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29
TRAINING
In conjunction with hospitals in the area the Council provides facilities
for the practical training of pupil midwives taking their Part II certificates
of a midwifery course; during the year 64 pupils completed district training
in this area. Twelve of the pupils were under the supervision of three of the
Council's midwives who are recognised as qualified teachers by the Central Midwives
Board for this purpose.
The Local Authority is also required to provide or arrange, in accordance
with the rules of the Central Midwives Board, refresher courses of instruction
for certified midwives practising in the area.
HEALTH VISITING
Health visiting combines the skill of nursing, public health and some
phases of social assistance. All health visitors function as part of the
total public health programme, the promotion of health, the improvement of conditions
in the social and physical environment, rehabilitation and the prevention
of illness and disability. The service is designed to serve the total population
with emphasis on the child under five and the young mother, and the mother with
particular problems. The health visitor is a state registered nurse with certain
midwifery experience who has taken a further year's course to obtain her
Health Visitors Certificate. The five main aspects of her work are:-
1) The prevention of mental, physical and emotional ill-health and its
consequences;
2) Early detection of ill-health and the surveillance of high risk groups;
3) Recognition of identification of need and mobilisation of appropriate
resources where necessary. This involves liaison with other statutory
and voluntary services.
4) Health teaching (see Health Education); page 34.
5) Provision of care; this will include support during periods of stress;
and advice and guidance in cases of illness as well as in the care and
management of children.
She is a practitioner in her own right detecting cases of need on her own
initiative as well as acting upon referrals. She has skills and knowledge
particular to her work and these are drawn from her nursing background and from
the additional preparation in her health visitors course. A health visitor's
training is designed to perceive early deviation from the normal and to work
out a programme of help for the individual where it is required. With practice
she is able to establish the priority needs among her clientele.
No other worker at present combines the type of knowledge and skills outlined,
and the service the health visitor offers is essential if medico/social
problems are to be contained within manageable proportions in relation to available
resources in money and personnel, quite apart from the promotion of the
health of the community in its widest sense.
Due to resignations the number of health visitors employed again fell during
the year and there is every indication that the number will be further
diminished in 1967. The strength is now very much below a reasonable establishment
for a Borough of the size of Hackney. The average family case load
for health visitors should be about 400 but in this Borough it is estimated that
the case load is as high as 850. Thus the health visitors have a case load
twice the size of that which they should have if they are to give a satisfactory
service to each family. I feel, therefore, that urgent consideration must be
given to attracting recruits to this important part of the service.