View report page

Child Welfare Clinics
The work done at these clinics is largely of a
counselling and supportive nature. Its object is the
promotion and preservation of health, the early
detection of disease or defect and the amelioration
of handicaps in children. To an increasing extent it is
being realised how important for its future physical
and mental health is the quality of parental care a
child receives in its earliest years. It is regretted that
once the child has reached the toddler stage attendances
at child welfare clinics either cease or become
infrequent.
Child welfare sessions are held at ten clinic premises
and a mobile clinic is used in part of the borough. At
each session a medical officer and health visitor are
in attendance and at some clinics are assisted by
voluntary workers. Vaccination and immunisation is
carried out at those sessions held in the Feltham,
Hanworth and Bedfont clinics, and this inflates the
numbers attending. It has been suggested that this
reduces the time available for the primary work of a
child welfare clinic and on balance it is probably
preferable to provide separate sessions for immunisation.
During the year 1,427 sessions were held at
which 7,856 children made a total of 61,120
attendances.
Welfare Foods etc
National welfare foods, dried milks and a selection
of other suitable preparations are stocked at child
welfare centres for sale, or if the need is proved, for
free issue. During the year sales to the value of
£13,230 were made and the issue of national welfare
foods was as under—
National dried milk (tins) 12,434
Orange juice (bottles) 56,679
Vitamin tablets (packets) 3,788
Cod liver oil (bottles) 3,235
Congenital Abnormalities
In accordance with a directive sent to Local Health
Authorities in November 1963 arrangements were
made, from January 1964, for all babies born with a
detectable abnormality to be notified by the doctor or
midwife to the Medical Officer of Health. A return
of such cases is sent at monthly intervals to the
Registrar General.
Observation Register
The Local Authority is able to provide help and
advice about the day to day management of the
pre-school handicapped child and later to provide the
type of education best suited to his needs. To undertake
this, however, early diagnosis and assessment of
handicaps are essential.
In recent years it had become apparent that in spite
of increased knowledge of the causes of various
handicaps in childhood, a certain number of children
were still being referred for specialist advice too late.
In 1961 under the former Middlesex County Council
a pilot scheme was inaugurated in the area and based
on the experience thus gained it was decided in 1965
to devise a comprehensive scheme whereby all
children born in the Borough liable to present a
handicap should be kept under observation in the
local infant welfare clinic.
Discussions were therefore held with the Obstetricians
and Paediatricians at the West Middlesex
Hospital, Chiswick Hospital and Queen Charlotte's
Maternity Hospital. A practical scheme of notification
at birth was evolved whereby it was agreed that those
children born with congenital defects and those
children born with a potentially greater risk of
developing a handicap should be notified to the
Health Department with the notification of birth.
The Consultant Obstetricians gave Local Authority
Medical Officers access to the Hospital records.
Medical Officers have therefore been able to obtain
accurate information direct from the Hospital records
since September.
It seemed desirable to follow up these children on
a developmental basis in normal infant welfare clinics
where the child is assessed for its physical and
intellectual development including the use of sight
and hearing. Only by such a comprehensive assessment
can the child be encouraged to develop in all fields
and the correct advice given to parents. If a specific
handicap is diagnosed or suspected then use is made
of specialist clinics such as the Medical Advisory Unit
Martindale Road Hounslow or the Hearing Clinic at
Heston. Ascertainment as a handicapped pupil will
follow if special educational treatment is required,
and surveillance throughout the child's school life is
maintained by the specialist clinic concerned in liaison
with the family doctor.
The foregoing arrangements for notification of
46