A brief history of healthcare provision in London


The Boer War (1889-1902) highlighted the physical decline of the nation.  For example, of 11,000 potential recruits, 8,000 (29-32%) had been found to be physically unfit, mainly because of the poor condition of their teeth (due to improper nutrition) and flat feet.  Of the 3,000 accepted men, only 1200 attained a moderate standard of muscular power.

Steps were taken to improve the health of the nation and to reduce the infant mortality rate.  The first milk depot, the precursor to the child welfare centre, opened early in the 20th century.  It followed the example of Dr Pierre Budin, who established a 'consultation de nourissons' clinic in 1899 at the Hôpital de la Charité in Paris.  Needy mothers could be given help and advice on feeding problems with their infants and poor families could receive cheap milk.  By 1903 there were 25 such 'milk depots' in Paris and the scheme was adopted by Dr Leon Dufour in Normandy, who held 'goutte de lait' clinics.

The milk clinics in Britain failed because the mothers did not attend on a regular basis and could not afford the high cost of the milk (French mothers were charged according to their ability to pay and had to bring their infants to the clinic in order to receive milk).

The first Infant Welfare Centre in London was probably the clinic established at the St Marylebone Dispensary at 77 Welbeck Street by Dr Eric Campbell Pritchard, who offered 'infant consultations'.  The second is believed to be the St Pancras School for Mothers in Chalton Street, which opened in 1907.

The work of the voluntary agencies culminated in the formation of the National Association for the Prevention of Infant Mortality in 1912.  The Maternity and Child Welfare Act, 1918, was the foundation of today's child welfare services.

The responsibilities placed by that Act on local authorities for mother, baby and child welfare created an explosion in the provision of such services during the 1920s and 1930s - providing an embryonic national health service to a significant part of the population.

See:  Infant and child welfare between the Wars

For a number of years the major work of the Infant Welfare Centres was advice on feeding, general management and hygiene (with its emphasis on physical care).  This resulted in a gradual improvement in standards of child care and a steady decline in infant mortality.  Some centres developed into hospitals for babies, such as the one in Ladbroke Square.

By the 1960s more stress began to be placed on emotional and social factors in child development, whilst the medical functions were reduced to screening for congenital and developmental diseases.  Smaller families and greater mobility in employment left some mothers without the close support of their own relatives for a while, and the Centres provided this.

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Dwork D 1987 The milk option: an aspect of the history of the Infant Welfare Movement in Enlgand 1898-1908.  Medical History 31, 99-119.

Mooney G 1994 Still birth and the measurement of urban infant mortality rates c. 1830-1930.  Local Population Studies 53, 42-52.

Sheldon W 1967 Child Welfare Centres.  London, HMSO.
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