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School Health Service.—A separate report has been submitted on this service which was provided
by Middlesex County Council. Apart from routine medical, dental and cleanliness inspections all the
facilities of the school health service were available to pre-school children.
Medical Out-relief.—This work was done by the District Medical Officers appointed by Middlesex
County Council.
Venereal Disease.—Facilities for free diagnosis and treatment were provided by Middlesex County
Council. The nearest treatment centres were West Middlesex and West London Hospitals and fares
were paid in necessitous cases.
Vaccination.—The work under the Vaccination Acts was carried out by the public vaccinators
appointed by Middlesex County Council. The number of vaccinated persons in the Borough is not known.
Tuberculosis.—The diagnosis and treatment of persons suffering from tuberculosis was undertaken
by Middlesex County Council and the clinic serving this area is at 28, Bell Road, Hounslow.
In December, 1947, the County Mass X-Ray Unit visited the Borough and was installed at Messrs.
A. & F. Pears, Ltd., Isleworth. Arrangements were made for factory groups, Council staff and civil servants
to attend, but the general public and school leavers were not included. All doctors were informed of the
visit and offered appointments for their patients. The total attendance of persons was 887 men and 900
women. Many employees who had attended eighteen months before on the first visit of the unit to the
Borough did not attend on this occasion. The absence of disease on one occasion is no guarantee for the
future, and full advantage should be taken of any facilities for regular X-Ray examination of the chest.

The work of the municipal midwives is supervised in detail by the Supervisor of Midwives, who
is also Superintendent Health Visitor, and in general by a medical officer. During the year it was not
necessary to report any midwife to the Central Midwives Board for a breach of their rules. Under these
rules a midwife is required in certain circumstances to summon medical aid. The Council pays the doctors'
fees in such cases and recovers all or part of the cost from the patient unless she has taken advantage of the
Council's insurance scheme to cover such contingencies. The percentage of cases in which the midwives
sought medical aid was 34.6 as compared with 37.7 in 1946.
All the municipal midwives have been trained in gas and air analgesia. Now that the supply of
apparatus has improved and the rule requiring the presence of a second midwife or nurse has been relaxed
it is easier to provide this service. The apparatus is heavy, bulky and not suitable for carrying on a cycle
and the only satisfactory way of overcoming this difficulty would appear to be the provision of cars for
midwives. During the year gas and air analgesia was administered by midwives to 60 patients as compared
with 35 in 1946.
Arrangements were continued for municipal midwives to attend post-certificate lectures and
demonstrations organised jointly by the London Middlesex and Surrey County Councils.
Care of Premature Babies.—The term " premature " is usually applied to every infant born before
full term. If a baby is small but not premature in the foregoing sense, it may need special attention,
and therefore doctors and midwives have been asked to record on birth notification cards all baby weights
of 5J lbs. or less. The number of Heston and Isleworth babies notified as weighing 5 J- lbs. or less at birth
when expressed as a percentage of the total Heston and Isleworth live births gave 5.2 in 1945, 5.7 in 1946
and 5.6 in 1947. Of the 104 premature babies in 1947, 25 were born at home, 73 in hospital and 6 in
nursing homes. Special equipment including draught-proof cots, hot water bottles, special feeding
bottles, thermometers, etc. is readily available at the request of doctor or midwife for use in cases of
premature birth.
Convalescent Treatment for Mothers and Children.—No facilities for such treatment are available
in the Borough, but mothers and children requiring convalescent treatment were sent where accommodation
could be found. During the year 1 mother was sent to a Convalescent Home. The cost was borne by the
Council and a charge made according to the circumstances of the patient.
Home Helps.—The chief development in this service during the year was the appointment of a
whole-time organiser. The concentration in one person of the recruitment, allocation of duties and supervision
of the home helps and of the investigation and priority selection of applications brought about an
immediate improvement in the administration and efficiency of the service. The close personal contact
oi the organiser with the home helps and applicants for assistance, resulted in the staff beipg used to the
est advantage and in the removal of friction and difficulties arising from misunderstandings and the
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