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there is increased pressure on the service due to illness of both recipients and home helps.
A small number of male home helps is employed to care for elderly men.
In times of heavy pressure it has not always been possible to supply as much service
as was considered desirable ; as in the past, the policy has been to supply some service
to all in need, but this year 161 applications had to be deferred for a time or refused
owing to inability to supply. The figures for the previous two years were 53 (1953) and
215 (1952).
An extension of the domestic help service which is used mainly for the aged chronic
sick is the provision of night helps to sit with patients in their own homes to enable the
relatives to get one or two nights' sleep a week. The demand on this service, which was
started in January, 1953, has been small, 65 cases only being supplied with help during
the year.
Night helps
Particular efforts were made to use the health services wherever possible to prevent
children being taken into care during periods of domestic difficulty, such as the
illness or confinement of the mother. Where there is no adult sleeping in the home at
night, as for example when the mother is in hospital and the father is on night work, a
child help may be supplied to sleep in the home and perform the usual household tasks
normally undertaken by the mother. Twelve families, in which were 34 children, were
supplied with the services of child helps during the first experimental year ended 30th
November, 1954. Where children have to be cared for during the daytime only, specially
suitable home helps are supplied and their hours of duty are adjusted to fit in with parents
hours of work and day nursery and school hours. Help was supplied for the care of
children outside normal working hours, i.e., between 7 and 9 a.m., and 5 and 7 p.m.,
to 185 families in 1954.
Child helps.
IMMUNISATION AND VACCINATION
Diphtheria immunisation
facilities for the immunisation of children against diphtheria are provided at the
Council's child welfare centres, special immunisation clinics, day nurseries, schools and
residential establishments in London. Parents may, if they prefer, have their children
immunised by the family doctor, who receives a fee of 5s. for each completed record of
immunisation sent to the Council. Prophylactic material approved for national free
issue is provided by the Council to general medical practitioners on request.

The principal cause of the fall in the annual number of children immunised against
diphtheria from 1950 onwards was the fear of a possible association between inoculations
and poliomyelitis. The possibility that paralysis might follow an inoculation was always
very small; with the new prophylactics in use during the last two years it is probably
infinitesimal. Moreover, a close watch is always maintained by the divisional medical
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