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As the notifications are made within the
first 48 hours of birth often before a doctor
has examined the baby it is possible that a
considerable number of congenital defects are
not notified by this method notably such
conditions as pyloric stenosis fibrocystic
disease various congenital heart defects and
various renal defects We therefore still rely
upon the hospital paediatricians for their co
operation with regard to notifying these defects
Observation Register
In the summer of 1965 a scheme was developed
in co operation with consultant obstetricians
and paediatricians at local maternity hospitals
whereby this department was notified at birth
of children whom it is considered should be
kept under observation because of pre peri
or post natal hazards The names of such
children and those born at home considered by
domiciliary midwives to be in need of observation
for the same reasons have been recorded
in the observation register The children are
called for developmental screening tests at the
ages of 1 month 3 months 7-9 months 12
months 18 months 2 years 2½ years 3 years
and 4 years The tests include hearing vision
social and emotional development sitting up
walking use of hands and language development
The screening tests are conducted for the
most part in child health clinics during normal
sessions although mothers attend by appointment
for these examinations
Since the inception of the scheme a total of
3,686 children's names have been placed on the
register as they were considered to be in need
of further observation
Of the 1 048 names added to the register
during 1968 156 were taken off because the
family moved 10 children died and 25 cases
were closed a total in all of 191 leaving 857
of those born in 1968 still on the register at the
end of the year
In all since the register was started 2 319
names remained as open cases at 31st December
1968
Phenylketonuria
Health visitors carry out phenistix tests for
phenylketonuria on as many young babies as
possible at the ages of three and six weeks
No positive reactions were obtained
38
Care of the unsupported mother and her child
The work of caring for unsupported mothers by
making arrangements for their welfare during
pregnancy their place of confinement and
eventually their return to life in the community
and also satisfactory care for their babies has
continued under the medical social workers whose
office is in Ealing but who undertake this work for
Ealing Hi Ilingdon and Hounslow During the year
the borough accepted financial responsibility for
5 mothers placed in St Agnes Home Chiswick
maintained by the London Diocesan Council for
Moral Welfare work (Welcare) and for 32 mothers
placed in homes outside the borough These mothers
are required to pay a standard charge towards their
care subject to assessment on the borough council s
scale of charges The London Diocesan Council
decided to close St Agnes in August this year and
sought advice from officers of the Town Clerks
Health Childrens and Welfare Departments as to
modernisation of the premises to bring them into
line with the modern concept of the needs of the
single mother and her child It was fully accepted at
the meeting that good use could be made of St.
Agnes for the accommodation of unsupported mothers
when the type of adaptations discussed could be
completed So far the London Diocesan Council has
not been able to start the work as resources are
limited and further investigations have yet to take
place
The London Diocesan Council Welcare workers
also undertake the care of unsupported mothers in
the borough and the work is shared informally with
the medical social workers based in Ealing
In July the chairman of Hounslow and District
Welcare Associations requested the borough to
nominate a member to their executive committee
My principal medical officer Dr E N Christie
agreed to represent the borough and it is pleasing
to report the ever-improving relationships between
the counci I and other organisations statutory and
voluntary who are concerned with this problem
Day Nurseries
There are three day nurseries in the boroughDanesbury
Road Feltham (50 places) Portsdown
House Brentford (32 places) and Nantly House
Hounslow (54 places) all of which reach the high
standard required by the Department of Health and
Social Security for approval as training nurseries
for student nursery nurses The theoretical part of
the students training is given at Chiswick Poly