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14
HOME HELP SERVICE
There were 1,005 applications for the Service in 1966. The number of cases receiving help at the
end of the year increased from 906 to 1,006.
Three tuberculous cases were helped, and help was provided free to four mothers suffering from
toxaemia of pregnancy. One hundred and forty-five bookings were taken for home confinements, but only
94 were helped, including fifteen 48-hour discharge cases in which help was provided free. The remainder
made other arrangements.
In December, the Minister of Health approved the Council's proposals to permit the Home Help
Service to be available to families in social need and without a medical certificate.
As an aid to recruitment, the Council decided in March to increase the rate of pay of Home Helps
from 5/l 3/4d. per hour (the rate agreed by the Greater London Joint Council) to 5/6d. per hour. The Joint
Council was informed of the Council's decision and the reason. Since this time the establishment of 90
full-time equivalent Home Helps was attained and has been maintained for the first time for many years.
The charge to the public remains at 4/9d. per hour.
Seven persons were employed as Neighbourly Helps, but only one was still working at the end of
the year.
The Organisers made a total of 5,742 visits.
LOAN OF NURSING EQUIPMENT
The Middlesex Branch of the British Red Cross Society continues to operate the Joan of nursing
equipment scheme on behalf of the Council.
Under these arrangements a hire charge is collected from the patients by the British Red Cross
Society and retained by the Society to enable it to purchase replacement equipment as required. If the
patient is unable to meet the hire charge it is paid by the Council. During 1966, 2,557 articles were loaned
to patients. Transport required for the collection and delivery of bulky articles is provided by the Council.
During the year the Council paid to the British Red Cross Society £573.1.5d. in respect of patients'
hire charges.
In general, the scheme is intended to facilitate simple, short-term nursing care in the patient's
home. Certain items of catheterisation equipment may be provided as a personal issue to paraplegic patients
to enable them to care for themselves in their own homes. Other items of equipment may be purchased in
special cases.
TUBERCULOSIS (Tables 14, 15, 16 and 17)
Mortality and Morbidity.
There were four deaths from pulmonary tuberculosis among men and one among women, all in the
older age group. The death rate was 2 per 100,000 population, the same as last year.
Two of the deaths occurred in an elderly man and a middle-aged woman previously unknown to
the health authorities. This indicates that in spite of the improvements in case finding methods, there is still
a reservoir of infection in the community, which holds special hazards for the young and unprotected. In
view of this 'hard core' of tuberculosis infection, B.C.G. vaccination is an important preventive measure
offered to all school leavers to raise their resistance to the disease. This is very necessary during adolescence
when the risk of infection is higher and many new stresses have to be faced (for details of B.C.G. vaccination
of school leavers see Report of Principal School Medical Officer, page 65).
Care and After Care.
The arrangements providing for the care and after care of persons suffering from tuberculosis have
continued throughout the year.
The chest clinic with the physician-in-charge is the focal point. The physician is employed by the
Regional Hospital Board and is a consultant in diseases of the chest. Although primarily a clinician concerned
with diagnosis and treatment, he is fully aware that the prevention of the disease on the one hand
and the after care of the patients on the other cannot be divorced from treatment. For this reason the
physician at the chest clinic is responsible for the general supervision of the local authority's scheme to
promote the after-care of patients. Experience has shown that this arrangement works smoothly and is effective.
To promote this, the staff of the local authority employed at the chest clinic come under the direct
control of the physician for the day-to-day administration of all routine duties relating to the management
and after-care of patients.
Home Visiting.
There were four tuberculosis visitors on the staff at the end of the year. In addition to home visiting,
they undertake duties at the chest clinic and act as clinic sisters at diagnostic and treatment sessions. During
the year they made 1,173 visits to patients' homes. The tuberculosis visitors advise on the prevention of
the spread of infection, on arrangements for care and after care, and keep all known contacts under close
supervision.
Included in the above figure of 1,173 visits, are those made to non-tuberculosis households, when
191 such visits were made.