London's Pulse: Medical Officer of Health reports 1848-1972

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London County Council 1924

[Report of the Medical Officer of Health for London County Council]

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113
that all the proceedings should be in the form of petitions on the part of the child
for protection against neglect, rather than the hearing of charges against the child
for any form of delinquency ; in case of action the children being regarded as being
the wards of the State or Province. Often the functions of wardenship are in large
part exercised through Provincial or State departments for child welfare, the officers
of which in turn are able to dispose of many of the children through voluntary
agencies.
The main object of the Courts with regard to delinquent children brought before
them is to adopt such measures as may bring about a normal level behaviour, and
an adequate adjustment to social relations; consequently, the Judge desires the
fullest information with regard to the child, his needs and problems. This attitude
has steadily increased during the past decades and has led to a widespread demand
for a full examination of each individual child prior to any judicial decision as to
his immediate future.
The gradual growth of the system of medical examinations may perhaps be
best illustrated by the story of the Chicago Juvenile Court. The law at first gave
the Court no specific power to require examinations, but permitted it to commit a
child in need of medical care to a hospital, or to adjourn proceedings for the filing
of a petition in the case of a feebleminded child. At this time there was no machinery
for the provision of probation officers, juvenile detention homes, or medical examinations
; these were first provided by private philanthropy. In 1902 the Children's
Hospital Society furnished a trained nurse, who attended the Court and secured
so far as possible medical care for any child committed to her by the Court. In
1907 this service was extended by the society, so that all children in the detention
home, and any others before the Court whose parents gave consent, were given a
general medical examination. In 1909 this work on the physical side was taken
over by the County Commissioners, and during the same year the "Juvenile Psychopathic
Institution " was established under private auspices to provide for any
necessary mental examinations. This institute was maintained as a private endowment,
although all of its services were given to the work of the Juvenile Court. In
1914 the institute was taken over as a regular department of the Court, in 1917 it
became a State Organisation under the authority of the Illinois Department of
Public Welfare, although the County still contributed to the expenses in return for
the services rendered in examining children, and in 1920 the name was changed to
that of " The Institute for Juvenile Research," and was withdrawn from the direct
control of the Courts, although these still referred their cases to it for mental and
social reports. With this change the services of the institute were thrown open
to cases referred to it by private individuals, or by social agencies generally. This
order of events, being the inception of the work by private bodies and its ultimate
adoption by public authorities, has been the general story both in the United States
and Canada, and all phases of the process can at present be found in operation.
The work commences by the provision of simple medical care for children actually
under detention, and terminates by the provision of a system whereby any interested
person, whether the Court, the school, or the parents, can obtain advice as to any
medical, educational, or social measures which might serve to adjust the child's
personality to his environment.
From the standpoint of the Court the functions served by these examinations
are :—
(i.) To discover and arrange for the treatment of any physical disorders or
disabilities, whether these be concerned as factors in the delinquency or not;
(ii.) To separate out mentally defective or abnormal children who may require
to be placed in institutions for the feeble-minded or in mental hospitals.
(iii.) To advise the Court as to the fitness of any children for industrial tra iling,
should the question of their commitment arise.