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7
The clinics in conjunction with the hospital maternity units
provide opportunities for local general practitioners to obtain
further experience or training in obstetrics when their application
for recognition as a general practitioner obstetrician
does not satisfy the Local Obstetric Committee.
At Infant Welfare Centres, attendances have fallen from
85,600 in 1949 to 71,736 in 1958. However, in the former year,
the infant mortality rate was 29 infant deaths per 1,000 live
births, whereas last year, it was 18. With easing of the
pressure of numbers, preventive mental health, group discussion '
and opportunities for education in wider aspects of health have
been possible. In 1952, I wrote about possible changes in the
medical staffing of Infant Welfare Centres and concluded that
their functions were not allied to hospital work. On the other
hand, it was certainly within the competence of general practitioners
particularly interested; but until group practice
became the established pattern, in urban areas clinic medical
officers not in general practice, should continue. If scrupulous
care is taken always to contact the family doctor directly
or by writing when medical intervention is thought to be necessary
for any individual child, the supervisory and educational
functions of the infant welfare centre unquestionably help the
family doctor in the prevention of ill health, the early treatment
of illness and the follow-up of patients discharged from
his immediate care.
Day Nurseries
These do reverse the general pattern, which has characterised
the first ten years of the Health Service as there were
nine in Croydon in 1949, whereas there is now one central
nursery only serving the whole borough.
Unmarried Bothers
In 1949, 4.9% of births were illegitimate and 123 unmarried
mothers asked for help and 30 were admitted to hostels. In 1958,
the illegitimacy rate was 5% but 185 mothers applied for help
and 63 were admitted to hostels. It is clear that the difference
is the greater use made of the facilities available.