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85
Report of the County Medical Officer—Education.
already been possible to employ the permanent officers on work of this kind. I am desired
to point out that the increase in the number of part time school doctors is in the nature of an
experiment, which will be reviewed at the expiration of two years, and the number of permanent
medical officers that will ultimately be necessary will depend to some extent upon
the results which will be found to have been obtained.
I am to express the hope that the above arrangements set out will meet with the approval
of the Board.
I am, Sir,
The Secretary, Your obedient servant,
Board of Education, R. Blair,
Whitehall, S.W. Education Officer.
All the arrangements forecasted in these two letters have actually been put into operation, and
so far as they relate to the separate branches of work are described under those heads. Unforeseen
difficulties connected with the war have somewhat restricted the progress which might otherwise have
been expected, and at the end of the year no final conclusion could be drawn as to the efficiency of the
measures adopted. There has, for instance, been considerable interference with the staff arrangements,
the nucleus of permanent medical assistants has been of necessity considerably reduced, and it has been
necessary to employ substitutes. Although these substitutes have worked very well indeed, they have
necessarily not had the knowledge, possessed by the permanent staff, of the special conditions
obtaining in the schools. In these circumstances the full effect of the new arrangements has not yet
been realised, and it will be necessary to wait for the return of normal conditions before any complete
and reliable estimate can be formed of the value of the alterations made.
Medical Inspection.
The examination of children was carried out in accordance with the regulations of the Board of
Education and the table appended to this report shows the details of the inspection of the various age
groups. The work of inspection during the early part of the year was carried out by a staff of 31 full
time and 4 quarter time assistant medical officers working under the direction of 5 divisional medical
officers. On the outbreak of the war several members of the staff were called up for military duties and
their places were in most instances filled by medical practitioners giving part of their time to this work.
This inspecting staff was assisted by 106 members of the nursing staff, who prepare the children for
examination and assist in the weighing, measuring and vision testing. Arrangements are made for an
examination to be held each term in every school, and in larger schools several times each term, so that
any special cases may be brought to the notice of the doctor. The date of the inspections at all schools is
notified in the Council's Gazette and the parents of children due for examination are invited to be present.
A representative of the Care Committee is also invited to attend at the time of examination in order to
make arrangements to secure that the child receives medical treatment where this is necessary. When
a child is found to be in need of medical treatment a card is issued to the parent pointing this out and
if the parent is not present at the inspection the school nurse visits and delivers the card at the home.
The scheme of inspection was as follows:—During the first term leavers were examined. The
expression "leaver" being taken to mean a child reaching the age of 12 during the year, i.e., a child
born in the year 1902. During the second term the inspection of entrants was carried out. An entrant
is a child entering a public elementary school who has not been medically examined either at that or
at any previous school. The term "entrant" is limited to children in the infants' department of the
school, and the majority of these children are under 6 years of age. The following table shows the
ages of the entrants examined during the year 1914.
Age 3—4. Age 4-—5. Age 5—G. Age 6—7. Age 7—8. Total.
Boys 6,478 15,753 21,231 3,437 743 47,(642
Girls 5,778 14,431 22,302 3,703 837 47,051
Total 12,256 30,184 43,533 7,140 1,580 94,693
12.9% 31.95% 460% 7.5% 1.7% 100%
During the third term of the year the remaining leavers were examined and also any children who
had in the meantime entered school. The remainder of the inspection during this term was devoted
to the examination of an intermediate group, children at age 8. The examination of this group has not
hitherto been required, but the Board of Education has decided to make this one of the statutory age
groups from 1st April, 1915.
The restriction of the inspection to children of one age group in each term was brought about
by the necessity for ensuring the complete inspection of the entrant group. Children, as a rule, begin
school in the Summer Term, and, as the Board of Education year formerly ended in July, it was necessary
to inspect this age group almost exclusively during that term. As three age groups are now included
in the Board's requirements for medical inspection, it is proposed to carry out the inspection as the
children arrive at school and reach the ages of 8 and 12 years. The fact that the Board of Education
year now begins in April makes it possible, while ensuring that practically all entrants are examined