View report page

37
One of the major problems in Westminster is the number of children under 5 who require day
care. Some of these are the children of unsupported mothers who require full day care in a day
nursery or with a child minder because the mother must work. Some are the children of professional
mothers, teachers or nurses who wish to return to work. Some have mothers who are students who
should continue their courses, or the fathers are students depending on the wife for support. But the
majority of children for whom day care is needed are those from a "deprived" environment—children
whose parents cannot look after them adequately, cannot provide a healthy and stimulating home in
which the child can thrive and develop normally. Priority is given in the City Council's day nurseries
to handicapped children—those handicapped by mental or physical disability or by social environment.
This is an important sphere of developmental paediatrics. Given special education and training
in a good day nursery or playgroup, these handicapped young children can and do achieve a performance
commensurate with their chronological age and are able to adapt to the infant school when the
time comes to enter it.
The appointment of an assistant nursing officer with responsibility for the day care of children has
resulted in considerable improvement in facilities. Her main task has been to improve the quality of
care given by child minders and playgroups, and to encourage suitable new applicants to register.
Playgroup leaders and assistants, as well as child minders have been advised about courses of
training, and have also been offered opportunities to observe existing groups. At one new playgroup
opened by the City Council, special arrangements are made for child minders to attend with their
children and learn about general child care as well as suitable play activities.
The attachment of health visitors to general practices proceeds slowly. In Westminster, the number
of family doctors greatly exceeds those of health visitors, and the majority of general practitioners
work singly or in partnership of two. However, two health visitors were allocated to practices during
the year and 3 district nurses on a part-time basis. There are now six health visitors and three district
nurses attached to practices. As in other areas, it has been found that attachment means more rather
than less work for both general practitioner and nurse, but the increased duties are welcomed. They
provide a better service to the public and real preventive medicine for all ages can be practised.
In the City of Westminster a significant proportion of its population lives alone in bed sitting
rooms, hotels and hostels. Some of these are students, often from overseas; some are mentally ill,
or they may be handicapped or elderly, but the majority are normal working people whose needs are
varied and largely unmet. London can be one of the loneliest places in which to live. True neighbourliness
is uncommon. Some people value the privacy and independence that this ensures, but for the
shy, the inadequate, the proud and poverty stricken, conditions may become well nigh intolerable.
For the mentally ill and mentally subnormal the City provides a social worker service with day care
facilities and some hostel accommodation (see page 49).
For the elderly, the service is provided partly by the Health and Social Services Departments and
partly by the City of Westminster Old People's Welfare Association. There are, however, many
elderly residents who need help but are unwilling to avail themselves of old people's clubs, day
centres, meals on wheels, home helps, and who will not even apply for Social Security benefits.
This is where the attachment of health visitors to general practice can be most beneficial, in the
identification of need and in persuading the people concerned to accept what is their right.
In 1966, 3,570 patients were nursed in their homes by domiciliary nurses. This number has
remained fairly constant in spite of the increasing proportion of the population over the age of 65.
For these patients, the incontinent laundry service, meals on wheels, home help and chiropody
services are available where necessary.
There are special problems connected with the home help service. Because of difficulties in the
recruitment of home helps and financial stringency service can only be provided where help cannot
be obtained from the family, friends or voluntary organisations. The number of applications is fairly
constant—1,529 in 1966 and 1,556 in 1970. The number of patients receiving help in 1966 was
2,695 and in 1970, 2,674. However, some patients receiving help would undoubtedly benefit from
more hours per week if this were possible. Normally home help service is provided during five days
a week only but I must pay tribute to those home helps who work on Saturdays, Sundays and on
Bank Holidays, often in a voluntary capacity, to ensure that their patients' needs are met.
The City Council's policy is to give every encouragement both financial and otherwise to voluntary
organisations, to continue existing work and to start new projects. For children, the City of Westminster
Health Society, the Save the Children Fund, the Westminster Council of Social Service and
the City of Westminster Society for Mentally Handicapped Children are fully supported. For the
mentally ill, services are provided by the National Association for Mental Health and the Institute for
Social Psychiatry; for family problems the Family Service Units, Family Welfare Association and the