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21
Tuberculosis.—The care of tubercular children as such is
entirely in the hands of the County Council, but every effort has
been made to co-ordinate the amenities available under your own
and under the County Council schemes.
The present position with regard to surgical tuberculosis is
rather open to criticism. A child is seen at the County Dispensary
by me ; if necessary, it is sent to Sir Henry Gauvain, as the county
specialist, and a report received by me. The child may then be
sent to Alton or some other similar institution, after which it is
returned to Barking and most probably will then attend the
Open-Air School, where, so far as you as a local authority are
concerned, Mr. Whitchurch Howell is in charge of the case for all
educational purposes; but, nevertheless, the county are still
responsible for the case if for any reason attendance at school is
discontinued.
This overlapping is further augmented by the fact that oftentimes
these and similar cases are taken by the parents to the large
London hospitals, and the whole question calls for discussion,
because unquestionably there is quite a lot of misdirected effort
which could be used for more useful purposes.
Skin Diseases.—With reference to the treatment of skin diseases,
I have already indicated that further amenities are desirable for
the treatment of intractable cases of impetigo.
The treatment of ringworm is satisfactorily carried on by
X-ray, and you yourselves have provided amenities for treating
cases of scabies.
It is, perhaps, in the treatment of skin diseases that the lack
of continuity of supervision at the Minor Ailments Clinic is most
felt. Thus children are often On the books here for an unconscionable
length of time.
The nurses at the Clinic are provided by rota by the Plaistow
Maternity Charity ; both your medical officers take the Clinic
from time to time, and there is no continuity of supervision. Add
to this the system of record keeping does not facilitate the