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HEALTH VISITING
The Younghusband Report on social services called to task the present system of
health visiting and suggested that social workers, trained in the techniques of case work
in social services and administration, might well have a greater part to play in the future
of local authority health services.
How much routine visiting of the healthy infant is really necessary now that the
maternity and child welfare services are known and accepted and now that the general
practitioners are taking an increasing interest in the normal development of the children
under their care ? Is it not now time to take stock of the position, and having seen with
satisfaction the great improvement in the general health of mothers and children, the
low maternal and infant mortality (for which much of the credit must go to the tireless
energy and enthusiasm of the health visitors) conclude that the time has come for further
efforts in different fields ? One problem solved, the next awaits.
Which are the next most urgent problems? The old people? The handicapped?
The mentally ill? The families with special difficulties (the so-called problem families)?
To recapitulate on previous years' reports, the health visitors have visited all neonatal
infants and then at intervals have followed the child until its fifth year, both at the clinics
and in the home. This year, neonatals have been tested for phenylpyruvic amentia
by the phenylketonuria test of the urine at 4 weeks old. 445 babies were tested and all
were negative. This condition accounts for the biggest clearly defined group of cases of
low grade mental deficiency after mongolism, and although the prognosis for life is
fairly good, mental development is extremely poor. If, however, treatment is initiated
early enough the mental degeneration can be arrested by arranging for the baby to be
fed on a suitable diet. As this condition is extemely rare and results depend upon early
treatment, it is important to test all children, particularly as no clinical signs appear at
or just after birth.
Special visits were paid to mongol children in the area, and each child was "paired "
by random sampling with a normal child and visits made to these also.
The health visitors continued to visit the families with special difficulties, to follow
up children discharged from hospital, and one health visitor attended the hospital
paediatric department to act as liaison.
The clinic for the over sixties has involved a great deal of work for three of the
health visitors specially concerned, but all have made visits to the aged.
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