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London is a great centre for medical education, and there are many voluntary
hospitals, which maintain orthopaedic departments, engaged in the teaching of
medical students. These are all eager to undertake the orthopaedic care of children.
There are also special voluntary orthopaedic hospitals at which orthopaedic surgeons
of the highest repute hold appointments. At some of the hospitals the Council's
organisers of children's care work attend in the orthopaedic departments as liaison
officers. These include the orthopaedic departments at Guy's, the Miller, St. George's,
the Metropolitan and the Queen's hospitals.
The Woolwich area stands in a category by itself owing to the lack of local
orthopaedic out-patient provision, and the distance parents must travel with their
crippled children for advice. In this area the Council subsidises the remedial clinic
which is provided by the Invalid Children's Aid Association. The number of children
treated at this centre in 1938 was 173.
The three main causes of crippling in London are tuberculosis, infantile paralysis
and congenital malformation. The first two conditions are notifiable, and schemes
are in operation on the general public health side of the Council's activities for dealing
with children under both these headings. A special unit for the treatment of congenital
malformation has been established at Queen Mary's Hospital, Carshalton.
The principal causes of crippling operate before school life begins, at which
period of their lives the children in London are under the care of the public health
departments of the Borough Councils, on behalf of whom the Council provides
institutional treatment whenever required.
Voluntary
hospitals
Co-operation of voluntary bodies
A very valuable arrangement exists whereby one of the Council's organisers
attends at many voluntary hospitals which are not included in the Council's scheme
of medical treatment. These include the children's departments of the following
hospitals : the Belgrave, Charing Cross, Guy's, the London, the Miller, the Queen's,
West London, the London Jewish, and Poplar. Organisers are also attached to the
aural, eye and skin departments of Guy's Hospital.
Pre-school
children:
co-operation
with Borough
Councils
In order to effect improvement in the pre-school care of children, particularly
of those between one and five years of age, the Ministry of Health issued Circular 1550
in May, 1936. This circular advised maternity and child welfare authorities to make,
wherever possible, arrangements with local education authorities for children of preschool
age to attend for the treatment of minor ailments and dental defects at the
school treatment centres.
Seven Borough Councils in London have made such arrangements with the
Council. These are Battersea, Camberwell, Finsbury, Lewisham, St. Pancras, Wandsworth
and Westminster.
In her annual report for 1938, Miss H. G. Nussey, principal organiser of children's
care work, says:—
All districts report very close co-operation with the numerous other agencies which
exist to help parents and their children, e.g., the Invalid Children's Aid Association, the
tuberculosis dispensary, the Charity Organisation Society, the Church Army, the N.S.P.C.C.,
Children's Country Holidays Fund, invalid kitchens, settlements and juvenile organisations. There
is frequently cross-representation. In fact, it may sometimes be said that "one man in his time
plays many parts." Requests for care committee reports, apart from those required by the
medical services, continue to pour in from almoners, relieving officers, the Charity Organisation
Society, Juvenile Advisory Committees, psychiatric social workers at the Council's mental
hospitals, etc., and after-care done by one of the care committees of a mentally defective school
has resulted in a very close liaison with the supervision section of the mental hospitals department.
An interesting new development is the reference of cases to the care committees by the judge
at one of the county courts when grants are being administered through the court to children.
Stammering
Stammering children
At the ten centres for the treatment of stammerers from elementary schools a
total of 403 children attended during the year; of these, 107 were discharged as
cured, while 42, many of whom had greatly improved, left for various reasons.