View report page

59
accidents and illnesses. The selection of children, who are matched with legitimate
children born in the same month, of the same birth weight and sex, whose mothers
are the same age and same school leaving age, is being carried out entirely by health
visitors, and a follow-up visit is being made at four-monthly intervals. Co-operation
has been promised by medical officers of health of the home counties and county
boroughs in the follow-up of children who move to other counties. Children's officers
all over the country, whose assistance is so essential to the success of the survey, are
helping to keep contact with the children, and valuable assistance is being received from
voluntary organisations concerned in the care of children.
The fact that a child has been placed for adoption is recorded and if adoption is
successfully completed, the child's name will be removed from the survey.
The first sample of children has already been taken and the second sample will be
taken in May, 1954. The children thus selected will be followed-up at least until they
reach school age. It is hoped that in this way valuable evidence may be obtained which
may be helpful in the formulation of future policies for the welfare of the illegitimate
child.
Co-operation with other parts of the National Health Service
Efforts to foster and improve co-operation with other branches of the National Health
Service were continued.
The scheme introduced in 1951 whereby the Council undertook through its divisional
organisation to carry out home visiting and provide after-care for patients referred by
hospital almoners continued satisfactorily. The direct approach of almoners to the
Council's field workers for mutual discussion and exchange of information is encouraged.
There is close and effective co-operation between hospital maternity and paediatric
departments and the Council's ante-natal and child welfare clinics. Hospitals also notify
the divisional medical officers of the discharge of maternity patients from hospital, and
this procedure continued to function satisfactorily.
Consultation has taken place with representatives of the hospital authorities on the
co-operation existing between their maternity services and the Council's domiciliary
midwifery, health visiting and maternity and child welfare services. The discussions
centred on the Ministry of Health circular L.H.A.L. 1/51, on the selection of maternity
patients for admission to hospital, and circular 5/53 on the need for continuity in the
care of mothers and babies as between the general practitioner, the hospital and the
local health services. The procedure for continuity of care is generally effective. The
selection of patients for hospital confinement and the closely allied question of the
extent of hospital provision for confinements present a more complex problem which
is still under consideration.
General
practitioners
Reference is made in the section on the domiciliary midwifery service (page 64) to
the liaison between ante-natal clinics and the general practitioner.
Endeavours were made during the year to effect even closer co-operation between
general practitioners and the Council's centre medical officers and health visitors. In
some divisions regular meetings were held and, in all divisions, general practitioners were
notified when it was proposed to refer any of their patients (mothers or children) to
hospital out-patient departments for further advice and treatment.
A new trend was shown in the direct association of a health visitor with a large group
practice and similarly of two domiciliary midwives with the ante-natal sessions held at a
group surgery. These were experimental and present some administrative problems, but
they may show the way to further co-operation.