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Association, the British Red Cross Society and the Women's Royal Voluntary Service. During
1966 the chiropody service for elderly persons was expanded by the provision of additional sessions.
In the sphere of mental health, Westminster has special problems. Owing to the large daytime
population, the number of visitors and the number of single residents without family support,
there are more emergency admissions to hospital for mental illness than in any other borough. The
same factors make community care for the mentally ill and the mentally subnormal difficult to
arrange.
In 1965, the establishment of mental health social workers was increased to meet the demands
of statutory duties and community care. A new day centre and clubs for the mentally ill are being
started. Provision is being increased for the very young mentally handicapped children and their
parents.
Screening for early carcinoma is being developed, and during 1966 two clinics were opened in
the City for cervical cytology. This service will be extended in 1967.
The City Council gives financial and professional support to voluntary organisations working
within its boundaries and owes a debt of gratitude for the services provided.
MATERNAL AND CHILD WELFARE
There are nine maternal and child welfare centres run by the City Council and two branch clinics
held in church halls. In addition, one centre is run on behalf of the City Council by the City of
Westminster Health Society/and one infant welfare centre is run by a teaching hospital in its own
premises.
Owing to the excellent provision of hospital maternity beds in the area and the fact that the
hospitals are undertaking an increasing responsibility for full ante-natal care for their booked cases
the number of patients attending the Council's ante-natal clinics is declining. Midwives hold
ante-natal sessions at four centres, chiefly for patients booked by general practitioner obstetricians
for home confinement, where they undertake intermediate examinations for the booked doctor.
There is still a need for a booking session in the Local Authority centres where pregnancy is
confirmed, where future arrangements are discussed and where social help can be made available.
This is particularly valuable for unmarried mothers and others with special difficulties. In order to
meet the needs of working mothers one evening session is held weekly.
Classes in mothercraft and home-making as well as in ante-natal exercises are held in most of the
centres, and all mothers, no matter where their delivery is to take place, are invited to attend.
In child welfare, two trends have become apparent. Advice on infant feeding and problems of
home management tend to devolve more on the health visitors, while minor ailments and illnesses
are, rightly, the concern of the family doctor. The clinic doctor is increasingly concerned with preventive
psychiatry; with the diagnosis, at an early stage, of maternal neurosis or disturbed motherchild
relationships, and with the diagnosis of, and arrangements for treatment of, behaviour problems
in children.
The second, and no less important function is in the sphere of developmental paediatrics. As
far as possible, regular developmental examinations are undertaken on all children attending the
centres. This work requires a high degree of skill, and formal training is necessary for all medical
staff undertaking it.
The effect of these trends is that more time must be allowed for consultations, and doctors see
fewer patients at a session. The number of sessions is being increased and where practicable an
appointment system is being introduced.
The difficulty in recruiting suitable full-time medical staff persists, and the Medical Officer of
Health is grateful to the general practitioners who undertake sessional work in the child welfare
clinics, and without whom an adequate service could not be given. The general practitioners so
engaged are, together with the full-time medical staff, supplied with up-to-date literature on
developmental paediatrics, and newly appointed sessional doctors are encouraged to 'sit in' with
more experienced medical officers to learn the techniques of developmental examination.
In this connection, it is of interest to note that the Medical Officer of Health is building up a small
lending library, with the main emphasis on developmental paediatrics.
IMMUNISATION AND VACCINATION
Immunisation and vaccination are provided for all children under 5 years either at the child
welfare clinics or by family doctots.
The following table sets out the percentage vaccination state, within the City Council area of
children born in 1965; the equivalent national figures are also shown: