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The equipment of this Clinic could be carried out for approximately £275
represented by an expenditure of between £150 and £200 for a well appointed
dental surgery, and £75 for the furnishing of the dental mechanic's workshop.
The staff requirements would be a dental surgeon part-time, one trained
nurse part-time, and a dental mechanic full time.
Foot Clinic.
It is well known that many people suffer acute physical discomfort due
to foot disorders such as corns, bunions, ingrowing toe-nails, etc. These disorders
are largely attributable to ill-fitting boots and shoes. Skilled treatment at a
municipal clinic for these affections would not only result in the alleviation of
these troubles, but would bring to light any orthopaedic defects existing requiring
treatment by a surgeon at a hospital. The activities of this Clinic would also
include the teaching of foot hygiene to patients.
Until it is possible to judge the number of sessions necessary each week
to meet the requirements of this service, I suggest that two sessions a week be
conducted, one of these sessions to be held in the evening.
The provision of two rooms on the first floor should be sufficient accommodation
for this Clinic—a surgery and a small waiting room adjoining, the
surgery to be equipped with three chiropodist chairs and operators' stools,
instrument trolleys and a nail drill.
The cost of furnishing this Clinic would possibly not exceed £150.
The staff requirements would be met by the appointment of two parttime
Chiropodists paid on a sessional basis.
Rheumatism Clinic.
Rheumatism is a disease which may be acute, sub-acute, or chronic, of
which the chief manifestations are carditis and chorea in children of school age,
acute poly-arthritis and carditis in adolescents and young adults, and sub-acute
inflammatory heart disease, fibrositis and chronic arthritis in later adult life.
The first manifestations of acute rheumatism occur in school children
and adolescents and are rarely seen in infancy or in pre-school life.
The public are beginning to realise the danger of rheumatism, its prevalence
and morbidity and the suffering and misery it causes. It is probably true to state
that adequate facilities for treatment are available for only a fraction of the cases
of chronic rheumatic disease existing in this country. The establishment in the
new Health Centre of a diagnostic and treatment clinic for rheumatism directed
by a specialist would ensure early diagnosis and adequate treatment of these
cases. Among the duties of the person appointed for this purpose would be the
responsibility of deciding whether the individual case is suitable for treatment
by the patient's own doctor or at a hospital, or whether treatment by radiant
heat or infra-red rays at the electro-medical department of the Health Centre is
indicated.
In the event of the adoption by the Council of this proposal, they should
also consider the desirability of requiring by Regulations the compulsory notification
of acute rheumatism in children up to the age of 16 years.
Acute rheumatism may be defined as represented by the following conditions
occurring separately or together in a child under the age of 16 years : —
(1) Rheumatic pains or arthritis if accompanied by a rise of temperature.
(2) Rheumatic chorea (St. Vitus' dance).
(3) Rheumatic Carditis.