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39
In addition there is an exchange system with St. James's Hospital, Balham, and a
paediatrician from St. Thomas's Hospital goes to North Lambeth Babies' Care Welfare
Centre to take weekly child welfare sessions and is paid the ordinary rate for a nonspecialist
session.
Among the services taken over from the metropolitan borough councils were a
number of specialist clinics for expectant and nursing mothers and children (e.g. gynaecological,
special women's, physiotherapy). Although these were provided under the
maternity and child welfare powers of the borough councils, they were not services
proper to the local health authority under the National Health Service. Negotiations
have, therefore, been proceeding with the Metropolitan Regional Hospital Boards with
a view to their assuming full responsibility for the administration of such clinics. In some
cases, responsibility has been accepted for clinics held in Council premises; in others the
work has been transferred to hospital premises or terminated. Negotiations are still
proceeding in some instances. The Council has continued the employment, under
arrangements made by the borough councils, of specialists provided by teaching hospitals
for ante-natal advice (5 sessions a week) and child welfare (3 sessions a week). Generally
speaking, however, specialist advice for maternity and child welfare patients is obtained
by referring the patient to a hospital specialist clinic and there is adequate liaison between
the clinics and the hospitals for this purpose.
Voluntary organisations
From the inception of the National Health Service the Council continued to utilise
existing voluntary committees as in the case of the home nursing service which is carried
out entirely by voluntary district nursing organisations on a grant-aided basis. Encouragement
has also been given, in appropriate cases, to the formation of new committees such
as those for tuberculosis care and the care of old people to which reference is made below.
The use of voluntary associations in connection with mental health is dealt with on
page 106.
When the Council assumed responsibility for the maternity and child welfare services,
an agreement to cover the period from 5-7-48 to 31-3-50 in the first instance was made
with 24 voluntary organisations providing maternity and child welfare and/or day nursery
services, arrangements being made for the Council to be represented on the managing
committees of these bodies and to inspect the premises and services, and for a grant to
be paid by the Council on a modified deficiency basis. The administration of two
maternity and child welfare centres has since been assumed by the Council. New agreements
in the light of the experience gained since July, 1948, are being negotiated with
the remaining voluntary organisations, and in the meantime, by mutual consent, the
original agreements have been extended.
Arrangements were also made with the Mothercraft Training Society, Cromwell
House, Highgate, for the Council to be financially responsible for the attendances of
London residents at their two out-patient clinics for mothers and children (a) at
42 Penywern Road, Kensington, and (b) at Cromwell House, Highgate, and for financial
responsibility to be accepted for the admission of London residents to the in-patient unit
at Cromwell House for mothers and babies with breast-feeding difficulties and babies
with dietetic upsets. These arrangements were terminated when the Society ceased its
activities at the end of July, 1951. Records relating to London children who normally
attended the out-patient clinics were passed to the appropriate divisional health office so
that these mothers and children might be referred to convenient welfare centres. Patients
who would have been referred by the Council for in-patient treatment at Cromwell
House are now referred to the residential unit at the Violet Melchett Infant Welfare
Centre (see page 51).
Many of the former voluntary hospitals provided maternity and child welfare services,
both ante- and post-natal clinics, child welfare clinics, and health visiting services, before
the 'appointed day' often by arrangement with one or more of the metropolitan