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(iii) Morning and evening helps—introduced in 1954—provided for children who have
to be cared for in the day time, hours being adjusted to parents' hours of work, day
nursery and school hours.
(iv) Problem families—introduced in 1956—provided by specially trained home helps
for families in danger of breaking up—the home helps teach the rudiments of housekeeping
to the mothers of such families in an attempt to keep the home together and
prevent the children coming into care: 118 of the helps are now trained.
Organisation
The service was reviewed by a working party in 1957 and a number of improvements
in procedure and organisation resulted. In 1958 there were 31 home help districts in the
nine divisions staffed by an organiser, one or more assistant organisers and clerks, together
with varying numbers of home helps : the latter work an average of 25 hours a week
and provide an average of 4 hours service weekly for each case.
Immunisation and vaccination
A detailed review of the first ten years of the immunisation and vaccination services
provided under section 26 of the National Health Service Act appeared in my report
for 1957 (page 64). During 1958 the only new developments were in poliomyelitis
vaccination. Arrangements were made for giving a third dose of poliomyelitis vaccine
to those who had received two doses more than seven months previously. The age
range of those eligible for this vaccine was also extended to include adolescents and
young adults born in the years 1933 to 1942.
London ambulance service
There was a large and immediate increase in requests for ambulance transport on the
introduction of the National Health Service in July, 1948, and demands rose steadily
during the remainder of that year so that by the end of 1948 the number of patients
removed daily was 35 per cent. more than at the beginning of the year. During the last
decade there have been continuing and substantial increases in demand year by year
(table (i), page 83) and in 1958 the service as a whole (including the services of the
Hospital Car Service and the Joint Committee of the Order of St. John of Jerusalem and
British Red Cross Society, with whom agreements were made to provide supplementary
and agency services from the 'appointed day') dealt with 1,096,586 sick removals
and responded to 99,188 emergency calls.
Out-patients attending hospital departments and clinics are by far the most numerous
users of the service and their demands accounted for over 80 per cent. of the whole.
It seems unlikely that this category of patient will diminish in numbers in future years
and, taking into account the various schemes now in hand for the re-building or
extension of hospitals within the London area, the policy of the Ministry of Health to
encourage out-patient as distinct from in-patient treatment by the provision of day
hospitals and the increasing average age of the population, it is not unreasonable to
forecast a continuing increase in the volume of out-patient treatments in the future.
The growth in the demand on the accident section, while not so dramatic as that
on the general section, has nevertheless shown a steady annual expansion since 1948
and the number of emergency calls received in 1958 reached a record level about 60 per
cent. above that for 1947.
A measure of the results of the efforts made to cope with these annual increases in
the volume of work is indicated in table (iii), page 85. However, in spite of increasing
efficiency in the deployment of men and vehicles to meet the growing demand, it
became apparent by the end of 1958 that some additional resources of men and vehicles
would be required to prevent any deterioration in the standard of service in terms of
delays in the transport of non-priority patients. The growing volume of out-patient
transport and the increasing number of patients in the priority groups, e.g., urgent
illness, specialist and consultant appointments, radio-therapy treatments, removals by