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A domiciliary family planning service has been in existence in the Paddington area of the City for many
years. Experience showed however that it was difficult in practice for doctors and nurses adequately to
carry out the necessary physical examination, fitting and instruction in the use of contraceptive appliances
in the homes of the patients concerned, particularly as these were often members of problem families.
Moreover, it was largely because of problems arising from their families and home conditions that they had
difficulty in attending the clinic. As an alternative, therefore, arrangements were made for health visitors to
visit these mothers to persuade them of the need for family planning and then to make such arrangements
as might be necessary — for example, by the provision of baby sitters and transport to bring them to the
appropriate clinic for family planning advice and service.
This arrangement has worked extremely well and since its institution it has not been necessary in any
case for the doctor and nurse to carry out the initial examination and instruction in the chosen method in
the home. The need has therefore been established for a domiciliary service on the lines of these later
arrangements and the time was considered ripe for an extension of this modified service over the rest of
Westminster.
The Health Committee agreed that an application should be made under the Urban Aid Programme —
Fourth Phase— for an adequate amount to enable this to be done and the Department of Health and Social
Security's approval was subsequently received.
Youth Advisory Service
In 1968 when the Health Committee were considering the family planning services to be provided under
the National Health Service (Family Planning) Act, 1967, it was decided that a counselling service should be
provided for young persons seeking family planning advice who would benefit from counselling, or who
requested it.
The Youth Advisory Service accordingly started in May 1968 with one evening session per week being
held at the Hallfield clinic. The session is run by a medical practitioner who has specialised in counselling,
adolescent problems and family relationships. A social worker assists the medical officer and undertakes
follow-up work. A Health Department secretary acts as receptionist at the clinic sessions.
The demand for the service led to a second session per week being started in 1969 in the consulting
rooms of the medical practitioner situated near Baker Street.
In April 1971 the social worker was transferred to the Social Services Department, as part of the general
reorganisation of the social services at that time, but she continues to work in close association with the
Health Services, assisting with the Youth Advisory Service.
During 1971, because of increasing demand, a second social worker was allocated by the Director of
Social Services for work with the Youth Advisory Service. The appointment of this additional social worker
has enabled the service to be provided for more young people and to improve liaison with clubs and other
agencies. At the present time there are some 300 young people currently making use of the service;
attendances at the weekly session average 8-10 persons at the Hallfield clinic, and a similar number at the
second clinic. A considerable amount of follow-up work has been found to be necessary because of the
nature of the problems presented and the unhappiness and disturbance found in many of the young people.
This service is an example of the close collaboration which exists between the departments in providing
health/social services for Westminster residents.
Vasectomy
With the presentation of the National Health Service (Family Planning) Amendment Bill before
Parliament early in 1972, it is of interest to note that payment for vasectomy was raised by my department
with the Department of Health and Social Security in May 1970. The advice received from the Department
was that vasectomy was only available under the National Health Service if it was necessary on clinical
grounds and that local health authorities were not empowered to pay for vasectomy operations. The
present Bill, if it reaches the statute book, will reverse this situation and its progress through Parliament is
watched with interest.