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to £17,690, divided equally between the Health and Children's Committees. A grant of
£1,000 was made, as in the previous year, to the Family Welfare Association as a contribution
towards their work with families with problems.
The arrangements for the co-ordination of social services within each division vary in
detail, but broadly follow a similar pattern. In each division there is a co-ordinating
committee which meets at regular intervals under the chairmanship of the Divisional
Medical Officer, the Area Children's Officer in each division acting as Vice-Chairman.
In some divisions the committee meets quarterly and is concerned only with policy; in
one division the main committee is a case-work conference, while in other divisions casework
is done by an intermediate committee meeting at monthly or fortnightly intervals.
Consultations between health visitors, social workers and voluntary workers at field
level are everywhere the rule.
Families are reported to the co-ordinating committees, not only by public health staff,
but also by Children's, Education, Housing and Welfare departments, as well as by
hospital consultants and general practitioners. In spite of all the work which is being
done, however, explosive and unforeseeable conditions arise in the family situation which
no department is in a position to prevent and which, from time to time, bring families
before the Courts.
Schemes for early discharge of mothers from maternity hospitals
Emergency Bed Service admissions to maternity hospitals in London have continued to
rise, although more than half of the women who had to be so admitted were known well in
advance to be in need of hospital confinement on social grounds; in some instances there
were added risks because of age and parity.

No particular reason is known for the marked reduction in admissions in the second
half of 1962, but it seems probable that the Council's participation in agreed schemes for
early discharge of maternity patients (see below) was a contributory factor. In an attempt
to relieve the situation, bed-booking bureaux have been established in the two hardest
pressed areas in north-west London and nine hospitals in various parts of the county
were operating schemes at the end of the year, in association with the Council, for the early
discharge of selected maternity patients 48 hours after delivery. In each scheme an agreed
number of mothers and babies may be discharged each month, these numbers being
sufficient to take the pressure off the hospital wards. Mothers, if they agree, are selected
for 48-hour discharge by the consultant obstetrician as early as possible during pregnancy.
A report on the home conditions is provided by the domiciliary midwife and the general
practitioner obstetrician is asked to accept responsibility for the care of the mother and
baby. Seven part-time midwives were recruited, to provide the reports on home conditions
and to nurse mothers and babies discharged home under the schemes. In consideration of
these facilities the hospitals concerned usually undertake to admit a small number of
patients each month for delivery and full term post-natal nursing, who would otherwise
have been referred for admission to hospital under the Emergency Bed Service procedure.
In practice the success of the scheme varies in different divisions. In the north west of
the county, for example, where the Emergency Bed Service pressure is highest, the social
conditions of the mothers often make early discharge impossible.
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