EDITORIAL COMMENT

We acknowledge receipt of several contributions in support and in criticism of Nurse Craddock's viewpoint published last week.

It is quite impracticable to publish all but we wish to assure our correspondents that the points they raise have been noted and will be conveyed to those for whom they have a special interest.

We welcome the views of one contributor who expresses concern about the future of The Standard itself, and who feels that the liberty of its columns has been taken for license with the result that there are those who have "mis-used" our magazine "to give vent to personal prejudices". This may well be so, and indeed it may give offence to some, but if any functional organ of this kind is to achieve such purposes as were originally set out, then the more that the "blue-pencil" gives way to the good sense and sound judgement of those who use its columns, the better for all concerned.

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The Service of the Future

Area Health Boards- continuing

Last week we looked at the skeleton structure of the Area Health Boards, and set out the likely ambit of their responsibilities.

In the Green Paper issued in 1970 it was pointed out that in its present form the Health Service is administered and controlled by some 5,000 men and women who voluntarily give up a considerable amount of their time by serving on Hospital Management Committees and kindred bodies controlling the service, and in tribute to the work of these public spirited people it was stated that the substantial developments which have taken place during the past twenty years or so has been largely due to the devoted and sometimes unacknowledged work of members of Boards and Committees.

Those of us who have had first hand experience of such Committees would regard that as an understatement of no mean dimension. Nevertheless 'tis said, the system used in their appointment has been subject to criticism, and that many have evolved into "self-perpetuating oligarchies".

In the light of this it is interesting to note the Government's proposals for making appointments to the Area Health Boards, because on information available at the moment these bodies will be the last line of functional control carrying executive authority. The Government proposes therefore that Area Boards should be appointed in accordance with the following arrangements:

(1) One third of the members to be appointed by the health professions
(2) One third to be appointed. by the local authorities
(3) One third, together with the Chairman to be appointed by the Secretary of State.

The idea lying behind this proposal is that there will be introduced a very powerful element of local participation, and thereby stimulate and promote co-ordination with other services of the area.

The recognition of the health professions as appointees of one third of the membership of the Area Boards, is a departure from previous practice which can only be regarded and welcomed as a desirable development. Since the term itself is a widely embracing term, and includes not only medical but as well dental, nursing and other professions engaged in the service, it means that at long last, local professions will be called upon "to shoulder their share of responsibility for the management of the health services in their area, which they so largely provide".

The details of working arrangements are still a matter for determination and the Secretary of State is in process of establishing a working party to study the subject in detail. We lock forward to the publication of their recommendations.

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THE DIMENSIONS OF CHANGE

Charge Nurses and Sisters affected by the current staff integration programme being carried out at Winwick have visited, I believe, Moston Hospital recently for the purpose of seeing how integration works in the actual ward setting.

In embarking on the introduction of revolutionary and dynamic concepts into an institutionalised setting, I wonder is this "one day" type of preparation adequate?

Might not such a worthwhile undertaking as integration have a considerably better chance of success if the minds of the nursing and medical staff were given a more thorough and comprehensive preparation for it?

Has it been forgotten, that the majority of medical and nursing staff in Winwick have been trained and spent most of their professional lives in a custodial and traditional setting?

A setting, it should be remembered, in which everything in the Nursing situation which was shapeable had to be made symmetrical; in which nothing that could be put in a straight line was left out of line - in which behaviour was acceptable only when it was compliant; in which activity was considered productive only when it was regimented.

Minds that have been subjected to this degree of obsessive indoctrination cannot be expected to adjust overnight to the stresses and uncertainties of a free-flowing and dynamic work situation.

Imaginatively formulated concepts evolved by courageous and visionary minds deserve to be approached with prudence and humility. The would-be innovator who is lacking in these qualities is bound to make a mess of things and when the material upon which he experiments is of human substance, the results of failure are measurable in terms of human misery.

The present writer does not want to give the impression of being opposed to the changes which are currently taking place in Winwick....

