[Report 1948] / Medical Officer of Health, Smethwick County Borough.
- Smethwick (Worcestershire, England). County Borough Council.
- Date:
- 1948
Licence: Attribution 4.0 International (CC BY 4.0)
Credit: [Report 1948] / Medical Officer of Health, Smethwick County Borough. Source: Wellcome Collection.
9/48 (page 9)
![cinumscribed, and his work in inanj' directions is frustrating because of the difficulties under which he works. Much of his time is inevitably taken up in non-medical work, such as nursing and clerical work which could be done very much more efficiently by non-medical staff. The numbers with whom he has to deal, especially in an industrial town, are greater than he can conveniently manage, and he is thus driven in many cases to treat symptoms rather than to act as a true family physician. The provision of health centres in large numbers will do much to remedy this state of affairs, but the position can never be satisfactoi-y until the general practitioner is enabled to earn a reasonable living with a much smaller number of patients, and by working considerably fewer hours. He must have more time to think, to read, to .study, and to talk to his |)atients at greater leisure. This steady reduction in the number of patients will occur in the natural course of events, as the number of doctors in the country increases. The general practitioner, in addition, must not be treated merely as a sorting machine for classifying patients into various groups and consigning them to other bodies or institutions for treatment. He must have available freely at his own disposal many of the facilities which now can only be obtained by the surrender of his patients to hospital. For example, many bacteriological, biological, biochemical and radiographic facilities are only available in hospitals. The general practitioner who wishes to treat his own patients at home must be given these facilities without the snrrendei' of his ))atient. An experiment of this nature^ is being tried out at one of the large hospitals in Birmingham, and its outcome will be watched with interest. Tin- family doctor must be enabled, if it is at all possible, to treat his patients at home. This is desirable not merely because the cost to the state is infinitely less than if the patient is admitted to ho.spital, but because the tieatment is very much more agreeable to the patient. It is difficult in a large hospital for a patient to be made to understand that it is he Avho is being treated and not one of his organs. The conscientious family doctor never has any difficulty in giving his patient to understand that he is interested in him as a person and not “ as a stomach, liver, pneumonia, or ulcer.” In hosjjital, however, patients are frequently referred to as “ the aijpendix in Ward B,” “ the j)neunionia in Ward A,” or “ the diabetes in 16X ” and so on. It would be difficult to imagine a doctor coming into a home where a child is ill, and asking the mother “how is ‘the .stomach ’ in the front bedroom?''' He would naturally eiiquire “ how is Johnnie feeling to-da.v,” Johnnie being an individual and not a stomach encased in bones, flesh and a wrapping of skin, J'o the medical officer of health the National Health .Service Act of 1946 lias come as a blessing in di.sguise. The words “ in disguise ” are added as many of us felt a sense of deep disappointment when we lost control of our munici])al hospitals. On reflection, however, it must be admitted that the greatest evil which has ever been done to medical officers of health within the last one hundred years has been the giving to them the control of general hospitals, and the Local Government Act of 1929 which transferred hospitals from the Poor Law guidance to Local Authorities, provided medical officers of health with a task, admittedly an interesting and absorbing task, but one which tended to rob them of their birth-right and to remove them from their true work, that of epidemiologists. The administration of general hospitals is interesting, absorbing and satisfying, but it is not work for which medical officers of health were created. The medical officer is a sociologist, and his duty is not the trivial and unimportant duty of curing disease, but in preventing it and of enhancing health. The years from the operation of the 1929 Act until the 5th July, 1948, were responsible in many towns for the decline in intere,st and knowledge of the medical officers of health in sociology and epidemiology. It is true that since 1929 municipal hospitals have been improved](https://iiif.wellcomecollection.org/image/b30091354_0009.jp2/full/800%2C/0/default.jpg)
