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85
by the establishment of a nursery school in a residential
town such as Bromley. The extension of the provision
would certainly fill the gap between the services of
Maternity and Child Welfare and School Medical, but
there are more economical methods, such as the adequate
health visiting of these children in their homes. I leave
out of consideration the doubtful question as to whether
there are any intellectual advantages to be derived from
school instruction of these young children.
Medical Inspection.
Medical inspections are made according to statute,
each child being examined three times in its school life:
at the age of entrance, at seven years of age, and again
at twelve years of age. Cases with departures from the
normal are referred for treatment and kept under observation.
Further medical examination of the child is
made at the special inspection at the School Clinic, where
cases are referred by head teachers, school attendance
officers, general practitioners, or referred from medical
inspections at the schools. As previously stated, no less
than 6,772 medical examinations of 3,241 individual
children were made during the year. Of the 1,416
children examined at school routine medical inspection,
20.6 per cent. required treatment. Table IIb. in the
Appendix indicates the number in the age groups
examined, and Table IIa. the defects discovered. It is
of some importance to note that leavers are examined
in the January term, intermediates in the March term,
and entrants in Autumn term. Seasonal illness plays a
part in the defects thus discovered, and in considering
the percentage of defects discovered this factor must be
taken into account.
One still sees at school the child who has been
returned too early after an acute illness, such as
influenza, and a subsequent loss of nervous vitality is
a not infrequent result. The keeping of a high school
attendance figure has become almost a fetish and must in
many cases run counter to the physical well-being of the
child. Admittedly, many cases are better at school than
at home, but that is not so with the intelligent