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103
Annual Report of the London County Council, 1913.
(b) The investigation of infectious diseases in the schools was already in part carried out by the
school doctors, but difficulty was experienced in making all the investigations considered advisable.
In the new organisation of the work provision has been made for more complete investigation of this kind.
(c) The medical inspection of children in secondary schools, and special schools, and of scholarship
candidates was carried out by a separate staff consisting of five full-time officers and two part-time
officers. It was provided by rearrangement of duties that a considerable portion of the work of this
staff should be carried out by the school doctors in the various districts, thus relieving the
officers of a higher grade of certain duties of a purely routine nature and setting them free to deal with
cases which require special investigation. It was borne in mind, moreover, that under the Mental
Deficiency Act, 1913, a number of difficult cases must arise, and unless some such rearrangement of
duties as that above outlined had been carried out, it would have been impossible for the staff to deal
with the new work.
(d) and (e) Research and laboratory work and administration.—Arrangements have been made
whereby each permanent whole time school doctor attends the central office periodically in order to
obtain an insight into details of administration. Time is also allowed for research and laboratory
work, and opportunity is afforded for studying the methods of the medical officers engaged upon
special work arising out of the school medical service.
Medical Inspection.
The Board of Education's regulations under the Education (Administrative Provisions) Act,
1907, place upon Local Authorities the duty of providing for the examination of children on
entering school life and again just prior to leaving school, and the tables appended to this report
show the details of the inspection of London elementary school children in the form prescribed in
the Board's schedule. The schools are grouped in metropolitan boroughs. In addition to the age
groups prescribed by the Board the Council has voluntarily made provision for the inspection of an
intermediate age-group, and the results of this inspection are also given in the Appendix.
In the year 1913 the Council further decided to extend the inspection of the age-groups to
the special schools for Deaf, Blind and Mentally Defective children, and particulars as to the general
physical condition of children in these schools are, therefore, also shown for this year, but as the
figures are small they are given for London as a whole.
The work of inspection during the year 1913 was carried out by a staff of 30 full time
doctors and 6 quarter-time doctors, working under the direction of 4 divisional medical officers.
Under this system it has been possible to exercise closer supervision over the work and by this means
to bring about a greater degree of uniformity in the standards adopted by the school doctors in their
routine inspections. The doctors were assisted in their work by a staff of 90 nurses, who prepare the
children for examination and assist in the weighing, measuring and vision testing. Arrangements are
made whereby some of the children in each school are inspected each term, so that the school doctor
visits each school, however small, in his district at least once a term, and opportunities are thus afforded
for any special cases in other age-groups to be brought to his notice. The date of the inspections at
all schools is advertised in the Council's Gazette, and the parents of children due for examination are
invited to be present. A representative of the School Care Committee is also invited to be at the
school at the time of the examination in order to make arrangements to secure that where necessary
the child receives medical treatment. Where a child is found to be in need of treatment an advice
card is issued to the parent. If the parent be not present at the inspection the school nurse visits
the home and delivers the card to the parent.
The scheme of inspection hitherto pursued is as follows. During the first term of the year
"leavers" are examined, The term "leavers" is taken to mean children who during the year reach
the age of 12 years, i.e., for the year 1913 this group comprised all children born during the year
1901. The advantage of adopting this plan lies in the fact that any children who may be found
defective and in need of treatment are kept under supervision during the remainder of their school
life, whereas if they were examined at a time nearer the leaving age many of them would have left
school without securing treatment and the following up of such cases would be impossible.
During the second term the inspection is mainly devoted to examination of entrants—that is,
children entering school life or children who have not hitherto been inspected at the present or at
a former school. The age of entrants varies considerably but the vast majority are under six years of age.

During the third term of the year inspection relates to the examination of outstanding cases
in the entrant and leaver groups and, in addition, to the examination of children reaching
the age of eight during the year—i.e., for 1913, children born during the year 1905. The inspection
of this intermediate group has not hitherto been required in the Code issued by the Board of
Education, but the Board have now intimated to local authorities that they will require the
examination of an intermediate age group in the year commencing April, 1915.
Although in some respects convenient, the method of dealing with a separate age group in each
term has certain grave disadvantages; chief amongst those is the alternation of periods of-pressure