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14
National
Health
Insurance
(Juvenile
Contributors
and Young
Persons)
Act, 1937
In connection with section 6 of the National Health Insurance (Juvenile Contributors
and Young Persons) Act, 1937, the Board of Education issued Administrative
Memorandum No. 175, dated 9th March, 1938, to local education authorities. A summary
of the memorandum is set out below:—
(1) The general effect of the Act, which came into force on 4th April, 1938,
is to provide medical benefit for boys and girls who leave school and become
insurably employed under the age of 16.
(2) Section 6 of the Act requires local education authorities to make arrangements
to furnish (on the application of a medical practitioner or of an insurance
committee on his behalf) such particulars of the school medical record or medical
history in their possession of any such young person as the practitioner may deem
necessary for the purposes of his functions in relation to the provision of medical
benefit for that person. A "young person" means a person under the age of
18 years.
(3) Local insurance committees are drawing the attention of practitioners to
the facilities afforded. The transmission of school medical records would in many
cases be of little or no clinical value to the practitioner, and a form of enquiry has
been prepared wherein the practitioner can apply for suitable information as to
the conditions noted at the last medical inspection in school and the medical
history of the young person.
Between 4th April and 31st December, 1938, 1,739 applications from medical
practitioners were received in the department. Of these, the records of 288 could
not be traced, and reports were forwarded to the practitioners in regard to 1,451
young persons.
Of this latter number, 427 were noted as clear of any defect at the last school
medical inspection, 860 were reported as showing minor defects (such as visual and
dental defects) and 164 with major defects (such as heart disease or orthopaedic
conditions).
Special
examinations
The number of children, not in the age groups for routine examinations, submitted
to the school doctors as special cases was 149,743, equivalent to three and a
half additional age groups. The number of special examinations in 1937 was 133,850
in 1936, 122,963, in 1935, 125,199, and in 1934, 91,880.
These figures do not include those who came under inspection in the course of
enquiries into outbreaks of infectious diseases and who numbered 20,939 in 1938.
The increase in the number of special examinations in the past four 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 since 1934 is equivalent
to that of six and a half 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
routine age groups were smaller.
Although the number of children seen at special inspections was less than the
number seen in the routine age groups, yet in the case of some diseases the actual
numbers found to be suffering therefrom in the former exceeded those in the latter.
Thus 5,436 children with scabies were referred for treatment at special inspections,
compared with 339 only at routine inspections. In regard to children with chorea,
190 were seen at special inspections, compared with 88 at routine examinations.
Five-hundred-and-forty children were classed as "nutrition 4" at special examinations,
while only 100 children were placed in this category at the routine examinations
of age groups.
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 among the special cases who were submitted to the
school doctors on account of real or supposed nutritional defect was 101,918, compared
with 87,567 in 1937, 78,706 in 1936 and 53,066 in 1935. At the resulting