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THE MAYOR, ALDERMEN AND COUNCILLORS OF THE LONDON BOROUGH OF WALTHAM
FOREST
Madam Mayor, Ladies and Gentlemen,
I have the honour to present my eighth Annual Report being that for the year 1972. As
Annual Reports are not in practice finalised until after the Registrar General's figures for the
previous year become available in April, this is the last which I shall write while still your
Medical Officer of Health.
It is a title one has felt honoured to hold and one whose passing I, like many of my
colleagues, view with some nostalgia. It has after all for over a century been an integral part of
the fabric of local government, attracting the jokes, the occasional fame, but predominantly the
unromantic treadmill routine by which a nation has steadily lifted itself from the unhygienic horror
and squalor it produced as the pioneer of industrial revolution.
Now, with the wealth that revolution produced, in social circumstances unknown to our
forbears, the health professions set out to pioneer a new sort of Health Service. It cannot succeed
unless it too is part of the fabric of local government though circumstances have produced a
structure which will bring it outside the control of the local municipality.
The future relationships between Health Services and Local Government are crucial. There
has already been deep consideration by the Working Party on Collaboration, some of whose proposals
are incorporated in the new structure, but that does not relieve one from working it out locally.
There must be mutual respect if the partnership is to work. The structures are quite different, one
having in essence a single Council with a hierarchical structure of officers, while the other has
teams of officers as equals, with a hierarchical structure of committees.
Clearly there must be mutual respect amongst officers for the professional skill of others.
There is nothing new about this, though it is only in recent years that it has been explicitly
defined as a goal. Domination of one by the other works and can be successful to a degree but it
is not as fruitful from the patient or client's point of view, and is an extravagant use of resources
the ultimate crime these days.
At the same time at member level there are great opportunities for the right people to give
direction and inspiration to the intricate tangle which the officers will be operating. The Community
Health Councils, if their members can demonstrate that they are statesmanlike, responsible,
constructive and above all really an expression of local opinion, could be a most powerful force
for good. They must however earn respect first, or all the misgivings expressed about them will be
tragically justified. One would hope therefore that every effort will be made to persuade the bright
lights of local communities, those who are the enlightened, progressive, and always extremely
busy people, to find time for this work.
The local authority representatives on the Area and Regional Health Authorities also have
a very constructive role to play and will require a skill at handling divided loyalties of a high
order, for if their loyalties are demonstrably more one way than the other their colleagues on the
deprived side will cease to listen to them. Their contribution can only then deteriorate.
For members of committees of different kinds and for officers the prospects are challenging
and the way untried. I believe that the ultimate position will be much improved services to patients,
and greater achievements by staff in their attack on the ills of people, but it is a long road and we
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