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felt that such an index, with the co-operation of all the statutory and voluntary bodies
concerned, would become a record of action taken on behalf of problem families and
would tend to encourage voluntary workers and others to consult the Council on
any new problem. Further, when action is required in any particular case, all those
interested could be consulted and, if necessary, brought together. Their knowledge
could be pooled, the next step planned, under the aegis of Council officers, and carried
out effectively by the most appropriate organisation. The general aim would be to
reduce the number of workers visiting the family to one, if possible, but in more
complex problems where more than one worker's help was needed the aim would be
to keep the number to the minimum; the family, therefore, would be saved the
embarrassment and confusion resulting from overlapping visits and enquiries. The
appropriate committees of the Council have therefore agreed to the development of
divisional indexes of families where there appears to be a need for help in bringing up
the children, the index to be adapted to suit local needs.
Where considered desirable, the establishment in each of the health divisions of a
small standing committee of the Council's officers, with representatives of other bodies,
as desired, to co-ordinate the case work has been recommended, no obstacle being
placed in the way of a merger with other case conferences held in the divisions, e.g.,
for maladjusted children or those referred to the N.S.P.C.C. It was also decided
that health divisions should prepare and publish a directory of organisations undertaking
social case work for circulation to all interested parties.
Medical supervision of residential establishments for children
The public health department has continued during the year to supervise the health
of the children in the Council's residential establishments. Apart from unusually heavy
outbreaks of measles at one residential nursery, chicken-pox at another and infective
hepatitis and Flexner dysentery at a third, the pattern of sickness was much as usual.
There was an outbreak of influenza in one residential nursery school in January.
The children in the residential nurseries and nursery schools are under the medical
care of the visiting medical officers, who examine them periodically, as well as on
admission and discharge, and as may be required. Close co-operation is maintained with
the Children's Officer in regard to questions affecting the children's health. With this
in view the establishments are visited at frequent intervals by senior members of the
Council's central medical and nursing staff.
The high incidence of infection in the Council's three large residential nurseries
(The Downs, Ladywell and St. Margaret's) was the subject of a conference between
representatives of the Home Office and the Council. A large nursery with a large
turnover of admissions inevitably produces a large crop of infections and many of the
hospital admissions to which the Home Office drew attention were mild infections.
Other children were admitted to hospital for diagnosis. The children nursed in the
nurseries represented either the ' secondary crop ' or those for whom no hospital bed
could be found.
The Cliffs Residential Nursery school, Dawlish, was closed on 30th June, and the
children transferred elsewhere.
Adoption and boarding-out
During the year 743 children were referred by the Children's Officer for opinion as
to their suitability on medical grounds for adoption or boarding-out in accordance
with the duties placed upon the Council by the Children Act, 1948. Of these 122 were
passed as fit for adoption and 621 fit for boarding-out.
Care of the unmarried mother and her child
The Council's duties for the care of expectant and nursing mothers and young children
include the care of the unmarried mothers and their babies. This duty is performed