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Home help—This service has responded to the national policy of using it as an ancillary
to the other medical and hospital services for confinement cases and for chronic sick
persons. The needs of old people and problem families have received special attention both
in the training and allocation of home helps. The full-time equivalent number of helps
employed has grown from 185 to 431 and the number of households served from 1,160
to 5,868.
Chiropody—From 1959, in accordance with a Ministry of Health decision, the number of
chiropody sessions at foot clinics for old people, expectant mothers and handicapped
persons was increased; 86 weekly sessions are now held, including a few at welfare centres.
Handicapped children—Intensive attention has been given to the care and treatment of
handicapped children of all ages, beginning with congenital malformations notified at birth,
incorporating the observations of clinic doctors and linking with the statutory examinations
under the Education Act and the Mental Health Act. Divisional registers have been built up
of children who are deaf, at risk for deafness and handicapped; the registers serve not
only as an index but as a basis for the regular review of the progress of each child.
Prophylaxis—Vaccination and immunisation have been maintained on a voluntary basis
by invitations to parents and general emphasis as part of health education. From time to
time public demand has been stimulated by incidents of infectious disease and resultant press
publicity. The divisional staff have taken a leading part in investigating local outbreaks and
in providing mass vaccination sessions in co-operation with general practitioners and
borough officers. Recent incidents of tuberculosis in schools have called for investigations
on a large scale and B.C.G. vaccinations in co-operation with the local chest physician and
mass X-ray unit.
School health service—The special investigation of pupils referred from school medical
inspections has grown considerably, due perhaps in part to the withdrawal of the issue of
cod liver oil and malt and halibut oil capsules in schools. The most noticeable fall has been
in cases and attendances at rheumatism supervisory clinics; although this may be
partly offset by a diversion of cases to special investigation clinics or to hospital departments,
it undoubtedly reflects a decrease in the overall number of cases. There has been a greatly
increased use of ear, nose and throat sessions over the same period.
The co-ordination of the activities for the prevention of break-up of families and the
rehabilitation of problem families has continued under the chairmanship of the divisional
medical officer and family caseworkers have been employed on the ' hard-core ' cases.
Co-operation—A well-defined pattern of co-operation has evolved with other branches
of the National Health Services, with other local authority services and public bodies.
These efforts have been directed towards special classes in the community, the care of
expectant mothers, problem families, maladjusted children and old persons, the prevention
and control of infectious disease, in health education and the avoidance of accidents.
They have included surveys, investigations and experimental schemes.
Following the recommendations of the Maternity Services (' Cranbrook ') Committee,
free use of ante-natal clinics has been given to general practitioner obstetricians to see their
own booked maternity patients and, by agreement, those of other doctors. At the end of
1964, ten ante-natal clinics were attended in this way for 15 sessions a week by 29 doctors.
Mental health—Following the passing of the Mental Health Act, 1959, with its emphasis
on community care, a team of mental health social workers was set up in the division in
October 1960. Since that date the establishment has risen to 16, including two psychiatric
social workers (one of whom is the divisional mental health social worker), two senior
occupational therapists and a craft instructor.
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