View report page

40
The number of cases dealt with by the Council's medical officers (both central and divisional)
on reference from the attendance staff is increasing at a very rapid rate. There is also a very close
co-operation between the attendance staff and the nurses in regard to the cleansing and other cases.
The general aim kept in view is that the greater the co-ordination between attendance staff,
care committee organisers, medical officers, and nurses, the more effective the work is likely to become.
6. Cleanliness of school children—In paragraph 7 the Board point out that efforts to improve
the cleanliness of the children should not be allowed to diminish owing to war conditions, and they refer
to the special problem presented by scabies. In reply. I am to inform the Board that, so far from relaxing
its efforts, the Council has given the greatest attention to this matter, and many improvements in the
scheme have recently been effected. Some months ago the scheme of procedure was carefully re-examined
and amended in certain respects with a view to expediting the work. In addition, the Council has
recently approved expenditure for the instalment of new baths, the provision of a new motor ambulance
and the employment of additional nurses for cleansing work. By these means it is hoped to secure a
considerable measure of improvement. It may also be mentioned that it has been made a condition
of the award and tenure of the Council's scholarships, exhibitions and free places that the candidate
or scholar shall not be found unclean or verminous (apart from accidental infection).
7. Provision of spectacles—Paragraph 8 of the Board's letter deals with the provision of spectacles,
and the Board assume that spectacles can be obtained at contract rates, and ask to be informed exactly
what the position is in regard to this question. In reply, I am to state that in the case of the special
schools, spectacles are supplied through the Council's stores to children requiring them, and the cost
or such part of the cost as the Council may determine, is recovered from the parents. In the case of the
ordinary schools voluntary committees have been formed in order to assist parents in obtaining the
spectacles. In some districts one committee deals with all the schools in the district, while in others
each school care committee deals with its own school. The procedure as regards supplying glasses and
collecting contributions varies in different districts, but an endeavour is made to provide that, whenever
a loan is asked for, the glasses are ordered at once, a grant being given in the necessitous cases. "Where
payment is to be made by instalments it is expected that at least Gd. a week, and, if possible, 1s. or
1s. 6d. a week should be paid. Under such a scheme long periods of waiting for glasses are avoided.
The Council agrees that it is very important that the delay incidental to obtaining glasses should not
be increased by a preliminary delay through waiting while small weekly instalments are being collected.
The terms upon which glasses are obtainable by London school children are in practice contract rates.
and compare not unfavourably with those mentioned in paragraph 186 of the chief medical officer's
report of 1913. There has, however, of course, been a rise in prices owing to the war, though the prices
are still below the non-contract prices referred to in paragraph 186. In view of all the circumstances
the Council is of opinion that of children requiring glasses the percentage who obtain them is extremely
satisfactory.
8. Supervision of medical treatment—It is observed that in paragraph 9 the Board state that
"it is very important that the whole of the Council's arrangements for securing the medical treatment
of the cases requiring it should be under the direct supervision of the school medical officer, whether
the treatment required in a particular case is treatment for the provision of which the authority is
responsible or whether it has to be obtained outside the authority's own scheme of treatment." With
regard to this point, I am to state that the Council is in agreement with the Board, and that the work
has been organised on this basis. The following up of children for whom it is proposed to obtain
treatment other than through the Council's treatment scheme, is accomplished in the main by care
committee workers whose activities are directed by the members of the organising staff working under
the control of the school medical officer. The children concerned, moreover, are subject to re-examination
from time to time by the school doctors. The supervision of medical treatment is, however, under
reconsideration.
9. Provision of meals and school medical service In the same paragraph the Board refer to the
importance of supervision by the school medical officer in connection with the Provision of Meals Acts.
On this point I am to remind the Board of the statement made by the Council on Form 9 M (Question 2)
in which the arrangements for co-ordinating the work in connection with provision of meals with that
of the school medical service are set out. For convenience of reference the statement referred to is set
out below—
"The school teachers, the school care committee, and the school doctors are closely associated
in the matter of the selection of the necessitous children. On the one hand school medical
records of individual children are referred to by the care committee, and, on the other hand
the attention of the doctor is called, at the time of the routine or other medical inspections, to
children about to be inspected who are on the feeding list, in order that he may give any special
advice as to the kind of meal which should be given. The menus of the meals are submitted to
and approved by the school medical officer, and the dining centres are visited and reported on
by the school doctors, in regard to questions of diet and hygiene. In addition, samples of the
meals are taken from time to time, without notice to the caterers, and submitted to the school
medical officer for chemical analysis. In the case of milk meals, the school medical officer from
time to time takes samples for analysis, and local medical officers of health are notified in those
cases in which the sample of milk is found to be unsatisfactory, in order that they may obtain
samples and prosecute if necessary."
While dealing with this matter, I am to refer to the statement towards the end of paragraph 7 of
the Board's letter, in which it is assumed that there may be a delay of six months before a child recommended
for milk actually begins to receive it. With reference thereto I am to state that careful enquiry