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As far as chiropody is concerned the Borough has been divided into two areas, North and
South, Mr.O'Brien supervising the South, and Mr.King the North, giving us ten clinics in all (each
with at least one full-time chiropodist in attendance) plus five Welfare Homes, in each of which
one chiropody session per week is provided.
Our staffing and accommodation situation is only fairly good, with most of our shortages
being in the South. During the year we have lost the services of Mrs.Skeets, due to retirement
after many years of faithful service, who was replaced by the return of Miss Hunter; we also have
had one or two changes of very short service chiropodists.
Our major problem in the staff field, is providing chiropodists for the domiciliary service.
This is not only a monetary question, but primarily one of conditions as the work is very exacting
and difficult, being clinically not satisfactory for reasons of lack of normal equipment and lighting
which all adds to the risk involved in the treatment of house-bound patients, thus it is difficult to
find chiropodists to undertake this work.
R.J.King
J.C.O'Brien
Chief Chiropodists
Community Factors
A principal concern of the Senior Medical Officer for community care during the year has
been the assessment of indications for medical priority in rehousing under the Borough's housing
scheme. During the past year, in co-operation with the Housing Department, a system has been
evolved for expressing on a points scale the effect of any medical disability upon a patient's
housing requirements.
It is a fact, both fortunate and deplorable, that housing factors (overcrowding being
excepted) in many instances do not have a great effect upon a medical condition, for good or for
bad. Stairs and their modifications, facilities for bathing and cooking, drains and waste disposal,
together with a weatherproof roof, are the chief medical measures at the disposal of the Housing
Department. In fact, generally they do not help medical conditions much Also, in the nature of
things, housing will exercise any effect it may have on a medical disability only quite slowly,
and so medical conditions concerned in this way must be expected to have a long history. For
assessing such cases therefore the assistance of the patient's doctor is essential; and it has
proved an indispensable rule that no case for rehousing with priority for medical reasons should
go forward without an informative certificate from the applicant's family doctor.
A further concern has been with the medical (and other) difficulties of aged persons,
particularly those in their own homes, and also of adults who are in varying degrees mentally subnormal.
To a large extent the problems of these two classes of people overlap. Frequently the
general picture of disability in the aged is the effect of a considerable number of adverse factors
all oppressing the individual, and some at least of thtse can be relieved. In the same way it is
the sum of many conditions bearing on the subnormal patient which taking everything together
makes it impossible for him to function acceptably in society.
Owing to this co-operation of a multiplicity of causes in these problems, it would in fact
seem possible to relieve much human misery by administrative action. In practice it is difficult
to achieve. It is like a small mouse nibbling at a very large cheese: now a bit and then a bit.
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