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Welfare Committee establishments
Medical supervision of homes under the control of the Welfare Committee was continued.
These homes include large and small homes for the aged and infirm, accommodation for
mothers and babies, and homeless families units.
The medical problems arising in large and small homes for the aged and infirm was the
subject of discussion at a conference of visiting medical officers held at County Hall in
October under my chairmanship. The conference was attended by some twenty general
medical practitioners who act as visiting medical officers of the homes. The Chief Officer
of the Welfare department spoke of the overall increase in the numbers of old people
resident in the Council's welfare homes and of the greater infirmity because of the rise in
their average age. The number of people designated as chronic sick had also increased,
in spite of the active liaison between visiting medical officers and the local geriatric units
for the interchange of residents and patients as appropriate. Moreover, it was recognised
that it was not humane to transfer an old person who had spent many years in a welfare
home to hospital, even if there were sufficient beds available in hospitals in London.
Nevertheless, their nursing care created staffing problems; the Public Health department
had had some difficulty in recruiting ward sisters to supervise the nursing care and administration
of drugs and there was an acute shortage of welfare assistants. The Principal
Medical Officer (Tuberculosis) spoke of pulmonary tuberculosis among the elderly, in
whom the incidence of the disease had not fallen as had been the case in the age groups
under fifty-five years. He emphasised the value and ease of sputum examination and
advocated an extension of arrangements for the routine examination of sputum of newlyadmitted
residents with a productive cough and of other residents with winter sputum.
These arrangements have since been put into effect.
There are units for lone women with a new-born baby in two of the large welfare homes,
where mothers may be resident for periods up to three months. The size of one of these
units has been doubled in the past year. Carisbrooke House is a mother-and-baby home
for single girls, who are admitted for six weeks before and six to eight weeks after delivery.
Outbreaks of infectious disease have not been a problem in these homes except at the peak
periods for confinements during March and April. The Welfare Committee also have a
hostel for mothers-in-work with a baby. Mothers are admitted when the baby is six weeks
old and may stay until the baby reaches the age of eighteen months. Three welfare assistants
have been replaced during the year by nursery nurses appointed by the Public Health
department.
The sharp increase in the number of homeless families received by the Welfare department
necessitated the setting up of further homeless families units within the large homes for
old people, in addition to Newington Lodge and Morning Lane reception centre.
The Public Health department advised on the adaptation of the accommodation for this
purpose and on the steps to be taken to limit the spread of infectious disease, particularly
Sonne dysentery and gastro-enteritis due to E. Coli. Many children had subsequently to
be taken into care by the Children's Officer and were segregated in special units for short
periods until free from infection. Three negative rectal swabs were required for each child,
or the period of incubation of disease outlived, before transfer to residential nurseries or
children's homes. It was found that 27 per cent. of children under five years of age had
developed one or other of the diseases with which they had been in contact compared
with only four per cent. among children over that age. It seemed likely in the light of
experience that children over five years of age may be received directly into children's
homes without undue risk, provided that reasonable observation by trained staff is maintained.
Invalid Meals for London
The Council for many years made an annual grant under section 28 of the National
Health Service Act, 1946 to Invalid Meals for London, a voluntary body providing meals
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