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23
REPORT OF THE SCHOOL MEDICAL OFFICER (Dr. W. H. HAMER) FOR THE
YEAR 1918.
PART II.—EDUCATION.
Introductory Note.
The comparison
of town
and country
children.
The wonderful years, as they have been termed, of the war, having extended over 1,560 days,
came to a close with the armistice on the 11th November, 1918. The " most wonderful year," it
has been said, was 1914, when the country, after persistently and earnestly fighting for peace, pledged
itself to carry out its obligations and entered upon the war; but the year 1918 was " wonderful also
for the material victory by which this vow was accomplished." Incidentally, it may be noted that an
outward sign of material victory, so far as school medical work throughout the country is concerned,
is to be seen in the Education Act, 1918. Already prior to, and during the years of war, however, something
material had been accomplished in London, as will be realised on referring to the Annual Report
for 1917 of the Chief Medical Officer of the Board of Education. The results of a typical medical inspection
carried out by Dr. C. J. Thomas with the help of Dr. R. H. Norman, " by the courtesy and good
offices of the authorities of the London County Council," are set out in that report and described by
Sir George Newman as " of exceptional value and extraordinary interest," and likely to be " studied
with care in town and country throughout the kingdom." The main conclusions reached by Dr.
Thomas (pp. 29 and 30 of Sir George Newman's report) bring to light differences between the London
and country children " due in the main to the facilities of treatment, cleansing and supervision
provided by the London County Council, which are not similarly available for the country children."
The "substantial evidence of the value of organised medical treatment" thus supplied by Dr.
Thomas was based upon the favourable position of the town children as regards sound dentition,
absence of affections of the nose and throat, and freedom from vermin; these results, which it should
be noted were recorded during the final stages of the war, were set out in abstract in the "London
County Council Gazette " for the information and encouragement of members of the school care
committees and the teachers and officers of the Council. It should be added that an important share in
bringing about the results must be ascribed to the steady work during several years past, of the committees
with which the Council had made agreements under its treatment scheme, and of the medical
men and dentists concerned.
The numerous difficulties, mainly arising directly out of the war, encountered during recent years
in connection with the scheme—the shortage of doctors, nurses, organisers and voluntary workers, the
numerous changes of personnel, the claims made that the school organisation or parts of that organisation
should be commandeered for other uses—all these have been set out in previous annual reports ;
it is, perhaps, needless to say that the year 1918 brought with it intensification of many of these difficulties.
Now that the grave menace of the dangers of war has been replaced by new difficulties associated
with " the return to peace," it is possible to look back with a sense of relief upon the unique experiences
of the early months of 1918, upon the steady aggravation of food difficulties as the year advanced, and
upon the growth in severity of the successive waves of influenza, culminating in the very fatal prevalence
of November and December which followed hard upon the armistice reioicings.
Medical
inspection
During the year 206,938 children in the age groups were examined by the school doctors ir
elementary schools and of this number 91,074 were found to require treatment for one or more defects
A further 1,579 children in the age groups were inspected in the special schools and 47,114 elementarj
school children not in the age groups were specially examined, giving a total of 255,631. In addition, th<
school medical staff inspected 4,835 children for scholarship awards, 7,953 students in secondary schools
and training colleges and 12,365 children in connection with their specific defect in special schools. A
detailed analysis of the results of the examination of elementary school children has been made b>
Dr. C. J. Thomas and is given on pp. 25—28.
Medical
treatment.
Five new centres have been opened and the provision at many ot the existing centres has been
extended. The total number of children who received treatment was 143,539 as compared with 122,765
in 1917. Under the arrangements approved for the year commencing 1st April, 1919, authority has
been given for schemes which will provide treatment for some 185,000 children annually.
Re-inspection.
The number of defects noted at primary inspections for treatment or observation coming under
review was 123,082. It was found that in the case of defects requiring treatment 36 5 per cent, of the
cases had received treatment within six months, almost the same proportion as in 1917. 17 0 per cent,
of the cases were deemed to be no longer in need of treatment, and in 46.5 per cent, treatment was still
required.
Co-operation
with Welfare
Centres.
Wherever possible, co-operation is established between the Council s centres and the infant
welfare centres. On p. 30 Mr. C. E. Wallis describes the dental work which is carried out at the
" Lissonia " Centre, where the Council's work is associated with the work of the infant welfare centre.
Government
grant.
The grant awarded by the Board of Education under Part 1. of the Medical Grant Regulations for
the year ending 31st March, 1919, amounted to £57,132 4s. 1d., representing 50 per cent, of the Council's
expenditure on medical inspection and treatment and ancillary work during the previous year. Under
Part IT. £1,002 10s. was awarded in respect of the open air schools at Kensal House, Birley House and
Shooter's Hill and under Part III. £640 l1s. 5d. was allowed for physical education.