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from more than one household. In addition, the local authority is empowered to impose requirements
considered necessary in the interests of the children.
Initially, one of the City Council's medical officers inspects the premises to be used and advises the
proprietor of the Council's requirements which include, in appropriate cases, town planning consent
and the provision of satisfactory means of escape and fire precautions. On the facts presented, the
Medical Officer of Health determines the number of children who can be accommodated and any
other special requirements. After registration, periodic inspection by the City Council's officers is
undertaken in order to ensure continued compliance with the requirements.
(a) Private Day Nurseries
There are 20 registered private day nurseries available to take 528 children of pre-school age.
Only a small number of these nurseries accepts children for a full day and provides a midday meal;
the majority are open for the mornings or afternoons only.
(b) Child Minders
Sixteen child minders catering for 82 children were registered with the City Council by the end of
the year.
Voluntary Child Minders
Women who look after one or two children under the age of five years may register with the City
Council as voluntary child minders. Before registration the premises are visited by the Health Visitor
who ensures that the child minder and the home is suitable; thereafter the Health Visitor maintains
general surveillance of the home. The minders are paid a small fee by the City Council for which
they are expected to take the children regularly to the infant welfare centres. At 31st December, 1965
there were 62 voluntary child minders on the register, authorized to mind 96 children.
Occasional Creches and Play Groups
The City Council provides nine two hourly occasional creche sessions per week at various maternal
and child welfare centres where children of mothers attending clinic activities or hospital appointments
are minded free of charge. Children are also accepted on payment of 1s. 9d. per session to allow
mothers to go shopping, etc. on their own. Approximately 135 children are minded weekly in this
way. In addition, there are a number of play groups open for a few hours a day run by voluntary
associations. These fulfil a need for children under five years of age of families who wish to have their
children looked after for part of a day, because of overcrowded home conditions or in the interests of
the children, thus giving them companionship and the opportunity for play in secure surroundings.
HOME NURSING
(Miss P. M. Adams, Superintendent of Home Nurses and Non-Medical Supervisor of Midwives)
Under Section 25 of the National Health Service Act, 1946, a local health authority is required
to make provision for securing the attendance of nurses on persons who require nursing in their
own homes.
Prior to April, 1965, this service was provided in the area of the "new" City of Westminster by three
separate District Nursing Associations whose districts were not co-terminous with the new authority.
The reorganization of London Government therefore created special problems so far as the home
nursing service was concerned in Westminster.
The City Council, after consultation with the Associations concerned, decided to provide a service
controlled and administered by the Medical Officer of Health.
The Headquarters of the former Paddington and St. Marylebone District Nursing Association,
situated in Sutherland Avenue, Paddington, continued to serve the northern portion of Westminster,
whilst a new Centre was opened in April, 1965 in Great Smith Street, S.W.1., to serve the area of
the "old" City of Westminster. Residential accommodation is provided at Nos. 90 and 117 Sutherland
Avenue for a total of 28 staff.
Home nursing is provided on request from Doctors and Hospitals who prescribe all necessary
treatments, drugs and dressings. Patients are visited according to need and treatment ordered.
Nursing staff are available from 8.30 a.m. until 9.30 p.m. each day but the bulk of the visits are
completed by 6 p.m. All types of nursing care are given and an increasing amount of time is spent
in the rehabilitation of patients following severe or disabling diseases. The majority of patients are
over 65 years of age when first referred to the service and some need care for many months or years.
A specialized scheme for the care of sick children at home is operated by St. Mary's Hospital,
paediatric unit, but the nursing staff is provided by the City Council; at the present time one full time