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intimated that there were prospects of additional maternity beds being provided in North
West London in the near future. In the meanwhile the Ministry asked the teaching hospitals
to reserve 20 per cent. of their beds for emergencies and late-comers and not to book
women, other than those needing hospital confinement on medical grounds in accordance
with the criteria laid down in the Cranbrook Report, unless the local health authority
had advised that there was a need on social grounds for hospital confinement. The Ministry
also proposed that for this latter type of case hospitals or groups of hospitals should accept
responsibility for all such cases from a defined area, it being left to local maternity liaison
committees to agree on the allocation of areas of responsibility and the machinery for
booking. A draft plan of catchment areas for the whole county is being drawn up for
presentation to local maternity liaison committees.
Detection of children suffering from phenylketonuria
Following the pilot survey on the practicability of routine testing described by the
divisional medical officer for division 3 in his report, arrangements have been made
throughout the county for mass screening tests of babies to detect phenylketonuria, a
rare inborn metabolic disorder which can give rise to mental defects. In addition more
extensive tests will be made of children thought to be at special risk.
Young children handicapped by impaired hearing
In recent years certain factors which may arise during pregnancy, labour and early
childhood have become recognised as potentially dangerous sources of deafness. In view
of the vital importance of early detection, an index of children subject to a risk of deafness
is kept in each of the nine divisional health offices. Arrangements have been made for
hearing tests to be carried out in the maternity and child welfare service and for all new
entrants to school to receive an audiometer test. General practitioners and hospitals have
been asked to bring to the notice of the Council any children considered to be at risk.
In September a joint circular on 'Young children handicapped by impaired hearing'
was issued by the Ministry of Health (Circular 23/61) and the Ministry of Education
(Circular 14/61). The services provided by the Council were already on the lines recommended
in the circular and therefore discussions with metropolitan regional hospital
boards and teaching hospitals were on the question of future planning in this field.
Arrangements were in hand at the end of the year for consultation with the London
local medical committee and the hospital authorities on the early ascertainment and
follow-up of young children at risk of deafness.
Mental health education
In further development of the arrangements made for intensive training of medical
officers and health visitors in mental health education, six additional case conference
groups were set up for medical and nursing staff of the child welfare centres to receive
training and guidance from psychiatrists and other professional workers attached to child
guidance clinics. The co-operation of the hospital authorities in these groups has been a
very great help. The aim is gradually to bring all child welfare medical officers and health
visitors into the groups and to develop the case conference groups into a permanent
consultative service under the leadership of the psychiatrist from the local child guidance
unit.
Residential establishments for young children
Private residential establishments and those under the management of the Children's
Committee are visited regularly by the Council's medical officers, who advise on hygiene
and child health. A register is maintained of physically and mentally handicapped children
and is reviewed periodically by a senior medical officer so that a handicapped child's
special needs for medical or educational treatment can be anticipated.
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