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action may not be confined to medical treatment under the Council's arrangements,
but may require that use be made of other ameliorative channels which are not
always under the Council's supervision.
In this way the Council's school medical service is brought into touch with other
social and medical organisations with undoubted advantages to the children and their
parents.
After a medical inspection the voluntary worker is expected to visit the homes
of the children recommended for medical treatment (except where satisfactory
arrangements can be made with the parents at the actual inspection) and, if the
parents do not propose to make other arrangements, are unable to afford treatment
from a private doctor, and are willing to allow the child to be dealt with under the
Council's medical treatment scheme, application is made by the care committee
secretary to one of the five divisional treatment offices for an appointment at one
of the centres or hospitals.
An analysis of the medical re-inspections in 1932 of children previously noted as
defective and requiring treatment reveals that by the efforts of the doctors, nurses,
care committees, teachers and parents, 81.6 per cent. of the children were treated
(not necessarily all under the Council's arrangements) or were discharged as no
longer needing treatment.
There are 150 paid organisers, including all grades. These organisers are
divided into two groups—(1) those engaged on "general" work, i.e., recruiting,
training and organising voluntary care workers, and (2) those engaged on medical
treatment centre work. The majority of the organisers possess a social science
certificate or a university degree, or both, and some have in addition a health visitors
certificate or nursing training.
At medical inspections an organiser is very rarely present, though a voluntary
worker is usually there in addition to a school nurse. A treatment organiser is
present on the occasion of a dental inspection and then no school nurse is there.
At about 95 per cent, of the medical inspections in elementary schools a voluntary
worker is present.
The treatment organisation is based on five divisions, corresponding to the
five divisions of the school medical work. Each of the divisions is under the control
of a divisional treatment organiser. The total paid staff allocated to the treatment
side is 86 organisers. The actual units of the organising staff, treatment and
"general," are, however, interchangeable between the "general" and the treatment
sides. The annual cost of the treatment organisation for 1932 is estimated at
£21,690, and, with the addition of clerical and typing work of £5,612 a year, a total of
about £27,000 a year. This represents approximately a charge of about 1s. per
head of the average school attendance.
A treatment organiser attends the Council's medical treatment sessions at the
centres and hospitals. She is expected to place before the doctor all relevant
information as to the home conditions, etc., which is provided by the care committee
secretary. She is required to advise the doctor as to the appropriate educational
and ameliorative agencies available, not only under the Council's arrangements, but
also through various social and philanthropic bodies, and she is required to convey
to the school care committee any suggestions as to social and convalescent treatment
made by the doctor ; and also, where necessary, she arranges for the case to be
transferred to wherever the appropriate treatment can be obtained.
The basis on which the number of the organising staff is allowed, by the Council,
is 1 unit of staff for each 2,200 medical or 4,400 dental cases. In addition, sessions
of organisers' time have been granted for special clinics, such as for rheumatism and
ionisation (or special ear inspection) centres. With the developments of the treatment
work, it has been possible to spread the time of the organisers over the centres,
and to pool the clerical work involved at the divisional treatment offices.
In this way it has been possible to effect economies by the substitution at various
times of clerical officers for 14 organisers authorised by the Council and in the future
this process will continue.