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advantage, however, emerged from the scheme and this was the making of direct
"gas" appointments at the dental inspections in the schools. By this method at
least one visit to the centre prior to the gas appointment is saved, and this arrangement
is being continued, and has, moreover, been applied in connection with other
centres in London. In making direct appointments it is essential that the dental
surgeon satisfies himself that no filling is also required, as it is the experience generally
that any necessary fillings shall be undertaken before treatment under an anaesthetic
is given.
Remedial
exercises.
The Council s medical treatment scheme does not include general subsidies for
the treatment of orthopaedic cases. These are dealt with through the special and
general hospitals of the Council and at voluntary orthopaedic hospitals and orthopaedic
departments of general voluntary hospitals. There is, however, one centre at
Woolwich, organised by the Woolwich Invalid Children's Aid Association, which is
assisted financially by the Council, owing to the distances to be travelled by the child
patients when attending hospitals in central London. At this remedial clinic
children suffering from paralysis, congenital deformities, rickets, poliomyelitis and
other crippling defects are given massage, manipulation, electrical treatment and
exercises. Mr. P. B. Roth, the visiting orthopaedic surgeon, attends the clinic
regularly, and Dr. H. R. Kidner acts as medical officer. The clinic is very popular
and the majority of the children are referred there by school doctors and the medical
officers of the borough welfare centres.
Charges to
parents.
For many years the standard charge made by the Council to parents in respect
of medical and dental treatment of school children has been 2s., covering all necessary
treatment for a period of 6 months. In the case of minor ailments free treatment
has been given for the first fortnight after which 1s. is charged, and, where slight
treatment only has been given in dental cases, the charge has been 1s. From 1st
April, 1932, these charges were varied in certain instances. Firstly, the charge for
operative treatment of enlarged tonsils and adenoids was increased from 2s. to 5s.
All children operated on under the Council's scheme are retained in the various
centres as in-patients. Although the cost to the Council has been considerably
increased, viz., by 7s. 3d. a case, compared with the cost when children were treated
as out-patients, the charge to the parents has remained the same. It was therefore
considered equitable that the charge of 2s. should be increased to 5s. Parents
appreciate the care and attention given to their children in the wards, and it was
found that some were desirous of giving more than the amount charged, as a mark of
their appreciation. Secondly, in those dental cases where extensive treatment is
undertaken the charge was increased to 3s., the normal charge for ordinary cases
remaining at 2s. The aim of the dental service is to secure that the children
commence treatment in the early stages of dental decay, when teeth can be saved.
Accordingly, with a view to encouraging early treatment, 1s. only has been charged
when slight treatment only has been necessary. The average cost to the Council of
dental cases is approximately 7s.
Although there has been a slight falhng off in the number of cases treated, the
total amount collected from parents has increased. So far as those parents who are
unable to pay are concerned, it is made clear to them that the care committees will
reduce the charge by 50 per cent., or remit it altogether.
Salaries of
officers.
Following the general lines adopted throughout the Council s service, the
various members of the staff of the school treatment centres and hospitals agreed to
a voluntary reduction in their salaries amounting on an average to 5 per cent., and
this was put into operation on 1st April, 1932, for a period of twelve months. The
reductions in respect of service on one session a week were as follows:—eye, ear, nose
and throat, and ringworm surgeons from £80 to £75 15s. a year, aural and dental
anaesthetists from £75 to £71 5s. a year, minor ailments doctors from £66 to £62 18s. 6d.
a year, and dental surgeons from £60 to £57 7s. 6d. a year.
Stammering children.
At the eight centres maintained for the treatment of stammerers a total of 371
children attended during the year; of these, 47 were discharged as cured and 36 as