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Personal health services in Westminster
PUBLIC HEALTH, July, 1948
185
The Department of Public H e a l t h has made one investigation on its own account to decide whether the new D . P . H . curriculum was meeting the requirements of students. The investigation aimed at covering the careers taken up by all past members of the D . P . H . classes at the London School except for the first course in 1929-30, for which the information was incomplete. The careers of past students h a v e been divided into classes:--(1) public health service in the U . K . ; (2) Colonial or other medical service abroad; (3) hospital service, consultant or general practice and p e r m a n e n t service in the Forces; and (4) academic research, laboratory and industrial medical fields. As was to be expected the majority of the students of the 1930's h a v e made their careers in the public health service at home and of a total of 342 students of the period 1930-39, 125 h a v e m a d e their careers in public health proper (another 87 were I n d i a n or foreign students). Of the 146 D . P . H . students at the School since the war the largest group of 41 h a v e again entered the public health service at home and the other largest sections are 24 who went into academic, research and industrial medicine, 23 of w h o m there is no in formation, and 25 who did not complete the D . P . H . We hope that this record will be continued in future annum reports as an indication of the extent to which public health attracts medical graduates and of the valuation of t h e D . P . H . as a qualification for other forms of medical work.
Child Health Services in the Oxford Re#on, The Berks, Bucks .and Oxon Regional Hospital Council set up under tile Nuffield Provincial Hospitals Trust* has long been known for its first-class reports on the hospital and health services of the area. T h e latest report is b y a Child H e a l t h Services Committee under the chairmanship of Prof. Moncrieff and with a strong membership from both the clinical and preventive sides of medicine. The Committee has produced a docmnent which will be of immense value in planning a co-ordinated child health service to the Oxford Regional Hospital Board and the Local H e a l t h Authorities situated within its area, i . e . , most of Berkshire and Buckinghamshire, the whole of Northamptonshire and Oxfordshire, part of Glmicestershire and WiItshire, and the three county boroughs of Northampton, Oxford and Re~ding. P a r t I discusses the causes of death and sickness in chil& hood with special reference to Oxford City and County. P a r t I I proceeds to the care of children under five and gets down to .detailed requirements of medical and nursing personnel and domiciliary care for the Region. P a r t I I I discusses the school health service and recommends in place of the three routine examinations of each child during school life one complete and thorough examination of each child at some period during the school career, together possibly with mass radiography, with, in addilion, fairly frequent surveys of children picked up b y doctors and teachers and more height aiad weight measurements at, say, half-yearly intervals. Particular attention is paid to school eye and ear, nose and throat services. P a r t IV deals with the .orthopaedic and accident prevention service; P a r t V with childhood tuberculosis, and P a r t VI with co-ordination between hospitals, medical officers of health, school medical officers and general practitioners. The report suggests t h a t the staff of the key hospital of each area should incl~d,e tinder the paediatrician properly qualified and experienced medical officers of registrar status who would spend perhaps one-third of their time in the hospital, and for the remainder of their thne work under the direction of the paediatrician in co-ordinating t h e clinical work of the local Health and E d u c a t i b n Authorities with that of the hospital. The only ,difficulty expected is to provide these officers with enough worthwhile hospital work, but it is thought that if the children's beds in infectious disease hospitals are brought into the general paediatric scheme tl~s difficulty would be solved. Apart from these Senior Assistants the report suggests that whole-time medical officers of public health or school health services should h a v e clinical assistantships in the hospitals. Several other methods of usetul co-operation are suggested and interested general practitioners are also * 12-I 3, Meeklenburgh Square, London,
W.C.I.
recommended for clinical assistantships so as to ensure that each district should h a v e a sufficient n u m b e r of doctors interested and skilled in child health and disease. P a r t V I I estimates the n u m b e r of children's hospital beds needed in the Region, and P a r t V I I I goes into detail regarding mental health questions and the needs of the local service. T h e Oxford Regional Board and the health authorities concerned are fortunate to have provided for t h e m such a comprehensive dossier of information and suggestions for the development of a co-ordinated service.
