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80
SECTION IV
PERSONAL HEALTH AND RELATED SERVICES
Since the Maternity and Child Welfare Act of 1918, local
authorities have had the power to introduce schemes for the care
of expectant and nursing mothers and their babies and these,
together with the midwifery, home nursing and home help facilities
form an integral part of local authorities' advisory and preventive
services.
During the past few years, however, paediatrics has gained a
more prominent position and doctors are now tending to favour
group practices which enable them to provide most of the services
which were, at one time, mainly those available at local welfare
clinics. As a consequence, local authority personal health services
are being inexorably pressured into a "supportive" role and the
domiciliary midwife and health visitor into socio-nursing health
educators of the expectant and parturient mother.
As malnutrition and communicable disease have become of
relatively minor importance, so a great deal more attention is being
paid to the "at risk" and mentally disabled children. Indeed,
following a report on child welfare centres, prepared by a subcommittee
of the Standing Medical Advisory Committee under the
Chairmanship of Sir Wilfred Sheldon and published in November
of the current year, a number of changes are presaged.
The undoubted value of existing preventive services in safeguarding
the health of children was acknowledged and affirmed by
the sub-committee which, however, considered the term "Child
Health Services" to be more appropriate than the previous title.
Although the process will be gradual, it was envisaged by the
sub-committee that this child health service, in the long run, will
form part of a family health service provided by family doctors
working in groups from purpose-built health centres. Nevertheless,
it was conceded that the special "expertise" gained over many years
by the local authority staffs will be needed for some years to come.
Briefly, some of the future functions expected of the child health
service by the sub-committee, are :—
(a) Routine medical examinations aimed at ascertaining a
child's physical, mental and emotional development with
the referral of affected children through the family doctor
to the appropriate hospital for full assessment, diagnosis
or treatment.