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Children Out oj School for Long Periods. .
The arrangement has continued whereby the attendance branch of the Education Officer's depart
nient submits each month to the School Medical Officer medical certificates concerning all children out of
school for a period of three months on account of ill-health. The total number of children who were
thus reported as absent from school on the 1st November 1917 was 2,311, and the conditions from which
they were suffering were as follows:—Rheumatism, including heart disease and chorea, 285 (12.33
per cent.); nervous disorders, 209 (9.04 per cent.); tuberculosis, 465 (20.12 per cent.); anæmia and
debility, 207 (8.96 per cent.); ringworm, 142 (6.14 per cent.); other diseases, 961 (41.59 per cent.);
unsatisfactory certificates, 42 (1.82 per cent.).
It will be noted that whereas formerly the rheumatic group accounted for the greatest percentage
of the total number of children absent for long periods, the premier place is now taken by tuberculosis.
This is not due to any alteration in the incidence of the two groups of conditions but to the extended
care and attention now being given to tuberculosis, whereby a larger number of sufferers from this condition
are discovered and followed up. All cases of tuberculosis and epilepsy are still being registered,
and apparently unsatisfactory or doubtful conditions are being followed up, especially such conditions
as ringworm, scabies, and minor ailments.
Tuberculosis.
During 1917 authority was renewed for the use of 231 sanatorium and hospital beds for children
in voluntary institutions at the expense of the Council and for the acceptance of beds as available in
Metropolitan Asylums Board institutions. During the year 784 children were treated in residential
institutions. In addition, through the I.C.A.A., with financial assistance from the Council, some 400
beds were available.
Returns from 22 out of 27 local tuberculosis dispensaries show that upwards of 10,300 child
patients from babyhood to sixteen years of age were in attendance during the year; of these 7,590
including 3,839 boys and 3,751 girls were of compulsory school age.
A new development during the year has been the establishment of day sanatoria attached to
certain of the tuberculosis dispensaries. The work carried out under the tuberculosis scheme of the
Council is dealt with in detail in the general section (Part I.) of this report.
Open-air Schools.
The Council's open-air schools at Birley House and Shooter "s-hill have been continued, and
individual records of health and progress have been maintained. The arrangements for the medical
inspection of the children have been set out in previous reports. The records show that the improvement
of the children in general condition, mental and physical, has been well marked. The physical
measurements present the same features as in former years, demonstrating the immense benefit to
debilitated and anaemic children which accrues from an open-air education accompanied by generous
and wise feeding. The majority of those in attendance are children in whom the onset of tuberculosis
was feared, or children returned from sanatorium treatment with the disease in an arrested state.
Further co-ordination of the work of the schools with that of the tuberculosis dispensaries has been
effected during the year with advantage to the children.
At Birley House school, improvement, in many instances great, was recorded in 101 out of the
103 children in attendance, and similar good results are evidenced by the school doctor's detailed reports
upon individual children in the case of Shooter's-lxill school.
The school has been under the regular supervision of Dr. R. S. Walker, who is also the medical
officer of the Paddington Tuberculosis Dispensary, from which the children are drawn. The number
of children on the roll on 1st January was 105 and on 31st December 91—the average for the year was
100. There was a marked variation in the average attendance from month to month, the lowest being
71 in December and the highest 84 in February. During the year 47 children left the school; of these
19 returned to ordinary elementary schools, 12 were excused further attendance after attaining the age
of 14 years, 9 left the district, 5 were excluded by the medical officer on medical grounds, 1 went to a
sanatorium and 1 to Greenwich Hospital. 35 children were referred for treatment—dental treatment,
20; throat treatment, 3; defective vision, 4; defective hearing, 2; ringworm, 1; whooping cough, 2;
diphtheria, 1; measles, 1; scabies, 1.
Careful measurements were taken, and it was reported that children who attended the whole
year gained considerably in weight.
Play-ground, Classes.
During the year two classes of type "A" 38 of type "C," and 16 of type "D" were conducted.
Particulars in regard to these different types have been set out in previous reports. Of the 56 classes,
16 were held in parks or open spaces and the remainder in school play-grounds; 5 were discontinued
before the summer holidays. Detailed reports have been received from assistant medical officers upon
24 of the classes. As in former years, it was found that the children placed in classes of type "C"
generally contained a larger percentage of those who are delicate or dull or backward than is to be found
in the remaining classes of the school. This has to be borne in mind when comparisons are made
between the progress physically and mentally of the children in the play-ground classes and those
remaining in the ordinary classrooms. The universal testimony of the doctors is that the general
improvement in colour and nutrition amply confirms the value of the arrangements made, and that
the open-air life is a deciding factor in producing physical and mental alertness in these particular
children. Reference to the happier, brighter and more ready response to all stimuli are found in all
Kensal
House
School.