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Well-Baby Clinics Held at General Practitioners' Surgeries
In addition to the Child Health Sessions at the Council's Maternity and Child Health Centres, four Health
Visitors attended Well-baby Sessions held in General Practitioners' surgeries. A General Practitioner also
conducts a well-baby clinic for his own patients in one of the Council's Maternity and Child Health Centres.
Cervical Cytology Screening Service (Prevention of Illness, C are and After-Care,
Health Services and Public Health Act 1968, Section 12)
Women of any age who live or work in Hammersmith may attend for cytology screening and are actively
encouraged to do so by Health Visitors. Some excellent publicity leaflets and posters have been provided by
the Women's National Cancer Control Campaign and the Health Education Council.
A limited number of appointments are made for each session so that in addition to the smear test each
patient has a urine examination, a full gynaecological examination, and examination of the breasts to screen
for early breast cancer. Our doctors instruct each woman on how to examine her own breasts and there is time
also for discussion of marital problems if required.
The family doctors are informed of all results, whether negative or positive, and patients are invited to have
a second test after 5 years. The Council also participates in the National Recall Scheme whereby women are
offered a further test after a five year interval.
Some general practitioners in the Borough prefer to provide a cervical cytology service themselves but the
majority advise and encourage their patients to attend the Council's clinics.
During 1972, 162 (137) sessions were held at which 1,203 (918) attendances were made. Facilities were
offered to all women regardless of their age group to take advantage of this test. In addition, letters were sent
to all firms in the Borough inviting women employees to attend our clinics, or offering to provide a service at
the place of employment, provided a sufficient number of individuals wished to take advantage of this, and
provided adequate facilities were available. 15 special sessions were held in 1972 accordingly at places of
employment.
HANDICAPPED CHILDREN
Of recent years considerable attention has been focussed on the needs of the handicapped child and his
family.
A child may be handicapped by reason of some congenital abnormality or deformity as a result of disease or
injury in early life or of adverse emotional and environmental conditions. There is a tendency for handicaps to
be multiple. The same pathological process that causes a physical handicap may also lead to an intellectual
one. A child with impaired physical or mental development may also suffer from emotional deprivation, over
protection and lack of opportunity in his home environment to develop his potential.
The emotional needs of handicapped children - the longing for love which a physically unattractive child so
badly needs, the self-awareness which he must learn at a very early age, or the frustration at lack of ability
which is expressed in temper tantrums - these are problems for the family. The whole family must be involved,
but when the daily regime of a young child is considered it is the mother who bears the greatest burden. The
mother will need help in understanding that when the other siblings have outstripped the handicapped child in
agility, performance and control of bodily functions, this one will continue to need the care usually bestowed
on a baby. She will also need to learn, and this is a difficult lesson, that a handicapped child must also be
subject to the ordinary rules of social behaviour. He must be allowed and encouraged to do things for himself
such as feeding and dressing. He must learn to accept "no" without resorting to temper tantrums or even fits in
an attempt to get his own way.
The local authority, the hospital and general practitioner service and voluntary organisations all have a part
to play in meeting the needs of handicapped children and their families. The early diagnosis of and treatment
of the condition is a medical responsibility. Support of the family in the home by provision of material help
and advice on day to day management is a role undertaken by the health visitors or social workers, while early
training and education may be undertaken by nursery nurses or nursery teachers. For any satisfactory service
a team approach is essential. No matter who provides the help it must be co-ordinated. There must be full
assessment of the family's immediate needs and of the child's potential. The parents must be given a realistic
prognosis and helped to accept it by counselling on a long term basis.
As a first step in the co-ordination of the services for handicapped children, the Health Department
maintains a register to encourage the early identification of handicaps to ensure follow up by regular review, to
arrange for appropriate management and treatment, and where necessary to ascertain for special education.
Children may be placed on the register because of congenital abnormalities notified at birth, or because of
failure to make normal progress in any sphere of development whether this is due to physical or mental
handicap or adverse emotional or environmental conditions.
The service for handicapped children has two main objectives. One is to provide the necessary help to the
child and his family from an early age so that he shall learn to live with the handicap, to adjust to it and
ultimately to become an independent member of the community. The other is to prevent handicaps
developing: to identify and treat deviations from the normal before all the secondary disadvantages,
emotional disturbance, educational failure and social maladjustment have overwhelmed him and turned him
into an unacceptable, unsuccessful, unhappy misfit.
Sufficient time is allowed for full examination and assessment of the child's immediate needs and as far as
possible of his future requirements and potential. Placement may be recommended in a special unit or day
nursery in order to provide training by skilled staff and an opportunity for the child to play and learn with
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