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17
It has been considered whether a more mechanical method can replace that of
the home visiting system in cases where the parents are willing to accept treatment
as soon as the need of it is brought to their notice. Although in the early days of
medical treatment much personal persuasion of parents was necessary, as the
education of parents proceeds personal persuasion can be reduced, and a communication
to them as to the need of treatment should suffice in many cases.
At the medical inspections where the parents are present, the care committee
worker makes all arrangements for treatment there and then, and even now in some
schools instead of visiting the homes of those parents who are absent an advice
card is sent to the parents informing them of the need for medical treatment and
asking them whether a voucher is required for attendance at one of the centres.
This card is intended to be returned to the head teacher, and it is only when the card
is not returned to the school or a refusal is obtained that the care committee is asked
to follow-up by home visiting.
This follows closely upon the lines of the method employed at dental inspections
where, in cases which the parent is not present, the cards asking for consent to
treatment are written by the organiser at the time of the inspection and given to the
head teacher to distribute and collect. In schools where the head teacher insists
upon the return of the dental consent cards, the scheme works well, but in others
little is achieved until the care committee begins to function.
The advantage of this scheme is that the voluntary worker is relieved of part of
her work of home visiting, though she may still be required to visit some of the homes
to enquire on general questions, such as the provision of spectacles, convalescence,
assessment, etc., but on the other hand some additional work is thrown on the
teaching staff.
It has been thought advisable to arrange for a trial of the scheme at about 30
schools where the care committees, head teachers and school doctors are all
sympathetic to the proposal. No economy is necessarily expected under this
arrangement, but greater efficiency may be effected. More time will be made
available to the voluntary workers for the persuasion of indifferent and difficult
parents by dispensing at the outset with home visiting in those cases where the
parents have shown their willingness to act upon the advice of the school doctor.
Unfortunately many parents display considerable dexterity in avoiding things
for their own and their children's good. Where the good offices of the voluntary
worker fail, such cases are handed on for special visiting to the "special officer," a
member of the divisional officer's school attendance staff.
If all this fails the school doctor issues a certificate in accordance with the
provisions of section 12 of the Children Act, 1908, and the case is forwarded to the
National Society for the Prevention of Cruelty to Children, which in appropriate
circumstances undertakes prosecution.
During 1932, 565 cases, involving 683 defects, were reported to the Society:
these included 303 dental defects, 196 vision cases, 94 nose and throat affections
and 21 cases of ear disease or deafness. These figures are appreciably smaller than
in 1931.
Cases
referred to
the
N.S.P.C.C.
The work of the care committee organisers who now attend many voluntary
hospitals has continued to be of inestimable value in co-ordinating the remedial
measures advised at the hospitals with the social activities of the school care
committees.
Co-ordination
of hospital
and social
work.
In the British Medical Journal for 21st January, 1933, a full reference was made
to the influential American " White House Conference on Child Health and
Protection." The ineffectiveness of general hospital work through its dissociation
from social agencies was the main theme. Co-operation between hospitals and
community social agencies is hampered, and there is failure by those responsible for
the treatment of children in hospitals and dispensaries to appreciate the strategic
opportunity for inculcating good habits based on sound principles. How to bring
the hospitals and social agencies together in a practical working arrangement which
will not cramp the free activities of either was the greatest problem, and difficult to