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7
The temporary medical assistance additional to fixed staff was reduced during
the year by fifteen sessions a week, the reason for this being the reduction of the
number of children of school age in the county area.
The other section concerned with the school medical service (Dr. F. C. Shrubsall,
senior medical officer) includes the medical examination at the County Hall of
scholarship candidates, school teachers, etc., and the medical work in special and
approved (reformatory) schools. Dr. Shrubsall also deals with the work under the
Mental Deficiency Acts, the Blind Persons Act, and the medical examination of the
Council's staff. In this section are included the services of a part-time consulting
surgeon for orthopaedics (Mr. K. J. Acton Davis); a part-time ophthalmic consultant
(Mr. N. Bishop Harman); two divisional medical officers (Drs. A. C. Williams and
Jessie G. Duncan) and an assistant medical officer who is attached to Ponton-road
remand home. The duties of consulting surgeon for aural disease are, in this branch,
rendered by Mr. A. G. Wells.
The duties of Miss D. E. Bannon, matron-in-chief in the public health department,
include the superintendence of the school nursing staff in addition to the supervision
and organisation of the nursing and certain other staff at the hospitals and institutions
transferred under the Local Government Act, 1929. The school nursing service comprises
at present five assistant superintendents, 74 nursing sisters and 296 nurses.
Co-ordination.
Whilst the school medical service is directed by the Council as local education
authority, and the Council is also the hospital and institutional authority for London,
much of the general health and sanitary work is carried out by the 29 metropolitan
borough councils who are the local sanitary authorities.
Work under the Maternity and Child Welfare Act is, in London, part of the
duties of the metropolitan borough councils. A change in the responsible authority
therefore occurs in the supervision of the child's health at the moment he or she
enters upon school life.
This is bridged so far as is possible by mutual co-operation. There is a system
of transfer of records from the maternity and child welfare departments of the
borough councils to the school medical officer on the entry of the children to
school. Particulars of the conditions found at medical inspection in the schools
are forwarded annually to borough medical officers of health. The tuberculosis
dispensaries are managed by the borough councils, but a system of exchange
of information between the divisional medical officers in the school medical
service and the local tuberculosis officers has been established, and, in general, child
contacts of tuberculosis of school age are notified by the tuberculosis officers and
supervised in school, where their weights are regularly ascertained by the school
nurses. Only on the supervention of symptoms are they referred back to the
tuberculosis dispensaries. The local tuberculosis officers also act as the school
doctors in charge of the open-air schools for the tuberculous in those boroughs in
which such schools have been established by the Council.
Daily consultation with the borough health departments is maintained in
regard to infectious diseases, and during the year an important new principle was
established whereby, with the consent of the Board of Education, the Schick-testing
and immunisation clinics of the local sanitary authorities have been placed on all
fours with the Council's school treatment centres, and are recognised for the purpose
of recording the attendances of school children during school hours, so that their
"marks" are not lost in school.
In one respect there is overlapping with certain of the local health authorities.
This occurs where there have been established municipal dental clinics which have
been thrown open to school children as well as to other members of the population.
Parents may take their children to the municipal clinics which are apart from the
system of regular continual oversight of dental inspection at school and treatment
at the school treatment centres provided by the education authority.