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The follow up of the children, after discharge from hospital, by school doctors and
rheumatism supervisory centres, is an important part of the rheumatism scheme but,
as explained above, difficulties have occurred in ensuring that such follow-up is initiated :
1951 1952 1953 1954
Number of children under supervision of school doctors
on 31st December 186 177 166 147
Number of children under supervision at rheumatism
supervisory centres on 31st December 2,696 2,218 2,346 1,840
Number of supervisory centres 24 23 23 23
Number of sessions at supervisory centres 905 877 840 780
Number of children attending for first time 1,100 971 959 786
Total number in attendance at centres 9,202 7,988 6,936 5,681
For some time past the prophylactic use of chemotherapy during convalescence has
become popular in the hope of reducing the relapse rate and more recently the exhibition
of daily doses of penicillin has been started in some quarters. It seems too early to
pronounce a judgment on the effectiveness or otherwise of this procedure at present.
The final assessment can only be made after a considerable time lag has allowed the
relapse rate to be compared with an earlier pre-prophylactic period and then be weighed
against the possibility of producing penicillin resistant strains of infecting organisms.
So far as can be seen at present, however, that risk does not seem to be a high one,
though the use of brisk intermittent dosage at the slightest sign of upper respiratory
infection may eventually prove to be a more effective method of prevention than
prolonged mild medication.
Remedial exercise classes
Special classes to correct foot defects, before they develop into permanent disabilities,
which were first introduced in 1948, continue to be held, mainly in primary schools.
They are taken by a class teacher who has attended a course given by the Council's
consultant on postural defects and the senior inspectors of physical education of the
Education Department. The general medical supervision of the classes is undertaken
by the consultant in postural defects who visits each class at least once each year. An
assistant medical officer in each Division is responsible for selecting the children and for
their discharge on improvement.
Psychiatry
The demand for treatment at the Council's four child guidance units has continued to
increase and the ever-growing waiting lists made it necessary to seek authority for an
increase of staff at each unit. Approval was given to the appointment of two additional
whole-time psychiatric social workers and one whole-time and two part-time psychotherapists,
as well as additional sessions at one of the units by an educational psychologist.
Some of these vacancies had been filled by the end of the year. It is envisaged that these
staffing increases will enable the units to function more effectively and to undertake the
treatment of a larger number of children.
A study group which had been set up under the chairmanship of Dr. John Bowlby
to consider mental health in the maternity and child welfare services published its report,
which caused widespread interest, and is set out in Appendix B on page 156. It is planned
to extend psychiatric services to more maternity and child welfare centres, in addition to
the work which continues to be carried out with children under five at the two child
guidance clinics run in conjunction with the local infant welfare centres.
Child
guidance
units
115