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140
An exhibition on home accidents was well attended, and the work of the health authority
with regard to the domiciliary care of older persons was publicised in an exhibit set up
in an 'Old Peoples' exhibition. The incidence of head infestation among children is
still far too high, and since the home seems to provide the reservoir, health visitors
directed special effort on this aspect of the problem, making insecticides available for use
in the home. An investigation as to the value and mode of employment of the preparations
of the new contact insecticides is in progress.
The home
help service
and older
persons
As was anticipated, demands tor this service have increased, and they will continue to
do so where older persons are concerned. The plight of many old people in the division
demands vigorous action. The domiciliary team under the guidance of the general
practitioner consists of district nurses, health visitors, home helps, and voluntary workers,
and full effort must be directed towards strengthening this band. In addition, more
half-way homes and residential establishments are needed urgently rather than long stay
hospital beds. Home helps—including males—are doing praiseworthy work, indeed,
without them the expanding problem of senescence would almost be insoluble. For a
short period, difficulty was experienced in meeting the demand, but authority for
increased recruitment was asked for and obtained.
Observations on these matters have been published elsewhere.*
School health
service
Space permits of mention of only one of the many interesting facets of this work—
the routine tuberculin testing and mass miniature radiography of pupils and staff in
schools in which one of the latter was found to be tuberculous. This method of quenching
epidemic foci of the disease is proving well worth while.
Day
nurseries
The numbers of attendances have fallen, particularly in the Lewisham nurseries, and
it was necessary to close part of the accommodation and reduce staff in certain nurseries.
The number of registrations under the Nurseries and Child-Minders Regulation Act
1948 increased. Experience has shown how valuable a sojourn in the day nursery is
proving in the case of children when there are adverse physical and psychological factors
in the home. The oft-repeated expression ' the best place for a child is at home ' needs
considerable qualification in certain cases, when housing conditions are very unsatisfactory
and the parents need education and guidance.
The role of the
health visitor
Much effort has been made to integrate the work of the health visitor more closely
with that of the hospital and general medical services, and other statutory and voluntary
agencies. The cohesion with hospital almoners was of the closest, in particular where
questions of rehabilitation and the care of the aged were concerned. The scope of the
health visitors' work has expanded to embrace the family unit rather than the individual,
and, in particular with regard to collaboration with general practitioners. It is believed
that a good deal of progress has been made in this not-too-easy field. Experiments in the
division which have shown already that minor difficulties can be overcome and that the
health visitor readily adapts herself to work with general practitioners, bode well for the
future.
The family health conference which met regularly at the Divisional Office proved
valuable in bringing together interested parties and in preventing unnecessary home
visiting.
Tuberculosis
Despite potential difficulties which the National Health Service Act brought into
being by its division of responsibilities with regard to prevention and treatment, liaison
with the chest clinics has been of the closest. A method of assessing housing priorities for
the tuberculous was devised, which it is hoped will be an improvement on the existing
system. This has been reported elsewhere, † The extension of tuberculin testing of
children was only made possible because the Camberwell Chest Physician co-operated to
the full. The mass radiography unit was used very considerably and thanks are due to
the Director of the unit and his staff for their help in making the unit available at schools
and for undertaking the examination of staff.
* The Medical Press, Vol. CCXXXI, No. 5984, 1954.
† Public Health, Vol. LXVII, No. 4. 1954.