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The conditions in the first four groups are common under 5 years of age, and in connection
with the prevention of crippling they must be dealt with. It behoves Local Authorities, therefore,
to use to the utmost all the powers they possess to prevent conditions tending to cripple children,
i.e., Tuberculosis, Rickets, Paralysis, Congenital defects and accidents at child birth, in infancy or
subsequently. There is no panacea for each or all of these conditions, but the Health Authority
either under the Public Health or Education Acts must do all they can to promote public and
personal hygiene, better housing conditions, cleanliness, improved dietaries, a better milk supply,
better care of the mother and the child, and the provision of an open-air school. Every such improvement
will bear fruit in healthier child life, increased fitness for industrial occupation and increased
longevity.
From the information set out above, the Committee will see that a considerable problem is
before them. They have not only to detect crippling in its early beginnings, but they have to arrange
for appropriate treatment at a Local Orthopaedic Clinic to be established, or at a Hospital as may be
necessary. Appropriate treatment includes immobilisation of joints, correction of deformity by splints
and bandaging, development of muscles and their re-education in function, the obliteration of
deformities, with, in addition, ordinary or special education as may be necessary. In these cases
education must be regarded as an adjunct to treatment. Many crippled children have to be for
long periods recumbent and during these periods education helps to keep them happy and contented,
relieves monotony and acts as a stimulating influence towards cure.
The Education Authority have also to arrange for the after care of hospital cases including
treatment at their Orthopaedic Clinic and education either at an open-air physically defective school
or ordinary elementary school as may be appropriate.
Taking into account these various considerations I beg to submit the following recommendations:—
Recommendations.
(1) That a local orthopaedic clinic be established with the functions noted above.
(2) That arrangements be made with the Stanmore Hospital (suggested in the Board's letter
of 7th March, 1924) for the staffing of the clinic.
(3) That arrangements be made with the Stanmore Hospital (suggested in the Board's letter
of 7th March, 1924) for the admission of suitable cases of children.
(4) That the provision of an open-air school be proceeded with.
APPROXIMATE COST.
Local Orthopædic Clinic.
Initial equipment, say £100
Annual Maintenance, including Staffing, say 600
Annual Hospital provision, say 4 beds per annum, say 400
Half of all above costs will be recovered from the Board of Education by way of a grant if
the scheme is approved.
Open Air School.
For costs see my report dated 15th March, 1924, on Open-Air Day School—Suggested Use of
Dollis Hill House.
Your Obedient Servant,
GEORGE F. BUCHAN,
Medical Officer of Health.
To be presented to the Children's Care Committee.
1415/24.
APPENDIX G.
To the Chairman and Members of the Children's Care Committee.
STAMMERING CHILDREN.
I beg to report in accordance with the following minute of the School Management and General
Purposes Committee, dated 28th March, 1924:—
"Treatment of Stammering Children.
On a reference from the Children's Care Committee, 19th March, 1924 (p. 569) we have
considered the question of the treatment of stammering children, together with a report of the
Chief Education Officer on an experiment he has inaugurated in regard to such treatment. We
report that we have referred the general question back to the Children's Care Committee for
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