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A domiciliary family planning service has been provided on an agency basis by the Marie Stopes
Memorial Foundation for mothers who find it difficult to attend a family planning clinic because of
various domestic commitments. Since the opening of the family planning sessions at the Maternal
and Child Welfare Centre, 283A, Harrow Road, the number of referrals for domiciliary visits has
fallen and during the latter half of 1967 the Foundation asked the City Council to take over this
service as from 1st January, 1968; arrangements were made accordingly.

CERVICAL CYTOLOGY
This important new screening activity of the Health Department is now firmly established.
In the light of the very satisfactory response to the facilities provided for the general public
during the latter part of 1966 at the Hallfield and Harrow Road Maternal and Child Welfare Centres,
two more screening clinics were opened in the early months of 1967. One of these was located
at the maternal and child welfare centre in the Westminster Council House Annexe, the first session
there being held on the 10th January; as in the case of the Hallfield and Harrow Road clinics,
arrangements were made with the Samaritan Hospital for up to twenty cervical smears to be examined
each week. The opening of the fourth clinic, at the Ebury Bridge Maternal and Child Welfare
Centre, took place on the 30th March, thanks to the similar laboratory facilities provided by the
Chelsea Hospital for Women.
Thus four strategically situated weekly cervical screening clinics are now in operation available
to all women under the age of 65 who live or work in Westminster. To encourage busy mothers
to attend, the central appointment system through City Hall has been made more flexible by
arranging for a certain number of bookings for the Hallfield and Harrow Road clinics to be made
locally by the health visitors concerned. Full use of the clinics has also been stimulated by
publicity in the local newspapers, the systematic contacting of business firms and other concerns
in Westminster employing an appreciable number of women, and the production for public display
—in public libraries, maternal and child welfare centres, and the staff rooms of private and public
organisations—of a specially designed leaflet and poster. The leaflet, "The Cervical Smear" has
been well received and the poster entitled, "Important to All Women" has proved sufficiently
attractive to be adopted, in a slightly modified form, by the National Cervical Cancer Prevention
Campaign (now known as the Women's National Cancer Control Campaign) for use throughout
the country.
Throughout the year the clinics remained pleasantly booked with an inevitable lull at holiday
times. No more than 20 persons were seen at each session thus giving time for individual
discussion as well as avoiding the over-taxing of available laboratory resources. This policy of
limiting the attendances had the additional merit of enabling the smears to be reported upon
quickly and results were usually available within a fortnight. Such a speedy service was greatly
appreciated.
In all 2,088 new patients were seen in 1967—614 at Harrow Road, 568 at St. Marylebone,
454 at Hallfield and 452 at Ebury Bridge. Six of these, as well as one patient previously seen in
1966, were found to have positive smears and all were referred through their family doctors for
further investigation. The presence of a pre-cancerous condition was confirmed in all seven
cases and the necessary treatment put in hand; all were between the ages of 29 and 47. In
addition, approximately one woman in every four attending a cervical screening clinic was referred
to her doctor in relation to such incidental findings as Trichomonas or Monilia infections, cervical
erosions, cervical polyps, uterine fibroids, and various forms of uterine prolapse. The discovery
and treatment of these conditions form an important by-product of the screening process since
they are often the cause of physical discomfort or mental worry.
Such screening undoubtedly has a useful part to play in improving and preserving health and
it is therefore a particular pleasure to record the indebtedness of the Health Department to the
consultant cytologists and their laboratory staffs at the Samaritan Hospital and the Chelsea Hospital
for Women for help unstintingly given. Their contribution has been a major factor in the present
satisfactory position of the community screening service provided in Westminster. An account
of this service, which appeared in the October issue of "Health", the journal of The Chest and
Heart Association, attracted considerable interest in other parts of the country.