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the health and welfare services of the local authorities do not
at some stage enter. Millions of people use them every year, These
services tend to be less in the public eye than the hospital or the
general practitioner service, but recent years have seen a rapidly
growing appreciation of their importance. Their value and
effectiveness cannot be measured in financial terms; but in the last
five years alone current expenditure on them has risen by 50 per
cent. and capital expenditure has quadrupled. The Minister goes on
to say that still further development of these services is essential.
They are far from having reached their full potential. Without them
neither the general practitioner service nor the hospital service
can evolve as it should. The ten year plans envisage an increase of
45 per cent. of the staffs employed.
Twickenham Council is soon to be heavily involved in these
matters when it joins with Richmond and Barnes to form the new
Borough. I have often said it is difficult for a councillor in a
County district like Twickenham to appreciate the extent and
ramifications of the County personal health services, when he is
concerned as a councillor with a health department staff of 15
dealing with a few environmental services as compared with a staff
of 430 dealing with all the personal services; and this does not
include still more dealing with welfare services. I personally
welcome the new set-up wholeheartedly. At long last we shall be
rid of this futile, stupid, artificial division between health
services and I trust, as I said in my last report, that we shall
not split into separate departments such things as mental health,
welfare, and environmental health. All these are so closely concerned
with the health and well being of every household that they
need staff who feel themselves to belong to one health-giving
organisation and who regard themselves as colleagues in one department.
Such an arrangement leads to greater efficiency, greater
interest for the members of the staff, and greater economy of
administration.
Within our health service the pattern of requirement of the
patient has undergone considerable change. The patient with symptoms
and signs fitting a textbook disease is no longer a "case". He is
a person bound up with the complexities of modern life and with all
sorts of relationships in his home with his wife, his children and
his house; in his travelling arrangements to work; in his type of
employment; in the personalities of his workmates and employers; in
his recreations and interests. The prescription of a few tablets is
no longer appropriate, because this patient may need adjustments and
advice about his mode of life which might help to readjust himself
to become again an efficient and responsible citizen. Thus in each
of his relationships he may need help not only from a practitioner
but also perhaps through his wife and children, the maternity,
midwifery, and child welfare clinic; the school health service or
child guidance; in an acute illness a home nurse, the home help, a
special appliance, or an ambulance; in convalescence a recuperative
holiday; in his attitude to life he may need a mental welfare worker;
perhaps a marriage guidance counsellor; or in distress an almoner.
If he is older he will need preventive medical services for older
people; the special welfare provisions; appliances for handicapped
people; chiropody; and may be admission to an old people's home.
All these ancillary services and many more are provided by or supported
by local authorities. You can see how these services can
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