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63,423 were found still to be in need of treatment or observation, and were scheduled for further reinspection
two terms later; 59,631 children due for second re-inspections were reported upon; 9,431
were reported removed, of the remainder, 16,155 were reported cured, and 34,045 were still in need
of treatment or observation. Moreover, 29,788 cases marked for observation, owing to doubtful
signs of illness, were reported upon; of these, 10,868 were discharged, and 18,920 were scheduled for
further observation.
Appendix IV. gives the detailed results of re-inspection under the headings of various ailments.
Of the 108,257 cases seen at first re-inspections, 45,152 were found to have sought treatment within
six months—i.e., 41.7 per cent., as compared with 42.3 per cent, in 1915, and 49.6 per cent, in 1914.
Of the 51,588 cases seen at second re-inspections—i.e., those who had not sought treatment
or had not been discharged as cured within six months after primary inspection, 16,170, or 31.3 per
cent, were found to have sought treatment by the end of 12 months, compared with 34.6 per cent, in
1915, and 43.1 per cent, in 1914.
These figures show that owing to the diminution of voluntary help for following up, and to the
pre-occupation of the parents with other matters, there has been a falling off in the proportion of children
obtaining treatment, but that the falling off occurred chief!v between 1914 and 1915.
Children
showing
errors of
refraction.
Of children seeking treatment for defective vision, 77 per cent, obtained it through institutions
included in the Council's scheme. The percentage is higher than ever recorded before, and this is
due to the fact that hospitals outside the Council's scheme have been obliged, owing to other and urgent
calls upon them, to reduce facilities for the examination of school children for refractive errors. 50 per
cent, of the children referred for errors of refraction came under treatment within six months, and
70 per cent, within 12 months of the discoverv of the defect.
Children
requiring
nursing
treatment.
Of children found at statutory inspections to require nursing treatment for "minor ailments"
including sores, inflammation of the eyes, running ears, etc., a little more than 50 per cent, had sought
treatment within 6 months, and 70 per cent, within 12 months. 56.4 per cent, of those seeking relief
obtained it at the nursing treatment centres established bv the Council.
Children
requiring
treatment for
defects of
ear, nose and
throat.
Children
requiring
dental
treatment.
Children
with other
ailments.
35 per cent, only of the children referred for defects of the ear, nose, and throat, obtained treatment
within 6 months, and 52 per cent, within 12 months. 60 per cent, of those treated were attended to
at centres or hospitals, with which the Council has arrangements—the remaining 40 per cent, obtaining
relief elsewhere.
Of the children in the age groups recommended for treatment for defective teeth, 39 per cent,
obtained treatment within 6 months, and 56 per cent, within 1-2 months. 63 per cent, of those treated
obtained it under the Council's scheme.
With regard to other ailments, including all those for which the Council has not made provision,
such as organic diseases of the heart and lungs, 35 per cent, of the children referred had commenced
to receive treatment within 6 months, and 54 per cent, within 12 months.
" Leakage.''
The greatest amount of "leakage," therefore, took place amongst children requiring treatment
for defects of ear, nose, and throat. The great majority of these require operation for enlarged tonsils
and adenoid growths. The Council has recognised that in cases involving an operation, the same amount
of pressure cannot be applied as in other cases, and no doubt the fear of operation is a great factor
explaining the comparatively greater amount of "leakage" in these conditions. With regard to the
results of re-inspection of children found to have defective teeth, it must be remembered that we are
here dealing not merely with children in the special age groups (6 to 8 years), for which the Council's
arrangements, as sanctioned by the Board of Education, are primarily designed, but with the whole
of the children seen by the school doctors, including those aged 12. For the latter there is admittedly
at present a want of facilities for treatment in London, and, under these circumstances, the fact that
63 per cent, obtain treatment within a year represents a considerable achievement, as the result of
"followinff-up."
Discharging
ears.
The Board of Education, on 24th June, 1913, in reviewing the arrangements for the medical
inspection and treatment of children in London, stated that, having regard to the fact that a certain
proportion of the cases of discharging ears were of a serious nature, it seemed desirable, with a view
to ensuring adequate treatment, that facilities should be provided for an examination by an expert
aural surgeon where that appeared to be necessary. With regard to this suggestion, the Council (2nd
July, 1914) replied to the Board that careful consideration had been given to this question, and that
it was intended that provision should be made for certain of the school doctors who had had exceptional
experience, to pay attention to this side of the work. During 1915, a special inspection centre for
ear cases was arranged at Paradise-road, Stockwell, under the supervision of Dr. A. G. Wells, one of the
Council's assistant medical officers. The work done at this centre has greatly improved the following up
of chronic ear cases, in the neighbourhood served by the centre.
The divisional treatment organiser in the North-Western division has devoted a very great
amount of care and attention to the minute following up and indexing of ear cases. During the period
April, 1915, to August, 1916, 2,760 notifications were received from nurses and head teachers. In many
instances, single cases were notified from several sources, and chronic cases have been repeatedly
notified, the actual number of individual children concerned being 1,266. All these cases were referred
to the care committees for arrangements to be made for treatment. 350 detailed reports were received
in reply, as well as a large number of applications for vouchers for the aural departments of hospitals
and centres. The cases have been most carefully followed up, and considerable trouble has been taken
by honorary secretaries of care committees to get the children quickly under treatment. The record
obtained up to the present shows that, of the 1,266 cases, 952 are being dealt with by care committees,
at least 112 of these being cases of long-standing difficulty, and 314 have been satisfactorily treated,
the ailment being cured or in abeyance, or non-existent.