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45
themselves of it, as many would probably not "bother their doctor" had not the
clinic doctor recommended them to seek his advice. An attractive birthday card is
sent to remind them of these facilities.
First attendances at ante-natal clinics amounted to 52 per cent, of all women
needing ante-natal care during the year (as estimated from confinements over a
corresponding later period) compared with 56 per cent, in 1948. Nowadays
practically every expectant mother has ante-natal care. The balance of 48
per cent, receive it from the hospitals where they will be confined, or from the
doctor who has been booked. Several hospitals refer their booked cases to the
Council's ante-natal clinics for intermediate supervision. The mothers attend the
hospitals to book and are referred from the Council's clinics to the hospital
at once if any serious complication arises. Though expectant mothers value the
medical supervision which they receive at the Council's clinics from experienced
medical officers (they attend about six times during their pregnancy), it is to be
expected that they will tend more and more to avail themselves of the general
practitioner obstetrician service. Towards the end of 1949 there was a decline in
pressure greater than could be accounted for by the fall in the birth-rate, though this
did not greatly affect the total attendances for the year, which were well maintained.
Attendances at breast feeding clinics declined, largely owing to the fact that
breast feeding advice is given in the ante-natal and infant welfare sessions, at the
latter of which test feeds are also carried out. There was an expansion in attendances
at educational and advisory sessions. Attendances were well maintained at
the light and massage clinics. Comments on the work of the dental clinics will be
found in the report of the Chief Dental Surgeon (page 102).
Joint arrangements with other Local Health Authorities
Arrangements were made with the Kent county council whereby expectant
mothers and those with young children living in the Mottingham area may attend
the maternity and child welfare centre nearest to their homes irrespective of whether
the local health authority administering the centre is the same as the authority in
whose area they live. This has saved the women concerned a great deal of travelling,
and it has been agreed that no financial claims will be made in respect of this reciprocal
service.
The Council also agreed to the attendance at its ante-natal, infant welfare and
foot clinics in Fernhill Street, North Woolwich, of women and young children living
in that part of the county borough of West Ham adjacent to North Woolwich.
It has also been agreed that, should these extra attendances overcrowd the Council's
clinics, the West Ham residents may attend sessions administered by the East Ham
county borough council in the same premises. Both arrangements are reciprocal
without financial adjustment between the authorities.
Should similar arrangements prove to be required elsewhere on the periphery
of the county area, the Council will be prepared to co-operate with other local
health authorities on the same basis.
Voluntary Organisations
The agreements made under Section 22 of the National Health Service Act,
1946, between the Council and the twenty voluntary organisations providing
maternity and child welfare clinics have been in operation for eighteen months and
have in general proved satisfactory. New agreements are being negotiated, and
the experience gained since the "appointed day" is proving most valuable in reviewing
the terms and conditions on which the Council gives financial aid to these
bodies. It is proposed that the centres shall continue to be managed by the voluntary
committees and that the Council shall continue to be represented on those committees
and have powers of inspection of the premises.
Providing
M. and C.W.
Clinics