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80
SECTION IV
PERSONAL HEALTH AND RELATED SOCIAL SERVICES
The operation of the maternity and child welfare clinics is
largely on the same lines as applied by the London County Council,
who in turn had inherited well established services from the old
metropolitan boroughs. A development which is being encouraged
is the employment to a greater extent of local family doctors at the
various local authority clinics. This brings them into closer contact
with the preventive services and promotes greater understanding.
The possibility, and at the moment it is no more than a possibility,
of attaching health visitors and home nurses to selected group
practices is being explored and, in any future clinic building,
accommodation for group practices will be provided if acceptable
to the general practitioners. At the same time, peripheral office
accommodation will be found for a variety of specialist officers in
the department, such as old people's visitors, mental health officers
and social welfare officers, so that a full domiciliary team will be
available in the field to serve the area community needs in partnership
with the family doctors.
Similarly, in organizing the local domiciliary midwifery
services, effort has been directed towards obtaining closer associa.ion
with the general practitioner obstetricians and the maternity
hospitals. Some thought has been given to the proper role of the
local authority clinics and the relationship which should exist
between the midwife and the other branches of the midwifery
service. A good maternity service is obviously begun with good
ante-natal care and regular supervision of expectant mothers from
the earliest months. The Council has therefore encouraged and
extended the practice inherited from its predecessors of making
clinic premises available to the local general practitioner obstetricians
who wish to use the facilities. These arrangements, together
with local Maternity Liaison Committees, have gone a long way
to bringing the midwife from a position of isolation and re-establishing
her in her true position as a professional person, qualified
after rigorous training and searching examination.
The modern trend is now undoubtedly towards hospital in
preference to home confinement. If this trend continues, and present
evidence on the social habits of the community suggest that it will,
a complete reappraisal of the role of the local authority midwifery
service will be necessary. To some extent this is already being done.
The early discharge system from maternity hospitals is working
admirably and the midwife is now undertaking social as well as