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37
Children absent from school on account of ill-health.
In the report of the Chief Medical Officer of the Board of Education for 1920, it was pointed out
that in general out of 100 children on the roll of elementary schools, 10 will be absent at any one moment,
and of these 10, 8 will be absent on account of illness. This accords with the results of an enquiry made
by the Council's staff so long ago as 1907. In London, the co-operation between the school medical
service and the school attendance department is thorough, joint action is maintained to ensure that all
children out of school on account of ill-health are followed up, and that unsatisfactory cases are reduced
to a minimum. A census is taken in November each year in regard to children who have been absent
for long periods—three months and upwards—on account of medical reasons. The results for the past
three years are given in the appended table.
When the ages of children who are habitually out of school for alleged ill-health are plotted, it
is found that the proportion steadily falls from the age of 5 to 11, and then again rises, but the rise at
the ages of 12 and 13 is far more marked in the case of girls and the conclusion can hardlybe avoided
that the usefulness of the older girls to their mothers in the home is a factor in non-attendance.

While skin complaints and external eye disease which were so rife during the later years of the
war have diminished, the number of chronic ringworm cases has increased. These form a small proportion
of the total number of cases of ringworm, which occur, and represent the residue in which the
parents object to X-ray treatment, and are content with the application of ointments and other external
medicaments, whose action is slow and uncertain.
Medical treatment.
The arrangements for medical treatment generally have continued to be developed according
to the scheme outlined in the annual report of the school medical officer for 1912. At the end of 1921,
the scheme included 14 hospitals, 56 treatment centres, and a dental centre at Bushy Park Camp School.
The treatment centres are managed by voluntary local committees of medical practitioners, nursing
associations, and dispensary and other committees. These 71 centres at the end of 1921 had available
accommodation for the treatment of 208,298 children, the arrangements including the following ailments
: eye (refraction, 30,530 ; eye diseases, 2,150); ear, nose and throat, 17,230; ringworm, 2,628 ;
minor ailments, 51,040 ; teeth, 104,720.
The facilities are available for elementary school children and scholarship holders in secondary schools
at a charge of 2s. for each ailment treated, except that for minor ailments a charge of Is. is made after
the first fortnight's free treatment. Fee-paying pupils at secondary schools are also treated in default
of available private means, subject to the actual average cost of treatment being refunded to the Council.
The scale of charges based on the average cost was for 1921 fixed at the following rates : aural operations,
9s 8d.; minor ailments, 9s 2d.; X-ray treatment of ringworm, 25s. 4d. ; and dental treatment,
7s. 7d.
The cost of equipment of new centres has not materially lessened during the past year, and no
alteration has been made in the scale of allowances set out in the report for 1920 (p. 67). It has, however,
been necessary to modify the salaries of doctors and dentists to accord with economic conditions,
and they are now as follows :—Surgeons, £80 a year for one session of 2½ hours a week, and proportionately
; anaesthetists, £75 a year; minor ailments doctors, £66 a year for a session of 2 hours onlv
each week; and dentists £60 a year for one session each week. The maintenance grants referred to
in the last report have been continued for one year.
The number of children actually treated under these arrangements is the highest yet recorded,
being 212,579, as against 197,700 during 1920, which again may be compared with the 27,647 children
treated in the year ended 31st July, 1912. More detailed particulars of the separate ailments are here
summarised.
(a) Minor ailments.—Notwithstanding the large increase in the provision for minor ailment
treatment during 1921 (i.e., from 44,440 to 51,040 cases), the number of cases treated, 68,283, was still
in excess of the nominal provision. The attendances numbered 1,274,613, which shows an increase
to 13'7 per cent, on the figures for 1920. In addition, 5,863 cases of scabies were treated at the cleansing
stations. The figures are a striking testimony both to the need for, and the popularity of, the Council's
provisions for ailing children.
Reference here should be made to the very helpful arrangements with the Metropolitan Asylums
Board, whereby children suffering from chronic ophthalmia and other external eye conditions are sent
direct by the school medical service to the Board's convalescent home for ophthalmia at Swanley. This