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Mr. Scott had developed a fresh and sizeable one of his own.
To complete the scheme, pre-school children were also given
appointments for Mr. Scott's clinics on reference by the Maternity
and Child-Welfare Medical Officers.
These clinics were held on the same premises as the other
school clinics in order to achieve the closest possible relations
with the school health service. For the specialist to come into
the school health service rather than to await the patients at a
hospital clinic is not only a great convenience to parents, but
also helps the specialist to understand the needs of the health
services and the facilities they have to offer in the way of
follow-up, reports from teachers and nurses, etc. It is not too
much to say that a specialist sees his problems from quite a
different point of view and develops a different outlook when
working as part of a public health team, which is much to the
advantage of his young patients. It may fairly be stated that
these clinics form an admirable example of what can be done
by co-operation between two Committees for the common good.
The establishment of these clinics provides the explanation
for the increase in the number of deaf and partially deaf children
ascertained during the year, while the epidemic of poliomyelitis
already referred to largely explains the drop in the number of
operations for tonsils and adenoids. At the same time, it should
be observed that Mr. Scott is adopting a conservative attitude
towards the tonsil and adenoid cases. The removal of tonsils
and adenoids is an operation which is not altogether devoid of
risk for the patient, and which on rare occasions ends fatally.
Its alleged benefits will not always stand up to critical examination,
though in carefully selected cases they may be very substantial;
moreover, many enlarged tonsils will return to normal
in time if left to themselves. There is no doubt that this operation
has been performed too freely in the past, and Mr. Scott's
caution in this respect is to be commended.
The total number of tonsil and adenoid operations performed
during the year was 273 (as against 356 last year). In addition,
105 children (as against 88 last year) were treated nonoperatively.
Five hundred and ninety-nine children (480 last
year) were treated for various conditions affecting the ears
(some of these treatments were given at minor-ailment clinics).
Details of the ascertainment of deaf children are given on
page 85.
Mr. Scott's report on the work of the Ear, Nose and Throat
Clinics follows:—
These clinics were established in July, 1947, to provide a
comprehensive ear, nose and throat service for the child population
of the Borough of West Ham.
SITUATION OF CLINICS. Two clinics were opened, one
in the north of the Borough, at 84 West Ham Lane, and one
in the south at Rosetta Road. This arrangement avoids the
necessity of travelling long distances for the patients.
Existing accommodation at Minor-Ailment Clinics was
72