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All cases are assessed by the traditional three experts of the child guidance team before treatment
or other therapeutic measures are decided upon. I am rather disappointed that, in 20 cases suggested
for a psychiatric opinion, the parents failed to come and see me,which seems to reflect the unnecessary
awe of the psychiatrist and fear of stigma of psychiatric examination in spite of all efforts to stress the
prophylactic value of psychiatric services to mental health and the enlightenment of the public on the role
of the psychiatrist as adviser on normal emotional problems rather than the therapist of mental patients.
Especially in the child guidance service would he prefer to be consulted whenever a child seems unhappy
about a personal problem in home or school and not only to exclude mental disturbance. On the other hand,
we appreciate very much that there are limitations to our competence and we are acutely aware that we
can be of little avail if a child's difficulties are not promoted by personal problems or tensions within
the family setting, but theresult of unalterableenvironmental circumstances, social conditions or complete
insightlessness of parents and lack of co-operation of the young person. Such cases, if presenting
serious social problems are frequently better dealt with by agencies who can apply a degree of coercion
which we must never apply.
Rheumatism Supervisory Centre
The Rheumatism Supervisory Centre operates at the Prince of Wales's Hospital under the overall
direction of Dr. I.M. Anderson, consultant paediatrician, with the close co-operation of the Health
Department. Weekly sessions are held.
Originallytheclinicwas set up to deal with children suffering from acute rheumatism and its aftereffects;
but its scope has widened to include the investigation of symptomless heart murmurs found at
routine medical inspections and of cases of congenital heart defects.
Dr. Anderson reports:-
"Rheumatic Fever is now becoming uncommon, but congenital heart disease still occurs as one
would expect. I think it is stll important to have a centre to which to refer cardiac problems, although
they do not appear to be of great magnitude. I would like to say that there is still a close link between
your department and mine in relationship to many paediatric problems from infancy to late childhood and
I appreciate considerably the help that I obtain from your medical officers and your health visitors".
The following is a summary of the new cases seen at the clinic during 1965:-
There were three new cases of rheumatic fever-two male and one female - all of whom were admitted
to hospital.
20 new cases with cardiac murmurs were seen - 13 male and seven female, and these cases were
classified as follows:-
Patent Ductus Arteriosus 1
Aortic Stenosis 2
Ventricular Septal Defect 3
Atrial Septal Defect 6
Innocent Murmur 8
Everyeffort is made to ensure that adequate information concerning diseases which may affect the
administration of anaesthetics for dental extractions is entered on the child's dental record card.
Speech Therapy
There are three part-time speech therapists, who carry out 20 sessions per week and are therefore
equivalentto two full-time staff. This is two below the establishment of four full-time therapists. Miss
J.D. Came, Senior Therapist, reports:-
"Without further staff, thefull needs of theBorough including those of the mentally handicapped child,
cannot be met. The speech therapist in Hornsey reports increased interest and better attendances. The
attractive new clinic at Fortis Green is appreciated. The interesting collaboration with Mr. Brown,
Headmaster of Blanche Nevile School, in the treatment of a few partially-hearing children, with unusual
voice and speech disorders has continued".
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