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51
HEALTH SERVICES - FAMILY CASEWORKERS
A third full-time family caseworker was appointed in November, 1968, but
there is still a waiting list for this service, of families referred through interdepartmental
case conferences. They are all specially difficult families, with
multiple problems, who need more time and individual help than can be given by
normal fieldworkers if family breakdown is to be prevented, not only through rent
arrears, but also through marital disharmony, promiscuity, prison sentences, drink
and, increasingly often, drugs, all of which render the children particularly
vulnerable to neglect. During 1968 the caseworkers worked with 41 such families,
having between them a total of 194 children
DOMICILIARY MIDWIFERY SERVICE
The number of domiciliary confinements continued to fall but this reduction
is partly balanced by the rise in the number of mothers who, having had their
babies in hospital, are discharged home before the tenth day after birth, mainly
at 48 hours, to the care of the domiciliary midwife. The pattern for the future,
however, is not clearly defined.
Clinics are held in maternity and child health centres by the Council's medical
officers and midwives and by general practitioner obstetricians, at which they
examine their patients with the midwives. The clinics are attended by patients
booked for both domiciliary and hospital confinements.
There has been an increase in the number of classes for expectant mothers
taken by the midwives, mainly in relaxation and mothercraft. In addition classes
in relaxation were given each week in three of the homes for mothers and babies.
During the year meetings were arranged between representatives from
St. James' Hospital, general practitioner obstetricians and the boroughs of
Wandsworth and Lambeth regarding the establishment of a General Practitioner
Obstetric Unit at the Weir Maternity Hospital. A scheme was agreed by the Health
and Welfare Committee and it is anticipated that it will become operative in 1969.
There are three Part II Midwifery Training Schools - South London Hospital,
Annie McCall Hospital and Dulwich Hospital - from which pupil midwives are
allocated to the Lambeth domiciliary midwives for their three months district
training. Owing to the decrease in domiciliary confinements, the Central Midwives
Board has stated that, instead of at least ten home confinements being attended
during a pupil midwife's district training, six would be approved for their final
examination, provided a satisfactory social studies programme was arranged. The
first programme commenced in December 1968 and was greatly appreciated by the
pupil midwives involved and made the community services far more realistic for
nurses who had worked only in hospital.