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for windows where not frosted, hinged wall lamp, six Windsor chairs, tablecloth,
fender and fireirons, umbrella stand, curtains for screening.
The reclining chair was intended for use for the occasional examination of
children in the recumbent position, but, owing to its low height, it is not very convenient
and it was decided that a suitable table with two blankets should be provided
for the purpose.
Instruments
for clinical
use.
For examination of the throat the difficulties of the use of metal spatulæ and the
time wasted in disinfection between the examination of one child and the next
soon became apparent and the officer in charge of medical inspection in London
struck the happy idea of utilising for the purpose gardeners' wooden labels which
could be thrown away after use. This solved all the difficulties and the practice
quickly spread so that it is now customary all over the country to use wooden spatulæ
which are made for the purpose. Such spatulæ are always, of course, available at
medical inspections. Children do not object to them, as they are familiar objects,
but the sight of a metal spatula will upset many children.
The school nurses who attend all inspections carry bags which contain:—drill
overall, thermometer, enamel bowl, magnifying glass, two steel combs, forceps,
lysol bottle, various sized envelopes, pocket diary, solid methylated spirit, culture
tubes, memoranda block, all medical inspection forms, notebook, wooden spatulae.
The weight of this bag with its normal contents is 10 lbs.
The school doctor invariably brings his stethoscope and any other instruments
he finds it advantageous to use. An electric torch is generally included in his
equipment.
Frequency of
examination.
The Education Act provides that local education authorities must make provision
for the medical examination of children at entrance to school, and at such other
times as the Board of Education prescribes. The Board has prescribed a routine
age examination at the ages of 8 and 12. This minimum examination has been
provided by all education authorities. London, provides in addition (with the
consent of the Board) a further age group examination in the term before that in
which the children leave elementary schools. The Board also directs that provision
must be made for re-inspection of children found defective, and for special
inspection of individual children at any age when the need is indicated.
In London 42 per cent. of the average number of children in attendance are
subjected each year to a routine inspection. Children referred for special examination
by school teachers, care committee workers, divisional officers, etc., are
equivalent to two further age groups. To these must be added the children who
had previously been found defective and who were kept under observation by the
school medical staff.
On an average, inspections of children to the number of more than 80 per cent.
of those on the roll are made by the school doctors for some purpose or another
in the course of the year. Further, every child is seen some three times a
year by a fully trained nurse who picks out for special examination by a doctor any
child suffering from a gross departure from health. All this is apart from the steps
taken by parents and teachers to secure medical attention when a child needs it.
The danger of failure in bringing before the doctor any child, whose condition needs
it, is small.
The question of the spacing of the routine medical inspections has received the
Council's attention. The reorganisation of schools has altered the position very
considerably and the points in the school life when children should be examined
should logically coincide with the big alterations or moves which take place. That
is, inspection should take place (a) at entrance; (b) at age 7 (corresponding with the
change in the status of infant to that of junior scholar); (c) at age 11 (corresponding
with the transfer from junior to senior school) and (d) preparatory to leaving school
altogether. In 1932, the Council decided to ask the Board of Education to agree
to the examinations at the ages of 8 and 12 being changed to examinations at the
ages of 7 and 11 respectively. The Board approved the scheme on condition that the
fourth or leaving examination was continued in London by the Council.