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A NEW CHILD-HEALTH CENTRE
1170 A NEW CHILD-HEALTH CENTRE Ex A7atal, ante natal, post natal is the comprehensiv( motto suggested by Prof. Alan Moncrieff for the net Province of Natal Centre of the London University Institute of Child Health. The centre was opened or May 26 by Mr. G. P. Jooste, High Commissioner for th( Union of South Africa, who said that the financial hell given by the people of Natal, in founding it, was part oj the " Salute to Britain Fund," which they collected as a gesture of sympathy for our war-time troubles.
PILGRIM’S How the fund
came
PROGRESS
to be
used in this way is
stirring story. In 1939 the medical committee oi the Hospital for Sick Children, Great Ormond Street, were already debating how the hospital might best collaborate with the preventive health services; and at the same time a committee at the British Postgraduate Medical School were discussing a plan for preventive paediatrics. By 1943 (and considering how our attention was occupied at the time, this must be regarded as fairly rapid going) informal discussions had taken place with senior medical officers in the London County Council, and the phrases model infant welfare centre " and " model a
"
school treatment centre " were heard. In 1946 the University of London Institute of Child Health, with Professor Moncrieff as director, was founded, and though it was tucked into the hospital, and using cubicles for offices, it began at once to investigate how a model The borough welfare centre might come into being. councils of Holborn and St. Pancras allowed the institute to use their centres for the teaching of preventive work ; but money for building was scanty, and building prospects scantier. But in the summer of 1947 this starcrossed project suddenly found friends : Mr. Rupert Ellis, the Mayor of Durban, mentioned, in the course of
friendly visit to Professor Moncrieff, that he was sorry the advent of the National Health Service had prevented the people of Natal from helping Great Ormond Street I remember gripping my chair hard," Hospital. Professor Moncrieff said at the opening ceremony, as I launched into a tactful explanation of how the money could still be used-for our model welfare centre." The sequel was a message from Mr. Ellis to the South African Gift Committee ; and on Dec. 4 news came that the institute was to have 106,888—the balance then remaining of the Natal Gift. During the next eight years-years littered with planning committees, building committees, architects’ conferences, and applications for building licences (finally issued in 1953)-the London County Council had time to consider their own part in the scheme, and undertook to pay 90% of the cost of maintenance and all the salaries of medical and nursing staff. By the time building the had increased to 120,000 actually began original gift interest ; by though unfortunately the rise in building costs had kept pace. a
"
"
- MODEL INFANT-WELFARE CENTRE
The
on land provided by the of Guilford Street, overlooking another site benign to children-that of the old Foundling Hospital. In the long run it will house both the Province of Natal Centre and the Institute of Child Health, but so far only the centre has moved in. The spacious ground floor is planned for maternity, and child-welfare work, with plenty of rooms for clinics (antenatal in the south wing, postnatal in the north), a waiting-room large enough to be used for demonstrations, lectures, and meetings, and a playroom for toddlers opening into what-when the builders relinquish it to the gardeners-should be a pleasant leafy garden with a fig-tree in the middle. This playroom, like almost every other room, and all the corridors, in the building, is heated from steam-warmed aluminium panelling in the ceiling-the steam being new
university,
building stands,
at the
corner
cleverly borrowed from the heating plant of the main hospital. A reinforced glass panel, reaching to the very floor, gives even the smallest child an outlook into the garden, and is guaranteed to stand up without splintering to thumps, kicks, and toy trains flung in anger. The playroom, with perhaps one or two others near it, is to be used as a creche on two half-days a week, and if thi, proves a popular arrangement it may be extended. We all know the drawbacks of the full-time day-nursery, anyhow from the children’s point of view ; but a couple of afternoons a week in the company of other children is sometimes just what the paediatrician prescribes for a child ; and it can also provide a welcome break for his mother. Unfortunately such sporadic attendance is not usually acceptable to day-nurseries, and hence few mothers can arrange it for their children. The Province of Natal centre may be starting a new and useful pattern, The ground floor also houses a shop for welfare foods, and a demonstration kitchen. Just outside the entrance is a covered perambulator store, on which an eye can be kept from the inquiry desk, just inside. MODEL SCHOOL TREATMENT CENTRE
