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In addition to the foregoing, the Council has again had the advantage of beds made available
through the I.C.A.A. as the result of a contribution from the Council to the funds of the Association
amounting to £1,500. These beds were used principally for cases requiring "convalescence" rather
than treatment in sanatoria. In this way, including 200 children under treatment on 1st January,
1918, 737 children received the benefit of treatment in convalescent homes, and, in addition, 23 children
were provided with such surgical apparatus as had been ordered by the surgeon in attendance.
The question of the provision of open air schools for tuberculous children has received careful
consideration. A small experiment was started in 1917 by the establishment of five such schools attached
to tuberculosis dispensaries accommodating about 25 in four cases and 50 in the other case. The Council
has provided the teacher and the educational equipment. Two of these schools (Battersea and
Hammersmith) have now been closed, the remaining three (Camberwell, Bermondsey and Fulham)
being continued for another 12 months. For some years an open air school has been conducted at Kensal
House, Paddington, in connection with the Paddington Tuberculosis Dispensary. The work at this
school is dealt with in the Education Section of this report. The Council has recently decided to establish
open air schools under the Elementary Education (Defective and Epileptic Children) Act, 1899, throughout
the County of London. The children will be selected by the Medical Officer, as they are now selected
for residential institutions for the treatment of tuberculosis, and it is hoped that in some cases this
may obviate the necessity for sanatorium treatment, while in other cases the schools will be beneficial
in breaking the otherwise too sudden change from sanatorium conditions to those of home and ordinary
school life. One school was opened at Springwell House on the north side of Clapham Common early
in the year 1919, and the 50 children from Battersea (see above) were transferred there. This school
will ultimately have accommodation for 100 children.
It is expected that several of these new open air schools for tuberculous children will be opened
in 1919.
Mental Deficiency Act, 1913.
Information was received by the Asylums Officer, from various sources, of alleged mental defect
in 445 cases during 1918. During the period under review 166 defectives were sent to institutions, 205
were placed under supervision, 8 were placed under guardianship, and 43 were sent to places of safety
pending the presentation of a petition.
On the 31st December, 1918, of the 1,443 cases being dealt with at the expense of the Council
there were—In institutions, 504; under guardianship, 10; under supervision, 923; in places of safety
waiting other action, 6. There remained 1,341 out of the total number (2,784) of cases of alleged mental
defect of which notice has been received since the Act came into operation. These cases include 210,
in which no action could be taken; 383 ascertained not defective or not to be London cases; 262 dealt
with through the poor law; 228 removed from the register (died, discharged or removed to lunatic
asylums), and 258 still under consideration.

Medical examinations—Staff.
The Council decided that so long as the appointment of Sir John Collie, as the Council's medical
examiner, was in abeyance while he continued his duties under under the Ministry of Pensions,
examinations for which the medical examiner was formerly responsible should be conducted in the Public
Health department. The work actually began in the Public Health department on the 15th April, and
continued until the 1st February, 1919. During that period, of 9£ months, 5,604 examinations were
conducted at the head office, 37 at homes, on three occasions the examiner had to attend County Court
compensation cases, on one occasion the examiner had to attend a post-mortem examination, 982
certificates were furnished to police authorities and 167 reports were made upon cases not necessitating
examination. The volume of work varied considerably from day to day but it was always possible
to finish all on the same day, the results being telephoned immediately in urgent cases and the written
reports posted each evening to the head of the department concerned.