Britain: An official handbook > 1959

j^g BRITAIN: AN OFFICIAL HANDBOOK
need to enter a mental hospital they can do so as voluntary patients with little
formality. If need be, they may be admitted under Order as temporary or certified
patients. If patients, or their relatives, are unable or unwilling to make the necessary
arrangements for admission to a mental hospital, it is the duty of a duly authorised
officer of the local health authority to do so. The local health authority is expected
to offer a welfare service to such patients, whether before admission or to help
their rehabilitation on discharge.
Local health authorities have a duty to ascertain mental defectives in the com¬
munity, to supervise them and to provide, where practicable, suitable training or
occupation. This is given in occupation centres where the defectives attend daily,
as at school, or by home teaching. If supervision affords insufficient protection it
is the duty of officers of the local health authority to take the initial steps to place
such defectives under guardianship within the community or to arrange for their
admission to a mental deficiency hospital.
Prevention of Illness: Care and After-Care
Measures for the prevention of tuberculosis, e.g., the tracing of sources of infec¬
tion, the prevention of its spread, and the removal of the cause of infection, are the
responsibility of all the local health authorities. Facilities for diagnosis and treatment
are the responsibility of the hospital service and are provided through sanatoria
and chest clinics. The chest physicians staffing these clinics are often employed
jointly by the hospital authorities and local health authorities, to ensure that diagnosis
and treatment are properly co-ordinated with prevention and after-care. Among the
duties of these officers are those of making recommendations for residential treat¬
ment, visiting the homes of patients, and examining and advising contacts . They
are assisted in this work by tuberculosis health visitors and nurses. Most local
health authorities have statutory or voluntary tuberculosis care committees.
Mass miniature radiography was introduced in 1943 as a means of early diagnosis
of tuberculosis. About 75 units now operate under the regional hospital boards in
England and Wales, in close co-operation with local health authorities; there are
10 units in Scotland. They examine nearly four million persons a year, concentrating
increasingly on areas with a bad record for tuberculosis, on specially susceptible
groups in the population, and on adults in regular contact with organised groups
of children.
Care and after-care of patients is supplemented by general advice and assistance
given to households in which the patients live. Local health authorities send suitable
patients to the village settlements for tuberculous persons which are run by volun¬
tary bodies or by local health authorities of other areas; and training for employment
is carried out in conjunction with the training and resettlement schemes of the
Ministry of Labour and National Service.
Care and after-care arrangements are made by all local health authorities for other
types of illness, including mental illness or mental defectiveness.
As part of their preventive work, local health authorities give help and advice to
families which may be in difficulties and in danger of breaking up.
A charge may be made for some of these services, if the person wishing to make
use of them can reasonably be expected to contribute towards their cost.
Vaccination and Immunisation
Arrangements for vaccination against smallpox and immunisation against
diphtheria, without charge, as part of the National Health Service, are made by
all local health authorities; in addition, most local health authorities have similar
arrangements for immunisation against whooping cough, and a small number have