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LONDON BOROUGH OF BRENT
Brent House,
High Road,
Wembley.
July, 1971
To the Mayor, Aldermen and Councillors of the Borough.
Mr. Mayor, Ladies and Gentlemen,
The second Green Paper on the health services was made available by the Government during
the year and for a large part of the period it was confidently expected that the suggestions put forward in
the Green Paper would be adopted and would represent a pattern for the personal health services of local
health authorities in the foreseeable future. However, the change of government completely altered this
picture and the concept of the area health board responsible for each of the three branches of the National
Health Service became very much less likely and certainly far more remote. It appeared, therefore, that in the
foreseeable future the personal services and the environmental activities of the health department must remain
local authority functions.
During the year, also, the Seebohm Committee Report was before Parliament and resulted in the
Local Authority Social Services Act, which produced a clear-cut line between medical services and social
services. Mental health, day nurseries, home helps and quite a number of other functions were to be removed
from the medical department and placed with the social services department. A division was necessarily
made and no matter where the line is drawn, this line must be fictitious, as the two are indivisible. However,
the Act clearly instructed local authorities to appoint a Director of Social Services and to transfer the
functions.
Needless to say, this division and this fragmentation of health including tha removal of functions under
the National Assistance Act from the Health Department has created a very substantial feeling of insecurity
amongst the members of the Health Department staff. Recruiting in all professional and technical categories
has become extremely difficult as the future is by no means clear. Many staff will be transferred to the Social
Services Department and opportunities in health will be substantially reduced. The Council appointed a
Director of Social Services in July, but in agreement with the Director, the Medical Officer of Health continued
to be responsible through his staff for the day to day running of social services, whereas the Director concerned
himself with forward planning. This agreement has meant that the clients did not suffer and despite
difficulties has functioned reasonably effectively.
Implicit in this arrangement was that the Annual Report should take the same form for this year
as it had done in previous years because the function of the services, despite committee changes, remained
substantially unchanged until the end of the year.
During the year the management report on Brent which was submitted late in 1969 was the subject
of discussion and decision by the Council, The effect of the report was to place members of the staff on their
mettle and insofar as it stimulated contemplation of function was of benefit to the Council's services though
considerable reorganisation and re-adjustment was necessary during the year under the management scheme
and the effects of this reflected substantially on the organisation of the Department towards the end of the
year under review.
The role of the medical administrator was examined by a National Working Party set up by the
Government called the Hunter Working Party which is at the present time reviewing the functions of the
medical administrators both in the health service and in the hospital and Executive Council services. What
the outcome of this investigation will be remains for the future but it is contained that the Health Department
requires as its head a medically trained manager just as a legally qualified person should be the Clerk
of the Peace or a financially trained director in charge of a financial corporation.
In the autumn the first health centre constructed in the Borough to bring together medical practice
and local authority services was opened at Chalkhill. This was the culmination of several years work and
planning and has resulted in a centre which is functionally more than adequate, in fact, it is one of the
better health centres which it has been my experience to visit. In the early stages of planning it was impossible
to obtain help from publications and difficult to obtain assistance from visits to existing health centres as
few were operative. However, the planning has resulted in a more than satisfactory health centre which with
the co-operation of the staff, the family doctors and the Executive Council is serving a large number of
residents in the Borough.
In conclusion, I express my gratitude to colleagues within the Department who have so conscientiously
helped to prepare the report and to the staff of other departments who have given advice and assistance.
My thanks are due also to the Mayor, the Chairman of the Health Committee and to all Members of the
Council for their continued support, guidance and advice during the year.
T am, Mr. Mayor, Ladies and Gentlemen,
Your obedient Servant,
E. GRUNDY,
Medical Officer of Health.