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9
in every future such development. At Heathcote we are planning a geriatric
clinic, at first to examine medically all the 65 year-olds of ten practices, the
clinicians to be G.Ps. from those practices working on a rota basis. In the
autumn the Redbridge B.M.A. branch is associating itself with the borough
council in initiating a cancer education campaign. We are daily in contact by
telephone with individual G.Ps. on problems of medical priority for rehousing
and staff sickness, as we do not find the formal certificate, often given under
pressure, of much value. Finally, we meet socially in the local B.M.A.and
Ilford Medical Society, where several members of the Health Department have
taken a most prominent part in conducting affairs.
In the hospital sphere, mutual arrangements are most evident in the
psychiatric field. Here we have the sessional use of psychiatrists from the two
mental hospitals in the borough, joint employment of psychiatric social workers,
and maybe soon a joint integrated social work department with Goodmayes
Hospital. Mental Welfare Officers are attached to "psychiatric firms" in those
hospitals, attend case conferences and in fact one of the hospitals is their
emergency base whence they are called outside office hours, thus ensuring
that psychiatrists are in the picture. The M.W.Os. run a club for ex-patients
and a psychiatrist is arranging an evening therapy group in one of our clinics.
All essential features of our plans for occupational centres and hostels for
the mentally ill are discussed with psychiatrists, including the physician
superintendent of one of the hospitals, who also advises on local authority
appointments in the mental health sphere. These hospitals also give in-service
training to our health visitors.
In midwifery we staff medically and with health visitors ante-natal clinics
for hospital confinements, health visitors visit mothers in the Maternity Hospital
before their discharge and naturally we assess social priorities for hospital
confinements and conduct Part II training for pupil midwives. It would help
considerably in integration if our midwives could conduct deliveries in the
Maternity Hospital, but an unwise legal provision makes this difficult.
In geriatrics the advice of the geriatrician is freely given, welcomed, and
often spontaneously forthcoming, although there is no formal joint appointment.
He is a prominent member of the Old People's Welfare Committee, of which the
M.O.H. is Chairman. Until recently all those about to be discharged from the
geriatric wards were visited by a local authority social worker, now it is by a
health visitor, and in the future it is likely to be a jointly employed medical
social worker. At the opposite end of the age scale it is to be regretted that
there is not a closer relationship with the paediatric department; here there has
been a step back, for the consultant paediatrician at the local hospital was
once, many years ago, paediatric consultant to the Borough of Ilford, but the
associated appointment lapsed. However, our health visitors routinely attend
his out-patient sessions. With the consultant pathologist, discussions have