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little effort made to counteract the effect of the loss of the
hours of rest and sleep incurred. Evolution works in many
unknown ways, but unless we make some counter by the
proper organisation of school games and physical training,
and have a right sense towards its importance in life, we
shall but encourage a moral and physical deterioration.
Another matter that will require attention by the
School Medical Service is the shifting of the school population
to the housing estates at the extremes of the Borough.
If our work is to be fully effective, it is just as important
to bring the Medical Service to the people in that neighbourhood,
as it is to provide school accommodation in the
neighbourhood. Clinic facilities have become necessary
in the Bromley Common area.
I have already given some figures indicating the vast
improvements that have resulted since the School Medical
Service became an active force in Bromley. It is not unfair
to give main credit for this improvement to the service
that has been engaged in the prevention of these defects.
Nevertheless we are dealing with small numbers and an
ever changing population, so that for true statistics one
must be referred to the Annual Reports of the Chief Medical
Officer of the Board of Education, who records the
state of improvement over the whole of the country.
As this is a Report upon the state of the health of the
school child in Bromley for the year 1930, the occasion
seems a suitable one for enumerating the changes in the
service since I became your School Medical Officer in 1925.
I was allowed the opportunity in that year of re-organising
the Public Health Service, so that the School Medical
Service, Public Health and Maternity and Child Welfare
Ser vices became one unit, and not as prior to 1925, separate
units working independently. This unification of services
has in my view been the main factor in the effectiveness
of the service; the pre-school child is a potential school
child, and the factors making for public ill-health interact
irrespective of the age of the individual. In 1925 I was
assisted by five part-time Medical Officers, two Health
Visitors, one Dental Nurse, one School Nurse and two
clerks. The following year, 1926, an Orthopaedic scheme
was commenced— an entirely new service, which to-day