View report page

18
Care and After Care
As in previous years, the same provisions for the care and after care of patients continued with
the 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 North-West Metropolitan 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 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. 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 practice has evolved of having chest patients who need occupational therapy being registered as
physically handicapped with the Social Services Department. Their therapy needs are then met by occupational
therapists in that Department as part of their general case load, both as regards guidance and training in
handicrafts 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
klucational establishments (for details of B.C.G. vaccination of school leavers see Report of Principal School
Medical Officer, page 47).
Home Visiting
At the end of the year 4 tuberculosis visitors were employed. Although their prime function is visiting
patients' homes to advise on methods to overcome the spread of infection, to explain care and after care
facilities, and to closely supervise all known contacts, they also have duties at the Chest Clinic, including acting
as Clinic Sister during diagnosis and treatment sessions. Home visits during the year totalled 1,103 of which
241 were to households proving to be non-tuberculous.
VENEREAL DISEASE
(Table 14)
The Venereal Disease Service was established in this country in 1916. Since then clinics staffed by
Specialists in venereology have been attached to the out-patient departments of most large general hospitals
in the United Kingdom. These clinics exist to advise and help patients and to control the spread of disease
by investigation of all cases in which genital infection is suspected, by prompt treatment of patients and
infected contacts, and by follow up, to establish that treatment has been successful.
The clinics now deal with all the conditions transmitted by sexual intercourse and with some other
non-transmissible conditions of the genitalia so that patients who attend are no longer clearly stigmatised as
"V.D. patients".
The majority of Brent patients attend either Central Middlesex Hospital or St. Mary's Hospital,
Harrow Road, but in order to be treated in complete anonymity some Brent patients do prefer to attend clinics
further afield. Conversely patients from many other Boroughs have attended the Special Clinic at Central
Middlesex Hospital.
Advice, treatment and indeed, attendance at the Clinics is entirely confidential. Details are not divulged
even to husband or wife without the written consent of the patient. The patient may attend without appointment
or doctor's letter. He does not have to give his name if he does not wish (although he is encouraged
to do so to aid in the procedure of follow-up). At the clinic he is referred to by number only. No charge
is made for drugs prescribed in venereal disease clinics. Rather than being forced to present prescriptions at
chemists or at the hospital pharmacy, patients are given their treatment at the clinic itself in order to avoid
any embarrassment and to ensure that they are in fact receiving the necessary treatment.
The Special Services Social Worker, who until April, 1971 was employed jointly by Brent and the
London Borough of Harrow, resigned in November 1971. It was decided to implement the recommendation
of the Department of Health and Social Security and to appoint a contact tracer to liaise with the Special
Clinic at Central Middlesex Hospital. It was arranged that this appointment would be made as early as
possible in 1972. The tracing of contacts is of the utmost importance in preventing the spread of V.D.
The increase in the incidence of V.D., particularly gonorrhoea, can be attributed to the popularity
of oral contraceptives and increasing nromiscnitv among younger people. People are coming forward in grov/ing
numbers for treatment, the main problem is lack of education amongst the young, many of whom have very
little knowledge of such details as signs and symptoms of gonorrhoea or syphilis. Health Education must,
therefore, be increased in schools and colleges and in the mass media.
V.D. was one of the subjects selected by the Department for display at the "Welcome to Citizenship"
held at the Town Hall in April. Considerable interest was shown by many of the young people who
attended and the staff who were present answered a number of questions. Talks on the subject were also
combined with sex education in some schools.