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Co-operation
with other
parts of the
service
Readers of the report will find reference in many places to the close co-operation
which exists between the Council's health service and the general medical services of
the London Executive Council; at many other places, although no specific reference is
made they will assume its existence. In fact general practitioners are in contact with the
department in every aspect of its work and their experience and co-operation are
invaluable to it. A considerable number of medical officers are employed on a sessional
basis in school health and maternity and child welfare clinics, many of them being in
general practice, and others hold appointments in hospitals and industry. Co-operation
with the hospital and specialist services continues and becomes more effective; whilst this
is highly appreciated by the Council's officers its effect is greatly to increase the value of
the service to the public.
Care of
mothers
and young
children
The proportion of children who attended welfare centres during the first year of life
was for the third successive year 86 per cent.
The case conference groups have continued to meet in six divisions and for medical
officers who have gained experience in this way a course of advanced training in the
study of parent-child relationship has been given at the Tavistock clinic. Problem
families in London are fully discussed in Appendix A (page 150).
Accommodation in day nurseries has been reduced from 5,580 places in 99 day
nurseries in 1955, to 5,143 places in 91 day nurseries at the end of 1956, whilst childminders
were caring for 1,497 children under supervised arrangements. The scheme
for the extended provision of occasional creches continued and it was considered that
they had proved of real value to mothers. It was decided, however, pending a further
review that no more occasional creches should be provided although the service should
continue.
As a result of the continuing diminishing demand the number of recuperative
holidays provided was lower than in the previous year.
Domiciliary
midwifery
service
Confinements attended increased in number from 9,898 in 1955 to 10,242. Inhalers
for the administration of 'trilene' were provided for all midwives and it was decided
following a successful trial, to equip all of the Council's midwives with intra-gastric
oxygen resuscitation apparatus after the completion of training courses.
At a conference of representatives of moral welfare associations the need for the
associations' workers to urge unmarried expectant mothers to seek early ante-natal
care was emphasised.
Home
nursing
Through the Central Council for District Nursing twenty-six voluntary district
nursing associations have continued to provide a home nursing servicc on an agency
basis. The total number of visits paid (1,962,733 as compared with 1,953,182) again
increased as compared with the previous year, although the number of treatments
completed showed a reduction (60,772 as compared with 64,256).
Domestic
help service
The equivalent of 2,089 whole-time staff (actual number of home helps 3,326) was
employed at the end of the year, and approximately 80 per cent of the persons assisted
were aged and chronic sick. During the year the service was reviewed by a departmental
working party and a number of recommendations made, for the improvement of the
service and, notably, to ensure greater uniformity in standards of service throughout the
country and establish desirable standards of home visiting by organising staff.
Prophylaxis
No interruption of the diphtheria immunisation programme during the year was
occasioned by poliomyelitis, as occurred in 1955, and probably this was the principal
reason for a marked increase in the numbers of primary diphtheria immunisations and
reinforcing doses, 44,237 and 43,866 respectively, as compared with the numbers for
that year. The estimated percentage of children 1-4 years who had at any time been
immunised against diphtheria was at the end of the year 68 per cent.
Whooping cough immunisation which also suffered a reduction in 1955, probably
for the same reason, increased from 27,941 completed vaccinations in that year to 36,556.
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