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the Medical Officer of Health, there is no need for an observation register. Its maintenance is an
expensive and cumbrous procedure with, as has been said, a great deal of abortive work. A valuable
lesson has however been gained from the observation register system—all children, and not merely
a selected group, need regular developmental examinations. This is becoming an established
procedure in the Council's clinics.
To complement this service, the Medical Officer of Health has arranged for members of his
medical team to attend the course in developmental examination run by Dr. Ruth Griffiths or the
course in developmental paediatrics arranged by the Society of Medical Officers of Health, as
opportunity arises. Medical Officers are encouraged also to attend shorter courses dealing with a
specific handicap, e.g. deafness, blindness, etc. Most of the City Council's full-time medical staff
have attended the standard course for ascertainment of educationally subnormal children and have
been approved for this work.
The special units established in three of the Council day nurseries (Katharine Bruce, Bloomfield
and Bessborough Street) together form a most valuable adjunct to the service for pre-school
handicapped children. Children are admitted to a special unit for a period of systematic observation,
assessment, and to give the mother some relief from 24-hour care.
Special clinics for assessment and parent counselling
Assessment clinics for pre-school children with suspected or known handicaps have continued
to be held at welfare centres in the City. Parent counselling is an integral part of their function.
During the year an assessment centre was established at Paddington Green Children's Hospital,
staffed by Dr. P. J. N. Cox, Consultant Paediatrician to the hospital, and by one of the City Council's
senior medical officers. This has the obvious advantage of providing supporting diagnostic facilities
on the spot. Since the hospital catchment area extends beyond the City boundary, not all of the
children seen are Westminster residents. The majority, however, are, and this clinic is providing a
valuable service. The Medical Officer of Health would like to express his gratitude to the hospital
paediatricians, not only for making this clinic possible but also for their generosity in so readily
sharing their clinical knowledge with the City medical staff concerned.
Transport
Children attending the special unit at Katharine Bruce day nursery are transported to and from the
nursery; those attending the other two special units (which have a more local catchment area) are
transported if necessary.
The I.L.E.A. provides transport for all children attending special schools, and, where needed,
for handicapped children attending ordinary schools.
HOME NURSING
Comprehensive nursing care is given in the homes of the sick, elderly and disabled, by skilled
district nurses and State enrolled nurses, assisted by bathing attendants.
Patients are referred mainly from hospitals and general practitioners.
Although there is good co-operation between the nursing staff and the many general practitioners
in the area, closer contact is to be encouraged.
With the use of modern disposable equipment and the loan of necessary nursing articles, there
are very few nursing treatments which cannot be carried out at home, and many unnecessary
journeys to hospital can be avoided. Also, extremely ill patients are successfully cared for in their
own homes by the district nurse helping the family, and calling on the aid of other supportive
services. Particular help for day and night nursing in special cases is obtained through the Marie
Curie Memorial Fund, which has been greatly appreciated during the year.
Organisation
The whole area is covered by nursing staff working from two centres, in the North from 117
Sutherland Avenue, W.9, and in the South from 36 Great Smith Street, S.W.1.