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126
Annual Report of the London County Council, 1910
employment of such part time officers. Again the surroundings of the medical inspection often
condition its completeness. The draughts of a corridor will not permit of the same thoroughness as an
examination in a teachers' room. Until the autumn of 1910 the medical inspection was so organised
that there was latitude for special enquiries allowed to the inspectors, and leakage was avoided in the
work. As each school came in turn to be inspected at the first visit the doctor and head teacher
arranged locally for the subsequent visits at the most convenient times. Experience showed
that this method gave the doctors a considerable interest in the work and that they averaged an
excess of time spent in school over that due by them to the Council's service, besides writing extensive
reports on many subjects of interest on which they made enquiries. It was probably these different
methods, and a misunderstanding of this last arrangement, which gave rise to the criticism
formerly applied to the medical inspection done by the part time school doctors.
In the autumn it was suggested that fixed examination hours, if advertised some time before,
would enable the care committees to make certain arrangements, and a rota was drawn up so that there
could be no variation from the announced times, and no inspections were to be made except at these
times, with the result that the doctors work at their allotted times only, and confine their work almost
entirely to routine inspection.
As the inspection is now carried out the days and times when the doctors will visit the schools
for the purposes of medical inspection are published each week in the London County Council Gazette.
The doctors are instructed that as the parents or guardians of the children about to be examined
are invited to attend the school these times must be adhered to strictly. For this purpose all the
schools are visited once each term, the doctors have three fixed half-days (9.30 a.m. to 12 or 2.15 p.m.
to 4.30 p.m.) weekly. The nurse arrives before the doctor to see that all is in readiness. She arranges
the children and their record cards in order for examination, assists in dressing and undressing, and
in testing vision, weighing and measuring. She also discusses the history of the child with the parents,
and enters particulars of infectious disease on the cards. After the children are seen details are
entered in the medical register at the school, and a form giving particulars of the inspection,
numbers of children seen, defects noted and recommended for treatment, is transmitted to the head
office. During the year 1911 the doctor inspects the entrants in the infants' school, the children born
in 1903, that is the 8-9 age group, and those born in 1899 ; this last represents the group of leavers.
Children of other ages are also examined by the doctor if he thinks fit, and any selected by the
managers, care committee, teachers or nurses may be submitted as in urgent need of medical attention.
The Model Schedule of the Board of Education is taken as indicating the scope of the inspection, but the
returns hitherto have been noted on a simpler card to save clerical work. Where a child is in need of
medical treatment this is explained to the parent, and an advice card is distributed, or if a parent
is not present, the card is delivered later by the school nurse at the home. No individual is examined
by a doctor alone, and undue privacy is always avoided. The inspection, and, indeed, all medical
examinations are of a confidential nature, and as it is impossible to examine the children properly or
to obtain the necessary information in regard to family history when strangers are present, no one except
those qualified to aid the doctor, namely, the parent, teacher and nurse, is allowed at the medical
inspection. This does not preclude a member of the School Care Committee being in the school and
conferring with a doctor either before or after, but not during an examination.
These medical inspections are not deemed sufficient for special school purposes and do not conform
to the requirements of the Education (Defective and Epileptic Children) Act, 1899, so that doctors
are instructed to advise the head teachers to nominate on forms prepared for the purpose all children who
might require further examination as suitable for deaf, blind, mentally defective, invalid or other special
schools.
The objections to medical inspection are very few and appear to become fewer with time.
Where objection is made either no action is taken or a record card is sent to the parent with an intimation
that if this is filled up by their own medical attendant and returned to school that will be
sufficient. So long as only one or two parents in a district object they can be neglected. In the
Hampstead district at the end of the year numbers of letters came in from parents objecting to
medical inspection on the ground that their children had already been seen by other doctors. It was
evident from the similarity of the letters that they were the outcome of some organized arrangement.
Enquiries were made and it was found that the Hampstead Council of Social Welfare were arranging
to inspect annually the children connected with their dispensary, some 2,000 in number. Any extensive
action of this sort would seriously diminish the value of the school work, and if the number of objectors
to medical inspection became other than negligible it would probably be necessary to obtain powers to
make the examination compulsory. Objections are raised more frequently to inspections of children
by the nurses, but there the course is quite clear, for under both Section 36 of the London County Council
(General Powers) Act, 1907, and Section 122 of the Children Act, 1908, the medical officer or any person
provided with the authority in writing of the medical officer "may in any school within the county
provided or maintained by the County Council as the local education authority examine the person
or clothing of any child attending such school."
In analysing the statistical returns of the medical inspection done during 1910, they may be
arranged in three categories, but at the same time it is to be remembered that inspection only attained
its full development with the appointment of the third instalment of the staff who began work in
September, 1910. The three categories under which medical inspection is arranged are—
(a) 140 schools, examined under the "old" scheme. All the children in the school
were examined. This took place during the earlier half of the year, and was necessary to
keep the treatment arrangements going.