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Much has been written and said in recent times in favour of the family doctor
taking over from local authorities all routine ante and post-natal care of mothers and
supervision of the health of infants and pre-school children. While this seems
logical in a fully integrated national health service it surely implies not only an
adequacy of doctors in general practice; but the existence of more group practice
premises or better still the provision of properly equipped and staffed Health Centres
where the family doctor may be assisted by health visitor, home nurse, midwife or other
members of a health team.
The changing pattern of the school health service becomes increasingly apparent.
With physical minor ailments in childhood less frequent, more emphasis is placed on the
early detection and treatment of emotional difficulties. The consultant child
psychiatrist, as leader of the child guidance team, yearly takes on more new cases and
by particular skills is able to help in preventing breakdowns in later life. Medical
officers and health visitors are becoming increasingly orientated towards early detection
of emotional and behaviour disorders. Also the school medical officer and health
visitor are required to-day to be more highly trained in early ascertainment of the
handicapped child, with special emphasis on the "at risk" group. Congenital abnomalities
as a cause of early death or later disability increase in relative importance. It
was said in 1962 that "one in every thousand children surviving the neo-natal period
will need special care, treatment and parental guidance for a severe handicapping
condition" (Dr. Mary Sheridan). Tottenham Education Committee was an early pioneer
in establishing special schools for education and treatment of the handicapped child
and recognises the need for reappraisal from time to time of what is being done or
should be done in the light of medical and scientific progress.
Before concluding this introductory letter I wish to record the loss to the health
department during the year of Dr. Wright, my deputy, who was a much esteemed colleague;
and left this country to marry and take up an appointment in Sydney, Australia. We
welcome Dr. Tranter to the department as his successor.
I wish to acknowledge and commend to the notice of the Council the hard and
unobtrusive work of the public health inspectors, medical, nursing, clerical and other
staff of the Health Department.
Also to express my sincere gratitude to the Chairman (Alderman R.H. Warren), the
Vice-Chairman (Councillor Mrs. Haynes) and members of the Health and Housing Conmittee
for their constant encouragement and support.
I have the honour to be
Your obedient servant
G. HAMILTON HOGBEN
Medical Officer of Health.
August, 1964.