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Medical officers, health visitors and outside speakers have given lectures, talks and demonstrations
on health and homecrafts, many illustrated with films.
Mothers have visited the Houses of Parliament, theatres, Southend, and, with their children, a pantomime.
A children's Christmas party and a sixth anniversary dinner were held at Stonebridge Clinic. An
annual donation of £1 is sent to the Willesden Old Folks' Association. A door-to-door collection was
arranged in aid of the National Society for the Prevention of Cruelty to Children and the proceeds were
given to the Society's funds.
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 assist in the prevention of the break-up
of families, referred by the health visitors. During the year an additional worker, half-time, was employed.
Altogether 43 families have been referred; 23 were found to be suitable for dealing with by the
Family Service Units, 17 were found to be unsuitable, and 3 families refused help.
The families receiving help are long-term, and none have yet been discharged. The Family Service
Units has relieved the health visitors of the heavy burden of work with these families; there has been good
co-operation between all workers concerned.
Joint quarterly meetings are held, 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. Reports are
exchanged, the families are discussed, and suggestions for helping them are made.
MIDWIFERY SERVICE
At the beginning of the year the Middlesex County Council employed six midwives in Willesden.
An additional midwife was appointed during the year making a total of seven at the end of the year.
Three or four pupil midwives work for three months at a time in Willesden under the supervision of
approved midwife teachers as part of their second period training for the Central Midwives' Board
Examination.
General practitioners and midwives together supervise the care of expectant mothers. The doctor
supervises the care of the expectant mother, and arranges for a blood specimen, chest X-ray and for a certificate
of medical fitness for gas and air analgesia. The midwife examines the mother at her special clinic
(Table 51), visits her at home and ensures that everything is prepared for the confinement. Every mother has
a general practitioner and a midwife booked for her confinement.
The assistant medical officers take blood specimens for expectant mothers referred by general practitioners.
Midwives instruct expectant mothers on the use of the apparatus for gas and air analgesia. Mothers
who have gas and air analgesia during labour have substantial relief from pain (Table 52). Midwives work
very closely with general practitioners who were present in about one in five deliveries (Table 53). 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 54). When labour tends to be long Pethidine or Pethilorfan is given.
This assists with relaxation and shortens the labour. In some cases Trichloroethylene is administered with
good results.
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 to two mothers during the year for the following condition:
retained placenta with post-partum haemorrhage.
The Hammersmith Hospital premature baby unit provides a special ambulance for 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 by the doctor who has been called for medical aid by a midwife. Four babies were
admitted to the unit during the year and one to University College Hospital premature baby unit at a time
when Hammersmith Hospital was under repair.
The number of visits made by midwives to mothers and babies discharged early from hospitals has
increased during the year (Table 53).
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.
Health visitors attend with the assistant medical officers at maternity and child welfare clinics, and
at schools for medical inspections and routine hygiene inspections. During the year they gave school talks to
senior girls on mothercraft. These talks were much appreciated by the girls who showed interest and asked
many intelligent questions. Health visitors make enquiries for the National Surveys and help in the practical
training of hospital student nurses, and student health visitors from Middlesex and Battersea Polytechnic
who are in training during the year (Table 55).
Health visitors work in close co-operation with general practitioners (Table 56), staffs of hospitals,
children's officers, welfare officers, public health inspectors and other social workers.