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70
Compulsion unwisely applied would undoubtedly defeat its object and bring
about a state of mind inimical to progress. It is inevitable, therefore, tbat progress
should be slow, but for that reason it is all the more sure. It can only be by the
willing co-operation of the people and their steady growth in knowledge and in
wisdom as well as in material prosperity that the desired results can be achieved.
The more intelligent parents eagerly avail themselves of the Council's facilities.
Dr. James Kerr, whose clinical experience and knowledge of the conditions are
unrivalled, has recently remarked upon the surprising improvement in the condition
of children who have qualified for scholarships and come before him for medical
inspection, and he particularly instanced their dental condition. The statistical
figures bear this out in a pronounced and convincing fashion. In 1913 out of 1,635
children examined on qualifying for junior scholarships, no less than 640 required
dental treatment before they could pass the medical examination. In 1923, out
of 1,560 junior scholars examined, only 111 were referred for dental treatment.
The fall here is from 39 per cent, to 7 per cent. These figures fully bear out Dr.
Kerr's clinical impressions, and clinch the argument that while amongst the more
intelligent of the parents full advantage is being taken of the Council's measures,
the task in the future, of the school medical service and indeed of the whole
education service, is to spread downwards amongst the population the knowledge
of the need for early attention to the defects from which children suffer, and
for a more hygienic way of living. The spread of enlightenment and the desire for
better things undoubtedly lead to improvement of environmental conditions, and
to a higher standard of living generally.
188,348 cases, which had been referred for treatment or placed under special
medical observation, were re-inspected during 1923. 89,191 of these were primary
re-inspections of children referred for treatment. Of these 54,747 (61.4 per cent.)
were discharged or were under treatment and 34,444 were reported as not treated
and still requiring it.
55,528 children requiring treatment who had failed to be discharged at their
first re-inspection matured for further re-inspection during the year. Of these, 31,637
(57 per cent.) were discharged, or were under treatment. Combining the results
of first and second re-inspections, it is found that 76.8 per cent, of the children found
defective obtained relief within a year of the primary inspection. This figure is
not quite as good as in 1922, when 77.7 per cent, of the children were found satisfactorily
dealt with. The failure to obtain treatment is mainly in the dental department,
and if the dental defects are deducted from the total it is found that the
percentage of children satisfactorily dealt with amounts to 83.0.
In a few cases when the parent has persistently refused to obtain treatment,
and when the child's condition is in consequence deteriorating, the good offices
of the National Society for the Prevention of Cruelty to Children are sought. Note
was kept of 398 children referred to the Society in 1923. These comprised 204
cases of defective vision, 140 of dental caries, 22 of eye or ear disease, and 32 of other
defects. The Director of the Society reports that the total number of cases of
neglect (medical and other) referred by the Council in 1923 was 670. Of these, 323
cases, affecting the welfare of 431 children, were referred to the Society's medical
board. Of the 323 medical cases, 193 have been closed, effective action having been
taken and the condition of the children alleviated.
Medical treatment.
At the end of 1923 the treatment scheme included 13 hospitals and 58 centres,
in addition to the dental centre at Bushy Park Camp school At these 72 centres
218,794 children, the highest total yet recorded, received treatment during the
year for the defects specified: eye, 31,986; ear, nose and throat, 11,936; ringworm,
1,591; minor ailments, 77,949; and teeth, 95,332. After consultation with the
British Medical Association the agreements have been amended with the view oi
Re-inspections.