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54
initiative in suggesting the desirability of greater co-operation
between general practitioners and the health visitors employed
by local health authorities. This was cordially accepted by the
Croydon division of the B.M.A. and the Local Medical Committee
and a letter was therefore sent to all general practitioners in
the borough drawing attention to these decisions and expressing
the willingness of health visitors to assist individual practitioners
in the care of their patients. The letter pointed out
that all health visitors in Croydon were State Registered Nurses
and also School Nurses and examples of their help might be supervising
infant feeding, advising on nursing techniques or diets
in cases where the attendance of the District Nurse was not required,
giving information regarding a child's behaviour at
school, advising the appropriate agency or voluntary organisation
for solving a family's social difficulties, or reporting on
patients after recovery from a serious illness when routine medical
visits were no longer being paid. A booklet issued by the
Women's Public Health Officers Association enlarging on the duties
of health visitors was enclosed with the letter, together with a
list of the health visitors' names and the areas of the borough
which they serve. The letter concluded by inviting the doctors
to contact the Superintendent Health Visitor, so that the district
health visitor concerned could be asked to obtain his direct
instructions, or to visit the family and report, as might be requested.
This approach appears to have been helpful and there is
a growing use of the health visitors by general practitioners.
Co-operation which depends on personal contact and mutual confidence
requires time for its proper development. We must show by
action that our offers of assistance are not merely paper promises
and on the whole, I think progress is reasonably satisfactory.
A major difficulty is the relatively high frequency of change
of staff as far as the health visitors are concerned, which does
tend to impede the building-up of local co-operation in the areas
of the borough affected.
Now that physical diseases which kill or cripple children
have been largely overcome, the importance of mental and emotional
developments are becoming apparent. Health visitors have shown a
keen realisation of their responsibilities in this field and a
firm resolve to equip themselves with the necessary knowledge
to develop such work. Considerable thought has been given to the
best method of meeting this challenge and it was finally decided
that "in service" training by group discussion methods was likely
to be the most effective. In the connection, the advice of the
Director of the Child Guidance Clinic was most helpful and it was
possible to draw up a scheme in which members of his staff would
assist, to commence operating in 1955.