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doubt as to some condition mentioned in the questionnaire, the applicant's
Q.P. or the treating Consultant is asked for a confidential report. If there
is any doubt as to whether the applicant would be suitable for the position
because of medical reasons the person has an interview with the Principal
Medical Officer concerned. This happened twice in 1973.
Cases of long term illness, sick absence, and accident are assessed by
a Principal Medical Officer. This can be very time consuming because it is
important in order that the correct assessment can be made, that the fullest
details be obtained. The final assessment is thus based on medical reports
from the employee's G.P. and/or from the treating Cbnsultant, and a sociomedical
interview in depth. The number of such assessments were 138, of
these 102 were for long term illness and 16 accident cases. The setting up
of the Administration Sub-committee dealing with high absenteeisms because
of illness was welcome although it has increased the number of difficult
cases to be assessed; during 1973 20 such cases were dealt with. Provision
is made for recommending employees found permanently unfit to carry out their
normal duties to be offered employment in certain designated light duty
posts, which they are considered capable of occupying. It would be an
advantage for many employees returning to work after a long term illness
to be allowed to work part time for a period before taking up full-time
employment, but this has not yet been possible.
During the year 30 heavy goods vehicle drivers were examined in
accordance with the Traffic Legislation.
There were 117 sessions held in 1973.
HEALTH VISITING
Recruitment throughout the year was well below the replacement level
and it was impossible to maintain the establishment. This was very largely
due to the lack of adequate housing within the borough and the expense, and
difficulty of travelling to and from the Borough.
Shortages of staff meant that individual case loads rose to between
600 and 700. Hitherto the main responsibilities had been for expectant and
nursing mothers, and children under five years of age, but responsibilities
have widened to include all health risk groups.
Throughout the year health visitors have carried out their liaising
functions with the psychiatric, maternity, geriatric and general maternity
units at Hackney Hospital and Queen Elizabeth Hospital for Children. One
health visitor attends the Child Health Clinic at the Mothers' Hospital once
a week.
The position with regard to district nursing is similar to that of health
visiting. The case loads are very heavy and are mainly for the elderly.
Arrangements are in progress to decentralise the service and it is hoped
to complete this by January 1st, 1974. It is thought that this should assist
with the development of the primary care teams.