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persons whether young or ageing, whether tit or
disabled, should in medical terms be the concern
of a doctor trained in occupational medicine. A
wonderful opportunity is available to demonstrate
boldness and imagination by creating an
occupational health service embracing everyone
from the age of five years until retirement and
even beyond. In my submission there is little
distinction between a school and a student health
service; there is no validity in providing a health
service to university students and yet refusing it to
even greater numbers attending Colleges of
Advanced Technology or Education'. (4)
'University health services, developed in British
Universities largely during the last two decades,
are now an accepted feature of university life.
During the next two decades "L'explosion
Scolaire" will continue unabated and full-time
students are expected to reach a total of over
half-a-million, almost a quarter in part-time
education. Perhaps the most urgent need at
present is to extend medical services along the
lines already well established in universities to the
large number of young men and women in
Institutions of Higher Education for whom, as
yet, little is done'. (5)
In Hounslow several students have already
made known their gratitude for this new service.
General Practice and Community Health Service
Present trends of thought suggest that a
population of 250,000 is the most suitable size
for coverage by a single urban borough local
health authority and by a single district hospital
with some 2,000 beds for acute, maternity,
geriatric, mental illness and mental sub-normal
cases if all such beds were provided within one
hospital. If this were the case provision could
theoretically be illustrated as follows—
a. A single district hospital with
approximately 2,000 beds for 250,000
b. A single local health authority for
the practice of the medical officer of
health/principal school medical
officer being 250,000
c. A single general practitioner
practice being 2,500
Each hospital/local health authority catchment
area would thus have about one hundred family
doctors practising within its boundaries and if
health centre practice were favoured this would
require the local health authority to provide, on
present day formulae, some ten to twelve health
centres only one of which could be adjacent to the
local hospital. This particular centre could of
course be made larger, but this might be at the
expense of the patients in terms of travelling time
due to the greater distances involved between
home and centre. The siting and size of the
centres would also relate to the location and
sizes of the pockets of population and the
shopping centres. In this context the future
provision of health centres in the London
Borough of Hounslow is envisaged as follows—
a. Feltham
(Approx population 50,000) 3 health centres
b. Heston & Isleworth
(Approx population 108,000) 6 health centres
c. Brentford & Chiswick
(Approx population 50,000) 3 health centres
At the time of writing one is complete in each of
the three areas listed above and two more are at
the working drawing stage in Heston and
Isleworth.
Although the population of Hounslow is a
little short of a quarter-of-a-million, from a
practical point of view it has been found to be
ideal for the provision of all the local health
authority services on a personal basis (in liaison
with other social service departments) except
perhaps in relation to the proper provision for the
assessment, care and education of handicapped
children.
The practice of each medical officer of health/
principal school medical officer in a local health
authority serving a population of approximately
250,000 would include for instance—
a. School children
(5-15 years of age) Approx 40,000
b. Pre-school children
(0- 5 years of age) Approx 20,000
c. Physically handicapped children
requiring day special schooling Approx 35
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