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65
The incidence of skin diseases remains at a comparatively high level compared
with pre-war conditions and, as in the previous year, the incidence of skin diseases
is highest in the leaver, girls, group.
Dealing with the increases in the 1948 figures compared with 1947, the increase
in defective hearing occurs amongst the nursery and entrant groups; similarly with
otitis media; with tonsils and adenoids there is an all round increase in the age
groups, but the increase is particularly noticeable with boys and girls in the entrant
and 7 years old and in girls in the leaver, groups. In the heart and circulatory group
of defects the increase is mainly in the younger age groups, but the figure for leaver
girls is double that of 1947, although the latter may be a "statistical" increase owing
to the fact that few leavers were inspected in 1947 and therefore the 1947 percentage
is not representative. The increase in orthopaedic defects is evenly distributed
between the age groups and between the three defects classified under this heading,
namely defect of posture, flat foot and other orthopaedic defects; and the increase
in psychological defects is also evenly distributed amongst the age groups.
Comparison with pre-war shows an increase in skin diseases, defective hearing,
otitis media, tonsils and adenoids, and defective speech. The increases in defects
in the past year and on pre-war conditions give no grounds for complacency in the
school health service, but it is probable that standards are rising and that more
minor illness is noted than in earlier years.
Parents are invited to be present at all routine examinations and their presence
is of great importance to the welfare of the child. That the parents welcome this
opportunity is evidenced by the large proportion who attend—65 per cent. Attendance
is highest in the early ages (92 per cent. in the "Entrant" group) and falls off
as the children become older (24 per cent. in the "Leavers" group).
Parents'
attendance
Much of the value of school medical inspection in London would be lost without
the help of the Children's Care organisation which forms a link between the parents
and their homes on the one hand and the school doctors, nurses, teachers and the
school on the other. The work of this organisation is performed on a voluntary basis
with a nucleus of paid organisers and the assistance rendered by the 1,430 voluntary
workers is of great value. The keenness of the voluntary workers is evidenced by the
fact that a care committee representative was present at 91.7 per cent. of the routine
examinations of the primary school children.
Attendance
of Care
Committee
representative
Until 1946 the figures for evidence of vaccination were remarkably constant,
the overall figure being around the 47 per cent. level. In the past two years there
has been a rise in the figure of pupils vaccinated, especially in the nursery and entrant
age groups. It is surprising that this should be so, in view of the publicity given to
the fact that the law concerning compulsory vaccination was repealed. It may be
that the diphtheria campaign has focussed attention on prophylaxis for other
diseases. It will be interesting to observe the effect on vaccination since repeal of
the compulsion as this becomes evident when the babies of to-day become the school
pupils of four or five years' time. The percentage of children found to have been
vaccinated was 52.9, 0.2 per cent. more than in the previous year.
Vaccination
For diphtheria immunisation the percentages of pupils stated to have been
immunised follow closely that of 1947. The overall figure for 1948 is 83.1 per cent.
against 82.7 in 1947 and 81.0 in 1946. The evidence as to whether or not a pupil
has been immunised is taken from parents at routine inspections and school health
service staff have instructions that unless there is positive evidence of immunisation
"no" should be recorded. Since, however, the parent's statement is in reply to a
leading. question, it may be that the parent answers "yes" when the true fact is
that the answer should be "no." For this reason it is probable that the figure of
83.1 per cent. immunised is an overstatement.
Statistics relating to the immunisation of children of all ages will be found on
page 126.
Diphtheria
Immunisation