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In the infant the early detection of hearing loss and the urine testing for the
metabolic disorder of phenylketonuria are already established. Developmental paediatrics
in depth is the preventive arm of to-day in this regard from the observation register.
Your clinic for preventive medicine for older people at Teddington under the direction
of Dr. J. Maddison is now well-known.
The limited start in cervical cytology in Barnes and Richmond areas has been
expanded gradually. You instructed me at the end of the year to explore the further
development in this field of screening for well women.
In other words there is a spectrum of techniques for all age groups, which is not
yet complete. One can see the day when the middle-aged man with risk of cardiac
catastrophe can be advised on how to prevent or avoid the aggravation of particular
health hazards pertinent to his group.
The family doctor has been described as the first contact physician, who treats and
cares for his patients, when illness strickens them. He has a further role to ensure that
the diagnostic and intensive therapy facilities of the hospital are available to his patient,
either on an out-patient or in-patient basis. He has a wider task in this early detection
of disease and disorder. The grand strategy of medicine may well be shifting to this
fundamental preventive style approach. These two interlinked concepts of community
medicine, liaison and screening techniques offer a stimulating challenge to all interested
in the health of the community. The services and resources of the hospitals, general
practice, and local health authorities in these matters) are interdependent. The silent
revolution in emphasis from a sickness and care service to a truly balanced National
Health Service may well be under way.
In accordance with Paragraph 7 (c) of Circular 1/67 from the Ministry of Health,
the following is recorded : —
"At the Council meeting held on the 25th January, 1966 it was resolved that the
London Boroughs Committee be informed that the Council are not in favour of an
approach being made to the Minister of Health for the introduction of legislation
enabling the fluoridation of water supplies to be directed nationally."
Grateful acknowledgment is made to the following for their help and collaboration
in the common task of promoting the health of the residents of Richmond upon Thames:
The family doctors.
The Hospital services and staff.
All voluntary organisations.
The Principal Chief Officers of the Borough.
The staff of the health department have shown deep loyalty. I would especially
thank Dr. J. K. Craig, Mr. E. S. Herbert, and Mr. H. J. Pugh.
I conclude by thanking the Health Committee, particularly the Chairman, Councillor
F. D. Gilday-Fox, for their constant encouragement.
I am,
Yours respectfully,
A. M. NELSON,
Medical Officer of Health.
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