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17
the Ministry of Labour, when it was unanimously considered that the method of
contra-indication was the best way of communicating the result of the examination
in those cases where choice of employment should be limited by medical considerations.
In view of the Board's memorandum, it was decided immediately to print
and issue " choice of employment" slips for supply to school doctors, with an
intimation that a slip should be made out for every child who possesses some
disability which affects choice of employment. These slips show the following
occupational conditions for which a child might be unsuitable and are attached to
the school-leaving form, thus being available at the school-leaving conferences:
heavy manual work; sedentary confined work; work involving exposure to bad
weather ; work in a dusty atmosphere ; climbing ; proximity to moving machinery ;
prolonged standing; eye strain; work requiring acute distant vision or acute
hearing ; handling of confectionery ; food preparation.
The school doctor indicates any of these occupational groups for which a child
is physically unsuitable.
Some criticism has been expressed with regard to the results of this procedure,
and cases have been reported in which children reported " fit " by the school doctor
have subsequently been rejected as " unfit " by the factory surgeon. The scheme,
however, has not yet been in operation long enough for its value to be assessed.
Records are made of the presence or absence of vaccination marks when children
are stripped for medical examination, but no inquiries are made. The following
are the results of the doctors' observation of the percentage of children having
vaccinal scars: entrants, 44-9; 7-year-olds, 45-5; 11-year-olds, 49-3; and
" leavers " (13t), 49-2 ; compared with, in 1935, entrants, 45-8 ; 7-year-olds, 47-7 ;
11-year-olds, 52-7; and "leavers" (13J), 48-4. These figures show that, except
in the case of leavers, the percentage of children with obvious vaccination marks is
less than last year, just as last year's percentages were less than those of the previous
year.
Vaooination.
The number of children, not in the age groups for routine examinations, submitted
to the school doctors as special cases was 122,963, equivalent to two and
a half additional age groups, and this figure does not include another 30,535 who
came under inspection in the course of enquiries into outbreaks of infectious diseases.
The number of special examinations in 1935 was 125,199, and in 1934, 91,880.
Special
examinations.
The increase in the number of special examinations in the past two years is
remarkable, and is chiefly due to the solicitude aroused in regard to the nutritional
state of the children generally, and to the desire that no child needing additional
nourishment should be debarred from taking part in the scheme of the Milk Marketing
Board. The additional work thus thrown upon the staff is equivalent to that of
four whole-time school doctors, and explains why considerable strain has been felt.
It could not have been carried out had it not been that the age group3, particularly
the leaver group, were smaller than in recent years.
Although the number of children seen at special inspections was much less than
the number seen in the routine age groups, yet in the case of many diseases the
actual numbers found to be suffering therefrom in the former exceeded those in the
latter. Thus 2,473 children with scabies were referred for treatment at special
inspections, compared with 157 only at routine inspections. In regard to epileptics
65 first came to notice at special inspections, compared with 16 at routine inspections,
and 224 children with chorea were seen at special inspections, compared with 48
at routine examinations.
This is evidence that full advantage is being taken of the doctors' visits to the
schools promptly to present to them really ailing children.
The number of children amongst the special cases who were submitted to the
school doctors on account of real or supposed nutritional defect was 78,706 compared