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14
(b) Every other child under the age of three years shall have a complete
stripped examination by the medical officer not less than once in every three
months.
(c) Every child over the age of three years shall be examined by the medical
officer not less than once in every three months and shall receive a complete
stripped examination once a year.
Medical
treatment.
Operation
cases.
A standard medical card has also been adopted tor recording these examinations.
With regard to medical treatment it became apparent from the beginning of
the scheme that many of these children were in need of operations for enlarged
tonsils and adenoids. An administrative arrangement was made whereby such
cases could be operated on in the Council's general hospitals (formerly Poor Law
infirmaries). The scheme was extended to embrace all operation cases including
such cases as appendicitis, hydrocele, etc. For urgent operation cases reliance is
placed upon the discretion of the local officers, who are advised to communicate
directly (a) in London, with the nearest Council hospital and (b) outside London,
with the local voluntary or public hospital. For cases in which this course cannot
be adopted or is unsuccessful and for less urgent cases a "fixed point" has been
designated in the general hospitals division of the public health department, it being
the duty of the "fixed point" to allocate cases to appropriate hospitals.
Medical
treatment
cases.
For children requiring non.operative treatment, e.g., for rheumatism, tuberculosis,
skin trouble, keratitis, and for infectious diseases the schools are instructed
to communicate by means of the appropriate form, or in urgent cases by telephone,
with the special hospitals division of the public health department who allocate beds
and when necessary provide an ambulance for conveyance. (The ambulance service
is also available for general hospital cases.)
Otorrhœa.
The medical officers of the institutions were invited to refer to the school medical
officer any cases of otorrhcea in which advice was required, and evidence was soon
forthcoming that many children in these homes were suffering from otorrhoea for
which the ordinary syringing treatment given at the homes was not effective in
providing a permanent cure. In dealing with these referred cases advantage was
taken of the scheme already in existence for London school children generally,
whereby such cases could attend at the Kentish Town clinic, for ionisation treatment
under the case of the Council's chief aurist. This clinic is conveniently near to the
Andover Children's Home (one of the transferred schools). Full advantage of this
contiguity was taken and owing to the fluidity of arrangement possible now that all
these homes are under one control, parties of children are temporarily lodged from
distant homes at the Andover Home where they stay until further ionisation
treatment bv the Council's aurist is no longer required.
Vision
treatment.
One of the points brought up for discussion at the conference was the question
of vision testing at the homes and the provision of spectacles. On enquiry it was
found that at seven of the homes no systematic arrangements had been made iu
this direction by the former authorities. This was rectified and arrangements are
now made for an ophthalmic surgeon to visit each of these seven schools once every
three months. Any prescriptions given are made up through the Council's supplies
department.
Dietaries.
Dr. Donald raterson has submitted some valuable suggestions as the result of
his visits to some of the schools. His investigations are not yet completed, but
from the facts already obtained it appears to be desirable as an early measure of
reform that a uniform dietary should be drawn up for all the schools.
Chronic Invalidity.
The school attendance department reports each month the names of all children
who have become chronic invalids, absence from school entirely on account of illhealth
for three months and upwards being taken as the criterion. Each year the
number of sick children remaining on the list in the month of November is analysed
in the medical department, and the result gives, in effect, a census of chronic
invalidity.