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A carefully worded letter was compiled to emphasize that this was a check offered
to every female patient in the practice by her family doctor. The first contact was
considered very important as the timid patient with a morbid fear of cancer is the
one required to reach. A certain number of women are invited to attend each week.
It has been noticeable that the elderly ladies form a high percentage of the attenders.
The time convenient to general practitioners (4-6 p.m.) may be difficult for women
with families of school age.
Tn the 4 months up to the end of 1966 434 women were invited.
162 attended
14 came uninvited (heard from relatives
or neighbours).
The nursing sister in attendance fills in a short questionnaire, the patient is then
examined by the doctor. It there is any doubt as to the diagnosis, or confirmation is
required of a positive diagnosis, the doctor arranges for the hospital consultant to
attend shortly. As every patient has been told by sister that the doctor may seek a
second opinion the patients are not alarmed when this occurs.
They appreciate the advantage of the consultant coming to see them than the more
ordinary routine of having to go to a hospital out-patient department.
Out of the 176 who attended:
3 have been admitted to hospital for operation
32 are having further investigation.
It appears that none of these women would have come to the ordinary surgery
with the symptoms they had when they attended the clinic. Questioning all age groups
seems to show that very few women examine their breasts as routine, although some
confess to a vague fear of cancer.
The value of the clinic is that patients are being requested to attend, feeling that
they are in good health, and are taking part in a scheme to assist their family doctor.
If this attitude could be encouraged and clinics of this nature extended, it seems that
the general practitioner could play a vital part, through his personal relationship
with his patients, in getting hospital treatment for women with breast cancer with the
least possible delay.
DENTAL SERVICES
We have been fortunate in attracting enthusiastic staff to this section of the Health
Department and this together with the continued replacement of equipment by the
most modern type available has helped materially in the improvement of the standard
of service available.
The use of Council transport for children attending schools some distance from
dental centres has proved to be most successful. Younger children are escorted either
by members of the staff or by School Care Committee workers.
The orthodontic side of the service, i.e. the straightening of irregular teeth, continues
to expand and during the year 42 patients were referred to consultant services
at Lewisham Hospital and 12 patients were referred to St. Alfege's Hospital for
treatment. So far 120 removable appliances have been fitted. Each of the dental
surgeons employed in the Council's service attends to their own patients guided by,
and in consultation with, specialist orthodontists.
A feature has been made of dental health education during the year, 65 sessions
having been devoted to this purpose at Central Lewisham and Amersham Road
Health Centres, where talks were given to mothers and pre-school children. A
dental hygienist visited 16 schools following dental inspections to give similar instruction
to the children. Pierre the Clown (sponsored by the Fruit Growers' Association)
visited 29 schools (infants and juniors), the junior mental health training centre
and two day nurseries to urge the importance of eating apples as a means of cleaning
teeth.
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