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The Marie Stopes Memorial Foundation provides a domiciliary service to mothers who because
of various domestic difficulties are unlikely or unable to attend a Family Planning Clinic and to whom
a further pregnancy might well undermine their health and welfare. Figures show that there is
still a need for this type of service.
The City Council also grants the free use of health service premises to the Catholic Marriage
Guidance Council.
Family Planning Sessions, 1966
(City Council Clinic at 283A Harrow Road)
Number of 1st attendances during year 368
Total number of attendances during year 819
Number of sessions held during year 52
CERVICAL CYTOLOGY
Section 28 of the National Health Service Act, 1946, also enables Local Health Authorities to
participate in a cytological screening service for the early diagnosis of cervical carcinoma. Within
the last decade, it has become widely recognised that by microscopic examination of the cells shed
from the surface of the uterine cervix, it is possible to detect early abnormalities which precede
malignant changes by a number of years. Each year, some 2,500 women, mainly in the prime of
life, die in England and Wales from carcinoma of the cervix. This heavy toll can now be prevented.
It is therefore the policy of the Ministry of Health to encourage, in so far as local resources allow,
the establishment of a screening service in which general practitioners may be supported where
appropriate by Local Health Authority clinics.
Taking a cervical smear is comparatively simple; on the other hand microscopical examination
of the cervical cells is a highly skilled process. The number of smears which can be taken is thus
primarily determined by the availability of suitably trained technicians in the hospital laboratories.
Late in 1965, the Inner London Local Medical Committee, representing all general practitioners in
the National Health Service in the area, requested local authorities to establish screening clinics in
their areas for the general population. Officers of the City Council had already been investigating
the possibility of such a service and, thanks to the help of the Samaritan Hospital, it was possible,
with the approval of the Ministry of Health, to meet this request. The first cervical screening
clinic was opened at Hallfield Maternal and Child Welfare Centre on the 5th September, 1966,
and a second at Harrow Road Maternal and Child Welfare Centre on the 4th November; each clinic
is held weekly, up to twenty smears being taken at each session.
Carcinoma of the cervix is most common in the 35-55 years age group, particularly in married
women who have had several children. It is, however, desirable to screen all women at least every
five years between the ages of 25 and 65; younger women should not be discouraged from having
this examination, so that no lower age limit need be set. Thus from the outset the screening
service has been available to all women under the age of 65 living or working in Westminster, all
appointments being made centrally through the Health Department at City Hall.
To encourage the use of this service, an explanatory leaflet was specially designed for the general
public for display in public libraries and maternal and child welfare centres; a large poster for
similar public display was in the process of production at the end of the year. The leaflet entitled
"The Cervical Smear", had two purposes—first, to provide a simple explanation of the test and,
secondly, to obviate any undue alarm caused by a request for a further smear to be examined or by
reference to the patient's doctor for investigation. All patients attending a screening clinic are also
offered a simple palpation of the breasts and this is accepted almost invariably.
By the end of the year, 370 women had attended a screening clinic 260 at Hallfield and 110 at
Harrow Road. Of this number two, aged 63 and 41 respectively, were found to have positive smears
and were referred to hospital by their family doctors for the necessary further investigations to be
undertaken—the presence of a pre-cancerous condition was confirmed in both patients and the
requisite treatment put in hand. In addition, a number of minor conditions, such as Trichomonas
or Monilia infection, or a cervical polyp or erosion, were discovered, and all such cases were
referred to their general practitioners for treatment to be arranged.
In view of the good public response, arrangements had been completed by the end of the year
for the opening of a third cervical screening clinic at the Marylebone Town Hall Annexe Maternal &
Child Welfare Centre early in January.
RECUPERATIVE HOLIDAYS
Recuperative holidays, normally of two weeks duration, are arranged for adults who have been
suffering from a recent illness and who, although not requiring special medical and nursing care
provided at a convalescent home, would benefit by rest, fresh air and good food at a recuperative