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35
BATHING SERVICE
The provisions of Section 43 of the London County Council (General Powers) Act, 1953, empowered
sanitary authorities to make arrangements for bathing old people at their own request or with their
consent. During the year a total of 560 baths were given, 477 to women and 83 to men, under a scheme
started in 1954 for bathing old persons at the Lissonia Centre. A trained nurse is employed parttime
to supervise the bathing and accompany the old people on the journeys in a Health Department
vehicle between their homes and the Centre. In addition, 735 women were bathed in their homes
by a woman bathing attendant who is based on the Wedlake Street Centre.
DOMICILIARY MIDWIFERY
The City Council, under the National Health Service Act,1946, must secure that a sufficient number of
certified Midwives are available for attendance on women in their homes.
The domiciliary midwifery service, prior to April, 1965, was provided by the District Nursing
Associations and Westminster Hospital. The re-organized service is provided directly by the City
Council except for an area in "old" Westminster which is still covered by Westminster Hospital.
The midwives provide a comprehensive service of antenatal care in co-operation with the patient's
own doctor.
A close liaison is maintained with all Maternity Units in the City with particular attention to the
follow-up care for mothers and babies discharged home during the lying-in period (defined as 10 days
by the Central Midwives Board). Arrangements for early discharge are made between the hospitals
and the City Council early in the patient's pregnancy, thus providing for continuity of care.
Domiciliary cases are provided for Pupil Midwives taking Part II Midwifery Training at Paddington
General Hospital, each pupil being seconded to the City Council for three months. Two of the
Council's midwives have special approval from the Central Midwives Board to supervise this training
(See Table 37, page 69.)
Notification of Defects Apparent at Birth
Congenital defects apparent at birth are recorded on the birth notification card sent to the Medical
Officer of Health whether the birth takes place in hospital, at home or in a nursing home.
There was a noticeable decrease in the total number of children notified as having such defects in
the year 1965; (50 children as against 85 children in 1964). When the present form of birth notification
card was taken into use in 1964 the cards often showed details of neonatal trauma which were not
true congenital defects. Even when full allowance has been made for this in the records, the difference
is still striking. Details of the types of defects shown are given in Table 38, page 69, from which it
will be seen that the major decrease is in the number of children shown as being born with talipes,
Polydactyly and syndactyly.
Observation Register
Many congenital defects are not discovered at the first examination a baby receives; congenital
lesions of the heart are not commonly diagnosed at this stage, nor always is mongolism. Deafness
can only be discovered later. With this in mind, all children attending clinics receive regular developmental
examinations. In furtherance of this important aspect of child care, the Medical Officer of
Health is indebted to Dr. Dorothy F. Egan of the Greater London Council, for her constructive
suggestions and her lectures to medical and nursing staff whilst acting as consultant to the Health
Department.
In addition to the defects apparent at birth, there are the handicaps which can only later be detected:
mental retardation, spasticity, and as has been said, some heart lesions, deafness and visual defects.
The Health Department maintains an observation register. This contains the names of all children
resident in the City where there are adverse factors in the mother's obstetric history or a family
history of such conditions as deafness or blindness, or where there were difficulties in the perinatal
or immediate postnatal period. The mothers of these children are encouraged to bring them to the
clinics, where, in addition to the ordinary care and advice, a full developmental examination is carried
out at the age of six months, one year and two years. At the end of this period, it is usual that defects,
if they exist, have become manifest and treatment instituted. Special education can be arranged for
those needing it from the age of two years, or, in appropriate cases, admission to one of the Council's
day nurseries can be arranged. This is particularly valuable in introducing the child of deaf or dumb
parents to an environment in which the child hears and learns normal speech.
The early ascertainment and treatment of handicaps is vital to successful treatment. It is very
probable that, in the past, children have been deemed backward or subnormal because of some undetected
defect of vision or hearing. Early diagnosis and the provision of hearing aids and suitable