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to be paid to " toddlers." Quite apart from the direct educational
work of the Health Visitor upon her call, this personal contact
greatly facilitates fuller use of the Council's Welfare Centres and
is more efficacious than our circulars, however persuasive their
style, in inducing the mother to bring the child up for medical
examination and any ancillary service that may be required.
Apart from this reason for increasing the staff, I find that there
is insufficient visiting of expectant mothers. The Health Visitors
are in touch with a substantial number of expectant mothers
through their visitation of children and through the notices we
receive from the Bethnal Green and London Hospitals concerning
the expectant mothers booked by those hospitals, but the actual
visits paid only amount to about 1 per mother. Having regard to the
inadequate attendance of these mothers at the Welfare Centres
and probably also at the Hospital Ante-Natal Clinics, it is very
desirable that they should be visited more frequently.
A further question which might be well investigated with a viewto
freeing the Health Visitors for more home visiting is the manner
in which their indoor time is occupied, especially in connection
with clinic records, which might perhaps be simplified with
advantage. Another matter, which may have a bearing on the
adequacy and duties of the Health Visiting staff, is the fact that
some of the original members of the staff will shortly be reaching
an age when it may be difficult for them to maintain the volume
of outdoor work which is desirable from the point of view of the
service. It is not easy to suggest a solution for this problem,
apart from an earlier retirement age, but one suggestion might
be to employ these Health Visitors more considerably if not wholly
on indoor duties at the Clinics and to relieve them of outdoor work.
2. The Borough Council's Welfare Centres are an established
and important feature of social life in Bethnal Green. The percentage
of new babies attending the Centres is now as high as
70 and each baby is seen by the doctor on an average five times in
the year. The attendances of children between 1 and 5 is, however,
far from satisfactory. Owing to technical difficulties, it
is not possible to state precisely the proportion of such children
attending, but it seems probable that it is not much than 10 per
cent of the available child population from 1 to 4. Taking the
whole of the children of these ages in the Borough, the consultations
with a Welfare Centre doctor actually work out at an average
of less than 1 per child per year, which means of course that many
of them are never seen by a doctor at all until they go to school.
There is a similar contrast in the Maternity Clinics. The number
of expectant mothers attending is 34 per cent. of the births
(which is very high, considering that more than half the women
are confined in hospitals and presumably attend the hospital
ante-natal clinics), but the number of mothers attending after
confinement is very unsatisfactory, only amounting to half the