London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1913

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

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148
Annual Report of the London County Council, 1913.
obtained treatment, the net result being that 56.9 per cent. obtained treatment, and of these in 87.5
per cent. of the cases the result was considered satisfactory.
It is to be noted that a somewhat higher proportion of ear, nose, and throat cases remains
untreated than of cases of defective vision. The repugnance to operation entertained by many parents
no doubt accounts for this.
An examination of the figures given in Appendix VII shows that on the whole more satisfactory
results were obtained in the cases dealt with under the Council's arrangements than in those obtaining
treatment through other channels; the percentage of cases which discontinued treatment before being
remedied, or which from other causes remained uncured, being only 5.8 in the case of centres with which
the Council had agreements, as opposed to 9.9 at other hospitals and 25.1 among those treated by a private
practitioner. The close connection kept up between the care committees and the treatment centres,
or hospitals, through the Council's organisers, provides a machinery whereby cases are followed up
during treatment, and successive visits to the centre until treatment is complete are in this way assured
in the majority of cases.
Dental treatment,.—The cases reinspected which had been referred by school doctors as
requiring treatment for dental caries amounted to 29,833. Of these 9,912, or 33.2 per cent., were
found to be treated, leaving 19,921, or 66.8 per cent., untreated ; at the second reinspection treatment
was found to have been obtained in 32.3 per cent. of outstanding cases. The amount of leakage in
the case of teeth is greater than in the case of any other form of defect, as only 49.7 per cent.
of those referred, or slightly less than half, obtained treatment. Only 39.6 per cent. of those treated
obtained it through the Council's agency.
It must be remembered, however, that the arrangements made by the Council do not extend
to children above the age of nine, and that in effect facilities do not exist for dental treatment of
children over this age. The figures here dealt with relate to children found at medical inspections,
and are quite distinct from the figures of the special dental inspections carried out amongst children
aged 6 to 8 in connection with the dental treatment centres. The workers on the care committee often
make complaint because of the refusal to receive the older children at the dental centres. It has
been necessary, however, rigidly to observe the rule that only in special cases can children older than
8 be admitted for treatment. Whenever disproportionate numbers of older children have been given
such facilities, it has inevitably resulted in the work at the centres becoming disorganised owing to the
accumulation of cases requiring anaesthetics. Exceptions when made are generally in favour of
children on whom the throat surgeon is unable to operate, until the mouth has been placed in a cleanly
condition, and of children whose certificate for fitness to hold a scholarship is being withheld until
treatment for oral sepsis has been carried out.
Minor ailments.—Reinspections were held of 7,770 cases which had been reported as requiring
nursing treatment; 5,032, or 64.8 per cent., were found to have obtained treatment; 45.9 per cent.
of these were treated at the institutions maintained by the Council, 21.1 per cent. by private
practitioners and 33 per cent, through other agencies. 64*3 per cent, of cases outstanding from
first reinspections had obtained treatment on the second reinspection.
Other ailments.—Of conditions for which the Council makes no special arrangements, 12,435
cases were reinspected; of these 6,225, or precisely 50 per cent., were found to have obtained treatment.
Of the outstanding cases the percentage obtaining treatment before the second reinspection was 55 6
per cent.
The total numbers of defects requiring treatment under revision during the year amounted to
82,736; of these 37,645 or 45.5 per cent. were found at the first reinspection to have been treated;
and in 25,258 cases, 67.1 per cent. of those treated or 30.5 per cent. of all defects referred, the report
was made that the treatment was complete and satisfactory. From the records of reinspection during
the year it was found that 58.1 per cent. of defects had been treated, and in 80.9 per cent. of these, or
4.7 per cent. of all defects referred, it was reported that the treatment was complete and satisfactory.
The percentage of defects which had not been treated and still found to be requiring treatment
at the second reinspection was 24.9 per cent., and of those which had been treated 10 per
cent. were found to have discontinued attendance before treatment was complete or remained from
other causes uncured.

T he reinspection figures tor each successive term shew a steady increase in the proportion ot children taking advantage of the arrangements for treatment made by the Council with hospitals and treatment centres as indicated in the following table, giving, in the case of all defects treated, the percentage which obtained treatment through the Council's scheme:—

Date of reinspection.Refractions.Minor ailments.Ear, nose and throat conditions.Dental cases.
Christmas term, 191268.028.241.324.7
Spring term, 191369.437.553.737.9
Summer term, 191372.644.757.535.8
Christmas term, 191373.851.458.845.6

In the appendices are given tables showing under the various county electoral areas the results
of the school doctors' reinspections of children found suffering from defects for which provision is
made under the Council's scheme. Considerable variations are found in the areas in the percentages of
children who thus obtain treatment. These variations depend partly upon the facilities for treatment
provided in each locality, but to a greater extent upon the ease with which voluntary workers can be
obtained to serve upon the care committees. At the first reinspection the average percentage, for