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The clinic is designed so that advice and treatment can be given to mothers, young children and
school children in the neighbouring community at mother and baby sessions (ante-natal, post-natal, and child
welfare) and at dental, immunisation, minor ailments, speech therapy, physiotherapy and chiropody clinics.
Mothercraft classes are organised. Specialist services including ophthalmic and ear, nose and throat sessions
will be added later.
The clinic, which is on two floors, has its main entrance in Balnacraig Avenue. It has been designed
so that, in general, expectant and nursing mothers and children under five are dealt with on the ground floor.
There is a waiting hall on each floor.
The general office and food sales room adjoin the main waiting hall on the ground floor. The
weighing and ante-natal suite lead directly off the waiting hall. A large physiotherapy room on this floor
can also be used for mothercraft classes and lectures.
On the first floor is the dental suite, comprising two surgeries with a recovery room between, together
with the minor ailments, chiropody and ophthalmic surgeries, a home nurses' room where they can sterilise
their equipment, and an office for the health visitors.
The building is centrally heated by oil-fired boilers in the basement.
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. In I960 an additional trained worker, half-time was employed and
this assistance is still being given.
Altogether 46 families have been referred; 26 were found to be suitable for dealing with by the
Family Service Units, 17 were found to be unsuitable and 3 families refused help. Of the 26 families, 1 family
has removed out of Willesden and 3 families have been referred to the care of the National Society for the
Prevention of Cruelty to Children. At the end of the year the Family Service Units were dealing with 22
families.
During the year 1,722 contacts with these families and 788 contacts on behalf of these families were
made by the staff of the Family Service Units.
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 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 seven midwives in Willesden.
During the year one midwife left making a total of six at the end of the year.
There 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 48), 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 liaison between the general practitioners
and the midwives is good. Several doctors attend at the midwives' ante-natal clinics to see the
expectant mothers booked with them.
The Maternity Record Card, based on the Enfield Chase one, is now being used by the general practitioners
and the midwives.
The general practitioners and the midwives also meet together at Pound Lane Clinic from time to
time to discuss points of interest over a cup of tea.
The assistant medical officers take blood specimens from 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 49). Midwives work
very closely with general practitioners who were present in about one in four deliveries (Table 50). 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 51). 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 six mothers during the year for the following conditions: one
ante-partum haemorrhage, two retained placenta with haemorrhage, one adherent placenta and two post-partum
haemorrhage.