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As the scheme came into operation during the year under review and as it is the first of its
kind to be introduced in this country by a local authority, it may be well to give a somewhat full
outline.
Notification.
Under the Kensington (Acute Rheumatism) Regulations, 1927, dated July 30th, 1927, made
by the Minister of Health, acute rheumatism, as defined in these Regulations,* was made a notifiable
disease for a period of three years from the 1st October, 1927.
The Regulations provide that "the Medical Officer of Health, or a person acting under the
instructions of the Medical Officer of Health, shall make such enquiries and take such steps as are
necessary or desirable for investigating the source of disease, for removing conditions harmful to
the patient and arranging for the treatment of the patient. The Local Authority may establish a
centre to be called the Rheumatism Supervisory Centre and mav make such other arrangements as
they deem necessary or desirable for the supervision, after-care and treatment of cases of acute
rheumatism in the district.''
Before sanctioning these Regulations, the Ministry required to be satisfied that:—
(a) efficient machinery existed for investigating the cases notified,
(b) there was accommodation for institutional treatment, and
(c) the Local Authority was well organised in regard to health administration and had
good housing records.
Rheumatism Supervisory Centre.
After conferring with the authorities of the Princess Louise Kensington Hospital for Children,
it was arranged that:—
(a) the Rheumatism Supervisory Centre should be at the new Children's Hospital, and
(b) a physician or assistant physician on the honorary staff of the Hospital should be
appointed as physician-in-charge of the Centre and consulting physician to the
Royal Borough of Kensington for cases of acute rheumatism.
The Rheumatism Supervisory Centre was opened in October, 1927, and Dr. Reginald C.
Lightwood, an assistant physician on the staff of the Children's Hospital, was appointed
physician-in-charge of the scheme.
Hospital Accommodation for Rheumatic Children.
By arrangement with the Poor Law Authorities of Kensington, the physician-in-charge of the
Rheumatism Supervisory Centre was appointed as visiting physician for acute rheumatism at St.
Mary Abbots Hospital (Kensington Infirmary). The Poor Law Authorities agreed to provide
sufficient in-patient accommodation for the rheumatic children coming under the Scheme.
Convalescent Accommodation for Rheumatic Children.
An annual grant is being made by the Council of the Royal Borough to assist in the provision
of accommodation for convalescent rheumatic children in suitable recovery homes.
Control of the Scheme.
The Scheme is under the control of the physician-in-charge of the Rheumatism Supervisory
Centre, who acts under the authority of the Medical Officer of Health. In this way a unified
control is obtained.
Details of the Scheme.
The Medical Officer of Health and the physician-in-charge of the Rheumatism Supervisory
Centre drew up the following experimental plan for the organisation of the work of the Centre:—
(1) On the receipt of a notification, a Health Visitor, acting under the instructions of the
Medical Officer of Health, visits the home of the patient and fills in appropriate
information on a card which is reproduced in miniature below:—
*The expression "acute rheumatism" means the following conditions, occurring separately or together in a child
under the age of sixteen years.
(a) Rheumatic pains or arthritis, if accompanied by a rise of temperature;
(b) Rheumatic chorea;
(c) Rheumatic carditis.
This definition is similar to the one used in the Paddington Notification Regulations.