View report page

68
Council's tuberculosis scheme. A child sent to a residential sanatorium would, at some period in its
career, if it made satisfactory progress in the residential sanatorium, return to the elementary school
via the school for tuberculous children, or possibly the open-air school, and similarly a child who was
sent in the first instance to the open-air school might proceed either to an institution for residential
treatment or to the school for tuberculous children if the disease turned out to be an active form
of tuberculosis.
Thf Education Committee will be concerned with the tuberculous child who is in attendance
at either of the types of school mentioned, or who is out of school, and the Fublic Health
Committee will be concerned with the child who is deemed to require residential treatment. The
pre-tuberculous child, who cannot yet be regarded as suffering from active tuberculosis, would be
put into the open-air school until such time as the diagnosis was sufficiently definite for it to be
transferred either to a day school for tuberculous children, or to a residential institution, or until
it was able to return to! an elementary school.
IV.
Distribution and structure of the proposed schools.—On the basis of 2,000 pulmonary cases and
an accommodation of 100 children to a school, it would be necessary for the Council to provide 20 schools
for children with pulmonary tuberculosis. In certain instances where the premises are suitable and the
accommodation available, it may be possible to increase the unit to 120 or more, in which case the total
number of schools would be proportionately reduced. As stated above, this number of schools may be
varied, but it is not anticipated that the total will be exceeded. The best situation for these schools
would probably be in the outlying parts of London, and on or near to a tram route. It would be
necessary for the Council to pay the travelling expenses of the pupils to and from the schools, and also
to provide meals for them, in cases where the parents or guardians of the children were not in a position
to do so.
The importance of a school being on a tram route cannot be too strongly emphasised in view of
the distance which many of the pupils would have to travel, and also the very great expense which would
be involved if it were necessary to organise an amblance service for the conveyance of the children. It
would be possible to provide these schools outside the county if it was thought desirable.
We have received several applications from local tuberculosis committees for the provision of
schools in various districts, and we propose, if the Council adopts the scheme, to consider each of these
cases.
It might be possible to obtain from the Government some disused army huts and adapt them
for this special purpose. Owing, however, to the need for supplying drainage, gas and water, kitchen,
scullery, store rooms, staff rooms, bath rooms, medical inspection room, etc., it would be desirable that
every effort should be made to obtain a large private house with grounds of fair dimensions in preference
to obtaining land on which all these rooms, etc., had to be provided. The existing day sanatoria are
insufficiently supplied as regards washing and sanitary arrangements, and other conveniences, and do
not lend themselves to improvement. We consider, therefore, that the Council should, on the opening
of proper accommodation in the district, cease to aid them.
For the accommodation of the 2,000 children who are in need of open-air schools, we consider
that eight open-air schools of the Shooter's-hill and Birley-house type, each accommodating 200 children,
should be provided in addition to the two existing schools—two in the south-west and two each in the north
and east, and one each in the north-west and west districts. This number of open-air schools, together
with a large development in the number of, and the improvement of, the playground classes would
probably be found to be sufficient.
V.
Management of the proposed schools.—The proposed schools for tuberculous children and the
open-air schools would come under the provisions of the Elementary Education (Defective and Epileptic
Children) Act, 1899, and they would, therefore, come within the regulations for these schools. For
the management of each school it is suggested that, if possible, arrangements should be made for members
of existing local tuberculosis committees to be appointed. These committees were formed by the Council
and comprise representatives from various societies and associations connected with the work. The
success of the schools would largely depend upon the activities of the managing committee, as so much
depends upon the after-care work and the inspection of the home conditions, and these committees have
already had considerable experience of the work. It would be necessary to appoint for each school
head teacher, a nurse, an assistant teacher for each 25 children, and also a cook, a helper, and a schoolkeeper.
In order to obtain full benefit from the schools, we consider that meals should be provided for
the pupils (the cost being recovered from the parents as far as practicable.) and that a part-time doctor
should be allocated to each school