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76
"The valuable assistance given by the Invalid Children's Aid Association is
much appreciated, and mention must be made of the ever-widening work of the
voluntary care committees who not only follow up and report on the home and
environmental conditions of children attending the centres, but also visit and report
fully on the home conditions of every child accepted for institutional treatment.
On these reports such action as is possible is taken for bettering the home conditions
or in suitable cases recommendation for houses is forwarded to the Council's
Housing Section. Insanitary conditions were notified to Local Sanitary Authorities
in 46 cases and 14 recommendations were forwarded for the consideration of the
Housing Section.
"Children on their return from High Wood or Carshalton are examined at the
County Hall and classified according to their individual fitness for ordinary or special
school and for full or modified school curriculum. The parents are advised as to the
regime best suited to the individual child, and arrangements are made for each child
to be put under or to remain under supervision at centre or hospital or under the
supervision of a private practitioner. Afterwards a representative of the care
committee again reports whether the doctor's advice is being carried out, and
whether such adverse home conditions as may have existed prior to his admission
to hospital are now bettered or abated. The child is specially examined at regular
intervals on his return to school and a full record is kept as to his future
progress.
"One session a week is held at each of the new rheumatism supervisory centres
which were opened after Easter, 1928. The aim of the centres is to examine and
supervise rheumatic children in the hope of preventing the development or further
progression of rheumatic heart disease and to guide children along the right lines
during periods of quiescence of the illness. It is at once a diagnostic centre and a
'clearing house' for shepherding the child into the channels that fit his particular
condition. The personal circumstances, both internal and external, of the actual
sufferers are investigated as far as possible in the hope that any adverse conditions
which appear to be common to all definite rheumatics may be recognised and avoided
in the case of potentially rheumatic children. No active treatment is given. Where
it appears necessary, children are at once referred to the family doctor, the hospital,
or such other agency as the case indicates.
"Children already under constant medical supervision or treatment are not
encouraged to attend these centres, too frequent examination by different doctors
is useless to the child and may even be harmful in some few cases when conflicting
advice might be given, besides too frequent examinations defeat their own ends by
taking up too much of the mother's time. The close co-operation between these
centres and the school medical service, the hospitals, care committees and bodies
such as the Invalid Children's Aid Association and in some cases with private
practitioners, reduces the chance of overlapping in the supervision and enhances
the sufferer's chance of immediately benefiting by the existing facilities for treatment
and convalescence or profiting by one or other of the many facilities for education
under special conditions.
"The numbers of children seen at the two centres up to the end of 1928 are
as follows. The figures represent a rough average of 6 new cases and 5 re-examinations
per session. So far it has not been found possible much to increase the number
of new cases per session.
Elizabeth Bullock Centre. Downham Centre.
New cases. Re-examinations. New cases. Re-examinations.
Boys 73 41 64 40
Girls 91 65 78 49
Totals 164 106 142 89