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32
Personal Health Services
MIDWIFERY SERVICE
The Borough has an establishment of 23 Midwives including a Non-Medical Supervisor and
Deputy. During 1966 there were 1,049 domiciliary confinements; 261 patients were booked for home
delivery but were delivered in hospital for various reasons. Of these, 198 were discharged before the
tenth day and cared for at home, and in addition there were 122 cases of arranged early discharge of
hospital patients.
Midwives had to call for medical aid on two occasions, and in another case assistance was obtained
from the emergency obstetric squad.
Twenty-four pupils were accepted for practical training from the Hillingdon Hospital Midwifery
Training School during the year. In addition, staff of the department co-operated with the hospital in
lectures and demonstrations to student nurses taking the general nursing and other training courses.
A table has already been given showing the work undertaken at ante-natal and post-natal clinics.
Analgesia During Labour
In February, 1966, as an experiment, two Entonox analgesic machines were introduced. These
machines involve the use of cylinders of already mixed oxygen 50% and nitrous oxide 50%. The
advantage over a nitrous oxide and air mixture is that an unvarying proportion of oxygen is always
inhaled by the patient and a simple demand valve is used instead of a mixing unit which could be
tampered with. The apparatus is also small and easier to carry about.
All the midwives were given an opportunity of using these two machines from time to time, and a
total of 52 patients used the machines during labour.
HEALTH VISITING
There is an establishment of 52 Health Visitors and Clinic Nurses, and at the end of the year a
full-time equivalent of 49 was employed. The Superintendent Health Visitor and her Deputy are
included in these figures.
A comprehensive health visiting service is available to members of the public and covers all
aspects of health and welfare.
Selective visiting to the homes of young families, the handicapped and the aged makes assessment
of individual and family needs apparent and presents the opportunity to advise as to the appropriate
service or agency that might assist. Being in continual contact with mothers and young children, the
health visitor is often the first person to detect deviation from normal health—particularly in the "at
risk" groups. During periods of stress advice, guidance and reassurance are offered in an endeavour
to prevent mental, physical and emotional ill-health and their consequences.
This supportive role is emphasised in the six-monthly visits to families having a mentally subnormal
child. Health visitors continue this family contact until the child is approximately 16 years of
age when his needs can be further helped as an adult by the mental welfare officers of the department.
The medico/social qualifications of the health visitor equip her to be the link between various
statutory and voluntary agencies; further, she is also a most important link in joining together the work
of the three branches of the National Health Service.
For the sixth year a health visitor on behalf of all her colleagues has maintained contact with the
Maternity Unit at Hillingdon Hospital. Appreciation of this link has been expressed by the mothers
themselves who now know of other services than those offered by the hospital.
Similarly, a health visitor has been nominated as the link between the Health and Welfare Department
and the Paediatric Unit at Hillingdon Hospital, and it is hoped that this service will develop as
the maternity liaison mentioned above has done.
Day to day co-operation with family doctors is becoming established with a more complete understanding
of each other's role—again resulting in a better service to the public.
Health education for expectant mothers is offered in 14 clinics throughout the Borough, and
classes for fathers in two clinics; health visitors undertaking the major part of these sessions.