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9
test, the numbers attending for examination fell. Undoubtedly
some are being seen by their own doctor but there is an indication
that many women are deterred by fear of adverse reports. Extension
of the family planning service is under consideration and particular
attention is being directed to the provision of a domiciliary service
and the possibility of a free service is being examined. Demands
on the home nursing service continue to increase, as do attendances
at child health centres. Greater attention is now being paid to
development assessment clinics. With specially trained doctors and
nursing staff available for consultation any deviation from the
normal development of a child can be detected at the earliest
possible stage.
In this, the final year of direct responsibility for registration of
playgroups and childminders, it is pleasing to record yet a further
increase in the number of registrations. The total places now available
in the Borough is 1,820, equivalent to 15 per cent of all
children between one and five years.
This Directorate co-operated in a number of research activities
and surveys. These included enquiries into childhood cancers,
cerebral palsied and normal children, a new polyvalent oral polio
vaccine, congenital rubella survey, the British Birth Survey and an
enquiry into chromosome anomalies and congenital malformations.
On the environmental health side, it is pleasing to note that the
Borough is now completely covered by smoke control orders
although during the early part of the year temporary suspension
of the orders was authorised by the Government, due to shortage
of smokeless fuels. Registration of houses in multiple occupation
became operative from 1st April and increasing attention is being
directed to noise nuisance and noise measurements.
The future needs of Thamesmead are being examined in detail
and plans are now in hand to provide a temporary health centre
in Stage III of the development. At the same time, preliminary
work continues on the main health centre to be located in the
Central area which will be a focal point of a new philosophy of
total health care, incorporating in the one building comprehensive
primary, preventive and specialist services. The Council are also
embarked on an ambitious health centre programme and it is
hoped that, in 1974, these proposals will be adopted and carried
forward on completion by the new Area Health Authorities.
The year under review was one of uncertainty for the health
services and, although we are now writing this preface with the
wisdom of hindsight, at the time, the irrational arrangement of
reorganising the social services, while leaving the health services
in limbo, caused unnecessary confusion and bewilderment. London
is fortunate in that the boroughs are exempt from the Government's