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

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London County Council 1931

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

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14
Children Act,
1908.
Children's
moral welfare
work.
Behaviour
problems.
Backward
children.
week to residential schools maintained by the Council for delicate children who have as yet no
physical signs. In all these cases the children's care workers are doing what is necessary with the
parents in regard to persuasion, payment and outfit.
A great change is coming over public opinion in regard to medical, and even dental, treatment.
In 1931, 81'6 per cent, of the children found through medical inspection to be ailing were finally
treated or discharged as no longer requiring treatment, the best result ever attained. The same
year the Council's consulting dental surgeon, in reporting that 138,000 new cases were admitted
to dental centres under the Council's scheme, attributed this figure largely to " the excellent and
continuous work of the care committees."
The strong opposition to the wearing of spectacles is also breaking down, not least because
of the activities of spectacles clubs, whereby the care committee worker collects the necessary
pennies regularly each week. Often the spectacles club is run side by side with a boot club, which
encourages thrift and foresight and incidentally helps to solve the problem of sound, inexpensive
footwear.
Dr. Eric Pritchard, Chairman of the Executive Committee of the National Baby Week Council,
recently advised those who wished to see the change which had taken place in child life during the
last thirty years to take a walk down Whitechapel or the Old Kent-road any day at about 4 o'clock
when the children are hurrying home from school. " The physique, clothing and cleanliness of
the children are at least a hundredfold better than they were thirty years ago and at least 50 per
cent, better than they were eleven years ago." The Education Act, 1870, which Sir William
Hamer has described as the greatest Public Health Act ever placed on the Statute Book, the
school medical service subsequently instituted with its school doctors and nurses, and the
untiring zeal of the care committee workers in following up the advice of the doctors, have all
had their influence in this general improvement.
The majority of parents are sincerely anxious to do the best they can for their children, but
there is still a mass of ignorance and carelessness to contend with. Where friendly offices fail the
neglect is handled officially either by a special officer of the Council or in more serious cases by the
National Society for the Prevention of Cruelty to Children, to whom the Council leaves prosecution
cases under section 12 of the Children Act, 1908, which deals with neglect to provide medical
aid, etc.
In contemplating the enormous elementary school population of London—well over half a
million—it is remarkable how seldom the need arises to resort to the more drastic methods.
A special group of officers has been appointed by the Council to deal with all charges under
sections 58 and 59, which deal with children liable to be sent to industrial schools, etc. The
care committee always has an opportunity of reporting on its previous dealings with the family
involved, and this information may prove an important factor in the decision of the Court.
Often, too, the care committee is made to realise through a charge having been brought that things
are not well in a particular home, and, if the child has not been placed on probation, the committee
renew their efforts to provide what is most needed—often recreative outlets for a healthy
young person who is getting into trouble for lack of them.
When the searchlight of the children's care organisation was turned on the darker places of
child life, some very serious instances of moral offences against children were revealed, and in
1912 definite arrangements were made for handling these cases through the organising staff. A
small committee of members and officers of the Council was formed to raise voluntary funds to
enable them to do what was best for each child, unhampered by difficulties of finance when parental
and local resources were insufficient. Gradually, however, voluntary societies were formed in
each district to provide a trained worker—called the children's moral welfare worker—for this
highly specialised work, which it was clear should be a first call on the time of anyone undertaking
it. The work is carried out in close collaboration with the district organiser, who delegates her
responsibility for the personal side of it to the worker, while remaining responsible to the Education
Committee for all action taken. The essence of the system is to maintain close co-operation
with the police with a view to supplementing their action on the social side whenever this is
desirable.
Among the many difficulties about which parents consult care committee workers and
teachers are problems connected with the children's behaviour, which is sometimes of the abnormal
or anti-social type causing anxiety and threatening serious consequences later on. Early consideration
of such problems may help many children to adapt themselves who would otherwise swell
the numbers of those charged in the juvenile and adult courts.
Certain clinics for " child guidance" are now available. Here the child's behaviour and point
of view can be studied in the light of a full examination of his physical, psychological and
intellectual equipment, and of his home and school environment.
In the framing of a " diagnosis and treatment " plan, the knowledge of the family background
possessed by the care committee is of great value ; and, with the help of experts, care committee
workers are gaining fuller understanding of the psychological needs of children and parents.
This growing insight is helping them not only to share in bringing about the social readjustment
suggested by the clinics, but, more valuable still, it is leading to preventive work when very early
signs of children's difficulties begin to appear.
Certain care committees have made special efforts to help backward children in the hope that
early concentration on the problem may help the child to make a better adjustment in school
and thus lessen the handicap when a start has to be made in the industrial world. Where, as so
often happens, backwardness is due to causes that lie in the home environment or in the physical