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years. The subjects have included immunisation, dental health, feeding and diet, care of the
feet and footwear, sleep and exercise, prevention of accidents, and anti-smoking.
Recently the most important subject of the danger of smoking has been brought before
the public. Attention has been drawn to the relationship between lung cancer and heavy
cigarette smoking and every effort has been made to draw the attention of the public to the
grave danger of cigarette smoking. In particular, efforts have been concentrated on the school
children. It is particularly tragic to see the practice of smoking among so many children at
such an early age. A health education officer from County Hall has visited the schools,
clinics and offices with a cinematograph projector, giving lectures and anti-smoking
propaganda. This has been a most valuable asset to the campaign.
School health service—The great achievement of the school health service, particularly
since 1948, has been the outstanding improvement in the health of the school children. This
has resulted in the main in a reduction of the services which have been provided and it has
been possible to terminate several treatment facilities which were no longer needed. These
included a tonsil and adenoid operative service, rheumatism supervisory sessions and some
minor ailment sessions. All minor ailment times throughout the division have in fact now
been drastically reduced, without ill effect, as is clearly shown from the satisfactory results
of school medical inspections.
Three sections of the school health service are still expanding, however—hospital work,
audiology and special investigation clinics.
During the period the teaching hospitals in the division have greatly developed both their
social medicine services and their arrangements for the assessment and treatment of handicapped
children, giving consideration not only to the child's medical condition, but also
to the personal and family problems arising from the condition, and to the close integration
of hospital and community services in meeting these problems. The public health social
workers attached to the hospitals have been asked to play an active part in both these
fields.
There has also been a great extension of awareness at all levels of the problems of the
children with impaired hearing and of the services for the early diagnosis, treatment and
education of such children. Audiology sessions have increased in the division from one a
month to two a week. Specially trained teachers from the deaf schools have been seconded
as peripatetic teachers of the deaf and, in fact, play a considerable part in the assessment and
treatment of infants, as well as of children over two. Partially hearing units have been opened
in both primary and secondary schools, divisional deaf and ' at risk ' registers have been
established and a medical officer designated for the general supervision of the registers, in
addition to the specialised diagnostic work of the divisional otologists. These services are
now linked through a public health social worker.
The third expanding service, the special investigation centres, is popular with the parents
largely because of the time available at the school treatment centres. Appointments
can be spaced to give mothers plenty of time to talk to the doctor about minor difficulties
of diet and behaviour and particularly about the social difficulties of enuresis, which some
feel nervous of raising in the more formal setting of a hospital out-patient clinic. Moreover,
many girls who have menstrual difficulties refuse to go to hospital and do not wish to consult
a male general practitioner but are set at ease by women medical officers who deal with this
matter at the school centres.
Mental health services—The mental health services have been steadily developed and
consolidated since the passing of the Mental Health Act, 1959. Referrals for mental health
action now amount to over 1,000 each year and the department carries an active case-load
of approximately 900 mentally disordered persons. At the same time, the mental health
social workers have been taking in their stride the admission of over 600 patients each year
to psychiatric hospitals.
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