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A NEW CHILD-HEALTH CENTREEx A7atal, ante natal, post natal is the comprehensiv(

motto suggested by Prof. Alan Moncrieff for the netProvince of Natal Centre of the London UniversityInstitute of Child Health. The centre was opened orMay 26 by Mr. G. P. Jooste, High Commissioner for th(Union of South Africa, who said that the financial hellgiven by the people of Natal, in founding it, was part ojthe " Salute to Britain Fund," which they collected asa gesture of sympathy for our war-time troubles.

PILGRIM’S PROGRESSHow the fund came to be used in this way is

a stirring story. In 1939 the medical committee oithe Hospital for Sick Children, Great Ormond Street,were already debating how the hospital might bestcollaborate with the preventive health services; andat the same time a committee at the British PostgraduateMedical School were discussing a plan for preventivepaediatrics. By 1943 (and considering how our attentionwas occupied at the time, this must be regarded as fairlyrapid going) informal discussions had taken place withsenior medical officers in the London County Council, andthe phrases

" model infant welfare centre " and " modelschool treatment centre " were heard. In 1946 the

University of London Institute of Child Health, withProfessor Moncrieff as director, was founded, and thoughit was tucked into the hospital, and using cubiclesfor offices, it began at once to investigate how a modelwelfare centre might come into being. The boroughcouncils of Holborn and St. Pancras allowed theinstitute to use their centres for the teaching of preventivework ; but money for building was scanty, and buildingprospects scantier. But in the summer of 1947 this star-crossed project suddenly found friends : Mr. RupertEllis, the Mayor of Durban, mentioned, in the course ofa friendly visit to Professor Moncrieff, that he was sorrythe advent of the National Health Service had preventedthe people of Natal from helping Great Ormond StreetHospital.

" I remember gripping my chair hard,"Professor Moncrieff said at the opening ceremony,

" as I

launched into a tactful explanation of how the moneycould still be used-for our model welfare centre." The

sequel was a message from Mr. Ellis to the South AfricanGift Committee ; and on Dec. 4 news came that theinstitute 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 (finallyissued in 1953)-the London County Council had time toconsider their own part in the scheme, and undertookto pay 90% of the cost of maintenance and all the salariesof medical and nursing staff. By the time buildingactually began the original gift had increased to 120,000by interest ; though unfortunately the rise in buildingcosts had kept pace.

- MODEL INFANT-WELFARE CENTRE

The new building stands, on land provided by theuniversity, at the corner of Guilford Street, overlookinganother site benign to children-that of the old FoundlingHospital. In the long run it will house both the Provinceof Natal Centre and the Institute of Child Health, but sofar only the centre has moved in. The spacious groundfloor is planned for maternity, and child-welfare work,with plenty of rooms for clinics (antenatal in the southwing, postnatal in the north), a waiting-room large enoughto be used for demonstrations, lectures, and meetings, anda playroom for toddlers opening into what-when thebuilders 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 thecorridors, in the building, is heated from steam-warmedaluminium panelling in the ceiling-the steam being

cleverly borrowed from the heating plant of the mainhospital. A reinforced glass panel, reaching to the veryfloor, gives even the smallest child an outlook into thegarden, and is guaranteed to stand up without splinteringto thumps, kicks, and toy trains flung in anger. Theplayroom, with perhaps one or two others near it, is tobe used as a creche on two half-days a week, and if thi,proves a popular arrangement it may be extended. Weall know the drawbacks of the full-time day-nursery,anyhow from the children’s point of view ; but a coupleof afternoons a week in the company of other children issometimes just what the paediatrician prescribes for a

child ; and it can also provide a welcome break for hismother. Unfortunately such sporadic attendance is notusually acceptable to day-nurseries, and hence fewmothers can arrange it for their children. The Provinceof 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 entranceis a covered perambulator store, on which an eye can bekept from the inquiry desk, just inside.

MODEL SCHOOL TREATMENT CENTRE

On the first floor are rooms for those activities of theschool health service which Professor Moncrieff describedas

" more conveniently carried out at a clinic than in the

schools "-such things as dental and orthoptic rooms, aminor-ailments clinic, and a room specially equipped forthe testing of deaf children. The child-guidance clinicwhich has been carried on at the John Street centre willalso be transferred here to continue its work. On thisfloor, too, is the health visitors’ room (there will be threeof 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 theinstitute, which is to occupy the third floor. The two

large research laboratories are equipped with a new andpractical type of bench, not built to the wall but fittedagainst it, with cupboards underneath which can bemoved along on skids to any convenient position. The

water-pipes to the sinks, and the gas-pipes, running alongthe wall behind the benches, are thus easily accessibleto the engineers ; and the layout of the laboratory caneasily 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 turnedcompletely over for cleaning, and adjusted at any anglefor ventilation. The decorations are the only part of thenew building which seem disappointing, being mainly in atimid shade of green ; but no doubt gay curtains, some ofwhich have already appeared, will make a great difference.

This is an important venture, a remarriage of therapyand prophylaxis-two partners who should have knownbetter than to get divorced.

1. Report of the Central Health Services Council for the yearended Dec. 31, 1954. H.M. Stationery Office. Pp. 26.

2. Report of the Committee on General Practice within theNational 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.

CENTRAL HEALTH SERVICES COUNCILTHE thunder of the latest annual report by the Central

Health Services Council is rather distant ; for accountof the two main tasks completed during the year—investigations of general practice in the National HealthService,2 and of the internal administration of hospital:’ - were published some time ago.