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London County Council 1912

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

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120
Annual Report of the London County Council, 1912.
CHAPTER XXXIII.
REPORT OF THE COUNTY MEDICAL OFFICER OF HEALTH AND SCHOOL MEDICAL
OFFICER (Dr. W. H. Hamer) FOR THE YEAR 1912.
Part II.—Education.
Introductory Note.
On 25th July, 1911, the Council resolved that the whole of the school medical work, including
the organisation and administration of medical inspection and treatment of children, should be placed
under the direction of the Medical Officer of Health of the County of London. The resolution of the
Council thus combined the duties of medical officer of health with those of school medical officer, and
took effect from 1st January, 1912. As the result of this decision the public health department has
during the year been re-organised, and many changes in administration have been effected. Special
attention has been directed to the co-ordination of medical inspection and treatment, "following-up,"
the control of infectious disease, and the increase of facilities for the cleansing of school children
found to be verminous.
Inspection
and
treatment.
The need for co-ordination of medical inspection and treatment had been especially felt owing
to changes brought about by the passing of the Education (Administrative Provisions) Act, 1907.
Section 13 (i.) b of this Act imposed upon local education authorities as from 1st January, 1908, the duty
of providing for the medical inspection of children on admission to a public elementary school, and on
such other occasions as the Board of Education may direct. This duty was compulsory, but the section
foreshadowed further developments by giving power to make arrangements for attending to the health
and physical condition of the children. A beginning as regards inspection had been made in 1889
when the late London School Board appointed a part-time medical officer, generally to advise the
Board on medical matters, and to examine candidates for permanent appointments. Owing to
increase of Work arising out of the Elementary Education (Blind and Deaf Children) Act, 1893,
the Board in 1898 appointed two doctors to give half their time to this duty. In 1902, Dr. James
Kerr was appointed as medical officer to the Board. Later eight oculists were engaged to devote
200 school sessions each to testing children's eyes, and a ringworm nurse was transferred to the
department. On 1st May, 1904, the London County Council assumed control of the work hitherto
carried out by the London School Board. The school medical staff then consisted of one medical
officer, one assistant medical officer (whole-time), one half-time and two quarter-time. There were
also six oculists and six ringworm nurses.
In 1905, a scheme was prepared for dealing with the general condition of the scholars, the control
of infectious disease, the promotion of cleanliness, school hygiene, and the sanitary condition of school
buildings. To carry out this work a permanent half-time assistant, and twenty quarter-time temporary
assistants were appointed in place of the six oculists. For dealing with ringworm and personal cleanliness
a superintendent and twenty-six nurses were added to the staff. The general routine was for the medical
inspector to visit the school and see the classes at work, take note of all hygienic matters, and examine
the children presented by the teachers as defective. During the year ended 31st March, 1907, as many
as 20,110 children had been examined at the routine inspections, and, of these, 6,271 were found to
require urgent treatment. These figures are interesting for the sake of comparison, and as illustrative
of the growth of the work in more recent years. For instance, in the year ended 31st July, 1912, nearly
260,000 children were examined, and treatment was actually provided by the Council for nearly 28,000.
Medical
treatment.
The detailed inspection required by the Education (Administrative Provisions) Act, 1907, and
carried out in accordance with the Code and Memoranda issued by the Board of Education was begun
in March, 1909. This work necessitated a considerable augmentation of the medical staff, and at the
end of that year 56 men and 12 Women giving time equivalent to the whole time of 19 medical officers
were employed by the Council. About this time, too, the inadequacy of the existing arrangements for
treatment was brought into prominence. With the inauguration of a scheme of medical inspection
it soon became evident that there was need for further facilities for treatment of some of the
ailments discovered. As the result of inspection the numbers of children attenoing the hospitals
were so seriously increased that many of the larger hospitals were compelled to limit the attendance
for school children to certain numbers of children to be seen on any appointed day. Thus,
the London Hospital set apart one day a week, and limited the number of children to 15. The Great
Northern Hospital made provision for the attendance of ten children a week. Complaints were also
received from the Victoria Hospital for Children, and the Royal London Ophthalmic Hospital as to the
very great difficulty in dealing with the numbers of children received. It was evident, therefore, that
the time had arrived for more efficient co-ordination of inspection and treatment, and that the facilities
for treatment should be materially increased. The story of the growth of the Council's treatment scheme
is outlined in the following report, and it will be sufficient here to mention that beginning in January,
1910, by agreement with six hospitals, the Council had at the end of 1912 made arrangements with 11
hospitals and 17 treatment centres for the treatment of 54,208 children suffering from diseases of the eye,
ear. nose and throat, from ringworm and from minor ailments.
Dental
treatment.
The Council's dental scheme may be said to date from January, 1910, when advantage was taken
of the offer of Dr. R. A. Kirby to provide dental treatment free of charge at St. George's Dispensary,
Blackfriars-road, for a period of one year. In order that the utmost benefit should be derived from