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to the families most in need of the help and support which she can give. Group working
has enabled problems to be shared, language and religious difficulties to be met more
easily and has provided continuity of staff during sickness and leave.
For over fifty years most of the home visiting and medical follow-up of children
attending the Council's schools has been undertaken by voluntary children's care
committee workers, trained and organised by social workers employed by the education
and public health departments. A continuing aim is the association of the health visitor
with the voluntary worker in the care of the school child.
Besides increased co-operation between health visitor, general practitioner and
voluntary and statutory organisations serving the family there have been experiments
in integrating the preventive and curative services. As there are only some 400 health
visitors and over 2,200 general practitioners the amount of effective help is necessarily
limited. Co-operation is very fruitful in dealing with medico-social problems of
families when difficulties have not come singly and in some districts it has been possible
to allocate health visitors to work with general practitioners in group practices and with
specialists at paediatric hospital clinics.
In addition to meeting the growing demand for teaching in child welfare centres and
schools, health visitors assist in Day Colleges, Polytechnics and Institutes at training
courses and refresher courses for nursery matrons, nursery nurses, wardens and house
mothers and in school pre-nursing courses.
History
Home nursing
Home nursing in London before 1948 was provided by 32 voluntary nursing
associations. Twenty associations were affiliated to the Queen's Institute of District
Nursing ; the Ranyard Nursing Association covered a large area in south London
with affiliated associations in Roehampton and Stoke Newington ; the Nursing Sisters
of St. John the Divine provided district midwifery and general nursing services in
Deptford and Poplar and the Catholic Nursing Institute did general nursing in Lambeth.
In addition, several very small associations worked in London and in the neighbouring
counties of Kent, Essex and Surrey.
Finance
When the Council became responsible tor home nursing in 1948, the district nursing
associations continued, but as agents for the Council, which made grants-in-aid based
on 90 per cent. of their approved expenditure. The Central Council for District
Nursing in London continued to act as a liaison and advisory body to the district
associations and distributed the Council's grant to the associations. The Catholic
Nursing Institute, however, remained outside the arrangement, and received instead a
direct grant based on the number of people nursed annually. The grant to the district
nursing associations was increased to 92 per cent. of approved expenditure in 1952 and
to 93 per cent. in 1954. The total annual grant increased from £168,371 in 1948 to
£485,000 in 1958. In addition, an ex-gratia payment of £12,000 was made to the
Central Council for District Nursing in 1958 to help reduce the accumulated deficits of
the associations which had experienced increasing difficulty in raising the seven per cent.
of their expenditure which remained for them to find from voluntary sources.
Organisation
The Silvertown and North Woolwich District Nursing Association closed in 1955
because the work was insufficient for the maintenance of an economical service in this
industrialized part of the county, cut off as it is entirely by the river and by the County
Borough of West Ham from the rest of the administrative county lying south and west
of it. District nursing for North Woolwich was taken over by the Woolwich and
Plumstead District Nursing Association which operates south of the river, and the
County Borough of West Ham undertook district midwifery on an agency basis.
Co-operation between the home nursing service and other local health authority
services has been promoted at all levels. Divisional medical officers have been members
of voluntary committees of district nursing associations and divisional home nursing
voluntary committees. In the field, direct contact between health visitors and district
nurses has been encouraged and informal meetings, talks and demonstrations are held.