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(v) The arrangements for the provision of orthopaedic treatment are satisfactory
but it might be desirable to overhaul the machinery for the follow-up of these cases
so that some check might be obtained of the progress which has been made.
(vi) Emphasis has already been placed on the fact that provision of convalescent
treatment is not at present satisfactory, and I suggest that the Council should not
relax their efforts to obtain a convalescent home.
(vii) The arrangements for home helps, home nursing and the supply of extra
nourishment are satisfactory.
(viii) I believe that there is in the Borough further need for day nursery
accommodation, and I suggest that the Council should consider the establishment
of a municipal day nursery.
I desire to draw special attention to the suggestion which is put forward in
paragraph 6 of the Minister's circular, namely, that the maternity and child welfare
services should be handed over to the Local Education Authority, which is in this case
the London County Council. Such a procedure might be very advantageous in the
case of a Local Authority which is constituted as a whole, but, in the case of the
Administrative County of London, the varying environmental conditions in different
constituent parts renders it desirable that the local needs should be met by bodies
who are closely connected with these areas, and that the necessary work should be
carried out by officials who are responsible to such local bodies. In Shoreditch the
needs of the child population, especially as regards the provision of clinics, has been
extremely well met, and this end has probably been attained largely because of the
close association between officials and the members of the community.
It is suggested that the health of young children can best be preserved if the
doctors who are responsible for child welfare work are also responsible for school
medical work. While this argument may hold for a small authority, it seems to me
that it is quite fallacious when an authority of any size is considered. Other
arguments can easily be given against the suggestion which is put forward, and there
is no doubt that any attempt to further this scheme will be met by the concentrated
opposition of all the Metropolitan Boroughs.
V—Recommendations.
To summarise, I recommend—
(a) The establishment of a toddlers' clinic for an experimental period of six
months.
(ib) The appointment of an additional health visitor. This appointment
should be made as early as possible.