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A comparison with the 1964 figures for Health Division No. 4 of the former
London County Council, however, shows that there has been a drop in total
attendances of children under 5 years of 3,984. This may be due in part to
the fact that an increasing number of general practitioners welcome mothers and
babies at their surgeries, but also to the fact that there is an acute shortage
of health visitors who have to concentrate on selective visiting and have insufficient
time at their disposal to do all the repeat visits they would wish
to encourage less willing mothers to attend the centres.
The number of attendances in the age group 3-5 increased from 4,099 in 1964
to 4,579 in 1965.
There are possibly several factors having a bearing on this, not the
least of which is the practice of the Department in sending out 'birthday'
cards to the parents of toddlers asking them to bring the children for a
check-up.
THE HANDICAPPED CHILD
For some time past the Health Division No. 4 of the London County Council
had been endeavouring to obtain from the local hospitals and general practitioners
details of children who, because of some abnormality in the pre-natal stage or
during birth, might be liable to some handicap, physical or mental, in later
life. Negotiations have since been going on with the hospitals to complete
records that would help us with this purpose and health visitors, wherever they
know of such cases, make a special attempt to watch out for any aberration from
the normal developmental process. These handicaps include not merely a physical
handicap, but the possibility of slow mental development, hearing loss, delayed
speech development, etc.
The early assessments of all these handicaps makes it much easier to predict
the future needs for special types of education for these children. Even
where a handicap is due to an accident after birth, early identification of
the defect might be of considerable importance; early detection is particularly
important with hearing loss as it is generally accepted that a child's ability
to speak and understand language properly later on depends to a large extent
on his ability to hear normal human speech during the first year of life.
CONGENITAL ABNORMALITIES DETECTED AT BIRTH
A standardised form of notification to the Registrar General of all babies
born with a detectable abnormality was introduced in 1964, following a directive
from the Minister of Health.
Its purpose is to show up any seasonal, geographical or other factors
hitherto unrecognised, giving rise to increased incidence of a particular
abnormality. While it will only be after a considerable time that the findings
can be of great significance, it is hoped that definite trends in the patterns
of occurrence of some congenital abnormalities will gradually emerge. The
primary purpose of studying these abnormalities is to assist in their prevention
in the future.
During 1965, 99 abnormalities were notified; of these 63 could be considered
minor in degree while 36 were major deformities, some being imcompatible with
life. The most commonly occurring defect was talipes deformity of one or both
feet. A follow-up of cases is carried out if necessary to confirm the diagnosis
made at birth, and to follow up the treatment being given at hospital.