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113
There appears to be little hope of eventually dealing with the more violent
cases outside a mental hospital or certified institution, although even there they
appear to be giving trouble.
Following up.
Parents are invariably notified of the approaching medical inspection of their
children, and the majority of them accept the invitation to be present. At the
inspection with the doctor are the school nurse and the representative of the school
care committee. It is the duty of the school care committee to follow up the cases
with a view to ascertaining the parents' wishes and means in regard to obtaining
treatment and to applying for vouchers for treatment centres or hospitals when
these are required.
As in the normal case the parent is present, arrangements are made in the
majority of instances on the spot. If the care committee representative is for any
reason absent, particulars are written by the doctor on the special following-up card
for her guidance, and acting upon these she interviews the parent at the next
opportunity. In cases where the parent is not present, an advice card is issued
by the school doctor stating the nature of the defect. This card gives directions
and advice in regard to the measures to be taken by the parent to obtain treatment.
It is often delivered in person by the school nurse at the home.
If no action is taken the care committee representative interviews the parent
with a view to helping and persuading her. Repeated visits are in many cases
necessary. If a parent is neglectful, a special officer in the attendance branch takes
over the case, and in a small proportion of urgent cases, where all else fails, the case
is reported to the National Society for the Prevention of Cruelty to Children for
prosecution. The results of following up by the school care committees are reviewed
at the doctor's re-inspections. In the ordinary case the doctor reviews all the
children, referred for treatment during one particular term, at the beginning of the
next term but one. Thus, children referred for observation or treatment in the
spring term are reviewed at the beginning of the Michaelmas term. All cases not
completed and still unsatisfactory are marked for a second re-inspection.
During 1925, of elementary school children previously referred for treatment,
111,561 cases were submitted for a first re-inspection and 55,166 cases that had not
been discharged on a first re-inspection were reviewed a second time. Of the 111,561,
47,778 (42.8 per cent.) were discharged as satisfactory and 9,892 (8.9 per cent.) were
reported improved but recommended to be kept under observation. At the second
re-inspection 57.3 per cent. of the cases seen were found to have been cured, or to
have improved and no longer to require treatment. By combining the results of the
first and second re-inspections it appears that 75.5 per cent. of the cases originally
noted for treatment are found ultimately to have been treated or discharged as
satisfactory. This percentage is the same as that for 1924. Of the cases treated,
76.5 per cent. were dealt with under the Council's scheme; 7.6 per cent. were patients
of private doctors, and 15.9 per cent were seen at hospitals and institutions not under
the Council's scheme.
It was pointed out last year that there was more difficulty in getting dental cases
treated than other ailments. There has been distinct improvement in this respect
during 1925. At first re-inspection 43.7 per cent. of the dental cases were discharged,
as against 42.4 per cent. in 1924. At second re-inspection the percentages were
42.4 in 1925 and 39.5 in 1924. The combined result shows that 70 per cent. of the
dental cases arising from medical inspection were satisfactorily dealt with in 1925
compared with 68.2 per cent. in 1924.
If dental cases be excluded from the total, the final result shows that 80.3 per
cent. of the cases requiring treatment are eventually satisfactorily dealt with.