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107
minor ailments referred to them from the toddlers' clinics already authorised
by the Council.
As the Council are aware these clinics have not yet been started as it is
clearly futile to do so until arrangements for treatment have been completed.
In obtaining the views of the respective voluntary hospitals management
committees, it will be appreciated that no data are available regarding
numbers, and every hospital has therefore been approached in so far as
financial considerations are concerned on the premise that any agreement
must be of a temporary character and that payment must be on a per capita
basis.
It was pointed out to the hospitals that they are in all probability treating
as out-patients without payment a number of cases which when the scheme
is in force would be sent through a toddlers' clinic, and on the other hand
some cases which would otherwise go to the hospital might well be dealt
with at the welfare centres.
Clearly therefore the voluntary hospitals could not expect that the
full charges for every case would be met by the Council. The hospitals are,
however, anxious to assist the local authority to the utmost, and are prepared
to carry out minor ailment treatment for each case however many attendances
of the individual are required at the rate of 6s. 6d. each per annum. For this
sum cases referred will received priority treatment, if individual appointments
are not made, with the object of reducing to a minimum any period of waiting
which may be unavoidable.
There is likely to be a difficulty in connexion with dental work as the
necessity for conservative treatment has been regardedas of prime importance,
and if arrangements are insufficiently elastic to cope with demands it may be
necessary for the welfare centres to increase the number of dental sessions
or to inaugurate new dental clinics in some of those welfare centres where
none now exists.
For eye cases, parents will be expected to pay for the spectacles, while
the refraction and any treatment will, of course, be covered by the 6s. 6d.
In so far as administration is concerned, the following brief outline will
serve to indicate how the scheme will work if put into operation.
The parents of a child found to require minor ailment treatment at a
toddlers' clinic will be given the choice of any of the four voluntary hospitals
in the scheme. Whichever is chosen the parent will be given a card of
introduction to that hospital by the doctor in charge of the toddlers' clinic
on which the name and address of the child will be inserted, the medical
condition for which the child is referred, and the time to attend the hospital
clinic. The hospital will retain the card as a voucher in support of its account.
A list will also be made of all cases referred to each hospital by the welfare
centre in order that defaulters may be traced and followed up by the health
visitor.
It is impossible to pretend that any estimate of probable expenditure
can be put forward. The Council should bear in mind that minor ailment
treatment only is being arranged, the bulk of which will be for teeth, ears,
eyes, and for some orthopaedic cases. Such things as accidents, cases requiring
in-patient treatment and so on are clearly excluded and the agreements
with the four institutions, St. Thomas's Hospital, King's College Hospital,
the Belgrave Hospital, and the Royal Waterloo Hospital should be so drafted.
The Medical Officer of Health is of opinion in the light of requirements
which can be foreseen that the accounts of the four hospitals will not exceed