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71
With a view to obtaining the highest attainable standard of work at those
centres where operations are undertaken, it had been agreed that for any appointment
involving specialist work, one or other of the following qualifications should
be required by the Council:—
(а) Tenure of hospital and other appointments affording special opportunities
for acquiring experience ; or
(b) Special academic or post-graduate study or recognised proficiency and
experience in the particular capacity for which service is offered, in each case to be
combined with evidence of actual practice of the speciality.
The Council had also decided that no surgeon should be required, as a rule,
to operate on more than eight tonsil and adenoid cases per session of hours, or
352 cases a year. Hitherto, the number of new ear, nose, and throat cases provided
for in the agreements has been ten per session of 2½ hours. It was also arranged that
a time book should be kept at each centre, in which the hours of arrival and
departure of the medical staff would be recorded.
These conditions would be set out in future agreements with the committees
of school treatment centres.
As regards (iii) the Council was considering whether it was possible to alter
the working of the cleansing scheme so as to remove any procedure which may make
the scheme unacceptable to parents and children.
Nursery schools.
Dr. Margaret Hogarth reports "The number of aided nursery schools in
London has remained the same, viz., eight aided voluntary schools and two belonging
to the London County Council with accommodation altogether for 450 children. The
largest nursery schools are the two adjoining Rachel McMillan Schools, one
voluntary and the other provided by the Authority, accommodating between
them 200 children, and sharing the same superintendent. The Council school was
opened in September 1921. Almost at the commencement the Council school was
considerably handicapped by an outbreak of measles. Yet, in spite of reduced
attendance, this outbreak served to demonstrate more emphatically than ever that
the school is the one place where such an epidemic can be satisfactorily controlled.
It was unfortunate that all the children in attendance were new-comers and, unlike
the children in the voluntary school where there were no bad after effects, had not
had any real opportunity of benefiting by the general regime of a nursery school,
but it should also be noted that in a congested neighbourhood such as Deptford,
the majority of these children would in any case have developed measles, which
was rife in the district at the time. On the discovery of the first case steps were
taken at once to deal with an outbreak, and teachers and nurse were on the alert
for the first crop due nine to fourteen days afterwards, the second crop following in due
course. A few sporadic cases completed the outbreak, which was practically over in
five weeks. It says much for the vigilance of the staff that only one case showed a
rash in the school. Each child as it showed symptoms was taken home and the
parent instructed to keep him in bed for a week, with the result that only two cases
developed discharging ears, and two were taken to hospital, where they unfortunately
died from a secondary infection. It was found practicable to re-admit the majority
of the children exactly a fortnight after exclusion, instead of the three weeks then
customary in the elementary school. There is no doubt that the good recovery of
these very young children was due in the main to their being kept in bed. They
benefited considerably, too, from the altruistic attention of the staff, who visited
the homes with practical advice and encouragement. The Borough Medical Officer
was of great assistance, sending nursing and material assistance where the superintendent,
Miss Stevenson, found it necessary.
"During the remainder of the year, in spite of an unfortunate occurrence of influenza
in the summer holidays, the daily attendance increased, and the high attendance
percentage maintained during the winter, when one expects the lowest numbers,
Dr. Margaret
Hogarth's
report.