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Report of the County Medical Officer—Education.
83
for bringing within the scope of the scheme verminous children attending schools in outlying districts
by means of an ambulance service, and for providing at reduced rates, hot baths for persons under and
over school age. In the secondary schools two pupils were proposed for permanent exclusion from
the institutions and eight for withdrawal of scholarships owing to unremedied defects in personal hygiene.
The depletion of the medical staff owing to war service has interfered with the continuity of
work of a special character. Something has, however, been done in connection with open-air methods
and detailed reports upon playground classes have been received from several of the assistant medical
officers, including Drs. Norman, Cowell, Elizabeth M. McVail, Margaret C. Macdonald and Griffiths
(p. 116). Special note should be taken of the reports of Dr. F. T. H. Wood and Dr. O. H. Peters upon
the open-air schools at Birley House and Shooter's-hill respectively (pp. 112-G). Dr. J.G.Forbes has
made a special examination of tuberculosis contacts and a summary of the results will be found on p. 94.
An investigation of the physical condition of children upon the necessitous lists has been carried out
by Dr. Elizabeth M. McVail and Dr. G. Chaikin (p. 108). Dr. Leipoldt has communicated the results
of his observations in the schools upon conditions associated with the thyroid gland in children (p. 89).
Reports upon remedial exercise classes have been sent in by Drs. Mabel Russell, Ruth Proctor and
A. E. Wells (p. 118), upon holiday excursions by Drs. Forbes, Peters, Margaret Macdonald, Lea,
Davies, Malcolm, Mabel Russell, Palgravc, Kidner, Lewis, Wood, Norman and Hanson (p. 118), and by
Dr. A. C. Williams on the mental condition of paralysed children.
Special
reports,
Letter of the Board of Education, 24th June, 1913.
In last year's annual report reference was made in some detail to the letter from the Board of
Education dated 21th June, 1913, embodying criticisms on the working of the Council's schemes of
inspection and treatment. Proposals for meeting these criticisms, were outlined, but at the time of
preparation of the report they had not been fully considered by the Council, although an interim reply on
minor matters had been sent to the Board on 29th July, 1913. This letter was as follows:—
1. London. 29th July, 1913.
2. School Medical Service.
Sir,—With reference to Mr. Davies' letter of the 24th ultimo (M.3303/13), I am directed
to state that the Council has given careful consideration to the points raised therein. With
regard to that part of the Board's letter relating to "following up," to the arrangements for
medical treatment, and to the extension of the functions of the assistant medical officers
(paragraphs 5, 8 and 9), I have to say that a further communication will be sent to the Board
as soon as possible.
With regard to the point raised in paragraph 3 as to certain inspection work being undertaken
by nurses instead of by doctors, I am to state that it is necessary, in order that the
requisite number of children shall be inspected by the doctor at each of his visits, that some
routine work should be done by the nurses in preparation for the inspection. In this connecttion
it may be stated that the physical measurements carried out by the nurses during 1911
are in complete agreement with the standards arrived at in former years from measurements
made by the medical officers. Arrangements are, however, being made for the school doctors
to take the physical measurements both at the inspections and at subsequent re-inspections
of those children who are found to be suffering from malnutrition. The school doctors have
also been instructed to examine all cases of defective vision reported as a result of the preliminary
examination by the nurse, and it has been decided that during the coming educational
year the standard of defect for which children are referred for treatment shall be made more
stringent. In connection with the examination of defective hearing, it has recently been
arranged that the preliminary examination of children for hard-of-hearing classes shall be made
jy the school doctor himself, and cases considered suitable are being further specially examined
by the Council's otologist.
The question of the investigation of absence due to illness, referred to in paragraph 6,
is receiving consideration, and modifications of the existing practice are made from time to
time in order to meet the exigencies of the situation. Some time must, however, elapse before
the information made available can be fully utilised.
With regard to paragraph 7 as to the desirability of establishing inspection centres for
more detailed examination, I am to state that arrangements have been made whereby the
treatment centres have been available for special medical inspections. It has not been found
possible to arrange special inspections as frequently as might be desirable, owing to the fact
that the statutory inspections and the re-inspection of children in the schools take up practically
the whole of the school doctors' time. Moreover, there has been difficulty in securing
the attendance of children on Saturday mornings. In view of these circumstances the Council
has combined special inspections with the ordinary statutory inspections in the schools themselves.
This question will be further dealt with in the later communication to be sent to
the Board.
I am to add that the Council notices with satisfaction that the Board finds that, as a result
of the organisation of the work carried out during the past year, satisfactory arrangements
have now been effected, and that the Board expresses its appreciation of the arrangements
made for systematic re-inspection.
I am, Sir,
The Secretary, Your obedient servant,
Board of Education, R. Blair,
Whitehall, S W. Education Officer.
27715 m 2