[Report 1970] / Medical Officer of Health, Surrey County Council.

  • Surrey (England). County Council.
Date:
1970
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1970] / Medical Officer of Health, Surrey County Council. Source: Wellcome Collection.

    8/108 (page 6)
    During the past few years there has been considerable discussion concerning the need for a domiciliary family planning service in this country. In several areas this has been provided by the local health authority with consider¬ able success. In Surrey, in spite of frequent discussion with field staff, it has always been difficult to obtain any great evidence of need for such a service. The Senior Medical Officer in charge of family planning services had herself visited such few cases as were put forward. In the Autumn of 1970, however, she resigned her post with the County and it was decided to replace her with a Countywide service constructed on a very simple framework. Each Division and Excepted District was asked to arrange with a trained doctor in the area to be on call for such cases as might require a home visit, this to be paid for on a fee per visit basis. By the end of the year the service had been set up, and it will be of interest to see how many calls are made upon it. It may be that in a County such as Surrey, with very good geographical coverage of clinics, and with health visiting and social work staff who are prepared to assist individual patients to get to clinics where necessary, the demand will not be great. Towards the end of the year discussions were begun with the Family Planning Association with a view to adopting their National Family Planning Agency Scheme during the next financial year. This would entail the pay¬ ment of an agreed per capita fee for medical patients in place of the present system of a lump sum annual grant from the County Council. WELL-WOMAN CLINICS The number of these clinics held in the County remained unchanged at 26 during the year. The object of these clinics is not purely the taking of a cervical smear, although this is the activity which usually receives the maximum amount of publicity and attention from the general public. It is, however, only part of the screening which consists of a more general health check, including examination of the breasts (there were 217 deaths from cancer of the breast in Surrey during 1970 as opposed to 79 from cancer of the uterus). The total number of new patients seen at well-woman clinics during the year was 5,486, and there were 3,380 return visits. A total of 8,685 cervical smears were taken, out of which 18 showed abnormal cells requiring further follow-up, 9 showed a pre-invasive cancer, and 1 showed an established cancer to be present by the time the patient had reported to the clinic. Apart from abnormalities uncovered by cervical smears, very many abnormalities of the genital tract were found, e.g., carcinoma of the cervix (3), pre-carcinomatous conditions (10), large fibroids (58), small fibroids (320), uterine prolapse (117), trichomonas infections (227) and mondial infections (122). Examples of major groups of abnormali¬ ties found by the general examination are given below, which demonstrate the value of the full examination as opposed to the isolated cervical smear test: — Obesity 299 Breast abnormalities 272 Hypertension 198 Anaemia 118 Urinary infections 49 Diabetes or glycosuria 22 PROMOTION OF HEALTH Health Education “Growth is a word, a term, a notion covering a variety of diverse and complex phenomena”. — Paul Weiss The nature of growth as the basis of human development has some relevance to the growth of health education activities over the years, for in each there can be seen not only an increase in size but also a series of changes in form and function. Growth in size is reflected in the very large number and category of professional staff now involved in health education, comprising medical, nursing, teaching, public health and ancillary staff. Changes in form and function are illustrated partly by an emphasis on the promotion of vigorous well-being, partly by an extension into the field of general medical practice and partly by a re-allocation of professional time. Thus health visitors who were spending less than one per cent of their time in teaching sessions in schools in 1960 are now devoting more than fourteen per cent of their time to this work. In the health centres and clinics routine health education proceeded unabated, while group sessions were devoted to relaxation and mothercraft courses, parentcraft evenings, well-woman clinics, geriatric clinics and mothers’ groups. The latter are meetings, held usually one a month, for mothers with children up to one year of age. Talks, often illustrated by film or other media, and discussions with the health visitor cover a wide range of topics including child development, immunisation, hypothermia, separation, prevention of accidents, nutrition, dental health, play material, and so on. Of especial interest, are the weekly obesity clinics now being established to deal with the problem of excess weight. In the wider field the staff have considerably increased the scope and number of illustrated talks to community groups, including, at Woking, people from overseas through a community relations club. Examples of other groups are St. John’s Ambulance and Nursing Divisions, Young Wives, Girls’ Life Brigades, Girl Guides and Rangers, 33