chairman
of the voluntary handicapped persons committee 1 happily become
aware of the plans and intentions of the County Welfare Committee toward
the physically handicapped, details concerning newly appointed visitors, or
proposed occupational therapy centres, holidays and many other matters.
As chairman, this information is mine, but the medical officer of health
(even in his statutory disguise as Area Medical Officer) is not informed,
although, once a year, at my request, I get a short resume of the previous
year's activities for my annual report.
Probably the activity that takes the largest single slice of my time is
the welfare of the aged. Under my control is the Welfare Officer for the
Aged and a number of health visitors, with similar interests. Yet when
Pegram House was planned and opened. I was not informed. True, I
knew all about it, as chairman of the voluntary Old People's Welfare Committee.
The opening of Pegram House was a most auspicious occasion, as
it is the very first residential accommodation ever to be provided in this
borough of 180,000 by the County Council (and it is only just in the
borough) I trust my disguise as chairman of the local voluntary committee
was not penetrated on the opening day by those who felt that it was
inappropriate for the medical officer of health to be there and did not
invite him.
Co-operation with the Children's Officer, her local representatives and
my staff is essential and occurs regularly. It is not made easier, however,
by the fact that no Children's Officer's visitor is responsible for the
borough. There are four such visitors, and each is responsible for part of an
adjacent borough as well as the segment of Ilford she serves. It is difficult
not to conclude that this arrangement (like the old divide and rule) is
aimed at preventing too close an identity between the health area for