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However, as already stated, it was nearly twelve years before circular 347 withdrew
the official directive, quoted above, given in circular 179.
At a meeting with the senior administrative medical officers of the metropolitan regional
hospital boards in November, 1948, there was general agreement that it was undesirable
and uneconomic for parallel 'centres' and 'clinics' to be established, the one by the
education authority and the other by the hospitals. The same staff should work in the
same building and be responsible for both diagnosis and treatment.
In January, 1949 the position was further discussed with the regional psychiatrists of
the hospital boards. General agreement was reached that 'clinics' should not be separated
from 'centres'; it would be too complicated to work out, for allocation of costs, how
much time was spent on diagnosis and how much on treatment and that as an alternative
the psychiatrists should be appointed and paid by the regional boards; the psychologists
and the psychiatric social workers should be appointed and remain on the staff of the
education authorities; the premises should be provided and maintained by the regional
boards, if they were in hospitals; or by the education authority, if they were in ad hoc
premises.
(j) Developments 1950-1958—In 1950 the Council's two clinics were removed to new
premises and became the Earls Court and Battersea units.
The first entirely new unit to be provided by the Council after the inception of the
national health service was opened at Brixton in 1951. The organisation of this unit is
unique since the medical director has been seconded by the Institute of Psychiatry
(Maudsley Hospital) and is assisted by a senior registrar plus five to seven registrars
pursuing studies in child psychiatry who work at the unit for six months at a time.
Experience has shown that the stimulus of working with a post-graduate teaching hospital
—and the need to train more child psychiatrists—has more than outweighed any disadvantages
arising from changes of staff.
A fourth child guidance unit was opened at Woodberry Down health centre in 1952,
and the fifth at Peckham early in 1958.
(k) Work done at the Council's units 1952-1959—A quantitative account of the activities
of the five Council units is given in tables (ii) to (v).
Table (ii) shows the number of new patients treated each year; it should perhaps be
mentioned that on average about 14 per cent of the so-called 'new patients' had a record
of previous attendance at the same or another child guidance unit.
The remaining tables analyse the patients 'discharged' (except for five who left school).
Tables (iii) and (iv) show respectively the types of problem and service given; both complicated
by the fact that an individual often comes under more than one heading. About
half the children had two or more problems, behaviour being the most common, similarly
two or more types of service were given in many cases and whilst individual child therapy
was most common, case work with parents was not far behind. Table (v) shows the reasons
for closure and the distressingly high proportion of cases in which attendance ceased before
completion or treatment was refused.
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