View report page

13
the Midwifery Service designed to improve the service by increased
job satisfaction and closer integration:
(1) A pilot scheme of midwife attachment to a combined practice
in Orpington to be reviewed after one year's trial.
(2) A scheme to enable three midwives (including relief) to attend
confinements selected for 48-hour discharge in a hospital with
a general practitioner obstetric unit. This scheme was initiated
by a Maternity Liaison Committee, and though other Obstetric
Hospitals linked to the other Maternity Liaison Committee
have no general practitioner obstetric units, an extension of
the scheme is a possibility for future consideration by that
Committee.
Progress may seem over cautious in these attachments of
midwives (as yet there are no attachments of Home Nurses) but
with a falling domiciliary confinement rate (and an increasing old
persons work load for Home Nurses) every scheme must be
economically justifiable and must fit into the general pattern without
detriment to other community services.
The attachment of Health Visitors to group medical practices
numbers eight and two more are in preparation. Here again very
careful selection and preparation is necessary for success and the
report emphasises the need for allocating in group practice premises
a room for the Health Visitor.
The co-ordinating function of the Health Visitor is shown by
the fact that of 50,000 visits, 10% were made to liaise with other
medical and social agencies.
Increasing integration with the general practitioner service was
shown by changes in the scheme for routine vaccination and
immunisation whereby routine vaccinations against smallpox have
become the primary responsibility of the general medical practitioner.
At the same time, the Committee has continued its investigations
into the feasibility and siting of Health Centres with
especial reference to one area of the Borough, and the problems
mentioned last year of site and cost are perhaps a little nearer
solution. The investigations included meetings with medical practitioners
in Beckenham, Penge and Orpington, and officers of the
Executive Council and Local Medical Committee.
Chiropody and Home Help Service
These services are grouped together though the disciplines and
skills are essentially different because the clients for both are in the
main elderly persons. The greater expansion in Chiropody is shown
by 28,097 treatments compared with 24,033 in 1967, whereas Home
Helps were provided for 3,039 homes compared with 3,015 homes
in 1967.
Effective use of both services depends on close supervision. In