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105
Report of the County Medical Officer—Education.
As a result of negotiations between the Education Committee and the Highways Committee,
the plan now to be more particularly referred to was put into operation in the middle of November, 1914.
The scheme provides for the issue of tickets at the rate of 1/2d. each for a single journey of any distance.
Both the child and the parent, or other adult accompanying the child, are entitled to use these tickets.
The tickets are available between 9.30 a.m. and 4 p.m., but are not available on Saturday. This
limitation was designed to prevent any interference with the normal traffic. Except as regards the
initial journey from home, the tickets are issued by the nurse or organiser who is in attendance at the
hospital or centre. Tickets for the first journey are issued under special arrangements made by the
district organiser. The average course of treatment entails three journeys to and from the hospital.
Assuming that the parent accompanies the child on each occasion, the total number of journeys would
be twelve, and if the ordinary fare per journey is l1/2d., the total saving to the parent, as a result of the
facilities would be Is. It is impossible to judge as yet of the effect of this plan in encouraging parents
to obtain treatment for their children, but it may be mentioned that the arrangement made by the
Highways Committee has been greatly appreciated by those parents who have already availed themselves
of it.
Following-up : Organising staff for children's care work.
Since the transfer of the work connected with the medical treatment of school children from
the Education Department to the Public Health Department, considerable attention has been given to
the respective claims of the two departments to the services of the organisers of children's care work.
The question was one of some difficulty, inasmuch as both departments were interested in the work of
the care committees, and it was essential that no step should be taken which would impair the efficiency
of the care committee system. As a temporary measure one half of the time of one of the principal
organisers and the whole of the time of one of the district organisers had been placed at the disposal of the
public health department, and the whole organising staff performed its duties in connection with medical
treatment under the direction of the school medical officer. On the 29th July, 1913, the Council decided—
(a) That a staff of organisers sufficient for the organisation and administration of medical
inspection and treatment of children, devolving upon the medical officer under the resolution
No. 9 (la) of 25th July, 1911 (p. 329), be allocated to the public health department, and be thus
placed entirely under the control of the school medical officer.
(b) That a staff of organisers sufficient for the work relating to children's care, other than
the organisation and administration of medical inspection and treatment of children, be allocated
to the education officer's department and be thus placed entirely under the control of
the education officer.
(c) That, so as to avoid overlapping and duplication of work the work of the organisers
referred to in the foregoing resolution (a) and (b) allocated to the education officer's department
and the public health department be for a period of one year co-ordinated by the
education officer and school medical officer through a principal organiser, who shall be a half
time officer in the education officer's department and a half time officer in the public health
department, and that the General Purposes Committee do report at the expiration of one
year as to the continuation of this arrangement.
Various proposals were considered for giving effect to these resolutions. The problem was to
divide the staff in such a way as to ensure that the efficiency of the care committee system should be
maintained and that duplication of work should be avoided. In the last annual report the work of the
care committees in connection with medical treatment was described in detail and it was pointed out
that the success of the work depended upon the co-operation of the organisers engaged in the work of
" following up " in the treatment centres, with the care committees, and that it was impossible to detach
the " following up " work from the general scope and structure of the care committee organisation
without imperilling the whole scheme of treatment. It was also stated that this view had been accepted
by the Council, who had decided that the organising staff dealing with medical treatment and work
ancillary to medical treatment, should be wholly included in the public health department under the
supervision of the school medical officer. As, however, the Council's decisions were not arrived
at until the 19th May, 1914, it was possible to make brief reference only to them in last year's report,
and this year a more complete statement of the arrangements made may be of interest. In their
report to the Council on the subject, the Education Committee, after reviewing the position of the
care committees and the organising staff, stated that, in view of the recognised place of the care committee
system [in the Council's administration, the time had come for placing the staff on a permanent
basis. They were of opinion that, so far as the supervising officers were concerned, there should
be one principal organiser instead of two, that two principal assistant organisers should be appointed,
one of whom should be allocated to the education officer and one to the school medical officer, and that
the appointment of a district organiser in each of the twelve educational administrative areas should
be continued. With regard to the division of the staff the committee reported as follows :—
" The Council has decided that for the proper organisation of the work of medical inspection
and treatment London shall be divided into five divisions, and that the medical work
in each of these divisions shall be placed in charge of a divisional medical officer. In the
five divisional offices the administration of the treatment centre work will be focussed, and each
of the five divisions for medical purposes will, therefore, include two or three educational
districts.
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