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CHILD HEALTH SERVICES
The Principal Medical Officer, Dr. R. Jacobs, reports as follows
"The Child Health Services in the two former Boroughs of East and West Ham differed
and a common policy had to be worked out, It was decided to develop a new pattern of
Child Health Services retaining the best features of the previous services and geared to the
needs of the new Borough taking into account modern trends and ideas.
The science of developmental paediatrics with its emphasis on continuous assessment of
children from birth up to school leaving age, has transformed the service from a defect and
treatment orientated one, to one of assessment of all children. Although many basic
principles of developmental paediatrics were applied in previous years, we have pursued during
the past five years a more systematic and deliberate policy of bringing the organisation of
the Child Health Services quite up to date. Despite the limitations imposed by financial
stringency wide opportunities were offered to all grades of staff to gain further experience
and training in the field of developmental paediatrics and mental assessment by attending
appropriate courses and in-service training.
Records of congenital malformations observed at birth were kept since 1964, as requested
by the Ministry of Health. In 1962 the Borough introduced a register of handicapped children
and those at risk of a handicapping condition. The list of conditions placing the child in
the risk category has been under review and modified, and in February 1969 the Oppe classification
was introduced.
We came to the conclusion that we should try and assess all children in the Borough by
offering appointments in our Child Health Centres and to arrange special follow-up through
health visitor home "visits, of only those children who have failed to attend for assessment.
Having taken into consideration the number of medical officers and health visitors available
for this work, and their other duties, we have decided to see children by appointment at least
four times in the pre-school period. The recommended ages were four weeks, nine months,
2½-years and 4-years,
In order to cover all the children in the available sessions with the available staff,
the number of appointments sent out for a session is l6. This number is considered to be
too high, but it was anticipated that attendances would not be 100%. In fact, statistical
analysis of attendances in all 12 centres are studied carefully every six months and the average
attendances for the four age groups during the last completed four surveys were as follows