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Assistant medical officers inform general practitioners if treatment is required.
A Mothers' Club is held in Kilburn Health Clinic once a fortnight in the evening and in Stonebridge
Health Clinic once a week. The mothers form their own committee and run the clubs themselves with the
help of the nursing staff. They arrange interesting programmes of lectures and demonstrations on health
and homecraft which are given by assistant medical officers, health visitors and outside speakers. The clubs
have had an active and interesting year. Outdoor activities have included a visit to a theatre, a visit to
London Airport with a conducted tour of the buildings there and a day trip to Bognor.
The Stonebridge Club also collected money for mentally handicapped children, and the old folk in
Willesden. They also supported the sale of work in aid of the Royal College of Midwives Building Fund.
MIDWIFERY SERVICE
At the beginning of the year the Middlesex County Council employed five midwives for Willesden.
During the year two midwives left and one was replaced, making a total of four midwives, with one vacancy
at the end of the year. There is generally a shortage of midwives, and during the year midwives who work
in the Wembley part of the area helped in Willesden.
Four or five pupil midwives work in Willesden (under the supervision of midwives who are approved
midwife teachers) for three months as part of their second period training for the Central Midwives' Board
Examination.
General practitioners and midwives supervise the care of expectant mothers. When a mother chooses
both a general practitioner and a midwife for her confinement the doctor supervises the care of the expectant
mother, and arranges for the taking of a blood specimen and a routine chest X-ray. The midwife examines
the mother at her special clinic (Table 58), visits her at home, and ensures that everything is prepared for the
confinement. Mothers are encouraged to have both a general practitioner and a midwife for their confinement.
A mother who chooses a midwife alone for her confinement attends the local health clinic, where
the assistant medical officer makes the initial medical examination, takes a blood specimen, and arranges for
a chest X-ray. She then attends the midwife's clinic regularly throughout her pregnancy, and is instructed
on the use of the apparatus for gas and air analgesia. The assistant medical officer examines the mother
again at the 36th week of pregnancy and gives a certificate of fitness for gas and air analgesia. Mothers
who had gas and air analgesia during labour had substantial relief from pain (Table 59). Midwives work
very closely with general practitioners who were present at many of the deliveries (Table 60). When a midwife
attends a case on her own and requires help, she must call in a doctor according to the rules of the
Central Midwives' Board (Table 61).
For serious emergencies, the midwife or doctor calls the Central Middlesex Hospital for the obstetric
" flying squad ", consisting of an ambulance, a doctor, a nurse, two ambulance men and blood transfusion
apparatus. The " flying squad " was called out twice during the year for ante-partum haemorrhage.
The Hammersmith Hospital premature baby unit provides a special ambulance for transporting premature
babies who require treatment in their unit. The ambulance is accompanied by two qualified nurses
with special training in the care of premature babies, and it carries a special equipment including a fitted cot
and apparatus for administering oxygen. The ambulance is sent for at the request of a doctor who has been
called for medical aid by the midwife. Five babies were admitted to the unit during the year.
HEALTH VISITING
The Health Visitor is the most important social worker for the care of expectant and nursing mothers
and young children. Under the National Health Service Act, 1946, her work has been extended to the whole
family for their health education and the prevention, care and after care of illness.
Health Visitors attend with the assistant medical officers at maternity and child welfare clinics, and
at schools for medical inspections and routine hygiene inspections. They make enquiries for the special
National Surveys and help in the practical training of hospital student nurses, student health visitors from
Middlesex, Battersea Polytechnic and the Royal College of Nursing and home nurse candidates who are in
training (Table 62).
Health Visitors work in close co-operation with general practitioners, staffs of hospitals, children's
officers, welfare officers, public health inspectors, and other social workers. The co-operation with general
practitioners continues to improve, since a document, "The General Practitioner and the Health Visitor",
was issued by the British Medical Association and the Society of Medical Officers of Health in January,
1954 (Table 63).
Some patients who attend diabetic clinics, require instruction on their treatment, diet and after care
to be given in their homes, and arrangements have been made for this to be done by Health Visitors' instruction.
Health Visitors are now attending the diabetic clinics at the Central Middlesex and Willesden General
Hospitals, and they are responsible to the physicians in charge for the advice given to patients in their homes.
There is a marked shortage of Health Visitors for the Willesden part of the area (table 64). Temporary
clinic nurses have therefore been employed to help at the clinic sessions and visit schools for medical
inspections and routine hygiene inspections.
The Middlesex County Council introduced a sponsored scheme for student Health Visitors in September,
1955. Students receive their theoretical training at the Chiswick Polytechnic and their practical training
in one of the areas. They must remain with the County Council as Health Visitors for two years after they
qualify. There were three students in Willesden in 1956.