On the first floor are rooms for those activities of the school health service which Professor Moncrieff described more conveniently carried out at a clinic than in the as schools "-such things as dental and orthoptic rooms, a minor-ailments clinic, and a room specially equipped for the testing of deaf children. The child-guidance clinic which has been carried on at the John Street centre will also be transferred here to continue its work. On this floor, too, is the health visitors’ room (there will be three of them and their superintendent) and also their common. room where they can lunch and brew tea. In addition, there are changing-rooms and lavatories for the children - boys at one end of the building, girls at the other, following the usual L.C.C. plan. "
THE INSTITUTE
This floor will also contain the reference library of the institute, which is to occupy the third floor. The two large research laboratories are equipped with a new and practical type of bench, not built to the wall but fitted against it, with cupboards underneath which can be moved along on skids to any convenient position. The water-pipes to the sinks, and the gas-pipes, running along the wall behind the benches, are thus easily accessible to the engineers ; and the layout of the laboratory can easily be altered by changing the position of the benches. On the landing outside is a cold room for storage of
specimens. All the windows in the building work on pivots at the mid-point of the two long sides : they can be turned completely over for cleaning, and adjusted at any angle for ventilation. The decorations are the only part of the new building which seem disappointing, being mainly in a timid shade of green ; but no doubt gay curtains, some of which have already appeared, will make a great difference. This is an important venture, a remarriage of therapy and prophylaxis-two partners who should have known better than to get divorced.
CENTRAL HEALTH SERVICES COUNCIL THE thunder of the latest annual report by the Central Health Services Councilis rather distant ; for account of the two main tasks completed during the year— investigations of general practice in the National Health Service,2 and of the internal administration of hospital:’ - were published some time ago. 1. Report of the Central Health Services Council for the year ended Dec. 31, 1954. H.M. Stationery Office. Pp. 26. 2. Report of the Committee on General Practice within the National Health Service. H.M. Stationery Office, 1954. See Lancet, 1954, ii, 32. 3. Report of the Committee on the Internal Administration of Hospitals. H.M. Stationery Office, 1954. See Lancet, 1954. ii. 741, 747.
PILGRIM’S How the fund
came
PROGRESS
to be
used in this way is
stirring story. In 1939 the medical committee oi the Hospital for Sick Children, Great Ormond Street, were already debating how the hospital might best collaborate with the preventive health services; and at the same time a committee at the British Postgraduate Medical School were discussing a plan for preventive paediatrics. By 1943 (and considering how our attention was occupied at the time, this must be regarded as fairly rapid going) informal discussions had taken place with senior medical officers in the London County Council, and the phrases model infant welfare centre " and " model a
"
school treatment centre " were heard. In 1946 the University of London Institute of Child Health, with Professor Moncrieff as director, was founded, and though it was tucked into the hospital, and using cubicles for offices, it began at once to investigate how a model The borough welfare centre might come into being. councils of Holborn and St. Pancras allowed the institute to use their centres for the teaching of preventive work ; but money for building was scanty, and building prospects scantier. But in the summer of 1947 this starcrossed project suddenly found friends : Mr. Rupert Ellis, the Mayor of Durban, mentioned, in the course of
friendly visit to Professor Moncrieff, that he was sorry the advent of the National Health Service had prevented the people of Natal from helping Great Ormond Street I remember gripping my chair hard," Hospital. Professor Moncrieff said at the opening ceremony, as I launched into a tactful explanation of how the money could still be used-for our model welfare centre." The sequel was a message from Mr. Ellis to the South African Gift Committee ; and on Dec. 4 news came that the institute was to have 106,888—the balance then remaining of the Natal Gift. During the next eight years-years littered with planning committees, building committees, architects’ conferences, and applications for building licences (finally issued in 1953)-the London County Council had time to consider their own part in the scheme, and undertook to pay 90% of the cost of maintenance and all the salaries of medical and nursing staff. By the time building the had increased to 120,000 actually began original gift interest ; by though unfortunately the rise in building costs had kept pace. a
