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become available to medical students, post-graduate
doctors and other students of these disciplines for the
teaching of community medicine and general family
practice medicine.
Several other health centres in the borough are in
varying stages of development and are the subject of
considerable discussion with the family doctors, the
Executive Council, the Local Medical Committee and
representatives of the Ministry of Health. All taking
part are most helpful and considerable progress has
therefore been made. A preliminary report on these
centres is given on page 37. Our endeavour is to
produce the best possible conditions to enable doctors,
with all the resources of the local health authority
available to them to practise modern medicine in such
a way as to bring the greatest benefit, satisfaction and
well-being to their patients.
Health Visiting
The health visiting service is still held back due to
difficulty in recruitment, which means that the limited
staff from the superintendent (Miss E L Donovan) to
the district health visitor has had to put in a considerable
amount of hard work. The borough council's
forward policy on the provision of health centres and
on the need for full co-operation regarding all the
aspects of community medicine renders the recruitment
of sufficient health visitors a matter of urgency.
No liaison or attachment schemes between general
practitioners and health visitors were inherited from
Middlesex, and any new scheme in an urban area such
as Hounslow would only be a success, and success it
must be, if there were a sufficient number of health
visitors on the ground.
Home Nursing and Midwifery
The home nursing and midwifery services have had
a successful year, due not only to the devoted work
of a full complement of nurses and midwives, but
also to the efficient and kindly guidance of the superintendent,
Miss V Murphy and her deputy, Miss M A
Taylor who is a welcome addition to the department.
Home Help Service
Each home help is an indispensable member of the
health service team, and works in close collaboration
with her nursing colleagues. The greatest number of
requests for her services come from family doctors,
and a breakdown of the client's health is often the
precipitating factor in the need for help. Many home
helps now come into the service because of a sense of
vocation, and soon find helping those in need can be
a very satisfying occupation. Miss D Claxton, home
help organiser, took over a team of home helps who
were second to none from her predecessor, Mrs R
Chapman MBE, who was well known in this field.
So many problems in the service have a medical
aspect whether the recipient of help is a mother, child,
handicapped or an elderly person, that it is essential
for the organiser to have medical advice near at hand.
Close collaboration between my deputy, Dr M E
Wilkinson, Miss V Murphy, superintendent of home
nurses and Miss D Claxton has enabled the newly
organised service to settle down and reach, by the
end of the year, a standard of which the borough and
community can be proud.
Physiotherapy and Speech Therapy
The Middlesex pattern of therapists working individually
in clinics, schools and medical units has been
modified by the formation of teams of therapists
co-ordinated by a superintendent responsible to a
principal medical officer. Mrs J Biddle has been
appointed to the newly formed post of superintendent
physiotherapist and co-ordinates a team of six physiotherapists,
a number of whom are part-time, and
similarly Miss E G Richnell has been appointed senior
speech therapist to co-ordinate a team of four speech
therapists. Fortunately full establishment has
obtained in both fields throughout the year, and much
devoted work has been done.
It is envisaged that these two paediatrically orientated
teams could form the nucleus upon which a
more widely based domiciliary team for the care of
the older age groups could be built. By the addition
of therapists trained in geriatric work much could be
accomplished in the rehabilitation of the elderly and
the handicapped.
Nation wide staff shortages however mean that
at present the domiciliary field could only be
strengthened at a cost to the hospital service. Therefore
much thought must be given to the question of
priorities, and in which field the patients will reap the
greatest benefit.
Vulnerable Groups ' Housing and Public Buildings
Despite everything that can be done on the
preventive side there will, for the foreseeable future,
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