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The change from
the Poor Law administration of hospitals in 1929-30, to local authority
control was the first major change in this arrangement. Local authorities
gave public health practitioners authority to manage and control these newly
acquired facilities. Medical Officers of Health responded to this challenge
in varying ways, many took this opportunity to improve services, while
others took a more relaxed attitude. The major drawback to this new
responsibility for public health was that those involved became more
concerned with the problems and minutiae of clinical/hospital administration,
became medical superintendents and thus directed clinical care. This often
gave rise to unease. Clinical consultants on the one hand, did not respect
Medical Officers of Health whom they considered divorced from “real medicine”.
MOHs on the other hand saw this as a means of acquiring power, authority and
status. At the same time they were charged with, and developed, community
services for pregnant women, infants, children and school health services,
particularly in poor areas where the population could not afford to use GP
services. Thus public health and general practice found themselves in
competition and tensions resulted. |