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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 was formerly expected to visit
the home of every child recommended for medical treatment (except where satisfactory
arrangements had been made with the parents at the actual inspection)
but in 1933 a method of written communication was introduced as an experiment
and this was so successful that it is now the rule in an increasing number of schools.
Only when no response is obtained or refusal is given does the social worker visit.
Children's
care
committees.
During 1934, 538 cases, involving 647 defects, were reported to the National
Society for the Prevention of Cruelty to children: these included 351 dental
defects, 162 vision cases, 48 nose and throat affections and 12 cases of ear disease
or deafness.
Cases referred
to the
N.S.P.C.C.
The influence of the acute infectious fevers on the production of aural disease
is shown by the high proportion of children who are deaf and partially deaf, in whom
the trouble can be traced originally to an attack of measles or scarlet fever. One
of the most important means therefore of preventing deafness and hardness of
hearing is the after-care of children when they are discharged from the fever hospitals.
An arrangement has been made whereby 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 no symptoms of
the disease are found. The number of cases reported was 850, of which 419 were
forwarded to Borough Councils or other local authorities. Of the cases followed
up at school, 16 were found on the first examination to have otorrhcea, and of the
cases seen at second examinations the condition persisted in six. All the cases
not cleared up are being kept under observation.
In view of the importance of this procedure, efforts were made to secure fuller
notification of cases. That these were successful is shown by the fact that the
number of notifications from the isolation hospitals was more than double that of
the previous year, but the large increase was chiefly in children below school age
who were therefore not under the school care organisation.
Aural
disease and
the acute
infections.