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membership was extended during the year by the inclusion of a Free Church minister.
Of the 206 families known, 44 were found in 1954 to present particularly intractable
problems and intensive case work for these families was undertaken. The method has
been to decide which of the field workers concerned could best act as co-ordinator of
services for the particular family, so as to establish the necessary personal, friendly
relationship and avoid multiplicity of visiting, and then to consider periodical reports
from the worker selected. Any of the Council's services may be called in to keep the
family going—day nurseries to care for the children and relieve a worried mother ;
recuperative holidays where there has been a breakdown in health ; home nursing for
sick members of the family ; home helps to cope with the household chores. Every
endeavour is made to ensure that the family have regular meals, that they receive
adequate medical attention and that their housing is brought up to a reasonable standard,
and the borough medical officers of health are most co-operative in requesting sanitary
inspectors, at short notice, to deal with defects, etc. within their province. The increasingly
intensive case-work has made big demands, particularly on the time of the health
visitors, and the Islington Family Service Unit had to take on a second field worker.
The care of old people formed a particular feature of the work of the division during
the year. Of the 2,599 households provided with home help, no less than 1,850 were
for chronic sick, aged and infirm people, an increase of 13-6 per cent, over the figure
for 1953 (1,628 out of 2,452) and more home helps had to be employed.
Care of the
aged
root ciimc attendances, over ou per cent, or wnicn were estimated to oe oy aged
persons, again rose, from 23,054 in 1953 to 25,264 in 1954, and arrangements have been
made through the North London District Nursing Association for the existing
domiciliary chiropody service, financed from voluntary funds, to be made available
at a nominal charge to home-bound old people recommended by the health visitors.
Close touch has been maintained with the Medical Officer of Health for Islington about
his Council's new scheme for a laundry service for chronic sick old people, which will
be an inestimable advantage to them, and cases have been recommended to him. In
association with the health visitors and home help organisers I have reviewed the
question of provision of meals by the Invalid Kitchens of London and have recommended
a number of extra persons for this service now that some expansion is contemplated.
Old people continue to form a large proportion of the cases on the books
of the district nursing associations, and there has been a marked increase in the amount
of home nursing equipment (particularly commodes) lent to these old people. Of the
956 persons who were provided with recuperative holidays during the year (itself an
increase of 14-8 per cent, over the 1953 figure of 833), 386 were adults (other than
expectant and nursing mothers and mothers with young children) and 75 were over
70 years of age.
«^ne or tne 10 wenare centres in operation at tne Degmmng or tne year naa to be
vacated at the end of March. Additional sessions were arranged at a nearby centre so
that the public should not be deprived of the services, and a diligent search for new
premises has been made—so far without success. Many of the services in the other
centres such as special toddlers' clinics, were expanded during the year. First attendances
of children under a year old (4,331) represented 90 per cent, of the live births for the
year. With the transfer to the Council on 1st April of the work of the former Maternity
Nursing Association, additional combined doctors' and midwives' ante-natal clinics
were established at three of the welfare centres. The additional clinics gave an opportunity
to introduce into the service the general practitioner obstetricians who would be called
in by the midwives to give medical aid if required. These doctors had no previous
experience of working in welfare centres and thus another link was forged with the
general medical services. Living accommodation for three midwives and six pupils was
provided in the staff hostel forming part of a day nursery and two more midwives
with pupils were housed in adapted rooms over another day nursery. The two family
planning clinics continued to function satisfactorily and 275 women were referred there
for advice during the year. Fewer dentures were provided this year for expectant and
131
Care or
mothers and
young
children