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36
Examination
of
candidates
and medical
inspection in
higher
education
institutes.
The total number of candidates medically examined was 5,333, an increase of 368 when compared
with the figures for 1917. In addition to the foregoing examinations, 1,778 references in regard
to the health of employees in the Council's service were considered. This number shows an increase
of 161 when compared with the figures for the previous year.
The medical inspection of pupils in London County Council training colleges and secondary and
trade schools, and of pupils in attendance at non-maintained secondary schools, was continued, and
the results are given in Table D on page 56.
The arrangements made last year were continued for the examination of discharged soldiers
and women who proposed taking up the specialised courses of training for munition students at the
Council's Brixton and Shoreditch munitions training centres. 348 men and 1,37ft women were examined ;
of these 101 men and 324 women were found to be unfit.
Correspondence between the Board oj Education and the Council.
Early in the year the Board of Education made an investigation into the working of the arrangements
for medical inspection and treatment. The following letters are the outcome of this enquiry :—
27th March, 1918.
The Board's
letter of
27th March,
1918.
Sir,
1. The Board have had under consideration the report received from Dr. Eichholz and Dr.
Crowley, two of their medical officers, on the recent inspection of the working of the arrangements made
by the authority for the school medical service.
2. The Board desire, in the first place, to express their appreciation of the efforts successfully
made by the authority to maintain the work of medical inspection and treatment, in spite of the absence
on military service of a large number of their medical officers and nurses, and other difficulties arising
out of the war. In particular, the Board note with satisfaction that the full medical inspection of the
intermediate and leaver groups has been continued throughout, and that, while some curtailment was
deemed to be necessary for a time in the case of the entrants group, it has now been found practicable
to resume the normal medical inspection of the whole of this group also. They also note that the provision
made under the authority's scheme for the treatment of the principal types of malady affecting
school children, which before the war was expanding, has continued to grow steadily during the war, the
total number of cases of all types of defect for the treatment of which provision is made under the arrangements
for 1918-19 (152,744) being about half as many again as in 1914 (98,976). In addition, the
arrangements for the systematic re-inspection of children, who are found to be defective in the course
of medical inspection and require treatment or to be kept under observation, have been maintained
unimpaired.
3. These achievements in the face of exceptional difficulties are most gratifying, and indicate
a strong desire on the part of the authority to maintain and develop their arrangements for the welfare
of the children of London. At the same time I am to express the hope that the need for still further
increasing the provision for all or almost all the various forms of treatment undertaken, particularly
for the treatment of " minor ailments " will be constantly borne in mind. From the experience of other
areas the Board would expect the number of children requiring treatment annually for " minor ailments "
to be not less than 65,000 (10 per cent, of the total number of children in average attendance), so that
the existing provision needs to be at least doubled in order to be comprehensive. Similarly, it would
appear that, while the arrangements already made for dealing with defects of eyesight cover the greater
part of the ground, some extension of the arrangements is required in order to make them thoroughly
comprehensive. In this connection the Board observe from the school medical officer's report for 1916
that at the second re-inspections carried out, during that year upwards of 5,000 refraction cases were
found still to require treatment.
4. The Board are also glad to learn from their medical officers' report of the measures taken
since the last inspection in 1913 to meet the suggestions then made, particularly the introduction of a
considerable amount of variety into the work of the assistant school medical officers—the permanent full
time assistants at any rate- and the development of the arrangements for the inspection of special cases
and inspection clinic work generally.
The use of the schools, offices of the divisional medical officers and treatment centres for inspection
clinic purposes, however, has certain disadvantages—the disturbance of the routine of the schools at
irregular intervals, the congestion of the premises of the divisional offices, and similarly the fact that
the accommodation of the treatment centres is limited and is frequently used up to its maximum capacity
for treatment work. The Board accordingly look forward to a time when inspection branch clinics will
be provided by the authority in the different districts in adequate premises of their own (as has been
done in most other large urban areas), with which will be associated the work of a minor ailments clinic
carried out by the authority's school nurses under the supervision of the authority's medical officers in
accordance with the practice now almost universally adopted. Such branch clinics would constitute
medical (as distinct from administrative) centres of the kind referred to in paragraph 7 of the Board's
letter of 24-6-13 " serving a comparatively small area, from which the school medical work might radiate
and a continual supervision over individual children, so far as necessary, might be exercised." The
authority should realise in this connection that they are now practically the only authority out of
all those undertaking treatment who debar their medical officers from taking any part in the actual
work of treatment. Further, while it appears that the school attendance officers perform useful service
in bringing large numbers of cases to the notice of the medical department, it is desirable that co-ordination
between the school attendance and medical departments should be developed as opportunity occurs.