"
"
- MODEL INFANT-WELFARE CENTRE
The
on land provided by the of Guilford Street, overlooking another site benign to children-that of the old Foundling Hospital. In the long run it will house both the Province of Natal Centre and the Institute of Child Health, but so far only the centre has moved in. The spacious ground floor is planned for maternity, and child-welfare work, with plenty of rooms for clinics (antenatal in the south wing, postnatal in the north), a waiting-room large enough to be used for demonstrations, lectures, and meetings, and a playroom for toddlers opening into what-when the builders relinquish it to the gardeners-should be a pleasant leafy garden with a fig-tree in the middle. This playroom, like almost every other room, and all the corridors, in the building, is heated from steam-warmed aluminium panelling in the ceiling-the steam being new
university,
building stands,
at the
corner
cleverly borrowed from the heating plant of the main hospital. A reinforced glass panel, reaching to the very floor, gives even the smallest child an outlook into the garden, and is guaranteed to stand up without splintering to thumps, kicks, and toy trains flung in anger. The playroom, with perhaps one or two others near it, is to be used as a creche on two half-days a week, and if thi, proves a popular arrangement it may be extended. We all know the drawbacks of the full-time day-nursery, anyhow from the children’s point of view ; but a couple of afternoons a week in the company of other children is sometimes just what the paediatrician prescribes for a child ; and it can also provide a welcome break for his mother. Unfortunately such sporadic attendance is not usually acceptable to day-nurseries, and hence few mothers can arrange it for their children. The Province of Natal centre may be starting a new and useful pattern, The ground floor also houses a shop for welfare foods, and a demonstration kitchen. Just outside the entrance is a covered perambulator store, on which an eye can be kept from the inquiry desk, just inside. MODEL SCHOOL TREATMENT CENTRE
On the first floor are rooms for those activities of the school health service which Professor Moncrieff described more conveniently carried out at a clinic than in the as schools "-such things as dental and orthoptic rooms, a minor-ailments clinic, and a room specially equipped for the testing of deaf children. The child-guidance clinic which has been carried on at the John Street centre will also be transferred here to continue its work. On this floor, too, is the health visitors’ room (there will be three of them and their superintendent) and also their common. room where they can lunch and brew tea. In addition, there are changing-rooms and lavatories for the children - boys at one end of the building, girls at the other, following the usual L.C.C. plan. "
THE INSTITUTE
This floor will also contain the reference library of the institute, which is to occupy the third floor. The two large research laboratories are equipped with a new and practical type of bench, not built to the wall but fitted against it, with cupboards underneath which can be moved along on skids to any convenient position. The water-pipes to the sinks, and the gas-pipes, running along the wall behind the benches, are thus easily accessible to the engineers ; and the layout of the laboratory can easily be altered by changing the position of the benches. On the landing outside is a cold room for storage of
specimens. All the windows in the building work on pivots at the mid-point of the two long sides : they can be turned completely over for cleaning, and adjusted at any angle for ventilation. The decorations are the only part of the new building which seem disappointing, being mainly in a timid shade of green ; but no doubt gay curtains, some of which have already appeared, will make a great difference. This is an important venture, a remarriage of therapy and prophylaxis-two partners who should have known better than to get divorced.
CENTRAL HEALTH SERVICES COUNCIL THE thunder of the latest annual report by the Central Health Services Councilis rather distant ; for account of the two main tasks completed during the year— investigations of general practice in the National Health Service,2 and of the internal administration of hospital:’ - were published some time ago. 1. Report of the Central Health Services Council for the year ended Dec. 31, 1954. H.M. Stationery Office. Pp. 26. 2. Report of the Committee on General Practice within the National Health Service. H.M. Stationery Office, 1954. See Lancet, 1954, ii, 32. 3. Report of the Committee on the Internal Administration of Hospitals. H.M. Stationery Office, 1954. See Lancet, 1954. ii. 741, 747.