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Miss Scott's departure was deplored by all. Her place has been taken by Mrs. Prissell who
already has shown her great interest in this branch of public health, and as a result of her enthusiasm
a considerable amount of the purely clerical work has been loaded on to the shoulders of two voluntary
workers.
The attendance figures for 1932 show a further rise.
The further increase in the number of new patients is made more surprising when it is recalled
that these amounted to 187 in 1930. The figures of the number of patients attending any clinic
may be used only to a certain extent as a guide of the necessity or popularity of such a department
of public health work. There is a tendency these days, especially among the general public and their
administrative bodies, to gauge the success and utility of such clinics entirely by the numbers of
attendances. In other words the clinic is a shop and the greater the turnover the more successful
the business. This rule will not apply to medicine, at any rate to any branch thereof that necessitates
a careful examination of the patient. Thus it is not advisable that the increase in the number
of patients should continue indefinitely. Should it occur some machinery will be necessary whereby
normal, uncomplicated cases are filtered, and only those whose pregnancy departs from the normal
should be referred for the so-called "specialist " supervision.
The routine of work done is identical with that outlined in last year's report. In order to
abolish unnecessary duplication of work no patient now attends who has booked for her confinement
any doctor in private practice or who is to be confined in any Hospital. It was found, for instance
that patients who had arranged for their confinement in the West Middlesex Hospital were attending
the Ante-Natal Clinics of that institution and also the clinics at Bath Road. Similarily, any patient
who states that she is being attended in her pregnancy and confinement by a doctor in private practice
is not examined. A note is sent at once to the doctor in question stating that the patient presented
herself at the clinic, and would only be seen if the doctor wished this to occur and sent with the patient
a note to that effect. It is gratifying to be able to state that slow but steady increase in the use
of the clinic is being made by doctors practising in the neighbourhood.
No treatment is dispensed by the Clinic. The investigation of the patient only is performed.
Furthermore it is only in exceptional cases that the patient is referred direct from the Clinic to any
institution, such as a voluntary hospital. The routine adopted and followed is that patients who
complain of such symptoms as obstinate constipation, dyspepsia, heartburn, insomnia, coughs,
colds, etc., or in whom any abnormality is detected are referred to their own doctor, or a doctor of
their choice. A letter is sent and states that at the visit of the patient to the Clinic such-and-such
an abnormality was found and that the patient has been referred to her doctor for advice and treatment.
Should the doctor in question require specialist advice on this or another point he is at liberty
to seek it wherever he will, and occasionally consults the Ante-Natal Clinic Officer to request his
aid. By this means it should be, and in practice is, possible for the clinic and private practitioners
each to fulfil their own function and to work in harmony.
As one who does similar work in other parts of Greater London the writer cannot omit to
make a few remarks on the "education" of the majority of patients who attend the Ante-Natal
Clinic. Elsewhere a woman, whose mouth contains a number of decayed stumps and roots of teeth
has more often than not to be dragged to the dentist, despite a full and patient explanation of the
necessity for advising the step.
In Hounslow this is the exception. Patients frequently ask at their first visit if they ought
to see their dentist, or should their financial state be poor, whether they may be allowed to attend
the Dental Clinic. Only occasionally is it that the medical officer's advice upon dental treatment
signored.
This year the clinic has served the public in another capacity. A few young mothers whose
new home is in Hounslow, had arranged to be confined in their parent's house, generally in a distant
part of the country. The Clinic has been able to provide these people with ante-natal supervision
before they are handed over to the local midwife.
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