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24
could achieve this end by either employing a special orthopaedic
nurse for the whole week or, by arrangement with a neighbouring
authority, employing two nurses for three days a week. With the
amenities you have available at Faircross, undoubtedly the former
would be rather more practicable than the latter ; although, if the
Tatter procedure were adopted, it would mean that you could retain
the services of your present masseuse and have an assistant nurse
to work with her.
The question of the provision of this extra service is intimately
linked up with the extension of the medical service as a whole,
and, although highly desirable, I do not advise it until the general
extension can be undertaken as well.
In necessary cases, children are sent by you to Brookfields
Orthopaedic Hospital where they still remain under the care of
Mr. Whitchurch Howell. You pay £2 2s. a week for this form of
treatment.
There appears to have been a general impression that these
cases could only remain in Brookfields Hospital for short periods
of time, whereas, during the year under review, we have had in
one case for the whole of the year. The cost to the authority has
been very considerable, and of course your special services will
cost you considerable while you very rightly undertake such
necessary work as this.
There is at the present time a lack of co-ordination between
various hospitals, and one child may during the course of treatment
come under two or three surgeons, as the parent moves from
hospital to hospital according to necessity or choice. In cases
such as these children present, where continuity of treatment over
oftentimes a long period of years is essential to success, this is to
be deprecated, and co-ordination is a matter of pressing moment.
Mostly this is a matter for the hospitals themselves, in which
the local authority, although vitally interested, has no opportunity
of expressing an opinion; but in one particular instance the
question does essentially lie within the purview of the local
authority and of the Essex County Council.