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Report of the County Medical Officer—Education.
139
divisional medical officer, who is instructed to visit all the centres in his district and to report
periodically upon the working of the arrangements.
The selection of the premises to be used as school treatment centres is the subject of careful
inquiry as to position, arrangement, equipment, and maintenance. The premises, moreover, as well
as the arrangements for treatment must be approved by the Board of Education. Generally, a private
house is used, sometimes an existing dispensary, sometimes a nurses home. Each centre should be
readily accessible from the neighbourhood of the schools which it serves, and though London is on
the whole well provided with the means of transit, there are limitations in this respect in certain
parts of the county. Reference to the map included in this report will show that the schools north
of the river are now fairly well provided for in the matter of hospitals and centres, but south of the
river there are gaps, and some difficult journeys are involved. Gradually, however, the lacunae are
being filled, and when the new centres now contemplated are established, the marked difference
between north and south will be materially diminished (see Diagram C).
In illustration of the character of the constituent units of the Council's medical treatment
scheme the following notes on the several hospitals and centres, with which arrangements were made
in 1913, may be of interest.
(1) Belgrave Hospital for Children, Clapham Road, S. W.—Provision has been made at this
hospital for the treatment of 500 eye cases, and 500 ear, nose, and throat cases a year. The Council's
cases are dealt with in the afternoons when, as a rule, no other patients are in attendance. The
children are received in an attractive waiting room and here particulars relating to the case are
entered in a special register. It is insisted upon that children shall be accompanied by an adult
person whenever possible; in default of this, one of the Council's organisers is present during the
treatment of the child, and receives the necessary instructions for the parent.
Arrangements are made for nurses to visit the homes at the surgeon's request, and nurses are
sent to the homes after operation in all cases. Children are prepared for operation in a small room
opening from the waiting room; they are then taken with their parents to the dispensary from
which direct access is obtained to the operating theatre. After the operation the child is placed on a
mattress in the recovery room, and attended by a nurse until the surgeon is satisfied that the patient
is fit to return home.
(2) Charing Cross Hospital.—The arrangement between the Council and the governing body
of this hospital provides for the treatment of 250 eye cases, 500 ear, nose and throat cases, and 70
ringworm cases a year. There has not always been a full attendance of ear, nose and throat cases,
but it has been deemed desirable to retain the existing numbers, as this hospital, owing to its
central and easily accessible position, is very useful for dealing with cases from outlying districts
when other centres are full. The children are received in the ordinary out-patients' hall, where they
are, however, kept apart from other patients. In the aural department no other patients are seen
at the special times arranged for dealing with children referred to the hospital by the Council. In
the event of a child requiring operation appearing delicate or neglected, the surgeon obtains through
the school care committee a report on the home circumstances before making an appointment for
the operation. When the appointment is made special attention is given to the general health of
the child, and the person in charge is given printed instructions as to the preparation for the operation
and as to the care of the child after the operation. The attendance of the parent is not insisted upon,
but the attendance of a responsible adult is required on the day of the operation.
This hospital is within the district of the Westminster Health Society, which has a special
organisation for attending to matters concerning the health of children in its district, and it has been
arranged for nurses to visit the homes of all children operated upon and to carry out home nursing of
children when necessary. Children in other districts are dealt with through local nursing associations.
(3.) Deptford Children's Health Centre, George Street, Deptford Green.—This centre was
established by Miss Margaret McMillan in June, 1910, and at first was supported entirely by voluntary
subscriptions. Since October of the same year the Council has given financial assistance in respect
of dental treatment, and since January, 1912, in respect of medical treatment also. In addition to
ailments for which the Council makes provision, the centre also deals with general ailments such as
anaemia and debility, and at a branch centre known as the "Evelyn Medical Home" breathing
exercises, massage, and treatment for spinal curvature are carried out. Cases under the Council's
scheme requiring operations for enlarged tonsils and adenoids are also treated at this Home.
The health centre in George Street consists of two rooms only, in which, with the exceptions
mentioned, all the treatment is carried out, One room on the ground floor is used largely as a
waiting and play room. The room above is that which is used principally for treatment, and here
it often happens that several children are being dealt with for different ailments at the same time.
Moreover, apart from the Council's work, the treatment of children under school age is also carried
on here.
The Home in Evelyn Street, besides being used as a centre for all operations under the
Council's scheme other than dental, is used for remedial exercises, and has been adapted as a night
camp for girls, the garden at the rear being used for this purpose, and on an adjoining open space an
open air school is held.
The agreement with the Council now provides for the treatment of 440 eye cases, 880 ear,
nose, and throat cases, 3,520 dental cases, and 660 nursing treatment cases a year. The attendance
of the children is very good. Miss MacMillan not only treats children for the specific ailment for
which they are referred, but attempts to make the centre an agency by which their general health
and well being is supervised. There is no doubt that the centre exercises an influence in the
neighbourhood of a remarkable kind, and its beneficial results are evident in the neatness, cleanliness,
and manners of the children who attend.
(4) Fulham Treatment Centre, 18 and 20, Bagley's Lane, Walham Green, S.W.—This centre was
opened for dental treatment by Mrs. G. M. Trevelyan in June, 1912, and extended to provide medical
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