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106
Annual Report of the London County Council, 1914.
With a view to co-ordinating the arrangements which the Council has now approved for
medical work, with the arrangements for education work, it is suggested that the responsible
organiser for the district in which the medical divisional office is situated shall in each instance
be allocated to the medical officer. Five officers having thus been allocated, the remaining
seven officers are allocated to the education officer. Each of the 12 district organisers would
in practice deal with the care committees of her district, but seven of them would have nothing
to do with purely treatment centre work. As the five district organisers allocated to the
public health department will have duties to perform beyond those required of the seven, they
will need special help. We therefore propose that in each of the five divisions an assistant
organiser shall be appointed in the public health department to deal more particularly with
the voucher and following-up work connected with the treatment centres, and be subject to
the direction of the district organiser allocated to the medical officer, and also that the
principal assistant organiser allocated to the medical officer, in addition to dealing with the
medical work of the organisers of the twelve districts, shall devote special attention to the
work of the treatment centres in the five medical divisions.
This officer and the five officers mentioned in the preceding paragraph should be able
to relieve the district organisers of the treatment centre work to such an extent as to obviate
any possibility of their efficiency being in any way impaired. With regard to the subordinate
officers, the individual members of the staff will be allocated in each division in appropriate
numbers to one or other department, and it will be the duty of the principal organiser, working
through the twelve district organisers, to make such special arrangements as will enable
individual officers to deal with two separate branches of work and, at the same time, to preserve
cohesion and prevent overlapping."
It will be seen that under these arrangements no portion of the work is divorced from the care
committee organisation, the whole of the medical work is dealt with by the same officers, the structure
of the organisation is maintained unimpaired and an allocation of the officers is carried out in accordance
with the intention of the Council.
Suggestions for increasing the staff to meet the growth of the work were submitted, the total
staff recommended for the public health department being one principal organiser (half time), one
principal assistant organiser, five district organisers, forty-eight assistant organisers and twelve women
clerical assistants.
At the same time the Council dealt with the question of giving clerical help to care
committees in certain districts. In July, 1913, a special experiment had been authorised in the
Whitechapel area, whereby a branch office was established as a centre for care committee
work. The accommodation provided was fully used by voluntary workers for committee meetings
conferences, and office purposes; and the work of twenty-four care committees was concentrated at this
branch office. The experiment was fully successful, and the Council agreed to make similar arrange,
ments in four other districts.
As stated previously the above proposals were adopted on the 19th May, 1914, and the Council in
July, 1914, selected the officers to fill the various posts. The new arrangements have not been
in operation a sufficient time to enable their full effect to be estimated, but there is evidence
that the care committees are at the present time taking a very keen interest in the " followng-up "
work connected with medical treatment.
Re-inspection.
A most important part of the school doctor's duty is the re-inspection of children found defective
at medical examinations. This work has now been thoroughly organised in London, and provision
has been made for every case reported defective to be re-inspected a few months after the primary
inspection, and for each case not discharged as satisfactorily treated at this first re-inspection.to be again
re-inspected at a later date. A system of control cards has been introduced which makes it impossible
for any children requiring inspection to be missed.
During the year 84,500 re-inspections were made, and the results are given in the following tables.
Of all children found defective 50 per cent, were found to have been treated by the time the first reinspection
was held, an additional 7 per cent, were no longer in need of treatment and 43-1 per cent,
had received no treatment though still requiring it. Out of the 50 per cent, in whom treatment had
been commenced, in 70 per cent, it had been completed satisfactorily, 19 per cent, were still under treatment
and 11 per cent, had discontinued treatment prematurely or from other causes were uncured.
Thus after the first re-inspection had been held 4.2 per cent, of the children were discharged as satisfactory,
while 58 per cent, were still requiring treatment; after two re-inspections it was found that
of children recommended for treatment, 66.6 per cent, were completely cured, while 25 per cent, still
requiring treatment had not yet procured it. The remaining 8.6 per cent, had all been under treatment,
but half of this number had discontinued treatment before being cured and in half the treatment was
still being continued. Of those children suffering from ailments for which the Council had made special
provision 62.6 per cent, of the cases which obtained treatment were dealt with under the Council's scheme,
the remainder obtaining relief at the hands of other agencies.
The largest proportion of cases which obtain treatment are found amongst those suffering from
minor ailments of whom in 65-5 per cent, the treatment is completed during the first 6 months, and
in 59-2 per cent, of the remainder treatment is completed during the second 6 months ; next come cases
of visual defect, of which 57 per cent, are treated in the first 6 months and 52-5 per cent, of the remainder