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From 1918 the Middlesex County Council was responsible for maternity and child welfare services, and, from 1948, became responsible throughout the County for health centres, care of mothers and young children, midwifery, health visiting, home nursing, vaccination and immunisation, the ambulance service, the prevention of illness, care and after care and community mental health services. In 1945 the Council took over the school health service.
The County Health Service introduced a building programme for new or replacement clinics - 22 purpose built clinics with modern facilities were opened between 1948 and 1963. Immunisation programmes were expanded to include smallpox, diphtheria, whooping cough, tetanus and poliomyelitis. Chiropody, geriatric, audiology and cerebral palsy clinics were provided. The ambulance service was improved with the building of a new central control equipped with radio, teleprinters and key and lamp units. Community services for the disabled were increased, including schools with special care units for severely handicapped children, adult training centres, including 3 in factories, days centres, hostels and so on. Training facilities were also introduced for health services staff including health visitors, district nurses, nursery nurses, midwives, mental welfare officers and teachers of the disabled.