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to ask the Council for an officer to visit the hospital to regulate the attendance of the
children and this duty was undertaken by one of the organisers of children's care work.
The experiment was so successful that it was extended to other hospitals.
The system of treatment centres (institutions for the treatment of children's ailments
only) was established with the co-operation of local committees of medical practitioners.
The treatment centres were of great benefit to children living in areas remote from
hospitals. Attendance for treatment was regulated by the Council's organisers of
children's care work, records of the children treated were kept at the centres, and the
care organisation followed up to see that treatment was completed.
During 1912 and 1913, the system begun at the London Hospital in 1911 was
extended to cover all the treatment arrangements of the Council. In the course of
development the school care committees, advised by the Council's organisers, were in
a position to note the course of treatment step by step to a successful conclusion. The
immense influence that this arrangement exerted on the harmonious working of the
treatment scheme was reflected in the very high percentage of treated cases.
By the end of 1912, arrangements had been made with eleven hospitals and seventeen
treatment centres providing for the treatment of 54,208 children.
Decentralisation
to
school health
divisions
Sir William Hamer in 1912 induced the Council to commence an experiment with
whole-time officers in one division in the East End and Dr. Menzies was appointed as
a divisional medical officer with six whole-time assistants. After six months this experiment
was declared a success, the whole-time system was adopted throughout
London and three more divisional medical officers were appointed. The Eastern
Division proved rather too bulky and was divided into two, so that the County was
organised on a basis of five school health divisions, with a divisional medical officer
and an assistant superintendent of school nurses at each office.
In the same year record cards based upon the Board of Education's schedule were
introduced and machinery was set up for transmitting results of inspections to the
Central Office. While the Board of Education directed that two age groups in every
school should be examined every year, the Council decided to carry out inspection of
three age groups, including one at eight years of age.
The improvement in health of the children in school threw into relief the neglected
state of infants at entry, but in 1918 the Maternity and Child Welfare Act entrusted
to the Metropolitan Borough Councils the safeguarding of the health of children under
school age and, by the supply of health records, the child welfare centres were able to
furnish a full account to the school doctors of the health of many children on entering
school.
The Education
Act. 1918
The passage of the Education Act, 1918, altered the conception ot the duties ot the
local authority with regard to treatment. The earlier Act gave an optional power to make
arrangements for the medical treatment of elementary school children. Section 2(1) (b)
of the new Act made this optional power a duty as regards elementary school
children, and Section 18 extended the optional power to include the provision of facilities
for treatment in respect of children attending any school or educational institution,
whether aided or not by the local authority. These powers and duties were later
incorporated in the consolidating Education Act of 1921. The Council made arrangements
for the medical and dental treatment of scholarship holders at secondary and
trade schools and extended the facilities to fee-paying pupils, subject to the actual cost
of treatment being recovered. Necessitous children were treated free, if the Care
Committee so advised. By this Act, too, the provision of schools for physically defective
children was made compulsory.
In 1920, examination of a fourth age group—the leavers—was established. The
Council's Economy Committee abolished this examination two years later but it was,
however, restored in 1925.
The Education
Act, 1944
The Education Act, 1944, came into operation in 1945. The relevant sections of the
Act materially altered the previous practice both as regards the medical inspection of,
and the provision of medical treatment for, school pupils. Under the Act the certification
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