What is being advocated, however, artlessly, is that these changes are introduced in a logical "cart after horse" sequence and that the blue print of change is made dimensionally proportionate.

In other words before the role dimensions are changed, an attempt must be made to alter proportionally the underlying attitude dimensions.

This degree of change is not going to be affected by a single flying visit to a neighbouring hospital.

C. Breslin

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LETTERS TO THE EDITORS

From comments that have been passed it seems that my recent article was expected to contain some secrets of the bedroom, and a Welsh bedroom at that.

I apologise for disappointing you.

I could continue the series with hazards in the bathroom, hall, children's rooms, caravans, workshops, boats, Hospitals and with contractors, and so monopolise a page or two of your magazine each week.

One must remember that there are other departments in the hospital equally or more able to advise and comment on subjects of interest. I therefore break off to make room for others.

Fire prevention advice will continue to be given when not wanted and continue to be ignored after being asked for, but we carry on in the hope that perhaps somewhere we may be instrumental in helping to save life.

May I remind you that the Hospital Fire Brigade is trained and equipped to deal with outbreaks of fire and evacuation of patients, but we rely on YOU for a quick call, sounding the alarm as soon as a fire is discovered.

The Fire Department is at your service. We exist for your guidance and our residents protection against fire.

C. P. Evans.

I wish sometimes that those members of the public who still regard Mental Illness as something to laugh at (such people still exist!) could sit at my bedroom window on a Sunday evening at around 7.30 p.m. It is usually the time when patients, both male and female, return to the hospital after a week-end leave. They return with the husband or wife, whichever case may be, sometimes children come along too.

It is with great pity that I watch their faces, reflecting sorrow, sadness and a big worry too. Even the children walk quietly alongside the parents.

I do think that if they could see their faces they would understand that mental illness can be a very distressing condition, very hard for anyone to bear, and not a punishment or something to laugh at and make fun of.

W. J. Hambleton,
South Lodge

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LIVERPOOL REGIONAL HOSPITALS

BOWLING COMPETITION 1971

The Bowling Section of Winwick Hospital Social Club entered three teams in the above competition this year. The C team was defeated by Liverpool Children's Hospital in the 1st round and the B team was also beaten in the 1st round by the Winwick A team. The A team managed to reach the semi-final of the competition but they met their "Waterloo" at the hands of Walton Hospital after a very close contested match which was held at Moss Side Hospital Social Club's Bowling green, Maghull.

The final of the competition between Rainhill Hospital and Walton Hospital was played on the large green at Winwick Hospital Social Club on Wednesday evening 12th August, 1971.

It was a warm and dry evening and the standard of bowling was very high indeed, with Rainhill finally winning the match by 7 points.

I must place on record the grateful thanks and appreciation of the two visiting teams, and their supporters, firstly to Mr. Stewart, the Gardens Superintendent and his staff and patients who prepared the green for the match, it was in 1st Class condition, particularly after the heavy rain we had had the previous day, and secondly to Mr. Bainbridge and Mr. Aston for the excellent and appetising refreshments they provided for our guests.

My final thanks are to Mr. Peter McLean, retired Deputy Charge Nurse of Winwick Hospital who so ably refereed the match.

J.G. Wright

WELCOME TO

S. Wright - Nursing Assistant (Pre-student)

FAREWELL TO:

J.A. Weilding	- Temp. Clerical Asst.
L. Smith	- Temp. Nursing Asst.
G. Taylor	- Temp. Nursing Asst.
J. Murley	- Temp. Nursing Asst.
Y. Taylor	- Temp. Nursing Asst.
L. Coleman	- Part time Nursing Asst.
C. Sedgwick	- Part time Nursing Asst.
L. Robinson	- Wardmaid
J. Chorley	- Wardmaid
E. Bolton	- Wardmaid
I. McEachern	- Deputy Sister
M.V. Thompson	- Deputy Sister
H. Dickson	- Deputy Charge Nurse