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Supervision of children out of school on account of ill.health.
Constant communication is kept up between the local officers of the attendance department
and the divisional medical officers in regard to children out of school for alleged reasons of health, and
the presence of the school doctors is frequently required in magistrates' courts in order to give evidence
in attendance cases. In addition to this valuable day.to.day co.operation, the attendance department
furnishes month by month a corrected list of all children who have been absent from school for three
months under medical certificate or upon other evidence of ill.health. Particulars of these children are
entered upon a card index in the public health department, and month by month are checked by an
assistant medical officer, who arranges for appropriate action in every case in which examination or
further enquiry seems necessary.
In the month of November each year a census is taken of children on the current out.of.school
register. In November of this year there were 2,856 names upon the current register, comprising 1,233
boys and 1,623 girls; 586 children (20.5 per cent. of the whole) were out of school on account of tuberculosis,
412 (14.43 per cent.) on account of rheumatism, and 129 (4.5 per cent.) on account of ringworm.
Re.inspections.
An important branch of the work of medical inspection is the periodical re.examination of children
found at inspection to be ailing. This section of the work has been carefully systematised in order to
avoid any possibility of cases which should be kept under observation being missed. All children referred
for treatment are re.inspected after the interval of a full term, i.e., at an average of six months from
the original inspection. Those not discharged at the first re.inspection are again re.inspected after
another interval of six months.
In 1919, 173,306 re.inspections were carried out, representing 155,020 children, since 18,286 were
twice re.inspected.
At first re.inspections, 57.8 per cent. of the children were found to be under treatment or no longer
in need of treatment. At second re.inspections, the percentage of children not discharged at first re.
inspection who were now discharged or found still to be under treatment was 54.7.
Number of
children
re.inspected.
Percentage
of children
treated.
The total percentage of ailing children discharged or under treatment at the end of twelve months
was 73.5 per cent. The lowest percentage of children marked off as discharged or treated is found under
the heading of teeth—namely, 51.8.
As the numbers referred for dental defect are so great as to swamp all other forms of defect, the
results are unduly weighted on the deficit side. The Council's arrangements for dental treatment are
primarily designed for younger children referred from dental inspections, while the children here dealt
with are older children referred from medical inspections for whom as yet sufficient facilities for treat
ment are not fully available.
Dental
defects most
difficult ti
cope with.
The re.inspection results show that the following.up of ailing children was more energetically
carried out in 1919 than in previous years; the total of 73.5 per cent. above referred to being an improvement
to the extent of 4.5 per cent. on the previous year and 5.9 per cent. on the results in 1917.
Improved
following
up.
A feature of the re.inspection results is the increasing number of children who undergo their treatment
under the Council's arrangements and the diminishing number who are received at hospitals outside
the Council's scheme. Of the children treated for visual defect, 83 per cent, went in 1919 to hospitals
and treatment centres under the Council's scheme as opposed, for instance, to 71 per cent, in 1915.
Thus the general and special hospitals are tending to throw more and more of the work of the treatment
of school children upon the Council, and the proportion of children finding channels of relief apart from
the Council's scheme tends in the case of some classes of ailments to become a negligible quantity.
Increasing
popularity of
school treatment
centres.
Medical treatment.
The year 1919 being the first complete year since the cessation of hostilities, it may be convenient
to refer to the great advance made in the arrangements for the medical treatment of school children as
compared with the years before the war. In this connection it may be mentioned that on the 31st
December last there were, including hospitals, 57 centres actually at work for the treatment of the
principal ailments found in the course of medical and dental examination of elementary school children.
The total number of cases for which facilities were provided at these centres was 174,878. These figures
may be compared with the 42 centres providing for 99,000 cases at the end of 1914, or the 17 centres
providing for 26,000 cases at the end of 1910, the year in which the medical treatment scheme was first
constituted.
The passing of the Education Act, 1918, has, moreover, somewhat altered the conception of the
duties of the local authority with regard to treatment. Section 13 (1) (6) of the Education (Administrative
Provisions) Act, 1907, gave an optional power to make arrangements for the medical treatment
of elementary school children. Section 2 (1) (b) of the Education Act, 1918, makes this optional power a
duty as regards elementary school children, and Section 18 extends the optional power to provide means
of treatment in respect of children attending any school or educational institution whether aided or not
by the local education authority. The Council has already made arrangements for the medical and dental
treatment of scholarship holders at secondary and trade schools, and it is proposed to extend these
facilities to fee paying pupils subject to the actual cost of treatment being recovered.
Another development of the medical treatment scheme is the use of the dental centres by schools
for mothers and infant welfare centres. Although the Council is in no way responsible for the work
done in this way, the associated use of the centre is of material benefit to all concerned in the larger