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It would appear that the expectant mother, when persuaded to attend
the clinic centre, will only be seen once in the ordinary course of events.
She would be examined, and advice on the care of her general health,
with particular instructions on any obvious difficulties, given. Patients
found to have serious symptoms would be referred to a private practitioner;
"no responsibility should be undertaken at the centre for the
continuous treatment of serious illness," a record is to be kept.
When the baby's turn comes to attend the centre it is natural that it
should be the chief focus of attention. "Commonly, it will be desirable
to secure that each infant attending the centre is seen by the doctor at
least every four or six weeks. These consultations should be arranged
more frequently, if the health visitor in the intervals finds that the infant
is not progressing favourably. After the early months of life less frequent
attendance will be needed, but the consultations should suffice to secure
early recognition of rickets, etc. After the child has reached the age of
two or three years, efforts should be made to secure a medical examination
at quarterly or half-yearly intervals, until the child is entered on a
school register." Record of the state of the infant is to be kept.
Besides the records of the mother and child there is to be kept a
record of the visits to the home and the conditions found there.
So much for the general scope of the work. There remains to
discover the medical arrangements.
At the end of Dr. Newsholme's report we find the following:—
"The value of a centre depends chiefly on the medical advice given
in it. The late Professor Budin, the distinguished founder of infant
consultations, said: 'An infant consultation is worth precisely as much
as the presiding physician.' This is even more true for the antenatal
work of the centre."
The medical arrangements for the centres are left entirely in the
hands of the local authority.
Each local authority opening a centre will decide the best arrangement
for medical service. An officer appointed by the local authority may
undertake this. The arrangement made should, so far as practicable,
be one which will receive the general approval of local medical practitioners.
This may sometimes be secured by appointing a practitioner
not practising in the district. It is less satisfactory to have a rota of
doctors. The last-named arrangement should not be entertained unless
it is provided that the same doctor will attend at consecutive consultations
for not less than six months.