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Health education—The Smokers' Advisory clinic at the Fulham Chest clinic, which
started in October 1963 with one session a week conducted by Dr. H. C. Price, Chest
Physician, was extended in February by the addition of a second weekly session conducted
by Dr. J. Vahrman. I reported in November that the Chest Physicians, although they were
unable to make any firm assessment of results, were satisfied that the progress made by
individual patients amply justified the extension of the experiment and the Health Committee
authorised the continuance of the clinic until further order.
A campaign was launched at the beginning of the Autumn school term and is to be
continued until the end of the Spring term 1965, directed at the education of school children
in the importance of dental hygiene. During November a ' Dental Health week ' was held
in the division, when talks were given and films shown to children at schools and clinics,
highlighting this important aspect of school health.
Further efforts were made to increase public awareness of the fire risk from the use of
oil heaters. Specially printed leaflets were distributed in the Autumn by bulk postage delivery
and, in the case of houses in multiple occupation, personally by health visitors.
Prophylaxis—The immunisation state of children in the division was further improved
and in November a trial was started with an additional protection, namely, vaccination
against measles. With the approval of the Health Committee arrangements were made, in
co-operation with the Medical Research Council, to offer this vaccination to children in the
age group ten months to two years and to follow-up all children vaccinated and also a
suitable control group. Six thousand invitations were issued to parents and two thousand
consents received. Forty-eight additional vaccination sessions were held between the end of
September and the end of November and all children will be seen again after three, six and
nine months.
Prevention of break-up of families—Divisional co-ordinating committee meetings and an
increased number of intermediate case conferences have been held throughout the year.
Nearly 40 per cent of the cases referred have come from Housing departments (both
L.C.C. and Borough Council) and rent arrears has been the biggest single problem. Referrals
have also been made by the N.S.P.C.C., the Family Welfare Association, the Family Service
Unit, probation officers, general practitioners, and the Council's own officers in Children's,
Health, Education and Welfare departments, the Mayor of Hammersmith and a Building
Development Corporation. During the year a second full-time family caseworker was
appointed, making two full-time and three part-time caseworkers.
School health service—The seven special investigation clinics continue to be well attended,
the main problems presented being enuresis and obesity. An increasing number of fathers
accompany children to these clinics, especially among the immigrant population. The
number of children attending vision, ear, nose and throat, and minor ailment clinics continues
to decline slightly.
DIVISION 2, comprising the boroughs of Hampstead, Paddington, St. Marylebone,
St. Pancras and the City of Westminster
Dr. H. L. Oldershaw reports:
Population—Despite a large increase in immigrants to parts of the division, the total
population has fallen by 76,000 (13-5 per cent) since 1948, due largely to the clearance of
slum dwellings and redevelopment schemes providing less housing accommodation than
hitherto. This, together with an expansion of service in some fields to older people, has
produced interesting changes in the use of the health services and consequential effect upon
the role of the health visitor, who traditionally had been associated almost solely with
maternity and child welfare.
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