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25
Aural
disease and
scarlet fever.
Owing to the close connection between certain infectious diseases and ear trouble
an arrangement is made by which notification is received of children who have suffered
from ear discharge while in a fever hospital. The names of infants under school
age are sent to the local medical officers of health for the necessary action, while
children of school age are examined by the school doctors at intervals of six months,
until at two consecutive examinations 110 symptoms of the disease are found. The
number of cases reported was 398, of which 69 were forwarded to borough councils
or other local authorities. Of the cases followed up at school, 4 were found on the
first examination to have otorrhoea, one of these had cleared up on second
examination. All the cases not cleared up are being kept under observation.
It is reported that there is an increasing tendency on the part of employers to
reject applicants with discharging ears.
Children's
care
committees.
The following-up of children found to be in need of treatment or special observation
is carried out by the school care organisation, consisting of upwards of 5,000
voluntary workers aided and supervised by a staff of paid organisers.
The voluntary workers are responsible for acquainting the school doctor with
any particular difficulties with which the family has been contending, such as
unemployment, lack of proper accommodation, illness, etc., any of which might help
the school doctor in determining the action desirable in any particular case. Such
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 or by written
communication) 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.
There are 143 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 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 79 organisers. The actual units of the organising staff, treatment and
"general," are, however, interchangeable between the "general" and the treatment
sides.
As a result of the scrutiny of the organisers' work by an interdepartmental
committee, it was considered that, as a rule, the organiser herself need not attend
every dental inspection, but that instead an experienced clerk might assist the
dental inspector. Putting into force this decision has rendered some economy
possible.
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.