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If a sick person is being cared for in the community, the burden, after a period of
time, on the immediate and extended family can be very heavy. Again due to a
portfolio of factors, the family doctor may not be able to arrange admission to hospital
immediately. A battery of domiciliary services can be mobilised in support. However
a gap does exist in that night surveillance may be too much for relatives. To fill this
hiatus in services, a panel of "night sitters" was created and is functioning satisfactorily
in a modest way.
The arrangements for the 24 hour call-out of domiciliary midwives and mental
welfare officers since the Borough was formed were adequate through the good offices
of the Metropolitan Police. The latter indicated that this function did not strictly
belong to the police service. By coincidence, the British Medical Association Emergency
Treatment Service was initiated during 1967 to cover Greater London. One of
the services offered was a 24 hour telephone answering service with trained staff in
this field. Agreement was reached whereby these two groups of your staff were
included in the telephone answering service. With an eye to the future, and the
economic deployment of personnel resources, it is hoped that a trial with radio telephones
will be conducted, and the results could well be beneficial to all concerned,
especially the patient.
Dr. John Maddison, who had held the appointments of Medical Officer of Health
for Twickenham Municipal Borough since 1938, and Area Medical Officer with the
Middlesex County Council since 1948, retired from your service in April, 1967. John
Maddison's direct approach is not always understood. However, his sincerity, energy
and enthusiasm, especially for the well being of the elderly, has been acknowledged by
all. When the history of Public Health over the last three decades comes to be written,
John Maddison will have an honoured niche in that volume of fame.
It is with regret that the death in January, 1968, of Mr. D. D. Moir, M.Sc.,
F.R.I.C., your Public Analyst is recorded. His advice at all times, both to the former
Barnes and Richmond Boroughs and to you, was sound and helpful.
In accordance with Paragraph 7 (c) of Circular 1 /68 from the Ministry of Health,
it is noted that you took no further formal action in the fluoridation of water supplies.
Grateful acknowledgement is made to the following for their co-operation 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 Chief Officers of the Borough.
The staff of the health department have worked with loyal diligence. I would
especially thank Dr. J. K. Craig, Mr. E. S. Herbert and Mr. H. J. Pugh.
I conclude by thanking the Health and Education Committees and the respective
Chairmen involved for all their encouragement.
I am,
Yours respectfully,
A. M. NELSON,
Medical Officer of Health and
Principal School Medical Officer.
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