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19
Pound lane clinic
This clinic has been open two years. The mothers find the bungalow type building more convenient.
The clinic is designed to afford facilities for giving advice and treatment to mothers, young children
and school children in the neighbouring community. These facilities include mother and baby sessions (antenatal,
post-natal and infant welfare), dental treatment and sessions for immunisation, vaccination, treatment
of minor ailments, speech therapy, physiotherapy, orthoptics and chiropody. Specialists' services include orthopaedic,
opthalmic and ear, nose and throat sessions. Mothercraft classes and ante-natal relaxation classes
are also provided. The additional facilities of physiotherapy and ante-natal relaxation classes which were
unable to be provided at the former clinic are appreciated.
In May, 1959 the County Council approved the provision of facilities at this clinic for the care of
children when their mothers were attending at the clinic. It was agreed to hold three sessions a week and the
first session was held on 28th July, 1959 and to the end of the year 43 sessions were held and 115 attendances
were made.
Prevention of break-up of families in willesden
In October, 1958 the Middlesex County Council entered into an agreement with the Family Service
Units for the equivalent of one whole-time trained social worker to be employed to assist in the prevention
of break-up of families in Willesden. The families are mainly referred by the health visitors, who already have
them under supervision.
Since the inception of the scheme 26 families have been referred of which 12 were found to be suitable
by the Family Service Units and with whom they could work. 12 were found to be unsuitable and 2
families refused help.
The families receiving help are long term cases and it is, therefore, too early to give a report an any
permanent results. The assistance given by the Family Service Units has relieved the health visitors of their
concentrated work with these families.
Joint quarterly meetings are held and are attended by the workers from the Family Service Units,
the N.S.P.C.C. Inspector, other social workers, assistant medical officers, and health visitors. The families
are discussed, various suggestions are made and reports are co-ordinated.
MIDWIFERY SERVICE
At the beginning of the year the Middlesex County Council employed six midwives in Willesden.
During the year one midwife left and was replaced, making a total of six midwives at the end of the year.
As part of their second period training for the Central Midwives Board Examination three or four
pupil midwives work for three months in Willesden under the supervision of approved midwife teachers.
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 a blood specimen and a routine chest X-ray to be taken. The midwife
examines the mother at her special clinic (Table 55), 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 confinements.
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 Midwives' Clinic regularly throughout the 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 medical fitness for gas and air analgesia. Mothers who had gas and air analgesia during labour had
substantial relief from pain (Table 56). Midwives work very closely with general practitioners who were
present in about one in four deliveries of their booked cases (Table 57). 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 58). In addition, pethidine is given to some mothers when labour is established; this assists
with relaxation and tends to shorten the labour. Trichloroethylene is now being used, but experience has
been too little to estimate its effectiveness.
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 a blood transfusion
apparatus. The "flying squad" was called out seven times during the year for the following conditions:—
ante-partum haemorrhage (2), post-partum haemorrhage (1), retained placenta with post-partum hæmorrhage
(3), and a still-born infant (1).
The Hammersmith Hospital premature baby unit provides a special ambulance for transporting
premature babies who require treatment in their unit. The ambulance with two qualified nurses trained in the
care of premature babies, carries 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 for the prevention, care and after-care of illness.