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behaviour in school and at home (20), unhappiness, immaturity or social withdrawal (31), or more specifically
enuresis, soiling, stealing and telling lies (2) were among the reasons for which parents sought advice.
As usual, boys (157) predominated over girls (78), the peak age for referrals was 7 years (33), the next most
frequent age group was 14 years (26), which means a shift from the usual average age of 11-13, up and down
the range.
The majority of cases were dealt with by more or less extended advice and help given to parents (99), a large
number of children (75) were helped by educational modifications including special school or residential
arrangements, while only 19 cases were found in need of individual psychotherapy. The parents of 21 children
referred failed to respond to our invitations to come to the Clinic, and 5 moved out of the Borough before they
could be seen.
Not every child required assessment by all members of the team and the psychiatrist, who has only two weekly
half-days, had 130 appointments during the year, usually of one hour duration. These were spent in establishing a
diagnosis (78), reviewing the progress of old clinic cases (27) or boarding school attenders (17) while one child
had eight therapeutic sessions with him.
The future of child guidance within the National Health Service is uncertain. Although child guidance clinics have
practised community and family therapy and casework long before its importance was recognised by other
medical and social agencies, and child psychiatrists created well over 50 years ago the concept of team-work which
is now the basis of the new Social Services, little attention to the future of this service and the status of
its staff has been given in the Seebohm Committee's recommendations or the Green Paper and Consultative
Document on the Reorganisation of the National Health Service. It may well be that health, education and social
services will compete for this valuable prize, but history clearly connects child guidance and psychiatric services for
children with the health and education departments, and it has been my privilege as a representative at the Annual
Meeting of the B.M.A. in Leicester this year to put a motion which emphasised the essentially medical nature of
our service, which was unanimously accepted by the meeting. It has also been suggested that diagnostic and
therapeutic clinics should be separated and organised by the education and health services respectively, but this
would in my view be a mistake since diagnosis and treatment form integral parts of the same process of helping
disturbed children, and / have always believed that in spite of the closest co-operation the separate areas of
competence and organisation of child guidance and school psychological services will have to be maintained."
Since Dr. Graf's report was written the Education Committee proposes to set up an additional child guidance
centre for children in the Wood Green district of the Borough in the near future, and the North West Metropolitan
Regional Hospital Board has agreed to appoint a psychiatrist to carry out two weekly sessions at the new centre.
Tuberculosis
Prevention of tuberculosis by B.C.G. vaccination
B.C.G. vaccination is offered to all school children over 13 years of age. No students of Further Education took
advantage of the opportunity to have B.C.G. vaccination during 1971.

Cases of Tuberculosis occuring in Teachers or Pupils
Investigations were carried out on the advice of the Chest Physician at two primary junior schools where cases of
pulmonary tuberculosis had occurred amongst the pupils.