View report page

29
The attendances have never fallen below 85 per cent. of the number
of children written for to attend each session. Because of this
good attendance, it has been very difficult to shorten the waiting
list of children referred from the School Medical Service, and
therefore Clinics have sometimes been held during the school
holidays. Even at such times, the attendance of the children has
been as good as during the school terms (e.g., Christmas holidays,
1932, two Clinics 90.9 per cent. and 86.3 per cent. attendances
of appointments made). At the end of 1932, there was a waiting
list of 98 children waiting for appointments to be seen at the Clinic.
"During the past year, there have been 45 sessions, with 795
attendances. Of these attendances, 298 were made by children
attending for the first time, while 497 were made by children who
were being kept under observation. A certain number of children,
after attending the Clinic for a few months, are adjudged to be
free from rheumatism, and are discharged; others are considered
to be not rheumatic at their first attendance. During the last
year, 249 children were discharged from further attendance.
"Of the children who remain under observation at the Clinic,
the majority have rheumatic disease of the heart; the number of
these cases is at present 130. Children with heart disease fall into
4 groups according to the way in which the Clinic can deal with
them.
"In the first place, there are the children with acute heart disease
who need either In-patient treatment at a hospital or treatment in
bed at home by the Private Practitioner, and these children are
referred accordingly. Then occasionally, there are children with
old-standing damage to their heart who need very prolonged rest
in bed with skilful nursing; 7 children in this category have been
admitted to my ward at the Cheyne Hospital for Children, Chelsea,
and I should like to thank the Authorities of that Hospital for
their kind co-operation in this matter.
"A third group of cardiac children are those whose hearts are
only mildly damaged, and who with careful and specialised convalescence
are thought capable of partial or even complete recovery.
The unflagging zeal of Miss Lewis of the I.C.A.A. has enabled 19
such children to be received at the various heart homes in the
country—West Wickham, Edgar Lee and Lancing. In addition,
21 other rheumatic children have also been sent away for periods
of convalescence, while 28 children who were found to be suffering
from debility for various reasons have also received convalescence.
I should like to express my gratitude to Miss Lewis for her splendid
efforts in getting so many children away. The fourth class of
cardiac cases comprises those children who are fit enough to live
at home and attend either an ordinary school or a Physically
Defective School. These children are supervised at the Clinic,
being referred to their doctor or hospital when any ailment arises.