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24
course, the function of child health clinics is preventive rather
than curative, laying strong emphasis on early detection and
assessment of handicaps, the general practitioner of the future
would be responsible for the complete care of the child. This
step forward assumes, of course, the establishment of health
centres run by groups of doctors whose members would include
those with a specitil Interest and skill in development
paediatrics. Health visitors and other local authority staff
would work closely with doctors practising from these centres,
with the eventual aim of team work covering both preventive
and curativc aspects of medical practice.
The Report goes on to say that this is a picture of the
future, but for many years to come a great deal of this type of
workwith children will be carried out by local authority medical
officers, who have more time to spend with the children and
their parents than general practitioners, whose attitudes are at
present largely conditioned by demands made upon them In the
therapeutic field.
In Redbridge we have, as well as our own full time staff,
four family doctors running infant welfare and toddler clinics
on our premises. These doctors do not deal exclusively with
their own patients, though some are working from centres in
their own practice areas, so at least we have made a start along
the lines advocated by Sheldon.
It is always administratively tidier, and therefore a temptation
to employ full time staff for clinic work of this type, as
one has more knowledge of their interests, capabilities and
training than that of part time staff working on a sessional
basis. If, however, our policy in the future is to pass most of
this work across to our general practitioner colleagues, it will
be most necessary to provide in-service training for all doctors
working from child health centres, whether they be general
practitioners or local authority staff. At present very limited
facilities exist for the free training of general practitioners
undertaking work in development paediatrics, and this must be
remedied if this is to be their future responsibility.
Particular emphasis' is laid in the Report on "screening"
tests. These tests are designed to pick out a child with
defect as early as possible, and thus ensure effective treatment.
For example, all children in Redbridge have their urine tested
in very early Infancy to see whether they are suffering from
phenylketonuria, as prompt recognition of this condition prevents
the onset of permanent mental defect. It may well be that
in the next year or two this procedure will be replaced with a