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by the school doctors, who saw them in the course of the routine medical inspection;
overlapping between dentists and doctors would thus be avoided.
Developments
after the
inauguration
of the
National
Health
Service
In the latter half of 1948 and in 1949 staffing problems became increasingly difficult
as dental surgeons resigned to transfer to the General Dental Service under the Local
Executive Councils where their earning capacity on a scale of fees method was substantially
greater. As a result of loss of staff during 1948, 1949 and 1950, the Council's
dental services for schoolchildren were curtailed and routine dental inspections in
schools were greatly reduced to prevent severe congestion at the surgeries, 58 of which
were closed or partly closed.
Local dental surgeons attended at most of the Council's residential establishments
on a sessional basis prior to 5th July, 1948, and, as their private commitments
increased after the introduction of the National Health Service, many of them resigned.
At the end of 1949 a number of these establishments had local pain-relief services only,
and no systematic examination and treatment was being carried out.
In 1951 perhaps the most important development in the Council's dental services
was the adoption of the agreed Whitley Council scales of remuneration for wholetime
dental officers serving with local authorities. During that year, in the Council's
dental services, a staff of approximately 50 dental officers continued to deal with numbers
which would have been completely overwhelming but for a system of control of
patients' appointments brought into force in 1950.
In 1952, for the first time in several years, it was possible to increase the number of
dental inspections and of treatment sessions and towards the close of that year the
Council adopted as policy the aim of establishing one full-time dental officer for each
3,000 schoolchildren on the school roll. To attain this ratio necessitates the employment
of almost 150 full-time dental officers and the provision of a similar number of surgeries.
Considerable progress with efforts to reach the authorised interim establishment of
93 dental officers and to acquire, adapt and equip additional premises was made in
1952 and 1953, but applications for appointments were not numerous and most were
for part-time service only. In 1954 the ratio attained was 1:5,600 for the County as a
whole. There was also some improvement of the dental services for boarding schools
and residential establishments.
Children are admitted to schools in each of the three school terms and in very few
schools is the number of new entrants in any one term, or even in a full year, enough
to constitute one full dental inspection of 120 children. Dental inspection sessions,
therefore, arranged to cover all new entrants, have to include children in other age
groups as well as infants. Subject to dental treatment waiting lists being small enough to
permit of dental inspections being held, all new school entrants are dentally inspected,
if possible, in the first year at school. So far as it can be arranged, however, dental
inspections other than those in infants departments are directed to cover children
aged 9 years and 13 years and any dental inspections conducted in excess of the number
required to cover these three age groups are directed at school leavers in the term before
that in which they leave school. Annual inspection of every school child in London
would require well over 4,000 inspection sessions a year which is not attainable at
present.
Orthodontics
An experimental orthodontic scheme was inaugurated in September, 1934, by
Mr. Bertram Samuel, who was then the Council's consulting dental surgeon. Before
that time, no special facilities had been provided by the Council for dealing with
orthodontic cases. Any children found at the school inspections or at the treatment
centres to require treatment had been referred to the dental hospitals or to the Eastman
clinic. The Council felt that the cost of equipment and staff for a special dental workshop
for the purpose of the school medical service alone was not justified. The position had
altered after the transfer to the Council in 1930 of the general hospitals as a special
workshop for dentures and dental appliances was maintained primarily for its general
hospitals.
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