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PREFACE
0.1 To present an Annual Report is the statutory duty of every Medical Officer of
Health. In the early years of public health I have no doubt that this was designed as a
means of enlightening and even exerting pressure on the Council which he served, and
this is borne out by studying reports of early Medical Officers of Health such as those of
Sir John Simon, the Medical Officer of Health of the City of London from 1848 to 1855,
and perhaps the greatest of them all.
0.2 But whilst many health problems remain, they probably do not require to be so
frequently high-lighted in a much more widely enlightened community. There are colleagues
who retain the same fabric of their reports, merely altering perhaps the figures in
the statistical tables. There are others who find the time and the subject matter to produce
an entirely newly structured report every year. And there are those, like myself,
who seem to fall constantly behind and find it easier to do things than to write them up.
0.3 Because of this dilemma we have joined the two reports for 1967 and 1968 into
one. But as a quid pro quo I decided to follow on this occasion the example of my old
chief and teacher, Sir Allen Daley who as Medical Officer of Health of the London County
Council selected a special theme each year and produced a feature on it in his Annual
Report.
0.4 I have chosen Planning, but hasten to add that this does not refer to the recently
developed and nowadays so popular "strategic planning" within an authority, but merely
to the story of eleven major projects in the department, two of them abortive. I have not
included here the many, many more inspections of sites and of buildings which could
have met some of our needs, nor the many alterations, adaptations and minor works.
0.5 We found, very early on in our planning in the new Borough, that my colleague
Sidney Cook, the Borough Architect, and his team were only too anxious to familiarise
themselves thoroughly with the functional needs of each of our projects. In the body of
the Report we describe how his representatives attended every one of our meetings-usually
over bread, cheese and beer — with the general practitioners who would be joint occupiers
with ourselves of a Health Centre, and our often quite heated arguments helped the
architects to understand the problems and to resolve them in architectural terms. Similarly,
Mr Michael Sanderson, who was responsible for the conversion of the Konstam Nursery
and Mr Mark Robertson who planned the new Regents Park Nursery, must by now know
more about the detailed running of a day nursery than 1. The same co-operation — though
naturally not requiring so much time —was shown by Dr Bruno Schlaffenberg, the Planning
Officer, and his team, the Town Clerk and his Department, and the Borough Treasurer.
0.6 We have learnt a good deal — for instance that, however tempting it may be
to include a health centre or clinic in a block of flats, the complications outweigh the
advantages. Thus, two central government departments are involved, and there is the
structural rigidity of the building which cannot be easily adapted to the, alas, not infrequent
changes of mind of general practitioners and of national health service authorities
outwith the Council's control. Lastly, we have found that informal consultation at a very
early stage with our colleagues in the Department of Health and Social Security has been
most helpful and productive, especially when our plans were not entirely orthodox — and
that happens sometimes in Camden. I cannot close this section of my preface without a
special word of thanks (to be enlarged in the section on planning) to my colleague and
friend, Dr R. Duncan Dewar. I consider it essential that one senior officer in the Department
must make planning his prime responsibility. I asked Duncan Dewar to take this on, and
from that moment had none of the problems, but solely the pleasure of nominal responsibility
for a job superbly done by him.
0.7 The remainder of the report — largely written, of course, by my colleagues who
are responsible for individual services — follows the pattern of the 1965 and 1966 reports.
But such division may unwittingly give an impression of separateness, and this would be
wrong. Communication within the department and beyond it has been a major priority.
0.8 Every Tuesday at 10 a.m. my senior colleagues meet me. We have no agenda,
nor any executive function. But everyone present is encouraged to raise matters of common
interest and to exchange views. For me this is a most useful sounding board, and we can
discuss in confidence what we find difficult to put in writing.
0.9 Another useful expedient is the "Float" file. Every senior officer is asked to
provide a spare copy for this file of any letter or memorandum he initiates and considers
of general interest. Nobody is expected to read the Float file, for everybody who is
expected to act will get his own copy. But nobody can say "I didn't know about this"
if it was put on the Float file — and people who initiate policy documents and forget the
Float copy are not very popular with the management!
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