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family case-worker on its strength. In addition, at the end of the year 18 social workers
(health services) were each undertaking the support and intensive care of a few families,
the actual number being determined with regard to their other duties. The case-work
consultant continued to give advice and guidance to field workers; in addition to supervising
the training of the less experienced members of the staff he has proved to be a valuable
member of the team. As a result of this appointment an increasing number of social work
students from the London School of Economics, the North-West Polytechnic and the
National Institute for Social Work Training are being allocated to the Council's family
case-workers for practical training.
As in previous years, the Council made a grant to Family Service Units in London
towards the cost of their work with families in difficulties. The grant for 1963/64 amounted
to £21,800, 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.
Detection of children suffering from phenylketonuria
Circular CMO 9/63 stressed the importance of close liaison between local medical and
hospital services for effective local arrangements in the early diagnosis and treatment of
phenylketonuria. Divisions were accordingly advised of the facilities for the treatment of
children with this disorder at hospitals in each of the metropolitan regional hospital board
areas.
Children with or at risk of congenital handicaps
The Council has been concerned for many years to ascertain and record physical and
mental handicaps of children, but following the recommendation of the Ministry of Health
(Circular CMO 23/63) these records were combined into a comprehensive register in each
division. Information is obtained from maternity and paediatric departments of hospitals,
general medical practitioners, domiciliary midwives and health visitors. The register is
reviewed periodically by a medical officer, to ensure that the parents of any child with
serious physical or mental handicaps will get support and guidance to help them in
the day-to-day problems of caring for their child and co-operation in the advance planning
of the child's needs for special educational facilities and subsequent placement in the
community.
By the end of 1963 'at risk' registers had been kept in all divisions for two years. The
total number of children recorded as being at risk of handicap was approximately ten per
cent of the number of live births. The 'at risk' registers are scrutinised regularly by the
reviewing medical officer to ensure that the appropriate screening tests have been carried
out and treatment begun where necessary.
Maternity and child welfare records
As a result of well-informed criticism that child welfare medical records did not
provide sufficient information on the physical, mental and emotional development of the
child, the Society of Medical Officers of Health designed a new record card for use in
maternity and child welfare centres. It was hoped that this would provide not only
better information of relevant facts of development but would lead to a re-orientation of
the work of doctors in the field to a more developmental approach. It is hoped that
the new form might become a prototype for a national record card and the Council was
asked, with two other authorities, to give it a pilot trial and agreed to do so early in
1964 in divisions 3 and 7.
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