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with last year, small though this is, but of a cessation of progress. This is
in spite of the fact that the care committees have concentrated especially
upon the following-up of dental cases during the present year. There is,
however, reason to think that many more children are obtaining treatment
outside the Council's scheme than formerly owing to the establishment of
additional agencies, e.g., municipal dental clinics and the Eastman clinic.
From some of the poorer districts there has come a suggestion that the
increased charges have adversely affected the proportion of parents accepting
treatment, and have increased the difficulties of persuasion.
At all times and in any circumstances (even if treatment is offered
free) it is difficult to get the consent of parents and children to dental
treatment, from which there is a special shrinking which is very widespread,
and the real effect of the increase of the normal charge from 2s. to 3s. for
extensive dental treatment (usually gas cases) is difficult to assess especially
as the care committees are authorised to remit or reduce the charge whenever
the circumstances warrant such a course.
New
centre.
The new centre in Streatham was opened on 25th September, 1933. For some
years past endeavours have been made to establish a centre in this district to meet
the needs of the large new population of children on the housing estates which have
been developed during recent years, but it has hitherto been impossible to obtain
suitable accommodation at a reasonable rental. The new centre is greatly appreciated
in the district, and is already working to its full capacity.
Block
grants.
In the year now under review a change has been effected in the method of
payments to hospitals and centre authorities in respect of facilities provided and work
done.
Prior to 1st April, 1933, the system included per capita payments and varying
special allowances in respect of such items as rent, use of premises for medical
inspection purposes by the Council's staff, ionisation, accommodation for rheumatism
supervision, and general maintenance. These varied according to the ailments
dealt with, the overhead charges and local considerations. Since 1st April, 1933,
these sundry payments have been commuted and block grants substituted. Under
the old system it was evident that some of the centres more favourably situated
were able to earn considerably more than was needed to maintain the centres, and
had in fact accumulated satisfactory and sufficient reserve funds.
Under the new system it will be possible, by examining the financial statements
provided by the local committees, by reviewing work done and by inspecting the
premises to see that they are maintained efficiently, to adjust the block grants year
by year so that efficient service can be rendered in return for financial assistance
adequate to meet financial commitments, and at the same time to effect economy in
expenditure by the Council. In certain instances, however, where it has not been
thought desirable to apply the block grant system, payments on the per capita basis
have been continued. These exceptions are the Charing Cross hospital, Eastman
clinic (throat and scholarship cases needing dental treatment), London hospital
(in so far as the treatment of ringworm cases is concerned) and Mildmay hospital.
Eye
defects.
During the year 40,434 cases of eye defects were dealt with, compared with
44,172 during the year 1932. Spectacles were ordered in 29,382 cases, and were
obtained in 27,292 cases. This represents 92.9 per cent., the best result hitherto
obtained.
Ear, nose
and throat.
The total number of cases dealt with in the ear, nose and throat departments
was 14,145, compared with 17,364 during the year 1932. The number of throat
operations performed was 10,008, compared with 13,765 during 1932. An analysis
of the operation cases shows that in only 798 cases (or 7.97 per cent.) was the
operation confined to tonsils, in 428 cases (or 4.27 per cent.) to adenoids, while in
8,782 cases (or 87.76 per cent.) both tonsils and adenoid growths were dealt with.
Simple tonsillectomy apart from the removal of adenoid growths is therefore a
comparatively rare operation.
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