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6
needed advice on family planning problems from the health point
of view would receive such advice with the least possible delay
and the minimum of formalities. I understand that the arrangements
which were made were much appreciated by the Association.
In conjunction also with the Association, a film show was organised
to which staff from the Health, Welfare and Children's Departments
were invited, showing the newer methods for family planning.
Another feature to which I would like to refer is our arrangements
for screening tests for cancer of the womb. There had already
been in this area over a period of several years arrangements for
offering this service but during the year a good deal of further
attention was given to this and a number of reports made to the
Health Committee. In the body of the Report, further details will
be found about this service. It can be said that it is now on a
firm basis and if and when facilities become available for an increased
number of smears to be examined at the hospital laboratories,
we will be in a position, provided of course adequate
experienced doctors are available, to step up the work considerably.
This aspect of preventive medicine has received much publicity,
undoubtedly well merited, but which in some ways has given rise
to misunderstanding. The emphasis in this publicity has been on
screening tests for cancer of the womb, particularly of the neck
of the womb, and this is justifiable since this is a very serious
killing illness of women. It must, however, be pointed out, and this
is shown from the figures given in the body of the Report, that
there are many other conditions not necessarily as serious as cancer
of the neck of the womb, to which women are liable and which
undoubtedly cause a great deal of ill-health and mental anguish.
It is for this reason that in Wandsworth we have thought in terms,
not exclusively of screening tests for cancer of the womb, but as
screening gynaecological clinics where a full examination is made.
Consequently, although we have considered the matter carefully
departmentally, we have not looked with favour on the proposals
which have from time to time been made for the smears to be taken
by staff such as nurses and midwives trained in the technique of
taking smears. We think that the examination should be a gynaecological
examination carried out, not only by a doctor, but preferably
by a doctor who has a special interest in and experience
of this work. To some extent, it is true to say that this might limit
the service offered although up to the moment in Wandsworth,
this has not been so. There is another important factor which
justifies this policy. If there is one thing more serious than a
diagnosis of cancer of the neck of the womb it is for a smear or
examination to give a wrong result with a false sense of security
resulting in the disease being left undiagnosed until it attains a
more advanced form at a later stage. The risk of such a happening
may not, it is true, be very great, but if reliance is placed solely on
the smears, then it can happen. A gynaecological examination
minimizes the risk of this happening, as well as diagnosing many