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able to say when the child should return to hospital to be seen
again by the surgeon who would determine when any further
operation is desirable. Subsequent operations may be necessary
so that careful supervision is essential. Should electrical treatment
be required the child could attend the hospital at Great Portland
Street.
"During the whole treatment the children would be kept under
the supervision of the School Medical Officer and his staff, who
could see that the children regularly attend the Hospital or School
Clinic. It is important to note that with this scheme the provision
of a school for Cripples would be avoided.
"For the purpose of estimating the cost of the proposals, I have
considered in detail all the crippled children coming within our
supervision. There are 51 altogether. Two children are at special
schools. Three are at home, two being cases of tuberculosis of
the spine, both of which are nearly fit for school, and one being
a physically and mentally defective case about to go into a special
school. Of the remaining 46 physically defective children all are
receiving or have received some form of treatment. At the present
time of these 46 cases six may benefit from operative treatment,
fourteen do not require operative treatment but may require it in
the near future,eleven may benefit from massage while the remainder
require little or no treatment.
"It is extremely difficult to say how many would require
operative treatment in the year, but it may be about 20 altogether.
I estimate, however, that to begin with, about half only would
come within the scheme, as some of the parents would prefer to
continue treatment at the hospitals already attended. As six
weeks is the average stay of each case in hospital this means that
during the year 60 hospital weeks at £2 2s. Od. a week, or £126,
would be the cost of the operation cases. For massage, allowing
two visits of the nurse each week, on 44 school weeks at 12s. a
visit (10/6 as fee and 1/6 as train fare), the cost would be £52 16s. Od.
Three massage treatments a week are advised for some cases, but
as a beginning it might be desirable to see how much the services
of the nurse are taken advantage of. The only other expenditure
would be a couch for the children while under treatment at the
Clinic.