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advice and treatment, as well as in respect of the salaries of health
visitors and other officers engaged for this work.
Up to the present, local authorities, in their infant welfare work,
have concerned themselves more especially with the child in its
first year of life ; the matter is, however, one which needs to be dealt
with on a more comprehensive basis and it is clearly desirable that
there should be continuity in dealing with the whole period from
before birth until the time when the child is entered upon a school
register, i.e., the register of a public elementary school, nursery
school, creche, day nursery, school for mothers, or other school.
Extension of the existing work is accordingly needed in two
directions; on the one hand it is necessary that measures should
be taken for securing improved ante-natal and natal conditions, and
on the other provision should be made for continuing the work in
relation to children beyond the first year of life.
The work of home visitation is one to which the Board attach
very great importance and in promoting schemes on the lines laid
down in the accompanying statement the first step should be the
appointment of an adequate staff of Health Visitors.
It will be desirable, at all events in the case of the larger urban
authorities, to provide consultation centres which may fitly be
termed Maternity Centres, to which expectant mothers and mothers
with infants and little children may be referred for advice and treatment;
the operation of these Maternity Centres will be rendered
most effective if co-operation is secured with the midwives of the
district and with any local hospital having a maternity department.
It will be necessary to arrange for a medical officer to be in charge
of such a Centre and for the attendance at the Centre of members
of the staff engaged in home visiting. Careful records, for which
the medical officer should be responsible, will need to be kept, and
in regard to children the records should be in such a form that they
may subsequently be available for the information of the School
Medical Officer when the child is entered at a school.
It is not expected that all local authorities will be able at once
to initiate complete schemes, but it is important that any partial
arrangements that may be made shall be such as can ultimately
form part of a more extended organisation.
Subject to the estimate now before Parliament being accepted
by Parliament, the Board will be willing to consider applications for
grants in respect of any work falling within the scope of the scheme
outlined in the memorandum accompanying this letter; the grants