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94
referred for observation and supervision children who had had
attacks of rheumatic fever and chorea. With the reduction of the
incidence of rheumatic disease in children, the importance of
supervision, although still considerable, had become less. It
happened that during the year the two physicians who had been
doing this work for many years retired from their duties and the
opportunity was taken to end the rheumatism supervisory clinics as
such without detriment to the children attending. This was because
over the years, co-incident with the reduction of rheumatic disease,
the facilities at hospitals for the supervision of cardiac cases had
greatly developed and some children therefore were referred to
hospitals or to their general practitioners. Others were asked to
attend at the ordinary Special Investigation Clinics run by the
school doctors. These arrangements have proved entirely satisfactory.
Another improvement was in the arrangements for the examination
and treatment of children suffering from ear, nose and throat
complaints. One of the difficulties in the past had been that the
doctors attending the clinics did not have direct access to their own
hospital beds so that if a child was considered to need operative
treatment, then arrangements had to be made with the hospital for
admission to the beds under a different surgeon. This was never
a satisfactory arrangement but fortunately during the year the
Regional Hospital Board decided to appoint a surgeon who would
not only attend the E.N.T. sessions in our clinics but would also
be on the staff of local hospitals with beds under his own control.
This, at the end of the year, had been working for ten weeks
and is a much better arrangement. It has sometimes been questioned
whether, in fact, E.N.T. sessions in school clinics are still
necessary when facilities are available at the hospitals. This has
some validity but on the other hand, hospital E.N.T. Clinics are
usually extremely busy and take adults as well as children and we
have held that clinics in our own centres, reasonably dispersed
throughout the Borough offer a service to school children which is
much appreciated and saves " educational" time. We feel, therefore,
that these clinics should continue the more so since they have
now been placed on a firm and rational basis. Unfortunately, the
attendance at the clinics has been less than anticipated and at the
time of writing their continuance is under further review.
One feature which is mentioned in the Report and to which I
would also like to refer to here was the Conference on health
education in schools which was held in April. To this Conference
were invited the head teachers and their deputies and some of the
senior staff of the secondary schools in Wandsworth. Speakers of
considerable repute were invited to open discussions on drug taking,
venereal diseases, sex education and hygiene and other matters and
the School Health Service was, of course, fully represented. The
idea of this Conference was to explain to head teachers some of