View report page

22
provision exists either for conservative treatment or even for extraction in London. They are convinced
that the existing provision is wholly inadequate, and, unless additional facilities are provided,
it is not possible for large numbers of children to obtain proper dental treatment.
Vision.—It is computed that about 60,000 children in the schools suffer from defective vision.
It appears that the hospitals can only deal with a small proportion of these cases. The work required
is mainly determining errors of refraction. This is tedious and without great professional interest,
while the number of cases involved is a serious strain on the hospitals. The Council has continually
received complaints from the hospitals on this point. At the same time, the bulk of the children seen
by the Council's oculists do not so far as can be judged, obtain advice. In consequence, the money
spent by the Council on the inspection of children is, to a great extent, wasted. They think that additional
provision is desirable for dealing with the large number of children suffering from defective vision
who under present conditions, can only obtain knowledge of what they need without any means of procuring
it.
Ringworm.—Ringworm is common all over London. The children affected are often away from
school for several months, and occasionally even for years. The effect upon the school attendance
is serious, equal to a loss of grant amounting to £5,654 per annum. The Committee think that additional
provision is desirable if this disease is to be effectively dealt with. They do not think that more
should be done with regard to the treatment of school children suffering from favus. The treatment
given in the favus school may be considered as satisfactory.
Suppurating Ears and Adenoids.—It seems that the hospitals are sufficiently able to deal
with the cases requiring operations. It is different, however, with those cases of discharging ears which
require prolonged treatment. This condition not only lessens the capacity of children to benefit by
instruction, but is extremely dangerous. Cases of middle ear disease would need careful examination
by a surgeon and then, in the majority of cases, frequent cleansing by nurses. There is great difficulty
in carrying out such a course of treatment as part of the ordinary out-patients' department of a hospital.
The Committee think that it is desirable that additional provision should be made for such cases, and
cannot resist the conclusion that in many instances such treatment would preserve life or save hearing.
General Debility.—General debility is often due to the poverty of the parents, and many
diseases, such as defective vision, carious teeth, suppurating ears and adenoids, dirt and other circumstances,
incidental to slum life are contributory causes of debility. In the large majority of cases a
stay in a home intermediate between the hospital and the special school provides the only prospect of
real recovery.
Tuberculosis.—When occurring sub-acutely in internal organs, might be provided for in residential
institutions where open air life could be secured, and in which a limited and graded curriculum
would be beneficial. When tuberculosis attacks bones or joints it should be similarly treated, unless the
condition is removed for the time from the education authority owing to the necessity for surgical
operation. The Sub-Committee believe that the general impression left on the minds of the Education
Committee will be that the existing provision of hospitals and other institutions as now organised is
generally inadequate; while in regard to particular diseases such as dental cases, errors of refraction,
ringworm and suppurating ears, little more than is done at present can be expected from the hospitals,
and other institutions with their existing resources and organisation. Finally the Sub-Committee
answered the questions of their reference as follows :—
Summary and Recommendations. (Questions i. to iii.)
In answer to the first three questions addressed to us—
(i.) What is the existing provision for the medical treatment of school children ?
Such facilities as exist for the medical treatment of school children are provided by
hospitals, dispensaries, infirmaries, etc., and the general practitioner.
(ii.) To what extent can this provision be rendered more available by the action (a) of the hospitals,
(b) of the Council ?
Many of the above-mentioned institutions with their existing accommodation can do
no more so far as the treatment of the cases indicated is concerned. Some could do more
if assisted from public funds; others could do no more whether assisted or not.
(iii.) What additional provision, if any, is desirable ?
We think that, generally, sufficient accommodation exists to deal with the graver cases
that require operative treatment. On the other hand, as regards the more ordinary ailments
of children a large amount of routine work is necessary, the provision for which is inadequate
and in many parts of the county non-existent.
Our findings with regard to teeth, vision, ringworm, favus, suppurating ears and adenoids,
debilitv, and tuberculosis are as follows—
(a) Teeth.
(1) That, in the opinion of this Sub-Committee, there is a prevalence of dental caries among children attending
public elementary schools, and that the existing accommodation in the hospitals and dispensaries for even simple
dental examination and treatment is wholly inadequate.
(2) That, in the opinion of the Sub-Committee, it is desirable that provision should be made for simple dental
treatment of school children.
(3) That it is desirable that instruction in the hygiene of the teeth should be given to school children and
to their parents or guardians.
(4) That it is desirable that the daily use of the tooth-brush by children in their homes be encouraged.
(5) That it is desirable that from time to time children be examined as to the cleaning of their teeth.