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necessary staff. Staff shortage has been particularly marked among health visitors.
Comments on the provision of suitable premises for these clinics will be found on
page 28.
Care of premature infants
Special attention has been, and is being, given to the care of the premature
infant. Doctors and midwives have been asked to record on the notification of birth
form the weight of any infant which weighs 5½ lbs. or less at birth, and these infants
are dealt with as "premature." Equipment likely to be required when a premature
infant is nursed at home has been provided. By the courtesy of the hospital
authorities some equipment is being kept at hospitals and is available on request
by day or night. In other areas equipment is held at centres scattered over the
district, thus facilitating quick delivery to any home where it is needed. Special
instructions have been issued to the Council's domiciliary midwives and to the district
midwives of hospitals and district nursing associations regarding the care of the
premature infant in the home, and, where necessary, the infant is removed to hospital
in a warmed cot. Heated ambulances are available for this purpose.
All hospitals which do not themselves employ trained visiting staff to follow up
premature infants on discharge have established close liaison through their almoners
with the Council's health visiting service. Opportunity has been taken to urge on
hospital authorities the need for the establishment of more special units for dealing
with premature infants on the lines of that established early in 1948 in the
Council's Hammersmith Hospital.
Dental care
Details of the priority service for mothers and babies will be found on page 83 in
the Report of the Council's Chief Dental Surgeon.
Welfare foods
A special departmental committee was set up to advise which welfare foods,
nutrients, medical requisites, drugs, etc., should be available at maternity and
child welfare centres. A list based on their recommendations has been approved and
will be revised periodically.
All the voluntary organisations having agreements with the Council for carrying
out maternity and child welfare functions have been offered the use of the Council's
central purchasing organisation ; the majority have preferred not to take advantage
of the offer.
Provision of maternity outfits
Every woman delivered at home is issued with a free maternity outfit, containing
accouchement sheets and dressings required for the confinement. The Council
supplies these outfits to its own midwives and to those employed by district nursing
associations. The hospitals supply the outfits to their district midwives and the cost
is taken into account by the Council in fixing the rate of payment to the hospitals.
Day nurseries and creches
The facilities available on the "appointed day" have been continued and, where
practicable, have been increased.
A scheme of priorities for admissions to day nurseries has been drawn up and is
applied where the number of applications exceeds the number of places available.
Due regard has been paid to the various factors—economic, health, etc.—necessitating
the placing of children in day nurseries. A standard charge of Is. a day for each
child placed is made to parents availing themselves of these facilities. This is
regarded as covering the cost of the midday meal supplied to the child and is not
abatable.