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It is quite apparent that whereas at the start of life we may
order this or that routine guidance or treatment in an infant welfare
centre, at the opposite end of the scale, with a lifetime's
experience behind him, the patient will only seek medical advice
in so far as it can disturb his daily routine as little as possible.
It seems to me that if at our clinic we can forestall incapacity
by the early detection of deterioration or even merely give the
patient reassurance and comfort about the limitation of his activities
according to his individual physique, then the knowledge
gained thereby is of immeasurable benefit to each patient, it also
lessens the burden on busy middle aged relatives.
Everyone is most impressed and appreciative. Some who come
rather apprehensively and obviously a little nervous go away feeling
completely confident, and often comment what a good idea it is,
and say how terribly grateful they are.
I have no difficulty whatever in my supply of clients. The
trouble is to give them all appointments. Up to now we have not even
contacted the old people's clubs. Miss Francis, the superintendent
health visitor, says in her subsequent visits to the people in their
homes it is very evident that they greatly appreciate the enormous
amount of time and attention given in the clinic.
An elderly woman said that these clinics were the most wonderful
thing that had happened, and already she and some of her friends
had begun to feel a sense of comfort from having somewhere to come
where they could be examined leisurely and fully. I have had one
or two come to the clinic uninvited seeking attention and treatment,
but I have had to explain that they must go to their private
practitioners for this. They have been invited to come again for a
full check-up if they wished. Almost every one who has come has said
how pleased they have been and even although I have not been able to
do much, they seem to have been reassured and comforted.
Extending the Existing Services.
In years gone by we have tackled a number of special groups of
the population the mother and her young child, the schoolchild,
the tuberculous, those with venereal disease, those needing
immunisation, the blind, the handicapped, the deprived, the factory
worker, and now the aged. I feel sure the day will come when we
shall be examining the whole population at all ages.
One of the duties of the medical officer of health is to inform
himself as far as practicable respecting all matters affecting or
likely to affect the public health in the district and be prepared
to advise the local authority on any such matter. Examining the
various groups of the population is an effective way of doing this.
As in the case of the infant welfare and school health services,
the people come to the geriatric clinic for a check-up. Almost without
exception everyone I have examined in the clinic has needed
help of some sort. This fact is the justification for the provision
of geriatric health clinics. Only a minority need urgent medical
treatment by a practitioner. The commonest conditions are malnutrition,
defects of vision and incorrect glasses, deafness, nasal
and sinus infection, ill-fitting dentures, atherosclerosis, endocrine
disorders, bunions and corns needing chiropody. I have to
write to the national assistance officer for supplementary grants
for food, glasses and dentures; to the area welfare officer; to
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