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A programme has been prepared for students undertaking their State registration course
to participate in the community care experience as suggested in the last General Nursing
Council 1969 syllabus.
Plans are proceeding with Thorpe Coombe Maternity Hospital to participate in the new
integrated midwifery training scheme after July 1972.
Liaison schemes with hospitals in this authority have already been started some years
ago. These relationships have been reviewed and in some areas revised. New arrangemements
have been made in two hospitals - Chingford and Langthorne. Plans are being made for
increasing the amount of time and interaction already spent in Whipps Cross to encompass all
the main units there. These new and improved exchanges of understanding and easier methods
of communication are showing an improved standard of patient care, both before admission
and after discharge from hospital and, in some cases, has enabled an elderly patient to come
home at an earlier date, or the time of waiting for admission to hospital to be less. At all
times general practitioners and social services have worked closely with hospital and
community nursing services-
Some members of management in the nursing team have taken special courses in
management alongside their hospital colleagues. Arrangements for training have been made
for the remainder. Special day courses for appreciation of relationships in Hospitals and
Health Centres have been arranged and were much appreciated by the staff.
SPECIAL ARTICLE
THE GROWTH OF ENVIRONMENTAL HEALTH
The first public health inspectors are said to have originated in ancient Rome in
494 B.C. Among the matters for which they were responsible were the city's drainage system,
the cleansing and paving of streets, the prevention of nuisances, the supply of good and
cheap grain to the market and the destruction of unsound goods.
For many centuries the epidemic diseases of cholera, smallpox, plague, yellow fever
and typhus ravaged countries in different parts of the world. The only measures countries
were able to take against these diseases from the fourteenth century to the beginning of the
nineteenth century were quarantine measures. In 1830 cholera appeared in England despite
these quarantine measures and during the next 3 years outbreaks occured throughout the
United Kingdom. The outbreak disappeared in 1833 but reappeared in 1848.
Although some rudimentary public health measures were taken by many societies
from earliest times their efforts were hampered by a lack of knowledge of the causes of
infectious disease and the absence of proper administrative machinery. In the British Isles in
early nineteenth century there was no comprehensive system of local government, the only
elected local authorities were the municipal corporations. There was no central government
department charged with responsibility for the health of the people. Bacteriology was an
unknown science and many quaint theories to explain the transmission of disease were then
current.
It was at this time that the foundations of the public health service were laid. This was
due in part to a growing acceptance of the principle that the state should accept some
responsibility for its people. It was due also to some extent to fear of disease - the cholera
epidemics, for instance provided a powerful stimulus to action - coupled with a growing belief
that much sickness was preventable.
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