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PROPOSED DEVELOPMENTS
High attendance figures at existing Council clinics and the lack of facilities in much of
the Borough indicated the need for expansion, and a review was made of existing services and the
current need assessed. As a result recommendations for a wider service were made; basically these
aimed at the provision of family planning clinics at each of our main welfare centres.
The recommendation was approved by the Health Committee (22 September 1965); training
of medical officers and nursing staff commenced immediately and expansion of the service started
early in 1966 with a target of 9½ sessions per week, compared with 4½ sessions when the service
was taken over by the Borough. In addition, approval was given to revision of the scale of fees paid
to the Family Planning Association, for Camden patients treated by them, including special charges
for those recommended for advice on contraception by oral methods or by the intra-uterine device.
A grant of £400 to the Marie Stopes Foundation was also approved to cover domiciliary
advice given to families who are unlikely to avail themselves of clinic facilities.
CHILD WELFARE SERVICE
REORIENTATION OF FUNCTIONS
The Child Welfare Service was set up at the beginning of the century as an effort to reduce
the persistently high infant mortality rate, then 156 per 1,000 in England and Wales. This has now
decreased by almost 800 per cent. to 19 per 1,000 in 1965, as standards of infant care and living
have been improved. Thus whilst maintaining our traditional role, we are able to concentrate on the
needs of vulnerable groups in the community and in particular on the potentially physically, mentally
and socially handicapped.
One in a 100 children who survive the first year of life may be expected to have a recognisable
handicap, and in many of these children abnormalities may be multiple. There are still, however,
far too many children whose handicaps are not identified sufficiently early in life, and there
is a high incidence of educational and social difficulties arising from disabilities which have not
been fully assessed. The local health authority's potential to act as a screening agency for the
early detection of abnormalities is now generally recognised. New screening procedures are being
developed which can be applied to whole infant populations in well-organised child welfare services
by doctors with special training for the task. Thus, the child who does not respond in the expected
manner to screening tests may, in consultation with the family doctor, be referred as early as possible
for specialist investigation and treatment. The family of the handicapped child may be offered
counselling and supportive services and the child's needs for training, education and recreation
planned well in advance.
To bring about this important reorientation as speedily and as effectively as possible a
new child welfare medical record card designed by the Society of Medical Officers of Health has
been brought into use in all our child welfare centres. Its purpose is to encourage the doctors at the
centres to observe and record the developmental progress of each child on the four parallels of
development - locomotion and posture; vision and hand and eye co-ordination; hearing and speech,
and social behaviour and play.
A two-day introductory course in screening techniques was planned to take place in April
1966. All doctors taking part in the Borough's child welfare services were given the opportunity to
attend. Consideration is being given to making attendance at this or a similar course a requirement
in future for all doctors who are engaged in the Borough's child welfare and school health services.
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