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that there should be continuity in dealing with the whole period from
before birth until the time when the child is entered upon a school
register, i.e., the register of a public elementary school, nursery
school, creche, day nursery, school for mothers, or other school.
Extension of the existing work is accordingly needed in two
directions; on the one hand it is necessary that measures should be
taken for securing improved ante-natal and natal conditions, and on
the other, provision should be made for continuing the work in
relation to children beyond the first year of life.
The accompanying memorandum, which has been prepared by
the Board's Medical Officer with a view to assisting the formulation
of schemes or extending the work already undertaken, sets forth in
outline the matters needing consideration in the preparation of a
comprehensive scheme. It will been seen that the memorandum
contemplates that medical advice and, where necessary, treatment
should be continuously and systematically available for expectant
mothers and for children till they are entered on a school register,
and that arrangements should be made for home visitation throughout
this period.
The work of home visitation is one to which the Board attach
very great importance and in promoting schemes on the lines laid
down in the accompanying statement the first step should be the
appointment of an adequate staff of Health Visitors.
It will be desirable, at all events in the case of the larger urban
authorities to provide consultation centres which may fitly be termed
Maternity Centres, to which expectant mothers and mothers with
infants and little children may be referred for advice and treatment;
the operation of these maternity Centres will be rendered most
effective if co-operation is secured with the midwives of the district
and with any local hospital having a maternity department.
It will be necessary to arrange for a medical officer to be in
charge of such a Centre and for the attendance at the Centre of
members of the Staff engaged in home visiting. Careful records,
for which the medical officer should be responsible, will need to be
kept, and in regard to children the records should be in such a form
that they may subsequently be available for the information of the
School Medical Officer when the child is entered at a school.
For the rural and smaller urban areas the Board think it
will generally be found desirable to develop a county organisation,
but in all cases the county work should be intimately related with
that of the local sanitary authority, and on the other hand any work
separately undertaken by a sanitary authority should be co-ordinated
with the county scheme.
It is not expected that all local authorities will be able at once
to initiate complete schemes, but it is important that any partial
arrangements that may be made shall be such as can ultimately form
part of a more extended organisation.