Health Services Provided By Local Health Authorities

19.-(1) Subject to the provisions of this section, the local authority for the purposes of this Part of this Act, who shall be called the “local health authority”, shall for each county be the council of the county and for each county borough be the council of the county borough.
(2) Where it appears to the Minister to be expedient in the interests of the efficiency of any services provided by local health authorities, whether under this Part of this Act or under any other enactment conferring functions on any local health authority in their capacity as such an authority, that a joint board should be established for the areas of two or more local health authorities for the purpose of performing all or any of the functions of those authorities, the Minister may by order constitute a joint board consisting of members appointed by those authorities and provide for the exercise by the board, in lieu of the authorities, of such of the said functions as may be specified in the order:
Provided that the Minister shall not make such an order except after a local inquiry, unless all the authorities for the areas concerned have consented to the making of the order.
(3) The provisions of Part I of the Fourth Schedule to this Act shall have effect with respect to joint boards constituted under this section, and, to orders constituting such joint boards and the provisions of Part II of the Fourth Schedule to this Act shall have effect with respect to health commit­tees of local health authorities.

20.-(1) Every local health authority shall, within such period as the Minister may by direction specify, submit to the Minister proposals for carrying out their duties under the next following eight sections of this Act.
The Minister may specify different periods under this section for proposals relating to duties under different sections.
(2) Not later than the day on which the proposals are sub­mitted to the Minister, the local health authority shall serve a copy thereof-
(a) on every voluntary organisation which to the knowledge of the local health authority provides in the area of the authority services of the kind dealt with in the proposals, and

(b) ) on the Executive Council (as constituted under Part IV of this Act), and the Regional Hospital Board for any area which consists of or comprises the area of the local health authority or any part thereof , and the Board of Governors of any teaching hospital situated in the area of the local health authority; and

(c) on every local authority for an area forming part of the area of the local health authority;
and any such voluntary organisation, Council, Board or authority may, within two months of the service on them of a copy of the proposals make recommendations to the Minister for modifying the proposals and shall, not later than the day on which such recommendations are made, serve a copy thereof on the local health authority.
(3) The Minister may approve the proposals with or without modifications (which may include additions or exceptions), and it shall be the duty of the local health authority to carry out their duties under the next following eight sections of this Act in accordance with the proposals submitted and approved for their area under this section, subject to any modifications made by subsequent proposals so submitted and approved.
(4) A local health authority may at any time, and if directed by the Minister shall within the period specified in the direction, submit new proposals providing for the modification of the existing proposals, and the last two foregoing subsections shall apply to any such new proposals.
(5) If any local health authority fail to submit any proposals which they are required to submit within a period specified by direction of the Minister, the Minister may himself make proposals, and they shall have effect as if they had been submitted and approved under the foregoing provisions of this section:
Provided that, before making any such proposals, the Minister shall serve a copy of the draft proposals on every voluntary organisation which to the knowledge of the Minister provides in the area of the local health authority services of the kind dealt with in the proposals and on the bodies mentioned in paragraph (b) or paragraph ( c) of sub­ section (2) of this section, and give an opportunity to those organisations and bodies to make recommendations to him for modifying the proposals.

21.-(1) It shall be the duty of every local health authority to provide, equip, and maintain to the satisfaction of the Minister premises, which shall be called “health centres”, at which facilities shall be available for all or any of the following purposes:-
(a) for the provision of general medical services under Part IV of this Act by medical practitioners;
(b) for the provision of general dental services under Part IV of this Act by dental practitioners;
(c) for the provision of pharmaceutical services under Part IV of this Act by registered pharmacists;
(d) for the provision or organisation of any of the services which the local health authority are required or empowered to provide;
(e) for the provision of the services of specialists or other services provided for out-patients under Part II. of this Act; or
(f ) for the exercise of ·the powers conferred on the local health, authority by section one hundred and seventy­nine of the Public Health Act, 1936, or section two hundred and ninety-eight of the Public Health (London) Act, 1936, for the publication of information on questions relating to health or disease, and for the delivery of lectures and the display of pictures or cinematograph films in which such questions are dealt with.
(2) A local health authority shall to the satisfaction of the Minister provide staff for any health centre provided by them :
Provided that a local health authority shall not employ medical or dental practitioners at health centres for the purpose of providing general medical services or general dental services under Part IV of this Act.
22.-(1) It shall be the duty of every local health authority to make arrangements for the care, including in particular dental care, of expectant and nursing mothers, and of children who have not attained the age of five years and are not attending primary schools maintained by a local education authority.
(2) The local health authority may, with the approval of the Minister, make and recover from persons availing them­selves of the services provided under this section such charges (if any) in respect of any articles provided as the authority consider reasonable, having regard to the means of those persons.
(3) The local health authority shall be the welfare authority for the purposes of Part VII of the Public Health Act, 1936, and section two hundred and fifty-five of the Public Health (London) Act, 1936, and the local authority for the purposes of Part XIII of the Public Health (London) Act, 1936.

