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Prevention
of break-up
of families
Arising from a suggestion in Ministry of Health Circular 27/54, a scheme was in
preparation at the end of the year for the training and employment of selected home
helps to work with health visitors in the homes of families in danger of break-up.
The aim is that trained home helps should teach the rudiments of housecraft to mothers
of such families in an endeavour to keep the home together and so prevent the children
from having to be received into care.
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 main reason for the reduced figures in 1955 was the poliomyelitis epidemic,
which was unusually widespread and which continued for a considerable time.
Immunisation was discontinued where and when the local incidence of poliomyelitis
appeared to warrant it. This aspect of diphtheria immunisation is deserving of further
study. Whilst the wisdom of postponing immunisation locally in the presence of a
poliomyelitis epidemic cannot be questioned, it is not a simple matter to pick up at a
later stage all those children who would have been immunised if the poliomyelitis
epidemic had not occurred, but some effective method of doing this must be devised
if a continued drop in immunisation is to be avoided.
The warning given in my report for 1954 that the modern generation of mothers
has not seen diphtheria and therefore has not learned to fear it was reinforced in that in
1955 there were two deaths from this disease, the first since 1952, when there were two.
In neither instance had the children, one aged 4, and the other 8 years, been immunised
against diphtheria. It cannot be repeated too often that the only effective method of
preventing diphtheria, either in the individual or the community, is immunisation.
Whooping cough immunisation
There is no scheme in London for immunisation against whooping cough corresponding
to that for diphtheria. Children may be immunised at the request of their parents by
arrangement at the Council's child welfare centres, and the Council pays the standard
fee of 5s. for records of such immunisation received from general medical practitioners.
Children may, if parents desire it, be immunised against both diphtheria and whooping
cough at the same time, by the use of a combined prophylactic. Although no publicity
is given to whooping cough immunisation there is an established demand for it from
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