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14
An application was received from King's College Hospital for a room to be adapted in the home of
a man aged 55 years suffering from renal failure. The Council approved the adaptation, and the necessary
work was carried out at a cost of £378. As the patient was receiving Social Security Benefit, he was not
required to contribute towards the cost. Another application was received from the Home Dialysis Unit of
the Charing Cross Group of Hospitals in respect of a woman aged 45 years. The Council at their meeting in
November decided to take no action in this case, but following representations and further medical
evidence from the Hospital it was agreed that the adaptation should be carried out. The estimated cost of
the work is £335 and it will be commenced in January 1970.
HOME HELP SERVICE
There were 1,053 applications for the service in 1969, and the number of cases receiving help at the
end of the year increased from 1,160 to 1,201. Two tuberculosis cases were helped, and help was provided
free to one mother suffering from toxaemia of pregnancy. Seventy-three bookings were taken for home confinements
but only 40 of these were helped, the remainder making other arrangements.
The maximum charge to the public remained at 6/9d. per hour, but this charge was under review
at the end of the year. The rate of pay of Helpers was increased from 5/9⅝fd. per hour to 6/4fd. per hour
from 29th September, and this probably helped recruitment as the establishment of 95 full-time equivalent
Home Helps was reached at the end of the year. An average full-time equivalent of 90.5 was maintained
throughout the year. Ten persons were employed as Neighbourly Helps.
The Organisers made a total of 6,121 home visits.
LOAN OF NURSING EQUIPMENT
The Middlesex Branch of the British Red Cross Society through its Divisions at Willesden and
Wembley continues to operate the loan of nursing equipment scheme on behalf of the Council.
Under these arrangements a hire charge is collected from the patient 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 1969, 2,421 articles were loaned to
patients and hire charges amounting to £1,053 17s. 6d. were paid by the Council to the Society. The Council
arranges transport for the collection and delivery of bulky articles.
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 13—16)
Mortality and Morbidity
Five men died from respiratory tuberculosis, but there were no deaths among women. This is an
improvement compared with last year when nine men and two women died from the disease. There was one
death in the age group 35-44 years, two in the group 45-54 years, one in the group 55-64 years and one in
the aged 75 and over group. Three of the men were previously unknown to the health authorities. This indicates
that there is still a reservoir of infection among older people in the community which holds special
hazards for the young and unprotected. In view of this "hard core" of tuberculous infection, B.C.G. vaccination
is an important preventive measure offered to all school leavers to raise their resistance to the disease.
(For details of B.C.G. vaccination of school leavers see Report of Principal School Medical Officer, page 61).
Care and After Care
The same provisions for the care and after care of patients, as have obtained in previous years,
continued with Willesden Chest Clinic, Pound Lane as the focal point of the chest services, although a small
number of Brent patients are also treated at Harrow and Edgware Chest Clinics. The Regional Hospital Board
employs the Physician-in-Charge at Willesden Clinic. As a consultant in chest diseases, he is primarily clinically
engaged with diagnosis and treatment, but he is also vitally concerned with prevention and after care. For
this reason, the Physician has general responsibility for this Authority's measures for ensuring the after care
of patients and this arrangement has stood the test of time well. To the same ends, the arrangements also
provide for the Physician-in-Charge to have direct control of Council staff at the Clinic who are involved with
the after care of patients.
Occupational Therapy
The services of a full-time occupational therapist have in recent years been shared with the London
Boroughs of Ealing and Hounslow. As these two Authorities have indicated that they are now able to make
their own arrangements for this work to be done, the sharing arrangements have been terminated. The services
of the occupational therapist are now fully utilised by this Department but in the main in the Welfare Division.
The practice has evolved of having chest patients registered as physically handicapped so that their therapy
needs are met as part of the general caseload, both as regards guidance and training in handcrafts at home as
well as placement, where suitable, in sheltered work centres.
Vaccination against Tuberculosis
B.C.G. vaccination is provided for persons who are tuberculosis contacts, school children aged 13
years and over as well as students attending Universities, Teacher Training Colleges and other further educational
establishments.