London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1904

[Report of the Medical Officer of Health for London County Council]

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"What can be done?
"General.—Experimental observation ia most wanted—standards of age, weight, height, &c., are an urgent
necessity.
"The amelioration of the unhygienic conditions of school life—the only remedy for this being efficient
knowledge on the part of teachers.
"The ultimate diffusion of knowledge of child-life through the teachers to the homes.
"Immediate.—Feeding in two or three schools under observation, with control observations of children in
similar but unfed schools would be advisable to gain knowledge.
"At present, excepting the blind and deaf specially exempted in their Elementary Education (Defective and
Epileptic Children) Act, 1899, any legal relief to children means pauperisation of the parents. The recent order to
Guardians is cumbrous and likely to become a dead letter, and any experimental feeding will best be done in
association with voluntary agencies.
"I do not think there are sufficient grounds for asking parliamentary powers at present."
A limited experiment in feeding in certain centres has been determined on, the Cookery
Centres being utilised for this purpose.
THE AGE OF ATTENDANCE OF SCHOOL CHILDREN.
Considerable attention is now being paid to this subject, which first sprung from a paper read
before the Childhood Society by Dr. Newsholme about three years ago.
The control of schools coming under the Sanitary Authorities, the Medical Officers of Health
have turned to the question of whether considerable reductions in the incidence of disease and in
certain death rates could not be effected by excluding children from school till comparatively late
ages.
The subject is likely to come up for further consideration, as the Board of Education have
altered their regulations and given Educational Authorities a free hand as regards school attendance
between the ages of 3 and 5.
In country districts, and more especially in the winter season, it may be very advisable that
young children should not be sent to school; but the criticism of school attendance for children,
under 7 is the age often discussed, has been chiefly directed against children in towns, and has been
altogether destructive and not constructive.
The age for school attendance in England is earlier than any other civilised country; the usual
age for compulsory school attendance on the Continent is the end of the sixth year, earlier generally
in the northern lands, a trifle later in the south. Kindergartens are, however, recognised for earlier
ages, and creches are common in the larger towns.
It is said that the infant school is chiefly responsible for the diffusion of such diseases as
measles and whooping cough. The natural history of these diseases has not yet been sufficiently
studied to deny the truth of this statement, but the greater part of the mortality of whooping
cough occurs at ages before school life begins, and from our experience in the past three years 25
per oent. of the infants entering school at three years of age have already had measles.
If the prevention of contagion can be accomplished in the case of these diseases, and for
measles probably no practical means of doing this is possible in large towns, it has to be done by
isolating the children as much as possible, and with the number of women who work nowadays
this means, if not school, some kind of creches.
The next reason put forward is that children at early ages cannot learn efficiently; but this is
entirely wrong. It is only really directed at the want of intelligence in the curriculum hitherto
prevailing under official sanction, but which now is being amended. Children learn more in
the years from 3 to 5 than they will learn in the same period at any time subsequently; but
if it is attempted to get work out of non-existent organs, there will be failure, and even immature
tissues may and do suffer. But this is merely a reason for improving the kind of education and
instructing the teachers.
The last argument is entirely short-sighted, and points out that much room is taken up by
these children in schools, and the accommodation which has cost much money would be set free by
excluding infants, and could be used for other children—but if these children are to be excluded
from school they must be accommodated elsewhere. There is no room in the homes, no one to
watch them, the older girls will be kept from school to do this. In the earlier days of the late