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authority and family doctor representatives on the Hospital Management Committee
and its Medical Advisory body, G.P. co-option to the local health
committee, local authority and hospital representatives on the Executive
Council and M.Os.H. on the Local Medical Committee. Non-statutory liaison
groups are flourishing; perhaps the most effective is that organised by the
North East London Regional Hospital Board to bring together M.Os.H., Senior
M.Os. of the Ministry of Health, and their own senior staff. Analogous are the
Geriatric liaison groups for each area, again M.Os.H., geriatricians and other
R.H.B. staff, and Chief Welfare Officers. The North East London Executive
Council has formed a liaison Committee with the Local Health Authorities
of its area. Then there are the well-established Maternity Liaison Committees,
with doctors of all three sections of the profession, plus nursing staff, on their
membership. On the psychiatric side there is a group of M.Os.H., psychiatrists
and their own staff, organised by the R.H.B., dealing mainly with the problems
of the fieverely subnormal.
At these levels are discussed matters of policy, such as the Ten Year
Development Plan of the Hospital Service, and the analogous plan of the Health
and Welfare Services. But it is at the "grass-roots" that co-operation is most
important, and communications are fundamental. Locally the Health and Welfare
Department has initiated the "Redbridge Medical Journal" issued monthly,
where, in addition to the publication of departmental matters of interest, hospital
doctors, general practitioners and outside authorities largely contribute, and
inter-professional correspondence and discussions have a permanent part. The
Executive Council is about to issue an information booklet for this area, for issue
to the public. Tentative agreement has been reached that next time we might
publish a joint venture, as the Health and Welfare Department has had its own
under consideration, to follow on one that was issued by the Ilford Public
Health Department.
It has become almost a platitude to state that the relationships between
the Health Department and the family doctors have greatly improved since 1948.
Here are some of our points of contact. Besides employing G.Ps. in the school
health service, infant welfare centres, first-aid training, etc., two infant welfare
centres have been, for many years, set apart entirely for G.Ps. to run, on a
rota basis of six months at a time, to familiarise them with the procedures in
case they should wish to run such clinics on their own premises. One large
partnership conducts its ante-natal work in our clinic. Health visitors, midwives
and district nurses are attached to practices on, so far, a small scale. For
logistic reasons any great expansion is difficult, but we endeavour to meet all
requests, bearing in mind that the work of district nurses and midwives is
entirely within the ambit of the family doctor, whereas the health visitor has
other interests as well. There has recently been a dramatic change of attitude
with respect to working in comprehensive health centres, consultations are
proceeding with local G.Ps. with respect to their working in the health centre
projected in Goodmayes Lane, and without doubt they will have to be consulted