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121
Report of the County Medical Officer—Education.
this offer a scheme was devised by the assistant medical officer who advises on dental matters, and
it is from this scheme that the subsequent dental treatment organisation has been developed.
Besides voluntary lantern lectures to children and parents the neighbourhood was thoroughly
worked up with the result that to-day St. George's Dispensary is one of the most popular of the dental
treatment centres.
In order to obtain the necessary attendance of children at the other centres it was found necessary
to appoint "dental inspectors," as the purely medical inspection did not cover the age group of
children amongst whom cases suitable for conservative treatment are more especially to be found.
The appointment of dental inspectors has been of great benefit, as, in addition to their work of
inspection, the last half-hour of their time is devoted to advising the parents who have been assembled
for the purpose. By this means their co-operation and interest is obtained in regard to the teeth of
the children, and thus the endeavour is made to minimise the incidence of dental disease and bring
about the ideal of combining preventive with curative dental treatment.
At the end of 1912 arrangements had been made for the treatment of 18,850 dental cases per
annum. The total number of dentists devote each Week 49½ sessions of 2½ hours to treatment, and
each fortnight 13½ sessions to inspection in the schools combined with the work of advising the
parents on the subject of the care of their children's teeth.
Government
grant.
During the financial year, 1912-13, the State has recognised the claims of local authorities for
grants towards the expenses of the medical treatment of school children and services ancillary thereto,
and a sum of £60,000 was placed on the Government education estimates for this purpose. Regulations
on the subject were issued by the Board of Education in April, 1912, and specified the conditions Under
which grants would be made (1) in respect of the medical treatment of children attending elementary
schools and work ancillary to medical treatment, and (2) in respect of the medical treatment and care
of children suffering from tuberculosis or from ailments for which open-air treatment is specially suitable.
No grant was allowed in respect of routine medical inspection, but the Board stated that, in determining
the amount of grant for treatment and work associated with treatment they would have regard to the
character and completeness of the arrangements and the degrees of efficiency with which the routine
inspection was carried out. The Board gave no indication as to the scale on which payment of grant
would be made, but the amount actually paid for the work carried out in London under part (1) for the
year ended 31st July, 1912, was £12,958 8s. 10d. This represents about 58 per cent. of the expenditure
on the work of medical treatment.
Developments
during
year.
The resolution of the Council of 25th July, 1911, which had for its object the combination under
one head of the Council's public health administration, the school medical service, and the arrangements'
for the medical treatment of elementary school children, has necessitated a reorganisation of the Public
Health Department. Reference to the following report will show that much has been accomplished
but much remains to be done, and the changes here briefly detailed merely indicate the progress made
in the year under review.
In March, 1912, an experiment was made in the East End of London with a view to the replacement
of the part-time school doctors, hitherto employed, by whole-time officers under the control of a
divisional medical officer. In consequence of the experience gained the principle was applied from 26th
August to the whole county, and four divisions were defined. In addition to the whole-time officer in
charge of each division there are in the north-eastern division ten, in the north-western seven, in the
south-western seven, and in the south-eastern six school doctors. Four quarter-time officers are also
employed, and their services are distributed over the four divisions. At the end of the year the school
medical staff consisted of 65 officers, including the school medical officer, who is also medical officer of
health, a deputy medical officer, a medical research officer, six full-time medical officers, twelve
part-time assistant medical officers, thirty-three full-time medical assistants, four part-time medical
assistants, and seven part-time inspecting dentists. Two of the full-time assistant medical officers are
engaged at the head office in the supervision of the work of medical inspection, the investigation of
epidemics and other medical problems in connection with elementary schools, and three carry out special
duties in regard to special schools, higher education, home nursing, first aid, etc. The twelve parttime
medical officers devote their time to special schools, secondary schools, ophthalmic, aural, orthopaedic,
tuberculosis, and dental work. Twelve of the medical officers and school doctors are women.
Concurrently with the reorganisation of the medical staff, the duties of the nursing staff have
also been rearranged and extended. At the end of the year the staff consisted of one superintendent of
nurses, six assistant superintendents, and 122 nurses. Four of the assistant superintendents of nurses
are provided with accommodation at the offices of the divisional medical officers, and each supervises
the work of the nurses in her own district. Ninety nurses assist in medical inspection in the schools,
22 supervise the work of cleansing verminous children and ten nurses are attached to the treatment
centres.
" Following
up."
In dealing with the question of staff, some reference should be made to the Council's Care Committee
system, and generally to the question of "following up," to which much attention has been given by the
Council during the past year. Care committees were originally formed in 1907 in connection with the
feeding of necessitous children. As reconstituted in 1909, their duties were extended to include arrangements
with regard to medical treatment, home visiting and after-care. The members of care committees
are voluntary workers appointed according to specified rules by the Children's Care (Central) Sub-Committee
of the Council, and a committee is appointed for each school except in the case of very small
schools, which are grouped. In order to standardise the work, and insure co-ordination, 27 local organisations
have been formed, the representation including members of school care committees, teachcrs'
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