Personal Health Services in Westminster As a farewell gesture before the appointed day, Dr. Andrew Shinnie, Medical Officer of H e a l t h for the City of Westminster, has written an ontline history entitled " The Personal Health Services of the Westminster City Council, 1903-1948." The Public H e a l t h and M. & C.W. Committees of the City Council welcomed his suggestion that this record should be printed as a memento of the excellent services developed in Westminster and now about to pass over to the London County Council and the Regional Hospital Board. No one could have been better qualified to produce this short history t h a n Dr. Shinnie who has 32 years' association with Westminster in which h e served as deputy to the late Dr. F. J. Allan before succeeding him as M.O.H. Westminster had promoted measures for the welfare of mothers and children long before the Act of 1918 and its anti-tuberculosis work was well in advance of compulsory notification and sanatorium provision. H o m e visiting in fact was pioneered in Westnfinster. Nineteen h u n d r e d and three was chosen as the beginning of this record because it was the founding of the Westnlinster H e a l t h Society, on whose voluntary effort the whole of the City's subsequent M. & C.W. services were built and which is still acting in one part of the City as an agent for the Council. The City Council from the first actively supported the Infants' Hospital opened in Vincent Square in 1907, and Dr. Allan and Dr. Shinnie h a v e both been members of the governing body. Dr. Shinnie looks back to memories as a house physician of the dark days when infantile diarrhoea brought the infantile death rate from 105 per 1,000 in 1910 up to 129 in 1911. I t was conditions like these which had led to the institution of the Westminster H e a l t h Society at the instigation of Dr. Allan by Mr. Richard Saunderson and other University Settlement workers. The work of child welfare soon attracted t h e practical help of the honorary staff of Charing Cross Hospital, a m o n g w h o m Dr. T. ,Watts E d e n played such a notable part. U p to 1918 the Westminster H e a l t h Society were largely responsible for m a t e r n i t y and child welfare throughout the whole City and after t h a t year it gave place to the Council's own organisation in the southern district and continued in the St. Margaret's and St. J o h n ' s areas and the northern district. Their reputation was such that they were consulted b y the central deparmeats as a b o d y whose experience was worth tapping in considering new methods in the maternity a n d child welfare service. Voluntary notification of tuberculosis also began in Westminster in 1903. This implied visiting of patients and educational work, which was another of the objects of the Westminster H e a l t h Society. A b o u t the same time the City pro•vided four sanatorium beds. The City's first tuberculosis visitor was appointed in 1910 and the E b u r y Bridge dispensary dates f r o m 1916. Dr. Shinnie's record mentions also the beginnings of antenatal consultations and the day nursery m o v e m e n t in Westminster. Generally speaking, the premises provided b y the Westminster City Council and its v o l u n t a r y collaborators have been as good as anything seen in L o n d o n and will give the L o n d o n County Council a flying dtart in p r o v i d i n g the divisional services for Westminster's population, which it may be forgotten covers m a n y social grades from Soho to Belgravia. The City Council and it officers m a y well feel proud of the record of these 45 years, arid we are glad to mention Dr. Shinnie's lit.tle book at some length as a typical tribute to the borough and voluntary services which now go o v e r to new management.
185
The Department of Public H e a l t h has made one investigation on its own account to decide whether the new D . P . H . curriculum was meeting the requirements of students. The investigation aimed at covering the careers taken up by all past members of the D . P . H . classes at the London School except for the first course in 1929-30, for which the information was incomplete. The careers of past students h a v e been divided into classes:--(1) public health service in the U . K . ; (2) Colonial or other medical service abroad; (3) hospital service, consultant or general practice and p e r m a n e n t service in the Forces; and (4) academic research, laboratory and industrial medical fields. As was to be expected the majority of the students of the 1930's h a v e made their careers in the public health service at home and of a total of 342 students of the period 1930-39, 125 h a v e m a d e their careers in public health proper (another 87 were I n d i a n or foreign students). Of the 146 D . P . H . students at the School since the war the largest group of 41 h a v e again entered the public health service at home and the other largest sections are 24 who went into academic, research and industrial medicine, 23 of w h o m there is no in formation, and 25 who did not complete the D . P . H . We hope that this record will be continued in future annum reports as an indication of the extent to which public health attracts medical graduates and of the valuation of t h e D . P . H . as a qualification for other forms of medical work.
Child Health Services in the Oxford Re#on, The Berks, Bucks .and Oxon Regional Hospital Council set up under tile Nuffield Provincial Hospitals Trust* has long been known for its first-class reports on the hospital and health services of the area. T h e latest report is b y a Child H e a l t h Services Committee under the chairmanship of Prof. Moncrieff and with a strong membership from both the clinical and preventive sides of medicine. The Committee has produced a docmnent which will be of immense value in planning a co-ordinated child health service to the Oxford Regional Hospital Board and the Local H e a l t h Authorities situated within its area, i . e . , most of Berkshire and Buckinghamshire, the whole of Northamptonshire and Oxfordshire, part of Glmicestershire and WiItshire, and the three county boroughs of Northampton, Oxford and Re~ding. P a r t I discusses the causes of death and sickness in chil& hood with special reference to Oxford City and County. P a r t I I proceeds to the care of children under five and gets down to .detailed requirements of medical and nursing personnel and domiciliary care for the Region. P a r t I I I discusses the school health service and recommends in place of the three routine examinations of each child during school life one complete and thorough examination of each child at some period during the school career, together possibly with mass radiography, with, in addilion, fairly frequent surveys of children picked up b y doctors and teachers and more height aiad weight measurements at, say, half-yearly intervals. Particular attention is paid to school eye and ear, nose and throat services. P a r t IV deals with the .orthopaedic and accident prevention service; P a r t V with childhood tuberculosis, and P a r t VI with co-ordination between hospitals, medical officers of health, school medical officers and general practitioners. The report suggests t h a t the staff of the key hospital of each area should incl~d,e tinder the paediatrician properly qualified and experienced medical officers of registrar status who would spend perhaps one-third of their time in the hospital, and for the remainder of their thne work under the direction of the paediatrician in co-ordinating t h e clinical work of the local Health and E d u c a t i b n Authorities with that of the hospital. The only ,difficulty expected is to provide these officers with enough worthwhile hospital work, but it is thought that if the children's beds in infectious disease hospitals are brought into the general paediatric scheme tl~s difficulty would be solved. Apart from these Senior Assistants the report suggests that whole-time medical officers of public health or school health services should h a v e clinical assistantships in the hospitals. Several other methods of usetul co-operation are suggested and interested general practitioners are also * 12-I 3, Meeklenburgh Square, London,
W.C.I.
