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The net effect of six years of war conditions on juvenile rheumatism among London
children appeared to have been negligible. Perhaps, in those affected, the disease assumed
a severer form; possibly rheumatism became more prevalent among the children
who were not evacuated (but of this there is no proof); perhaps chorea was rather
more common as a result of emotional disturbances. Nevertheless, it seemed that such
maleficient effects were on the whole more than offset by the general dispersal of the
juvenile population to less overcrowded areas.
Post-war
years
Although, in the post-war years, the incidence of acute rheumatism has greatly
diminished, it is felt that the Scheme still fulfils an essential purpose. The great changes
in the Council's Public Health service brought about by the National Health Service
Act left the organisation of the scheme very much the same as it was before 1930.
Although Queen Mary's Hospital, Carshalton, is situated within the area of the South
West Metropolitan Regional Hospital Board, any child under sixteen years of age with
acute rheumatism who is resident within the Council's administrative area can be
considered for acceptance.
Conclusion
The term 'school health service' covers a very wide range of medical facilities and
perhaps an even wider range of complex administrative problems. In a broad historical
survey of this kind many subjects, though each important in varying degrees, have been
only mentioned in passing or are of such recent introduction as not to be mentioned at all.
Development of the service, improvements and the search for efficiency with economy
are continuous, and such matters as the periodical surveys of the heights and weights of
schoolchildren, the provision of recuperative holidays, remedial foot exercises for the
correction of postural defects in primary schoolchildren are only a few of the matters
of which little or no mention has been made.
The half-century of the service here reviewed has seen very great changes in the
everyday world, particularly in science and engineering, but even those changes are
possibly of less vital importance to the nation than the tremendous improvement in the
living conditions and general enlightenment of the working class of the London
population. The social changes and the enlightenment among parents of children that
followed have had their effect on the school health service. Far higher proportions of
parents are not only willing to accept but are anxious to secure the medical treatment
their children need than was the case 50 years ago.
There are still problem families, often referred to as 'the hard core', but there are
now far fewer of them. There is no complacency, however. On the contrary, the
smaller numbers offer encouragement to try to raise them to the generally prevailing
level.
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