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

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London County Council 1905

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

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24
It may be suggested that these precocious workers are children who have already suffered in the
battle of life, whose parents are not well equipped mentally, that poverty has forced the children into this
slavery, and that they are of an inferior type physically and mentally, so that apart from sentimental
considerations this is not serious as a matter of national economy.
It was, however, found, on making a detailed enquiry, that in two schools recorded in the last
report, where the physique of the boys had been accurately noted, the children who subsequently went
to do this kind of work were as follows:—
Numbers.
Considerably
above average
physique.
Below
average.
Workers at "The Chaucer" 29 18 7
Leipsic-road 40 23 11
Total 69 41 13
Thus, only 26 per cent. were below the average physique, and of these below the average more
than half were exceptionally brilliant mentally, although 17 per cent. of all were mentally below the
average. These results show that this out-of-school work is a wanton dissipation of the children's
powers, the chief national capital, and that the evil effect falls on the best of the children. This is in
complete agreement with what I found in Bradford, that it was the sharpest and physically the best
children who went off as half-timers.
We must set up as an ideal the suppression of child labour below 12 years of age, and during school
life regulate it to 20 hours weekly, and a maximum of 5 hours on any one day.
PERSONAL CLEANLINESS.
School Nurses.—The staff of school nurses numbering 12 had to be increased to 32 from April,
1906. It will also be necessary shortly to appoint a superintendent of nurses, as there is danger of the
school work losing in efficiency if it is not well controlled and maintained at a uniform level in all parts
of London. A more senior officer of good ability is required to deal directly with many matters which
arise with teachers and parents, to smooth over difficulties, to arrange details with Divisional Superintendents,
and to give attention to cases which come before the magistrates.
Each nurse visits the schools in her district; examines the children for all forms of obvious
uncleanliness and disease; advises the teachers in regard to exclusion of doubtful cases, and applies
the Cleansing Scheme. In numerous instances children have been followed up at their homes and the
influence of the nurse's visit has been seen in the parents taking a better view of their responsibilities,
as ignorance is often the sole cause of uncleanliness and disease.
His Majesty's Inspectors now frequently draw attention to the necessity for cultivating habits
of personal cleanliness Recently in the case of a non-provided school His Majesty's Inspector stated
that many of the children were in an unclean condition; that some were offensive both to their neighbours
and teachers, and that unless considerable improvement was made in this very important particular
the school could not be regarded as satisfactory. Speaking generally, the condition of non-provided
schools is very bad in respect to cleanliness.
Complaints are also received from parents that their children are compelled to sit with unclean
children. The mere fact that such objectionable children should be in attendance shows that the school
has to this extent failed in its aim.
The labours of the nurses have been the means in a great measure of bringing to light the cases
of favus, for which a special school is being provided. Often a nurse has to postpone her ordinary visits
in order to give special attention to a school threatened with an outbreak of one of the gross infections,
as for instance ringworm or scabies.
It would be almost impossible to exaggerate the importance of the nurses' work. It has gained
widespread approval, and has developed into a sanitary crusade which trains the children in habits of
cleanliness and the associated self-respect. This is an educative force and does far more than a large
amount of theoretical teaching of the elementary principles of hygiene unaccompanied by practice.
The work has been seen by hygienists from other parts of the country and a number of local
authorities have now followed the example of London in the appointment of school nurses, but these
nurses must in all cases be under medical direction and have the support of a doctor for the many
doubtful cases that arise.
Up to the present the gross contagions alone have been dealt with by the nurses, but with the
fuller medical supervision which will now be possible much useful work may be done by the nurses,
in aiding the prevention of the spread of infectious diseases which play so much havoc not only with
the health but with the attendance of the children. The duties already referred to are all connected
with the prevention of spread of disease in schools and the inculcation of cleanly habits among the
scholars. It is a prime duty of education authorities to spare no endeavour to make their schools
healthy and the attendance of the scholars as free from risk as possible. Another principal which has
been generally accepted is that it is the duty of authorities to discover remediable conditions in the
scholars which prevent the latter from obtaining full benefit from the instruction given, to advise with