(4) Regulations may provide, in the case of areas where, under Part III of the First Schedule to the Education Act, 1944, schemes of divisional administration relating to the functions of local education authorities with respect to school health services are in force, for the making, variation and revocation of corresponding schemes of divisional administration relating to the functions of local health authorities under subsection (1) of this section with respect to the care of children who have not attained the age of five years and are not attending primary schools maintained by a local education authority, and the functions of such authorities under sub- section (3) of this section.
(5) A local health authority may, with the approval of the Minister, contribute to any voluntary organisation formed for any of the purposes mentioned in subsection (1) of this section.

23.-(1) The local health authority shall be the local supervising authority for the purposes of the Midwives Acts, 1902 to 1936, and accordingly in section eight of the Midwives Act, 1902, for the words “council of a county or county borough” there shall be substituted the words “local health authority” and for the words ”said county or county borough” there shall be substituted the words ”said authority”.
(2) It shall be the duty of every local health authority to secure, whether by making arrangements with Boards of Governors of teaching hospitals, Hospital Management Com­mittees or voluntary organisations for the employment by those Boards, Committees or organisations of certified mid­wives or by themselves employing such midwives, that the number of certified midwives so employed who are available in the authority’s area for attendance on women in their homes as midwives, or as maternity nurses during child­birth and from time to time thereafter during a period not less than the lying-in period, is adequate for the needs of the area.
In this subsection the expression “lying-in period” means the period defined as the lying-in period by any rule for the time being in force under section three of the Midwives Act, 1902.
(3) Subsection (1) of section nine of the Midwives Act, 1936 (which enables the Minister to prescribe conditions subject to which fees are to be payable by the local health authority to medical practitioners called in by midwives) shall have effect as if at the end of the subsection there were added the words ”including conditions as to the qualifications of such medical practitioners”.

24.(1) It shall be the duty of every local health. authority to make provision in their area for the visiting of persons in their homes by visitors, to be called “health visitors”, for the purpose of giving advice as to the care of young children, persons suffering from illness and expectant or nursing mothers, and as to the measures necessary to. prevent the spread of infection.
(2) The duty of a local health authority under this section may be discharged by making arrangements with voluntary organisations for the employment by those organisations of health visitors or by themselves employing health visitors.

  1. It shall be the duty of every local health authority to make provision in their area, whether by making arrangements with voluntary organisations for the employment by those organisations of nurses or by themselves employing nurses, for securing the attendance of nurses on persons who require nursing in their own homes.

26.(1) Every local health authority shall make arrange­ments with medical practitioners for the vaccination of persons in the area of the authority against smallpox, and the immunisation of such persons against diphtheria,
(2) Any local health authority may with the approval of the Minister, and if directed by the Minister shall, make similar arrangements for vaccination or immunisation against any other disease.
(3) In making arrangements under this section a local health authority shall give every medical practitioner providing general medical services in their area under Part IV of this Act an opportunity to provide services under this section.
(4) The Minister may, either directly or by entering into arrangements with such persons as he thinks fit, supply free of charge to local health authorities and medical practitioners providing services under this section, vaccines, sera or other preparations for vaccinating or immunising persons against any disease.
(5) The Vaccination Acts, 1867 to 1907, shall cease to have effect.

27.(1) It shall be the duty of every local health authority to make provision for securing that ambulances and other means of transport are available, where necessary, for the conveyance of persons suffering from illness or mental defectiveness or expectant or nursing mothers from places in their area to places in or outside their area.
(2) A local health authority may carry out their duty under this section either by themselves providing the necessary ambulances and other means of transport and the necessary staff therefor or by making arrangements with voluntary organisations or other persons for the provision by them of such ambulances, transport and staff .

28.-(1) A local health authority may with the approval of the Minister, and to such extent as the Minister may direct shall, make arrangements for the purpose of the prevention of illness, the care of persons suffering from illness or mental defectiveness, or the after-care of such persons, but no such arrangements shall provide for the payment of money to such persons, except in so far as they may provide for the remuneration of such persons engaged in suitable work in accordance with the arrangements.
(2) A local health authority may, with the approval of the Minister, recover from persons availing themselves of the services provided under this section such charges (if any) as the authority consider reasonable, having regard to ·the means of those persons.
(3) A local health authority may, with the approval of the Minister, contribute to any voluntary organisation formed for any such purpose as aforesaid.
29.-(1) A local health authority may make such arrangements as the Minister may approve for providing domestic help for households where such help is required owing to the presence of any person who is ill, lying-in, an expectant mother, mentally defective, aged, or a child not over compulsory school age within the meaning of the Education Act, 1944. ‘
(2) A local health authority may, with the approval of the Minister, recover from persons availing themselves of the domestic help so provided such charges (if any) as the authority consider reasonable, having regard to the means of those persons.

  1. This Part of this Act, except sections nineteen and twenty, shall come into force on the appointed day.

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