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104
A speech clinic has lately been started under the supervision of an expert in
voice production. This is primarily intended for the benefit of adult patients who
have had serious throat operations, but a Council elementary school boy was recently
referred for stammering and is attending twice weekly.
Although the numbers are not large there is a good deal to be done in connection
with this hospital, and the work of the organiser is much heavier than it
would be for an equivalent number of cases at a school treatment centre. The
cases are followed up as after all aural sessions, but very few forms can be used,
therefore the correspondence is heavy, and two whole mornings have to be given to
attendance at the sessions.
In six cases, Mr. Somerville-Hastings advised admission to an open-air school.
These cases were referred to Dr. Sikes, who arranged for special examination. In
four cases the recommendation was endorsed and the children have been admitted,
three to St. Pancras open-air school and one to St. James' Park open-air class, the
remaining two were found to be unsuitable for admission.
No definite steps can be taken to increase the number of children attending, as
it was made quite clear when the scheme started that no effort must be made to
force up the attendances. It is, however, undoubtedly, of value to have a representative
in the hospital, as otherwise the care committees would not receive reports
of undoubted utility. The almoner and her staff are most friendly and consult the
organiser from time to time about difficult cases attending other departments, and
any special schools spectacle cases are passed on to her.
Other
hospitals.
The children's care organisation also works in close co-operation with several
of the other hospitals by correspondence between the almoners and the district
organisers. At Great Ormond Street the cases dealt with comprise (1) rheumatic
children attending the hospital, who have been followed-up by the care visitors and
home reports submitted for the inspection of the treating physicians ; (2) children
operated upon at the hospital for enlarged tonsils and adenoids upon whom home
reports have been furnished to the hospital. These are classified into satisfactory
and unsatisfactory home conditions, and the majority of the latter has been admitted
to the wards. Similar work has been carried out in connection with the Royal Free
Hospital, the Royal Northern Hospital, St. Bartholomew's Hospital, the City Road
Chest Hospital, and St. Thomas' Hospital.
Official
bodies—The
M.A.B.
Very intimate associations exists between the work of the school medical service
and that of the Metropolitan Asylums Board. In addition to the joint action taken
in providing residential treatment for tuberculous children and those suffering from
poliomyelitis, the M.A.B. puts at the disposal of the Council's school medical
service numbers of beds at Swanley for children suffering from ophthalmia of certain
kinds, including blepharitis, corneal ulceration, trachoma and interstitial keratitis,
and at the Downs hospital for mastoid operations upon intractable ear conditions,
while at Highwood and Queen Mary's hospital, Carshalton, over a hundred beds are
now available for rheumatic children and ample provision is in preparation.
Notifications are made to the school medical officer of children discharged from the
Board's fever hospitals who have suffered from otorrhœa so that they may be kept
under observation.
Infant
Welfare
Centres.
In a number of instances the work of school medical treatment is carried on in
the same premises as that of the infant welfare centres.
London
Federation
of Infant
Welfare
Centres.
An Infant Welfare transfer card was adopted as a result of a conference with
the London Federation of Infant Welfare Centres in 1920. This card is being used
by some 40 centres in London and has been adopted by the borough councils of
St. Pancras, Finsbury, Shoreditch, Stepney, Bermondsey, Camberwell, Greenwich
and Stoke Newington—Shoreditch alone using some 3,000 cards a year.
Tuberculosis
Dispensaries.
The scheme for mutual interchange of information and transfer of child patients
between the school medical service and the local tuberculosis dispensaries continues