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104
cases the child is either seen at home by one of the health visitors or
examined on a subsequent occasion at the school and treatment
again urged if not already secured. Should the parents not be
present at the inspection any serious defect is reported in writing,
the communication being left bv the health visitor who supplements
the written advice and otherwise endeavours to assist parents in
securing treatment.
Speaking generally, the present arrangements for securing
medical treatment for the poor leave much to be desired. This is
specially so in the case of all children whose parents are on the
poverty line, and, above all, when the illness is not of an obviously
alarming nature, though as a matter of fact requiring careful,
skilled and, possibly, prolonged treatment. Thus many young
children suffering from measles and whooping cough are untreated
until complications ensue and their lives are in danger.
Similarly mild cases of diphtheria and scarlet fever often
escape detection because the symptoms are not sufficiently obvious
to insure the provision of medical aid. In many instances we are met
with the plea of poverty when we urge parents to obtain medical
advice for such children, and the attempt to refer such cases to the
district medical officers is frustrated by the fact that destitution is
the test of eligibility for medical relief. Under these circumstances,
not only do the children suffer, but the community fails to obtain
the protection against disease which a better organised medical
service would provide.
Again, the excellent work done by the General Hospital is
somewhat marred by the fees demanded from out-patients, a system
to which there are many objections, of which the chief—from our
point of view—is the fact that many children are thereby deprived
of the special help which an institution of this kind, with its
excellent equipment, can alone afford. Thus the Health Visitors
sometimes find that, after hospital letters have been procured, the
children are refused treatment because they have not brought the
necessary sixpences, and this is particularly the case when treatment
is prolonged, or when more than one member of a family is in need of
advice.
I do not wish, however, to enter into a discussion of the general
medical treatment of the poor, but would confine my remarks to
certain conditions, for which it is urgent that further provision
should be made.