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Home help service—Demands for this service continued to increase and it is gratifying,
therefore, to be able to report some improvement in staff recruitment. The number of
home helps employed in the division at the end of the year was greater by the equivalent of
39 full.time units than at 1 January. The staffing position, nevertheless, continues to occasion
concern. Recent increases in demand have been mainly for more morning and evening
service to families to keep children out of care (now an important adjunct to services
provided under section 1 of the Children and Young Persons Act, 1963) and for service in
the homes of women recently discharged from hospital after confinement (following an
an extension of planned early discharge schemes). Cases in both these categories call for
qualities in the home help of ' motherliness' and ability in home management together
with a sense of vocation, and the field from which applications for appointment are
considered is thus very much narrowed.
DIVISION 2, comprising the boroughs of Hampstead, Paddington, St. Marylebone,
St. Pancras and the City of Westminster
Dr. H. L. Oldershaw reports:
Maternity services—In order to deal with the shortage of maternity beds in the area a
central booking bureau has been in operation for some years. Efforts are made to book
beds for expectant mothers who require hospital admission on medical or social grounds
and for whom their local ante.natal clinic has been unable to obtain a vacancy. Recently
many hospitals have been restricting their catchment areas and refusing cases from this
division. In 1961 the bed bureau found beds for 498 of the 724 cases referred; in 1962 for
399 out of 726; and in 1963 for only 326 out of 791.
Prophylaxis—Now that most eligible adults have been protected there has been a fall in
demand for polio immunisation, from 17,791 in 1962 to 7,801 in 1963; the latter figure
relates mainly to infants and young children. The level of immunisation against diphtheria
is gradually increasing; in 1963 it was estimated that 80 per cent, of children under five
were protected.
Prevention of break.up of families—A considerable amount of health visitors' time is
taken up with preventive work in this field, particularly in making arrangements for the
care of young children during family crises. Intermediate case conferences have been held
regularly throughout the year; 68 new cases and 48 old cases were discussed, and a further
23 cases were reviewed briefly. The families discussed were referred from many sources—
both statutory and voluntary and the co.operation received from all organisations has
been very much appreciated.
At the end of the year the division had two full.time family case workers, three social
workers undertaking part.time case work with difficult families and special home helps
were working with 21 problem families.
Mental health—The general work continued and the extreme pressures in the division
have not lessened. The number of mentally ill patients in community care has risen during
the past year. Although it has not been possible to obtain a psychiatric social worker for
duty in the Westminister day hospital, a senior mental health social worker has undertaken
work there; this is a valuable step forward in co.operation between hospital and local
authority. Mental health social worker staff now attend weekly at two of the division's
catchment area hospitals and this is furthering the development of an effective aftercare
service.
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