recommended for clinical assistantships so as to ensure that each district should h a v e a sufficient n u m b e r of doctors interested and skilled in child health and disease. P a r t V I I estimates the n u m b e r of children's hospital beds needed in the Region, and P a r t V I I I goes into detail regarding mental health questions and the needs of the local service. T h e Oxford Regional Board and the health authorities concerned are fortunate to have provided for t h e m such a comprehensive dossier of information and suggestions for the development of a co-ordinated service.
Personal Health Services in Westminster As a farewell gesture before the appointed day, Dr. Andrew Shinnie, Medical Officer of H e a l t h for the City of Westminster, has written an ontline history entitled " The Personal Health Services of the Westminster City Council, 1903-1948." The Public H e a l t h and M. & C.W. Committees of the City Council welcomed his suggestion that this record should be printed as a memento of the excellent services developed in Westminster and now about to pass over to the London County Council and the Regional Hospital Board. No one could have been better qualified to produce this short history t h a n Dr. Shinnie who has 32 years' association with Westminster in which h e served as deputy to the late Dr. F. J. Allan before succeeding him as M.O.H. Westminster had promoted measures for the welfare of mothers and children long before the Act of 1918 and its anti-tuberculosis work was well in advance of compulsory notification and sanatorium provision. H o m e visiting in fact was pioneered in Westnfinster. Nineteen h u n d r e d and three was chosen as the beginning of this record because it was the founding of the Westnlinster H e a l t h Society, on whose voluntary effort the whole of the City's subsequent M. & C.W. services were built and which is still acting in one part of the City as an agent for the Council. The City Council from the first actively supported the Infants' Hospital opened in Vincent Square in 1907, and Dr. Allan and Dr. Shinnie h a v e both been members of the governing body. Dr. Shinnie looks back to memories as a house physician of the dark days when infantile diarrhoea brought the infantile death rate from 105 per 1,000 in 1910 up to 129 in 1911. I t was conditions like these which had led to the institution of the Westminster H e a l t h Society at the instigation of Dr. Allan by Mr. Richard Saunderson and other University Settlement workers. The work of child welfare soon attracted t h e practical help of the honorary staff of Charing Cross Hospital, a m o n g w h o m Dr. T. ,Watts E d e n played such a notable part. U p to 1918 the Westminster H e a l t h Society were largely responsible for m a t e r n i t y and child welfare throughout the whole City and after t h a t year it gave place to the Council's own organisation in the southern district and continued in the St. Margaret's and St. J o h n ' s areas and the northern district. Their reputation was such that they were consulted b y the central deparmeats as a b o d y whose experience was worth tapping in considering new methods in the maternity a n d child welfare service. Voluntary notification of tuberculosis also began in Westminster in 1903. This implied visiting of patients and educational work, which was another of the objects of the Westminster H e a l t h Society. A b o u t the same time the City pro•vided four sanatorium beds. The City's first tuberculosis visitor was appointed in 1910 and the E b u r y Bridge dispensary dates f r o m 1916. Dr. Shinnie's record mentions also the beginnings of antenatal consultations and the day nursery m o v e m e n t in Westminster. Generally speaking, the premises provided b y the Westminster City Council and its v o l u n t a r y collaborators have been as good as anything seen in L o n d o n and will give the L o n d o n County Council a flying dtart in p r o v i d i n g the divisional services for Westminster's population, which it may be forgotten covers m a n y social grades from Soho to Belgravia. The City Council and it officers m a y well feel proud of the record of these 45 years, arid we are glad to mention Dr. Shinnie's lit.tle book at some length as a typical tribute to the borough and voluntary services which now go o v e r to new management.