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In the section on Health Visiting are described some of the liaison arrangements
which have operated so successfully with the hospital service. There may well be
opportunities for further developments in this direction. Co-operation in the Chest Clinic
between the Chest Physician and the Council's staff of Tuberculosis Visitors is both close
and cordial; and later in the report an account is given of the working arrangements
between the hospitals and local authority in the field of mental health. Moves have also
been made towards an understanding in the rather more knotty problems of co-ordination
within the maternity services and in the control of Infectious diseases.
The principal means adopted for co-ordination between the health services and general
practitioners was the establishment of an unofficial professional "Liaison Committee",
consisting of representatives of the Local Medical Committee, Senior Medical Officers of
the Local Authority Health Services and, more recently, also representatives of the local
hospital group Medical Advisory Council. Meeting approximately bi-monthly, as business
requires, It has already enabled understanding to be reached on a number of difficult
administrative problems such as the method of reference of children to specialists, medical
certification of school children, and others of more local moment. Of perhaps even greater
importance, it has done much to build up mutual confidence between the doctors in the
various services represented. It is hoped moreover, that in this way the ground will be
prepared on which liaison between health visitor and general practitioner may come to
flourish as it has done within the hospital services.
Information to General Practitioners and the Public.
A section on the local health services is Included in the West Ham Official Guide,
and a separate Health Services Handbook is in course of preparation.
At the commencement of the National Health Service a short memorandum of guidance
was circulated to local practitioners and further informative circulars are sent out as
circumstances require. We are indebted to the Clerk to the Executive Council for making
his normal weekly circulation arrangements available for this purpose when appropriate.
Joint Use of Staff.
The services of the Chest Physician and Assistant Chest Physician are available to
the local authority to the extent of three elevenths of their time. It is hoped that
regular meetings between these officers and senior officers of the Health Department will
ensure that their specialised knowledge Is used to the fullest advantage in the fields of
preventive and social medicine for which the local authority is responsible.
An earlier proposal for the joint use of a mental health medical officer between
Hospital, School Health and Local Health Services did not prove practicable but the need
has to some extent been met by the services of Psychiatrists provided by the Regional
Hospital Board. The question of a mental health officer will require review at some
future date in the light of experience. Doctors in general practice are not employed in the Local Authority Health Services
at present but they do, of course, participate in the vaccination and immunisation scheme
in their own surgeries.
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