London's Pulse: Medical Officer of Health reports 1848-1972
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Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
Hillingdon 1969
[Report of the Medical Officer of Health for Hillingdon]
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36
Personal Health Services
It follows that the register itself is divided into 2 sections, those "at risk" and those with a handicap.
The majority of names fall into the "at risk" category and these are deleted after the child's second
birthday when it is reasonably certain that development is normal. The remainder are children who
require special attention and help during their childhood and possibly for the rest of their lives.
The following table shows these categories, together with some detail of the type of handicap involved. It can be seen from the figures for previous years that the total number of names on the register has been increasing, but now seems to be levelling off, while the figure for handicapped is much smaller and more stable.
| Year of Birth | Total | |||||
|---|---|---|---|---|---|---|
| 1965 | 1966 | 1967 | 1968 | 1969 | ||
| Defective Vision | 1 | 3 | 12 | |||
| Defective Hearing | 3 | 7 | 4 | — | 21 | |
| Mental Defect | 15 | 10 | 7 | — | 36 | |
| Mongolism | 5 | 16 | 7 | 2 | 2 | 32 |
| Autism | 1 | — | — | — | — | 1 |
| Spastic | 5 | 2 | 3 | — | 1 | 11 |
| Epilepsy | 4 | 3 | 1 | 1 | — | 9 |
| Heart Disease | 1 | 3 | 6 | 3 | 2 | 15 |
| Spina Bifida | 3 | 2 | 4 | 3 | — | 12 |
| Congenital Dislocation of Hip | 3 | — | 2 | — | 1 | 6 |
| Fibrocystic Disease of Pancreas | — | — | 2 | — | 2 | |
| Diabetes | 1 | — | — | 1 | 2 | |
| Haemophilia | 1 | — | — | — | — | 1 |
| Cretinism | — | 1 | — | — | — | 1 |
| Other Physical Handicap | 8 | 6 | 7 | 7 | 3 | 31 |
| Totals | 52 | 51 | 45 | 32 | 12 | 192 |
| Total numbers on Register | 91 | 78 | 95 | 431 | 447 | 1,142 |
Total number on Register at the end of each of the previous five years was:—
1965 557
1966 710
1967 928
1968 1,101
1969 1,142
The concept of observation and early detection is excellent, but its effectiveness depends upon
the first person to realise that "risk" exists. This is usually the midwife, either hospital or domiciliary,
and she should be the one making most notifications to the register. Her colleague the health visitor
is the next person involved, and between them they should be able to give warning of all children
who require special observation.
The criticism which has been levelled at the observation register is that the foregoing process
overloads it, and one may find 80% of notified births on it. This is a valid criticism, and there is a
need (which is beginning to be met) for research into the categories of environmental hazard which
render a child liable to develop a handicap. Until definite results emerge from this however, it seems
reasonable to continue the present system, well tempered with the application of practical commonsense.