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CHAPTER XXXIII.
Public Health Reports (continued).
Report of the Education Committee Submitting the Annual Report of the Medical Officer
(Education) (Dr. J. Kerr) for the year 1910.
In presenting the report of the medical officer (education) for the year ended 31st December,
1910, we would direct special attention to the great increase in the extent of the medical work which
has engaged the most careful attention of the sub-committee concerned. In submitting the report
for the year ended 31st December, 1909, attention was drawn to the great advance which had been
made during that year in the matter of the health of children in public elementary schools. That
advance has been well sustained during the year under review, owing in the main to the increased
frequency of medical inspections and the steady development of the Council's scheme for the provision
of medical treatment.
The scheme of medical inspection has passed, during the period under review, through a transitional
stage, the nature of which has to be borne in mind in considering statistics relative to the
results of inspection during the year. During the earlier half of the year the school inspections
included all the children in the school at the time of the doctor's visits. At a later stage the new
entrants, the children about to leave, and those between the ages of 8 and 9 years were examined. The
infants in these cases were only cursorily examined and medical record cards were not filled up in
respect of infants unless there was urgent need for treatment. At the inspections held towards the
end of the year, the new entrants, the children about to leave and those of between 8 and 9 years of
age were all inspected and medical record cards were filled in for all the cases. The examination of
children between the age of 8 and 9 years was in accord with the foreshadowing by the Board of
Education of the examination of a third "age-group" as a likely code requirement. In May, 1910,
the Board of Education expressed the opinion that the staff proposed was insufficient for the work to
be undertaken.
Naturally, the increased work undertaken has necessitated the augmentation of the medical
staff engaged upon the work. Beginning with 40 quarter-time doctors, in 1908, this staff has been
increased to 56 on 1st September, 1909, and to 72 on 1st September, 1910. The professional staff
employed at the end of 1910 numbered 84 doctors (70 men and 14 women) giving time equivalent to
the full-time of 24 medical officers. As from 1st January, 1911, this staff has been further increased
to 114 doctors (96 men and 18 women) giving time equivalent to the full time of 32 medical officers
The permanent staff at the end of 1910 comprised the medical officer (education), two assistant
medical officers (full-time), two assistant medical officers (half-time), seven assistant medical officers
(quarter-time), including specialists in mental, ophthalmic, aural, orthopaedic, and dental work, together
with 72 medical inspectors (quarter-time). This staff has been increased as from 1st January, 1911,
by two assistant medical officers (full time), and 28 medical inspectors (quarter-time).
The Council's arrangements made four years ago for carrying out the statutory duties imposed
by the Education (Administrative Provisions) Act, 1907, have now fully developed, and medical
inspection is completely organised in all the schools. The medical officer (education) is therefore
of opinion that the staff at present engaged will be sufficient to cope with the work and to comply with
the requirements of the Board of Education.
The following figures give a general idea of the results obtained during the year under review.
Of the children examined in full detail there were recorded in last year's report (1909) the results of
37,420 examinations, with 12,656 or 33 per cent. requiring medical treatment. These represented
chiefly children at all ages. Of the 172,619 children examined in 1910, and noted in detail, 52,954
or 32.6 per cent. received advice cards. The medical officer (education) states that the proportion
of children who will be selected by the doctors after careful examination and given advice cards can
now be fixed on the basis of the last two years as 65,610 out of 210,039, that is 32 per cent. or approximately
one-third of those examined.
Of the 172,619 children recorded, 81,151 were returned as normal, that is free from any definite
organic defect. Bad defects of vision or eye diseases were recorded in 18,923. Defects of throat or
nose were 29,927; of ears or hearing, 9,499; skin disease, 2,913, this includes 453 ringworm cases
found by the doctors, ringworm cases being generally excluded by the nurses. Other diseases were
recorded in 15,296 children.
It is pointed out that considerable importance attaches to the estimate of the state of nutrition
of individual children. This is usually done by ocular inspection, the general appearance of the child,
his person and carriage, expression, signs of activity or listlessness, colour of the face and of the lips,
roughness or otherwise of the skin, all being taken into consideration. The children so inspected are
classified under three main headings, viz., (i.) those in good condition, (ii.) those in moderate condition,
and (iii.) those in bad condition. The number falling under these headings during the year
1910 were 46.7 per cent. under (i.), 41.8 per cent. under (ii.), and 11.5 per cent. under (iii.), as
compared with 46 per cent., 41.2 per cent., and 12.8 per cent. in 1909.