[Report of the Medical Officer of Health for Port and City of London].

  • London (England). Port & City Council.
Date:
1978
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: [Report of the Medical Officer of Health for Port and City of London]. Source: Wellcome Collection.

    11/78 (page 9)
    To:- THE RIGHT HONOURABLE THE LORD MAYOR, ALDERMEN AND COMMONS OF THE CITY OF LONDON IN COMMON COUNCIL ASSEMBLED My Lord Mayor, Ladies and Gentlemen, I have the honour to present my Fourth Annual Report, dealing with the year 1977. The year has been characterised by the continuing struggle to provide a high standard of service at a time when money remains in very short supply. It is important to consider what should be the proper function of a Medical Officer of Health in such circumstances. Whilst his statutory position may have changed somewhat since the reorganisation of the health services in 1974, his professional situation remains the same. I am still personally responsible for the professional work of my department and for all those decisions on professional matters which are taken day by day. One cannot expect a controlling committee to be willing to accept the responsibility for deciding such matters as whether a given consignment of imported food should, or should not, be allowed into the country. This is a professional decision and, despite the fact that the value of such a consignment may run into hundreds of thousands of pounds and the Corporation may be involved in litigation involving sums of that order if an error is made, I must carry the responsibility myself. It is ironic, in view of this responsibility, involving very large amounts of money, that one is not allowed to spend more than a minimal amount on one's own authority. However, in matters of general policy the democratic process must prevail. It is the duty of the Medical Officer of Health to advise the Corporation, or any of its Committees, on, among other things, the requirements of an efficient health service. If, by that democratic process, it is then decided that a certain service will not be fully provided, it is the task of the Medical Officer of Health to accept that situation and continue to provide the most efficient services that he can. It should not, however, be the duty of an officer to decide which statutory responsibilities of a local authority should, or should not, be carried out. In 1977, staff shortages continued to cause problems in the City and Smithfield sectors. It is regrettable that Government policy should result in a situation where, if a vacancy cannot be filled, for whatever reason, in one financial year, an attempt to fill it in the next financial year will be regarded as growth which must be set against whatever small increase in costs is permissible. It is apparent that some solution to these staff shortages must be found, whether by improvement of terms and conditions of service, or by the appointment of staff who are differently qualified, or by some other means. The increase in the work load in the City resulting from the appointment of enforcing authorities under the Health and Safety at Work etc. Act, is dealt with in the body of my Report. While welcoming the fact that decisions have, at long last, been taken, it is by no means easy to find properly qualified staff to carry out the work. During the latter half of the year it became apparent that the Department of Health and Social Security wanted to amend the Regulations which enabled Port Health Authorities to run the quarantine services. As a result of these amendments, there will, in future, be no routine boarding of ships by doctors. It is hoped that an on call system for infectious disease control will be developed, to which appropriately qualified doctors will be seconded by Area Health Authorities up and down the River. Discussions with the National Health Service are now being carried on and it is hoped that, by the Autumn, the system will be in operation. I cannot say that I consider that the new system will be anywhere near as effective in protecting the public health as the old one. However, it is the opinion of the powers-that-be that the risk of infectious disease coming into this country by sea is very small indeed. One can only hope that those powers know what they are talking about. It is also to be hoped that, as a result of this reorganisation of medical staff in the Port, sufficient money will be forthcoming from the National Health Service to make possible the appointment of a Deputy Medical Officer. The situation which has obtained during the past four years, where there has been only one person with medical expertise actually employed by the Corporation, and where the Corporation has had to go outside its own staff to provide for medical examinations and locum-tenens services for the Medical Officer of Health, is not satisfactory. The time has come when a review of the situation, aimed at the Corporation's undertaking the control of its own medical services, should be set in train. The Animal Quarantine Station at Heathrow has presented many problems during the year. Because of the cost of keeping animals in the station, the impact of the legislation now controlling imported animals and the efforts of Conservationists abroad, the throughput at Heathrow and particularly at the Animal Quarantine Station, has been much lower than expected. As a result, the station has not achieved the aim of being self-financing. The AQS can be only one of two things — either it is a statutory service or 9