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former Southall standards) and an endeavour made to obtain an attendance equal to our
previous figures, from which it could be seen that 90-95% of new-born infants attended
at least on one occasion at a local authority Clinic. The improvement should be carried
out whether they are held in local authority buildings or in private practitioners' premises,
and they should all be modernised and made able to provide for group discussions, Parentcraft
teaching, physical training classes, and have creches manned by voluntary workers
and well equipped with play material where toddlers can be kept amused while they are
waiting, and there should be a two-way traffic, with the mutual goodwill of the general
practitioners and the local authority doctors, so that health visitors and secretarial staff
can be made available for all maternity and child welfare clinics, with the simple condition
agreed with general practitioners that appropriate records of those attending such clinics
should be available for the use of the Medical Officer of Health for statistical and research
purposes. General practitioners should be able to refer directly to special services, i.e. for
physiotherapy, chiropody, dentistry and orthodontic treatment, ophthalmic investigation,
etc.
Day Nurseries and Day Hostels for the Chronic Sick should be provided at the earliest
possible opportunity, to help those members of families who are willing and anxious to
care for their children or disabled relatives, but who either must work to live (i.e. widows,
widowers, unmarried mothers, unmarried sons or daughters of sick persons), or who need
some relief from the heavy duty of constant care of children or sick relatives (i.e. when in
poor physical health), or when needed in some of the sorely pressed public services because
of special qualifications but unable to work because of home ties (i.e. school teachers,
nurses). Southall had four Day Nurseries, where children not only had good care and
happy companionship, but where many mothers learned a great deal of mothercraft;
now it has none, but very many young children spend the days with strangers, unselected,
unsupervised, some excellent, some careless, some frighteningly incompetent.
The School Medical Service whereby all children are seen in school by a doctor, with
parents and the Health Visitor in attendance, and with the opportunity of a case conference
with head teacher and class teacher to follow, should be expanded to have routine inspection
at ages 5, 8, 11 and 14, and yearly inspections after that age. The Clinics to which
children with minor ailments, injuries and emergencies, can be referred direct from the
schools should be open every day all day with a doctor either in attendance or on call.
This, which was our custom in Southall, saves much distress to school teachers who have
to search for working parents, private doctors who are probably out visiting, or to take or
send the children to hospital.
Equipment in offices and clinics should be brought up-to-date. For offices and clinics
good filing systems, plenty of intercommunicating and external telephones, visual aids for
Health Education, typewriters and dictographs are needed, while for the department as a
whole part of the services of a printing department and of a computer for statistical surveys
and reports are most important. More clinic centres need to be provided, but all the existing
premises should be kept up-to-date. Old houses used for homes and hostels should be studied
and improved, shiny new buildings are most depressing for the homeless and the old, and
such new homes as are required should not be obviously modern, and should allow some
privacy and decency for the unfortunate dwellers.
Mental Health—little has been done as yet for this branch of Public Health in local
authorities. One of the first links must be with the Psychiatric Hospital at St. Bernard's,
and the Psychiatric Units of the local general hospitals—and home visiting should be shared
by hospital psychiatric social workers and local authority mental welfare officers. Day
hostels and resident hostels for patients convalescing from mental illness are urgently
necessary, and could combine well with the Industrial Training Schemes now in operation
in the hospital and in Hanwell. More training centres and greater variety of work opportunities
are needed for those handicapped by mental subnormality.
Welfare. Since the War, the social conscience has been stirred by the plight of the homeless,
the destitute, neglected and abandoned children, the disabled or handicapped and the
lonely aged. The work of the Welfare Section is to accept responsibility for all of these,
and the Medical Officer of Health has a duty to enlighten the Local Authority on how
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