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38
PERSONAL HEALTH SERVICES
Since 1965 when the new City of Westminster was formed, there have been many changes
affecting the demands made on the personal health services. There has been an estimated decline
in the total residential population from 266,770 in 1965 to 240,360 in 1969 while the number of
births has fallen from 3,952 in 1965 to 2,899 in 1969. The illegitimacy rate remains high (17.63%)
compared with the rest of London (11 %), details of which are given on page 12.
The entrance of new immigrants from the Commonwealth has slowed down and there is evidence
that those already in the City have settled well and are becoming accepted by their neighbours. More
immigrants are coming from Europe, chiefly because of the availability of work, especially in hospitals,
hotels, restaurants and private domestic service.
In the field of housing, both the Greater London Council and Westminster City Council have made
strides in slum clearance and have rehoused many families in new flats or reconditioned older
properties. Rehousing, however, nearly always results in higher rents; added to this, the increasing
cost of gas, electricity and transport leads to financial difficulty for many families. Because of the
shortage of sites within the City, many families with children are housed in tower blocks of flats.
This gives rise to many social problems. Many mothers of young children have to, or wish to, go out
to work - perhaps to meet the high cost of rents in new property or because they live in old, depressing
and unsuitable housing or perhaps because mothers are the sole supporters of the family
whatever the cause, the problem of day care of their children is acute.
Mental health presents a special problem in the City. The number of temporary residents without
roots, often lonely and living in bed-sitting rooms and the attraction of the West End for unstable
misfits, produce an undue concentration of the vulnerable or mentally ill within the City's bounds.
The medical services within the City are excellent. There are five teaching hospitals, two of
which are now accepting full district responsibility. So far as maternity is concerned, it is now
possible for every woman who wishes to do so to have a hospital confinement and in 1969, 97 per
cent, of births took place in a hospital. Two hospitals have accepted responsibility for geriatric cases
and only from the southern part of the City is it necessary for elderly patients to be sent to Regional
Hospital Board hospitals outside the City boundaries. A small in-patient unit for psychiatric cases
has been opened, but most of the mentally ill have to travel to Regional Hospital Board hospitals in
Surrey.
There are nearly 350 general practitioners providing services under the National Health Service
Act in the area, besides many engaged solely in private practice. Co-operation between general
practitioners and the City of Westminster Health Department is excellent.
Westminster has an undue proportion of elderly residents, 13.8 per cent, compared with 12 per
cent, for the rest of England and Wales. It is almost impossible to identify all those in social need but
increasing numbers are coming to the attention of the statutory or voluntary workers. In this field
increasing demands are made on the home help service; referrals rose from 1,188 in 1966 to 1,266 in
1969 (see report on page 48 and Table 39, page 86).
Tribute must be paid to the work of the various voluntary organisations providing services in the
City. The City Council has always encouraged voluntary effort and makes substantial financial
contributions to enable these bodies to undertake their work. There is close co-operation between
the Council's staff and the voluntary bodies and their work in all spheres is appreciated ; particularly
is this true of their efforts for the elderly.
Maternal and Child Health
Antenatal care
Antenatal clinics are held at seven of the Council's maternal and child welfare centres. Most of
the patients book for hospital delivery and for these patients antenatal care may be provided by the
hospital and the local authority clinic or by the hospital and the general practitioner. Cases booked
for home confinement receive their antenatal care from the general practitioner and domiciliary
midwife. A co-operation card is used in the Council's clinics for record purposes.
Courses in mothercraft are undertaken by the health visitors and antenatal and postnatal exercises
are taught and supervised by a physiotherapist with special training in this field.
In order to cater for the needs of working mothers one antenatal clinic each week is held in the
evenings.