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Co-operation
with hospitals
and general
practitioners
The scheme of interchange between the Council's medical officers and the medical
staff of the Hospital for Sick Children has proceeded with mutual benefit and the usual
two sessions weekly have been resumed after a short interruption caused by a temporary
shortage of hospital medical staff. Regular reports on the discharge of children have
been received from this hospital and have been followed up, but it has still not been
possible to persuade other hospitals in the division to send such reports as a routine.
Four meetings with hospital almoners were held in 1955 and at two of these I was
able to arrange for officers of the Welfare Department to give talks on the Council's
services for the physically handicapped and the blind. These talks were most stimulating
and helpful and are to be repeated for the benefit of divisional staff.
I continued to be a member of the National Health Service Liaison Committee for
the North Central Area of London and was able, with the willing co-operation of the
Welfare Department, to give the committee details of the technique used in adapting
the homes of handicapped persons to their special needs.
Relations between health visitors and general practitioners have continued to be
good.
I referred last year to the closer co-ordination with hospitals resulting from the new
syllabus of general nursing training, which requires that student nurses shall be introduced
to the work of the local health authority. During 1955, 966 student nurses from
nine hospitals (408 more than in 1954—an increase of 73 per cent.) were given insight
into the Council's services in this division, as were 31 nursery nursing students and
36 medical students. In addition, 31 lectures were given and discussions were attended
by the senior divisional nursing staff. Student district nurses from the North London
and the Metropolitan District Nursing Associations were also introduced to the work of
the division.
Problem
families
My report for 1954 dealt in some detail with problem families, their characteristics
and the methods adopted to help them to play their part as satisfactory members of
the community. It may suffice to refer to them here very briefly. Monthly conferences,
attended by voluntary and statutory workers, consider the families under review,
decide which of the field workers can best co-ordinate the services for each family,
and from time to time consider reports from those workers. This enables a personal,
friendly relationship to be built up and all necessary services to be provided, whilst
avoiding multiplicity of visiting. These broad methods were continued in 1955 and as
a result of the careful and systematic work done it is possible to say that some families
showed distinct signs of improvement. A special survey was also made with the object
of assessing the extent and the degree of the problem, and it was found that, out of
15,573 families known to the health visitors in this division, 233 families were known
to need special attention but only 79 could properly be classified as 'hard-core problem
families'. Most of the others were 'potential problem families', a category less menacing
to the community, and capable of reasonably speedy return to normality, though none
the less in need of help and advice. It is noteworthy that the families needing special
care amounted to 1.5 per cent. of all families known. It has been argued that it would
be more practical to concentrate the ameliorative social services on those families
which show some hope of redemption rather than spread the effort to include the
' hard-core ' families which, even with continual support, are never likely to be better
than a drag on the community. This is clearly a matter of opinion, and in this division
we offer help to all in need.
Child neglect
and
ill-treatment
Allied to the question of problem families is the neglect and ill-treatment of children
in their own homes. Every effort has been made to ensure that such cases are brought
to notice so that remedial action can be taken, and to this end a meeting has been held
between representatives of the various field workers (health visitors, domiciliary
midwives and home nurses) to discuss co-operation in this and other common problems.
In some cases it is found necessary to take the children into care under Section 1 of the
Children Act, 1948, but this can often be prevented by the timely provision of help
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