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Mental health education
Further development of the arrangements made for intensive training of medical officers
and health visitors in mental health education, following the report of a study group in
1954, was approved. This development (foreshadowed in paragraph VI (b) of Appendix B
to my report for 1959) was based on the view expressed by the departmental committee,
set up in 1955 to advise on general developments in this field, that the work could no longer
be regarded as experimental but should be expanded as necessary and put on a permanent
basis. Arrangements were approved which had the threefold aim:
(a) to set up in those parts of London which lack them at present case conference
groups, where medical and nursing staff of the child welfare centres will receive training
and guidance from psychiatrists and other professional workers attached to child
guidance clinics;
(b) to bring all child welfare medical officers and health visitors into the groups; and
(c) to develop the case conference groups into a permanent consultative service under
the leadership of the psychiatrist from the local child guidance unit.
Implementation of these arrangements must necessarily be spread over a period of time,
depending mainly on the availability of the psychiatric staff to lead the groups, but discussions
with hospital authorities about their professional staff taking part in the work
were in hand at the end of the year.
Welfare of children in hospital
The Ministry of Health, in a circular letter (LHAL 2/59), drew attention to the need for
co-operation between the hospital, general practitioner and local health authority services
in securing the welfare of children in hospital and on discharge, and the nursing of children
at home as an alternative to their admission to hospital.
There are, of course, general arrangements for ensuring co-operation between the three
branches of the health service, irrespective of the age of the patient. Hospital authorities
are asked to arrange that when a patient who is likely to require the Council's health or
other services is about to be discharged from hospital the necessary information, including
a report on the patient's condition on discharge, is given to the Council's divisional medical
officer. Hospital almoners are invited to attend meetings periodically with the divisional
health office staff to consider matters of mutual interest and the use of the Council's
services. The divisional medical officers also meet the local general practitioners as and
when necessary and a booklet about the Council's health service, with a local appendix
showing details of maternity and child welfare and school health clinics, etc., is issued to
all general practitioners. The importance of co-operation and personal contact between
the health visitor and the family doctor is encouraged.
In London, co-operation between the school health and hospital services dates back
to the earliest days of the school health service; as long ago as 1911 a children's care
organiser was appointed to the London hospital to direct the flow of young patients and
act as a liaison officer between the voluntary school care committees and the hospital.
Today, the co-operation takes several forms, in all of which the children's care organiser
in the Public Health department plays an important role. At some hospitals special sessions
are held for the treatment of school pupils and the care organisers make the appointments
and attend the sessions; at other hospitals the organiser, although not present at the
sessions, makes the appointment for the children to attend. At certain hospitals the
organisers attend to carry out the liaison between the children's out-patient departments,
the specialist clinics, the school health service and the care committee organisation.
St. Mary's hospital scheme—In 1954, St. Mary's hospital, Paddington, after consultation
with the Council, organised a scheme whereby a team of paediatricians and nurses visits
and treats selected sick children in their own homes at the request of the general practitioner.
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