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CHAPTER II.
REPORT OF THE SCHOOL MEDICAL OFFICER FOR THE YEAR 1929.
By F. N. Kay Menzies, M.D., F.R.C.P. (Edin.), D.P.H., F.R.S.E., County Medical
Officer of Health and School Medical Officer.
In reviewing the work of the school medical service one is struck by the
immensity of the task. The London County Council is responsible for the education,
if all branches of educational effort be included, of nearly a million persons. Success
in this gigantic task can only be secured by an active co-operation of many agents.
An important one is that which has as its aim the improvement of the health of
those who come within the sphere of the educational machine.
As regards the child, the work of the health service begins before its birth,
when the infant welfare centres and schools for mothers, mostly under the supervision
of the borough councils, give advice and assistance to the expectant mother.
After the birth, this help is continued to the age of five years, when the child comes
within the purview of the education authority. Here the supervision of its physical
needs is undertaken by the Council's own school medical service, and continued
throughout the years of school life and early employment. Candidates for scholarships
and higher education awards have continued medical supervision to a higher
age.
It is interesting to compare the benefits accruing to the school child of to-day
with the few advantages possessed by the child contemporaries of middle aged people
now living. A generation earlier, say, 1841-50, conditions were very much worse,
and it was no uncommon thing for a baby to be born in a domestic workroom where
perhaps two or three men were carrying on their customary daily tasks throughout
the confinement.
Education among the poorest classes was unknown. Mayhew (London Labour
and the London Poor, 1851) records that among the costermongers, to
mention one class only, it was the custom for boys to accompany their fathers on
their rounds at a very early age, and when fourteen years had been attained, they
customarily contracted alliances with girls of the same age or younger, and started
business for themselves, their average combined earnings being 15s. a week. From
such a union it could not be expected that the children would have any great hold
upon life.
The first real statutory provision for improving the state of children was
Talfourd's Act of 1839, followed by the Chimney Sweepers' Act of 1840, but what
should be called the children's charter was the Education Act of 1870, though
compulsory attendance at school was not enforced by Statute until 1876. William
Edward Forster "builded better than he knew" in designing this Code, and only
now, after more than fifty years, are its ultimate benefits beginning to be realised.
This is not the place to describe the sequence of Education Acts to the number of a
score or more which have followed the Act of 1870, but this Act in itself was of the
greatest importance in that it was the foundation of all later statutes which together
have brought into being the mighty organisation now existing for the amelioration
of the life of the child.
The question of environment is one of the difficult problems which both health
and education authorities have ever before them, and here again the outlook is
hopeful. If health administration during the next twenty years, shows a record
of progress as rapid as that of the past twenty years, the problem of environment
should have solved itself. Moreover, in London especially, the environment of the
child of to-day is incomparably better than at the time of Dickens. Owing largely
to the action of the Council, slum areas are being transformed, and recently proposed