[Report 1966] / Medical Officer of Health, Epsom & Ewell Borough.

  • Epsom and Ewell (England). Borough Council.
Date:
1966
Catalogue details

Licence: Attribution 4.0 International (CC BY 4.0)

Credit: [Report 1966] / Medical Officer of Health, Epsom & Ewell Borough. Source: Wellcome Collection.

    24/74 (page 22)
    PERSONAL HEALTH SERVICES Health Screening Clinic, Epsom, 20th to 30th September. 1966 lTp to the present few Health Screening Clinics have been organised in this country, and in consequence we have insufficient evidence of the permanent value of this means of detecting early signs of disease. Meanwhile the Minister of Health awaits with interest reports on the findings of future Health Screening Clinics before he is satisfied that this method of detecting disease should be recommended to Local Authorities generally. In October 1965, I visited Dr. R. J. Donaldson’s Health Screening Clinic at Rotherham, Yorkshire, because I was interested in the early detection of disease by certain accepted tests. I was impressed by this experiment and with the encouragement of Dr. K. A. Soutar, County Medical Officer, I decided to organise a Clinic along similar lines in Epsom. Planning of this project covered a period of 11 months and entailed close co-operation between Local Authority, General Practitioners, Hospital Consultants and Technicians, the Ministry of Health and representatives of Voluntary Organisations. The Clinic was a stimulating experience and evoked a magnificent team spirit on the part of the staff enthu- siastically supported by voluntary helpers. As the Clinic was on the “open door’’ principle, it was difficult to forecast how many would attend. However, the response over each of the 9 days was so overwhelming that during the last 3 days it was necessary to limit attendances to those living within the Borough. Well over 500 attended daily and the total attendances over the period was 4,844 (3,951 women, 893 men). The tests offered included cervical smear, examination of the breasts, anaemia, diabetes, chest X-ray, hearing, vision and estimation of blood pressure. For years women’s organisations have been pressing for the cervical smear test for the early detection of cancer and this proved to be the most important and the most sought after of all the tests. All women between 30 and 60 years were offered this and 3,567 smears were taken. While the gynaeco- logist took the smear he carried out a full pelvic examination and also an examination of the breasts. A variety of pelvic abnormalities, not necessarily malignant but which nevertheless required treatment, were found. Due to shortage of laboratory staffs, the examination of cervical smears had to be spread over a period of 7 months and results have not yet been finally assessed ; but we expect to find signs of early malignant change in about 5 per 1,000 : 87 women were referred to the family doctor for breast conditions, e.g. chronic mastitis and fibro-adenoma, three of which have since shown malignant changes. Women of child bearing age commonly suffered from anaemia which was of the iron deficiency type (4.7 per cent.). At present much attention is focused on the preventive cervical cytology service. While research is proceeding not only in Britain but also abroad much remains to be found out about this “pre-cancerous state” and we need proof that this state necessarily progresses to clinical carcinoma if left untreated. The ministerial policy is to plan mass cervical cytology screening Services and to make them available to all women “at risk”. The scale of expansion has been based initially on the screening of women over the age of 35 (the priority group). However there is good reason to believe that this screening Service should be designed to bring in younger women; firstly because the early cell change which we recognise as pre-invasive may take 5-10 years to show established malignant changes ; and secondly, nowadays women marry at a younger age, pregnancy occurs at a younger age, and parous women under 21 may be in a greater risk group. In accordance with ministerial policy, I look forward in the near future to organising a weekly “well-women” Clinic in the Borough. Parous women, including those of a much younger age group, would be invited to attend for a general examination and a cervical smear. Attendances would be by appointment and numbers limited to 20 per session. Results would be available to the family doctor without delay. The Health Visitor in attendance would welcome this opportunity for Health Education. Ante-Natal Care Ante-Natal sessions are held at the Health Clinics in Ewell and Epsom. At Ewell a weekly session is conducted by a Consultant Obstetrician from Epsom District Hospital assisted by a Medical Officer of the Borough Council. The Midwives hold a session twice weekly at Ewell Clinic and one a week at Epsom Clinic. Details of attendance at these sessions are given below : Number of Women Total Number of who attended attendances Clinic Sessions held by during the year during the year Ewell Obstetrician and Medical Officer 158 1,106 Ewell Midwives 227 1,221 Epsom Mid wives ...... 101 364 In addition 72 women attended at Ewell Clinic for post-natal examination. 99