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process by creating a stronger link at first line manager level between the two services. The degree
of co-operation which can obtain may be illustrated by the night nursing service which commenced
on 1st December, 1971. A detailed description of this service appears elsewhere in the report.
By providing care throughout the night in appropriate cases this service has already ensured that
some patients who could otherwise receive adequate care from their family doctors do not have
to be transferred to hospital merely because of their need of nursing attention during the night
time hours. The service has been fully utilised from the moment of its commencement by family
doctors whose patients it exists to serve. Nevertheless, the service itself is based in hospital
premises made available to the staff of the local authority. This enables the community night
nurse to benefit from the presence and support of her hospital nursing colleague and may also
allow reciprocal support to be given to the hospital nursing services.
Environmental Health Services
Changes were made during the year in existing arrangements for pest control and concentrated
responsibility for this service within the public health inspectorate. There was an impression that
the rat population had increased and vigorous attempts at eradication were pursued.
A report in the medical press gave further confirmation of the previously noted association
between soft water and an increased mortality from certain causes. Enquiries from all of the local
water companies revealed that the existing water supply in this area is relatively hard and apart
from a limited degree of softening in one part of the supply, there are no plans to soften water
supplies in the foreseeable future.
Considerable interest was aroused later in the year by the discovery that one well in the area
was producing a water supply containing 1 part per million of fluoride. Most waters in this area
are deficient in this trace element which appears to be essential to the full protection of teeth
from dental decay. Efforts to replace this deficiency by artificial means have foundered on the
need for agreement amongst a variety of water companies and a number of different local authorities.
The knowledge that a number of Hillingdon residents are enjoying the benefits of this satisfactory
water supply was most encouraging and detailed plans were made to investigate the possible
beneficial effect on children's teeth in the area of the supply. The Council continues to support
the principle of fluoridation of water supplies in view of the obvious benefit to dental health that
would result.
Personal Health Services
The Chief Nursing Officer, Miss J. Byatt, took up her duties in August and her report on the
work of the community nursing services will be found on page 40. Reference has already been
made to the major changes which have been introduced.
At the beginning of the year a report on the dental service was received following a visit by
a dental officer from the Department of Education and Science and the Department of Health
and Social Security. The report gave impetus to changes which had already been foreseen and
planned. The Chief Dental Officer describes the improvements which have occurred, elsewhere
in this report.
Circular 36/71 urged local health authorities to review their present family planning arrangements
and meetings were held with hospital and family doctor representatives together with
voluntary organisations working in the area. As part of the five year plan to develop health and
social services in the area, it had been agreed in November 1970 that family planning facilities
should be extended. The Council accelerated this programme in July 1971 and resolved to provide
a medical advisory service free to all who might wish to use it with effect from 1st April, 1972,
and to encourage the development of the service as quickly as possible. The appointment of
Dr. Joan Marshall as consultant adviser in family planning matters enabled the Council's first
directly administered clinic to receive her valuable professional guidance. Later in the year plans
were completed to assume financial responsibility for Hillingdon residents attending the clinic
at Mount Vernon Hospital operated by the International Planned Parenthood Federation. This
clinic also provides valuable training facilities which enable local authority medical and nursing
staff to obtain the additional training which will be necessary as the service expands.
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