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satisfaction rate of people falls below a certain
point this seems to correspond to the onset of
social or emotional breakdown. It is also
significant that when frustrations override
satisfactions in the five main areas of life (work,
finance, family relationship, friendship and the
more personal area), there is then danger, both
with young and old, of finding unsatisfactory
compensations.
Such compensations may be any of the
following—promiscuous sexual behaviour,
drug addiction, smoking, alcoholism, crime,
delinquency, etc. It is now thought likely that by
assessing people's satisfactions and frustrations
at an early stage such unhealthy patterns can be
prevented from developing. Satisfied people,
whether young or old, do not need abnormal
stimuli.
The implications of this research for health
education are only too obvious. They can be
enumerated as follows—
1. Teachers, health visitors, social workers and
general practitioners can be trained to identify,
on a scientific basis, people's satisfactions and
frustrations at an early stage either before
breakdown occurs or resorting to unhealthy
stimuli.
2. Through group discussions (small groups of
eight to ten people), people can be taught the
need for self-fulfilment in the five main areas of
their lives. Such group discussions could be used
to instruct on the consequences of heavy drinking,
drug addiction, smoking and other forms of
abnormal satisfactions which undermine health.
3. Through the use of a screening device which
ascertains people's problems in the community,
and by using the community's resources such as
social clubs, educational facilities, etc, people can
be helped to function more effectively in society
and thus avoid the danger of breakdown.
4. Methods and techniques can be developed to
help individuals and their families to realise and
utilise their potentials more fully; such techniques
can be shared with social workers, clergy, health
visitors and others.
5. The possible recognition, through scientific
methodology, of abnormal patterns may lead to
the early identification of stress conditions which
may contribute to blood pressure, gastric
conditions, coronary thrombosis, etc.
Through this work we are now beginning to
discover new methods of health education and we
hope in time to be able to develop more effective
ways of influencing people's attitudes to health
problems.
We are also now beginning to explore the
relationship between institutional life, such as in
hospitals, Homes and hostels and it's effect upon
people's satisfaction whilst within such settings,
and thus we may be able to make recommendations
as to the necessary changes which might
enable an individual in such a setting to gain the
maximum satisfaction and benefit from his stay.
Cervical Cytology
The memorandum on population screening for
carcinoma of the cervix was received in October
1966 with circular 18/66 which conveyed the
Minister of Health's approval under Section 28 of
the National Health Service Act 1946 to all local
health authorities to make arrangements for
obtaining cervical smears for cytological
investigation by hospital laboratories. Approval
had already been given in March 1966 to this
council for the institution of these arrangements.
The department has co-operated closely with
Ashford and West Middlesex Hospitals and with
the family doctors in the development of this
service.
The scheme was put into operation at the end
of August when the hospitals could accept only
30 smears a week from this department. We were
therefore able to start only on a limited scale
and publicity was avoided as the demand might
otherwise cause a breakdown in the service. A
letter was sent to all family doctors in the
borough explaining the position. They were
informed of the times of the clinics and were
offered the service for their patients. Women
could also apply direct to the clinic for an
appointment. The smears were taken at the close
of ante-natal sessions as this was economical
in terms of clinic staff.
Although the Ministry of Health's directive is
that women of age 35 and over should have a
smear every five years, women over the age of 25
who presented themselves were accepted.
In this borough cervical cytology is part of a
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