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Arrangements regarding the care and supervision of the handicapped child
and his family are under constant review and I reported to the Health Committee
on the problems arising from provision of services for which a charge is made according
to means. Many families can adapt and cope adequately with the problems
presented by the handicapped child, especially if the handicap is not severe. However,
there are those who find that the burden of a handicapped child is almost intolerable
when added to pre-existing problems of overcrowding; financial hardship; ill-health
of one or both parents or their inadequacy to cope. Unless they receive the full
support of all the services available, the strain becomes unbearable and the child
goes into hospital or residential school or long-term care of a similar kind.
Many of the services which can help these families are those for which a charge
is made according to means. It has been found, however, that a charge, no matter
how small, often deters the parents from making use of the service, to the detriment
of the child. This may be because of resentment at disclosing the family income; a
sense of injustice at being penalised financially because of circumstances beyond their
control; or genuine inability to pay because the statement of income and expenditure
does not reveal all the additional expenses of caring for a handicapped child.
To encourage and support these parents in caring for the child at home, it was
decided that, subject to the child being on the handicapped register, services should
be provided free. The decision to provide these services is made at a case conference
of senior officers most closely concerned with the child. As a general rule, it was
found that the families described above who require the supporting services envisaged
were from the lower income groups and assessment often produced little or no
charge and, consequently, there is loss of very little revenue to the Council.
We are particularly fortunate in Southwark to have a comprehensive assessment
centre for multiple handicapped children at Guy's Hospital. This centre, which has
been designed to supplement existing services, is concerned with young children
from the age of six months when the possibility of handicaps is usually first raised,
and when there is a need to assess, advise and help families. It also deals with specific
cases where specialist services and knowledge are required. Among cases which are
dealt with are suspected visual and auditory defects, delayed or disordered development,
gross physical handicap and obscure problems of assessment and management.
This assessment centre is known as the "Newcomen Clinic for Handicapped
Children" and the liaison which exists between the Borough, the hospital and the
Inner London Education Authority owes much to the work in the Centre of a former
Principal Medical Officer of the Authority. Southwark bears 50 per cent of the cost of
her services and, in addition, provides a health visitor for the necessary follow-up
with children and families from Southwark.
Experience has shown that the volume of work in connection with Southwark
children attending the centre has expanded and that intermediate follow-up examinations
would be of benefit. Special follow-up sessions have therefore been started in
the Borough at one or two of the existing welfare centres where the Senior Medical
Officer for maternity and child welfare services, who is in close touch with the work
of the Newcomen Clinic, is able to see the children referred by the Centre. If specialist
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