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8
In IIford approximately 20 HVs must work with 70 GPs; this in
itself makes any exclusive arrangement at present impossible. But there
is a further problem resulting from free choice of doctor (and free choice
of patient). With the help of the Executive Council for Essex an investigation
has been made in a street adjacent to the surgery of a local doctor
who is most anxious to have his own HV. In that street are the patients
of 13GPs (three of whom have their practices centred outside the borough).
Thus in that street 13 HVs (half of our staff) will be practising and often
more than one (and maybe strangers to each other) serving the same
household. Each individual HV will have clients in each ward of the
town, and some in adjacent boroughs. Files and records will be in confusion.
This cross-movement chaos adds to the harmful effect such a
practice would have on the fundamental basis of the HV's professional
activities. She is no longer purely a medical auxiliary whose work is
confined to helping a specified physician, but a social worker as well,
whose client may not even be consulting a doctor. She is interested in
the client's family, relations, house, street, school, club, neighbourhood,
clinic, friends, neighbours, place of work, park, pub, and indeed everything
that goes by the name "local" and the smaller the area she has
to cover the better will be her local knowledge. I am not suggesting she
should not co-operate with the family doctor. This co-operation should be
as close as possible, but each GP should co-operate with more than
one HV, who cannot be exclusive to one practice.
I am aware that exclusive allotment of HVs to GP practices works in
certain areas. I feel sure that this is only because in most cases the practice
concerned is the main one in the area,orthe GP is the only one amongst
many colleagues who really appreciates and uses the HV's services.
Exclusive allotment of HVs to GP practices, if generally carried
out, will only lead to confusion and a decline in the quality of the social
work that the HV is able to do.
I must once again acknowledge the help given to me by my staff and
fellow Chief Officers. The support of the members of the Council, Chairmen,
Vice-Chairmen, and members of the Ilford Borough and Essex County Committees
with which the department is concerned has been most encouraging.
Finally, again I wish to thank the numerous helpers in a number of
voluntary societies for their continued and essential help.
I have the honour to be
Your obedient Servant,
I. GORDON,
Medical Officer of Health.
Postscript (from a letter received in the Public Health Department):-
"I am writing to ask yon, if you have any vacancies, in the "Valentines
Mansions**, as I have heard how very nice it is there for elderly people,
and I am wanting to find some-where for my mother-in-Jaw."
*The Public Health Department.