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HOME HELP
Immediately before 5 July 1948 all the metropolitan boroughs (but not the City of
London) operated home help schemes for maternity cases and all but one of the boroughs
and the City had schemes for assisting sick and infirm persons. The extent of the provision
varied widely from borough to borough—in all 7,389 cases were attended in 1947 and at
the end of that year 826 home helps were employed. Section 29 of the National Health
Service Act 1948 brought together these two kinds of help (previously provided under
separate powers) and widened the circumstances in which help could be given, making
it turn on the presence in the household ' of any person who is ill, lying-in, an expectant
mother, mentally defective, aged, or a child not over compulsory school age . . . ' After
5 July 1948, under the Council's arrangements, there was a rapid increase in the number
of home helps and cases assisted and the demand for the service continued to increase
thereafter:
1947 1949 1959 1962 1964
No. of home helps (equivalent full-
time units) 826 1,265 2,150 2,192 2,469
Households assisted 7,389 25,933 36,056 38,461 40,217
The growth in the service, since the first expansion in the late 1940s, is accounted for
almost entirely by the increasing demand from old people and the chronic sick. The number
of maternity cases has remained fairly steady; the number of tuberculous and miscellaneous
cases has declined.
The Council has introduced five extensions of the service:
Night helps—introduced in 1953 (after an amendment to the scheme)—provided for the
chronic sick in their own homes to enable relatives to get one or two nights' undisturbed
sleep a week. Demand was always small and, perhaps because of known difficulty in
finding staff, has latterly declined even further.
Child helps—also introduced in 1953—for children in their own homes who are
temporarily deprived of both parents and with no other adult to care for them. Again
demand has been small, partly because home conditions are often unsuitable for sleeping
an additional adult. Alternative arrangements under section 1 of the Children and
Young Persons Act 1963, are now possible.
Morning and evening helps—introduced in 1954—provided for children who owing
to their parents' hours of work cannot be cared for in the day time at a day nursery or
school. This service has continued to play a part in avoiding the reception into care of
the children of between 150 and 250 families every year.
Specially trained home helps—introduced in 1956—for families in danger of breaking up.
They teach the rudiments of housekeeping to the mothers of such families in an attempt
to keep the home together and prevent the children coming into care. These home helps,
there are now 118 trained, do not spend their whole time on these more demanding calls
but have helped about a hundred or more every year.
Provision—introduced in 1960—of free home help for expectant mothers suffering from
toxaemia of pregnancy to ensure complete rest for the patient.
In addition, experiments have been in hand in limited areas to provide a more flexible
allocation of help to old people. Something on these lines, possibly leading to an arrangement
where one help is made responsible for a group of old people, is the most likely
next development in the service.
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