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the Medical Officer of Health proceeding on active service.
After the war the laboratory was not re-opened, at first
because the premises were occupied by the military, and later
on account of the increased work of the Public Health
Department.
In October, 1926, I received instructions to report on the
question of this work being again taken up by the wholetime
medical staff. I pointed out that while the staff remained
of the same size as in 1914, the Public Health work
had increased by the addition of an entirely new Section
under the Maternity and Child Welfare Act,, 1918, by an
extension of School Medical Treatment (1920), by the admission
of cases to the Wimbledon Isolation Hospital from
outside areas (1920), by the examination of sick employees
of the Council (1925), and by the natural growth of the
Borough and by the passing of new Acts, Orders and Regulations
(1915-1926).
It was, therefore, obvious that the medical staff could
not devote the same time to bacteriological work as in 1914.
I advised that there should be a slight re-arrangement of the
duties of the medical staff to permit of better "team" work
and that a trial run should be made by carrying out the
hospital bacteriological work only, as there is less urgency
as to the results of these examinations than with specimens
handed in by general medical practitioners.
After twelve months' experience on the above lines I am
of opinion that no further work can be undertaken without
additional assistance. During "outbreak" conditions the
hospital bacteriological work increases so greatly that in
spite of working in the evenings, etc., the carrying out of
some routine medical duties must of necessity be postponed
for an indefinite time until the rush is over. By so doing
the efficiency of the department is jeopardised.
This question of bacteriological work is still under consideration
by the Public Health Committee and I have no
doubt it will be suitably adjusted.
The need for economy in all public departments is still
very pressing, and in this respect the Public Health Department
has admirably seconded the efforts of the Borough
Council as is evident from previous Annual Reports. There
is, however, a limit to which economy can be carried in
regard to Public Health, and the addition of further new
duties will undoubtedly necessitate an increase of staff. The
value of a public health department is in the amount of
preventive work that can be undertaken, and the results of
such work, unfortunately, cannot be given in stated terms,
for the better the prevention the less there is to show.
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