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Special investigations
The investigation being conducted by Dr. W. F. Dunham, of the Department of
Physical Medicine at Charing Cross Hospital, into the early detection of infantile
cerebral palsy was extended during the year to all nine health divisions.
Follow-up continued of registered rubella cases for the Ministry of Health enquiry
into virus infections during pregnancy.
Maternity and child welfare and school health records
When the National Health Service Act came into operation in July, 1948, a series of
forms was introduced for use by clinic medical officers and health visitors and, subject
to small amendments, they have continued in use. The forms were reviewed in the
light of experience and certain changes were introduced in 1955. Three major departures
were decided upon—firstly, to combine the child welfare and school medical
records, so that the essential information of the pre-school period of a child's life may
be transferred to the school and assimilated to the school medical record ; secondly, to
combine the pre-school prophylaxis records with the child welfare record and to transfer
this information to the school medical record ; thirdly, to institute new forms appropriate
to the wider responsibilities of the health visitor towards the family as a whole.
One of the main objects of the review in planning new forms and revising existing
forms was to do away with overlapping between forms, which results in repetition of
the same information on two or more forms, with a consequent increase of work for
the health visitor.
Medical
supervision
Residential establishments for young children
The health of the children in the Council's residential nurseries is supervised by
medical officers of the Public Health Department. Children admitted to these homes
are medically examined by the visiting medical officer who also does routine medical
examinations at intervals according to the age of the child. Where appropriate, children
are immunised against diphtheria, whooping cough and smallpox.
Dental inspections are made at the nurseries, usually by local dentists, and treatment
is given at the dentists' surgeries.
A psychiatrist makes monthly visits to the larger nurseries and bi-monthly visits
to the smaller ones, to advise the child care staff on the management and care of children
who are emotionally disturbed. Primarily these visits are made for the education of the
staff, and children who are sufficiently disturbed to require psychiatric treatment are
referred to the local child guidance clinic.
Minor outbreaks of gastro-enteritis and Sonne dysentery occurred, particularly in
the two admission nurseries for children under three years of age where the high turnover
and size of the nurseries increase the risk. A major epidemic of Sonne dysentery
occurred in one of them. All contacts, children and staff, were swabbed and 5 staff
and 34 children were found to be carriers and were treated in the nursery.
There was an outbreak of ringworm of the scalp in a large nursery, introduced by
a missed case among the admissions. Repeated investigations with Wood's Lamp
were made, and all cases were transferred to Goldie Leigh Hospital, Abbey Wood, for
treatment.
Central medical staff visited a number of private residential nurseries offering
vacancies to the Children's Committee for residential care of children under five years
of age, to advise the Children's Officer on suitability of the nurseries. Plans of property
likely to be adapted as residential nurseries were scrutinised and exploratory visits made
together with officers of the Children's Department.
Adoption and
boarding-out
The Medical Officer of Health advises the Children s Officer on the suitability on
medical grounds of children for adoption and boarding-out in accordance with the
duties placed upon the Council by the Children Act, 1948.
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