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I am to say that if the Authority are willing to take advantage of this opportunity and to
consider the establishment of a scheme for dealing with crippled children on the lines suggested in
Chapter VIII. of the Annual Report for 1922 of the Board's Chief Medical Officer, based on Stanmore
as the Hospital for in-patient treatment, the Board on their part would be willing to approve such
a scheme and to take the expenditure on the approved arrangements into account for grant. Full
particulars of any proposed scheme should be submitted in due course to the Board for approval.
I am, Sir,
Your Obedient Servant,
(Signed) J. R. Warburton.
To the Local Education Authority, Willesden.
Chapter VIII. of the Annual Report for 1922 of the Board's Chief Medical Officer deals with
the whole subject of " Orthopaedics and the Child." Within recent years great progress in the treatment
of paralysis and deformity has been made, and an extensive and closely knit organisation is
gradually being established to ensure that the results of treatment shall be permanent. A scheme
for the care and education of the cripple child includes:—
(1) Organisation to ensure the discovery of children when first paralysed, deformed, or otherwise
threatened with crippledom.
(2) The provision of the most effective treatment possible at a clinic or in a hospital or otherwise
as may be necessary.
(3) Organisation of after-care and restoration of activity.
(4) Suitable Education.
To this end the Chief Medical Officer of the Board of Education suggests the establishment
of a Local Orthopaedic Clinic working in conjunction with an Orthopaedic Hospital. Such a local
orthopaedic clinic would act as a centre for early ascertainment and diagnosis, as well as for treatment
and after-care.
It would be staffed by:—
(1) A Visiting Orthopaedic Surgeon, who would attend periodically and ;
(2) A Visiting Orthopaedic Sister fully trained in orthopaedic splint and plaster work.
(Note.—Both Surgeon and Sister should be attached to the Orthopaedic Hospital.)
The functions of the Clinic would be :—
(1) Examination by the Orthopaedic Surgeon of cases sent up for consultation by Doctors,
Health Visitors, Infant Welfare Centres, etc.
(2) After treatment and supervision of cases discharged from the Hospital.
(3) Treatment of certain cases which can be effectively treated as out-patients.
(4) Renewing and repairing of plasters, and fitting and examining splints and appliances.
Three rooms would be required:—
(1) Waiting Room;
(2) Doctors' Consulting Room, sufficiently large to enable him to see the patients freely walking
and perhaps running; and
(3) Plaster Room.
An orthopaedic organisation established on the above lines would lead to a reduction of the
number of Special Schools required for crippled children, as it is claimed that such an organisation
would get the children early and deal with them at once, so as to prevent serious crippling and enable
them to attend the ordinary elementary schools.
It should be noted that the approximate average total cost per annum of a Willesden child
at an ordinary Elementary School is £13 l1s. 0d., at a Day Special School £48 2s. 0d., and at a
Residential Special School for Cripples £86 0s. 0d.
Extent of the Problem in Willesden.
Information as to the number of cripples in Willesden, has from time to time been obtained
from the following sources:—
(1) Health Visitors carrying out their duties relative to the Notification of Births Acts;
(2) Infant Welfare Clinics ;
(3) School Clinics, and in association therewith Teachers, School Attendance Officers and School
Nurses; and
(4) Hospitals and voluntary agencies such as the Invalid Children's Aid Association.
The following table shows the number of crippled children under 16 years of age resident in