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tions and they could well come to a group practice or health centre
to see patients on request, if the circumstances are appropriate. Three
health centres—at Bridge Lane, Brocklebank, and Larch Road respectively—are
in the current capital development programme of the
Corporation and, when completed, these multi-purpose buildings will
foster that sense of teamwork which is the hallmark of an integrated
service; they will also enable outdated accommodation to be vacated,
and it is pertinent to mention in this context the opening next year of
the new Doddington Child Health Clinic.
In Wandsworth, where well over 5,500 births occur annually and
the pre-school population exceeds 25,500—a highly mobile group,
since some 3,000 children under the age of 5 leave the borough, and a
similar number enter, each year—eleven child health clinics are operated
by the Health Department. At these clinics facilities are available
for ante-natal and post-natal care, including mothercraft and relaxation
classes, and for the routine supervision of the infant and toddler;
special investigation clinics for both pre-school and school children
are held; and a comprehensive dental health service is provided for
expectant and nursing mothers and their children. Immunization and
vaccination continue to receive the attention which they have long
merited. Regarding child care generally, however, the medical emphasis
has changed in recent years from the giving of advice on infant feeding,
hygiene, clothing and general management—now properly, unless
there are special problems, the domain of the health visitor—to the
monitoring of healthy physical and emotional growth and development
through the use from early infancy of screening tests designed to
assess in a friendly informal manner progress in relation to posture
and locomotion, vision and manipulative skill, hearing and speech, and
social behaviour and play. The performance of such routine developmental
paediatric examinations at regular intervals (which happily
often coincide with the recommended time scheduled for immunization
and vaccination during the first eighteen months of life) reflects the
immense importance now attached to the recognition of handicapping
conditions as early as possible so that, in consultation with the family
doctor, arrangements for remedial measures can be made promptly
where appropriate, thus keeping disability to a minimum and preserving
educational potential to a maximum.
All too frequently today handicaps are multiple. Systematic followup
is essential, and to this end, a special handicap and observation
register is maintained, containing the names of all children—currently
numbering 1,042 in Wandsworth—known to be handicapped or considered
to be at risk (on account of genetic factors and other potentially
adverse influences during pregnancy, confinement, and the first few days
of life). Through regular medical examinations, the progress of these
children is kept under continuous review so that, when this proves to
be satisfactory, the appropriate deletion from the register can be made;
for others, day care can be arranged where necessary in liaison, in
the future, with the Social Services Department; the need for special
educational measures can be anticipated well in advance; suitable provision
accordingly made by the Inner London Education Authority;
close supervision subsequently continued at school to ensure from a
medical standpoint that handicaps impede education as little as possible,
and special consideration can be given to the future of the handicapped
school leaver. The register is constantly being updated, reflecting the