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4
PROVISION FOR MEDICAL INSPECTION.
In November, 1889, the late School Board for London decided to appoint a medical officer, to
give his whole time, at a salary of £400 a year, to report on candidates for permanent offices and generally
to advise the Board on any matters on which his special medical knowledge might be useful. The
medical officer was appointed, with a junior clerk to do his clerical work, but the condition that the
whole time should be given was abrogated. Consequent on the passing of the Elementary Education
(Blind and Deaf) Act, 1893, the Board, in 1898, appointed temporarily two doctors to give half time
for the purpose of examining children alleged to be defective. One of these was a woman who also
had the duty of examining female candidates for permanent employment. The chief work of the
department was the medical examination of candidates for permanent offices, the supervision to
some extent of infectious diseases in the school and the medical examination of defective children.
In 1902 the staff consisted of the medical officer, two medical examiners giving half-time services,
and four clerical assistants, when the medical department was reorganised. The present medical
officer succeeded Dr. Smith; eight oculists were appointed to give 200 school sessions each to testing
the children's vision, and a ringworm nurse who had been working under the supervision of the School
Management Committee was transferred to this department. Two half-time assistants were appointed
for work in connection with the Special Schools, and shortly afterwards an additional half-time assistant
for a special measles enquiry projected by the medical officer. It was almost at once found that a laboratory
was required ; this was provided, and Dr. C. J. Thomas was made a full-time assistant; six of
the oculists were reappointed, but their duties were now tacitly extended to include a great deal more
than mere vision testing, and later five additional nurses were appointed. The whole work of the
department was by this time organised so that systematic records of all observations were established,
and many enquiries could be commenced. The field of work taken by the department was the investigation
of all conditions affecting or tending to affect the health of those working in the schools.
The First Annual Report of the medical officer was published in April, 1903. During the following
year a cleansing scheme for the schools was established; a complete report of the visual conditions of
the children obtained ; the method of bacteriological control of diphtheria established ; the measles
enquiry extended ; the whole of the children in the Special Schools generally reviewed ; and enquiries
commenced to elucidate the conditions of congenital aphasia, which have thrown so great a light on
school work.
The London County Council took over the Educational work in May 1904, but the non-provided
schools did not then come under medical inspection. During 1903-4, work had so rapidly extended
that it could not be systematically carried out for want of staff, and what had been done showed the
serious conditions existing in various directions. A scheme was therefore prepared for dealing with
the general condition of the scholars ; the prevention of diffusion of infections ; the promotion of cleanliness,
which is the basis of all hygiene; the hygiene of school work ; and the sanitary conditions of
school buildings. To carry out this work, one permanent half-time assistant and 20 quarter-time
temporary assistants were appointed in place of the six oculists. For dealing with ringworm and
securing personal cleanliness in the schools a superintendent and 26 additional nurses were added to
the staff. It was then possible to do more work, and the method of the measles enquiry was extended
bo the whole of London ; the Favus School was opened, and new regulations for the further control of
diphtheria established. In January, 1906, a complete system of medical supervision was extended
bo all the non-provided schools, and large numbers of children who should have been in special schools
were discovered ; the rolls of the special schools increased from 7,056 to 8,892, and, with the closer grip
of the work now required, the staff had to be increased by the addition of four quarter-time medical
officers. During the same time medical work had also been extending in other directions ; for instance,
before any scholarship was awarded the candidate was medically examined, and the need of this is shown
by about a quarter of them being referred in order to have some medical treatment. The secondary
schools, pupil teachers' centres and training colleges are also under regular inspection, although this
work has not yet been put on a permanent basis. Card records are kept of children from the time,
at the age of eleven, they enter as scholars until, from the training college, they pass on to the teaching
staff. The department is now worked in four sections :
(1) The examination of candidates for employment in schools, scholarship candidates,
scholars in secondary and trade schools, and students in the pupil teachers' centres and
training colleges.
(2) Medical inspection of schools, including the detailed examination of many children,
vision testing, the general physique, school conditions—such as lighting, heating, ventilation,
sanitation, furnishing, educational work such as timetables, play, exercise, out of school conditions,
and the hygiene of reading, writing, manual work and so on, dealing also with the work
and health of the teachers.
(3) Prophylactic measures of cleanliness and disease prevention, co-operating with
managers and Care Committees in respect to cleanliness and personal hygiene ; and with the
medical officers of health and sanitary authorities in respect to infectious and other diseases ;
for the protection of children and teachers without undue interruption of educational work.
(4) Special school work—Examining under the various Education Acts children nominated
by the school doctors, teachers, managers and others, with a view to admission to special
schools and periodically examining children already in these schools. The special schools
include schools for the mentally or physically defective, the blind or deaf, and similar institutions.
The Council is also in touch with various Custodial Institutions and establishments
for care of industrial, truant, crippled, epileptic, morally defective and various other classes
of cases.